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Sample records for rectum classes t3-4

  1. Radiotherapy indications - rectum cancer

    International Nuclear Information System (INIS)

    2009-05-01

    This document is addressed to oncologists radiotherapists and to any health professional concerned by rectum cancer treatment. Rectum cancer therapy is based on various technical procedures including surgery, radiotherapy and systemic treatments defined for each patient according to his clinical situation. This document precises the specific situations where radiotherapy can be employed. However, the radiotherapy decision must be taken with respect to other therapeutic alternatives. Such a decision must be validated and must be the object of a discussion in the framework of a pluri-disciplinary consultation. (J.S.)

  2. Foreign Objects in the Rectum

    Science.gov (United States)

    ... Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids Levator Syndrome Pilonidal Disease Proctitis Rectal Prolapse (See ... Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids Levator Syndrome Pilonidal Disease Proctitis Rectal Prolapse NOTE: ...

  3. Adjuvant radiotherapy for pathologic stage T3/4 adenocarcinoma of the prostate: Ten-year update

    International Nuclear Information System (INIS)

    Anscher, Mitchell S.; Robertson, Cary N.; Prosnitz, Leonard R.

    1995-01-01

    Purpose: To determine the role of adjuvant postoperative radiotherapy (RT) following radical prostatectomy (RP) in a group of patients with pathologic Stage T3/4 adenocarcinoma of the prostate followed for a median of 10 years after treatment. Methods and Materials: Between 1970 and 1983, 159 patients underwent RP for newly diagnosed adenocarcinoma of the prostate and were found to have pathologic Stage T3/4 tumors. Forty-six received adjuvant RT and 113 did not. Radiotherapy usually consisted of 45-50 Gy to the whole pelvis followed by a boost to the prostate bed of 10-15 Gy, to a total dose of 55-65 Gy. Patients were analyzed with respect to survival, disease-free survival, local control, and freedom from distant metastases. A rising prostate-specific antigen in the absence of other evidence of relapse was scored as a separate category of recurrence. Results: Both groups of patients have been followed for a median of 10 years. The actuarial survival at 10 and 15 years was 62% and 62% for the RT group compared to 52% and 37%, respectively, for the RP group (p = 0.18). The disease-free survival for the RT group was 55% and 48% at 10 and 15 years, respectively, compared to 37% and 33% for the RP group (p = 0.16). Similarly, there was no difference in the rate of distant metastases between the two groups. In contrast, the local relapse rate was significantly reduced by the addition of postoperative radiotherapy. The actuarial local control rate at 10 and 15 years was 92% and 82%, respectively, for the RT group vs. 60% and 53% for the RP group (p 0.002). Conclusions: While postoperative pelvic RT significantly improves local control compared to RP alone for pathologic Stage T3/4 prostate cancer, it has no impact on distant metastases and consequently does not improve survival. These data are consistent with the conclusion that many patients with pathologic Stage T3/4 prostate cancer have occult metastases at presentation and will not be cured by local therapies alone

  4. Patterns of Failure After Radical Cystectomy for pT3-4 Bladder Cancer: Implications for Adjuvant Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Abhinav V. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Pariser, Joseph J.; Pearce, Shane M. [Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Weichselbaum, Ralph R. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Smith, Norm D.; Steinberg, Gary D. [Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Liauw, Stanley L., E-mail: sliauw@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States)

    2016-04-01

    Purpose: In patients with muscle-invasive bladder cancer, local-regional failure (LF) has been reported to occur in up to 20% of patients following radical cystectomy. The goals of this study were to describe patterns of LF, as well as assess factors associated with LF in a cohort of patients with pT3-4 bladder cancer. This information may have implications towards the use of adjuvant radiation therapy. Methods and Materials: Patients with pathologic T3-4 N0-1 bladder cancer were examined from an institutional radical cystectomy database. Preoperative demographics and pathologic characteristics were examined. Outcomes included overall survival and LF. Local-regional failures were defined using follow-up imaging reports and scans, and the locations of LF were characterized. Variables were tested by univariate and multivariate analysis for association with LF and overall survival. Results: A total of 334 patients had pT3-4 and N0-1 disease after radical cystectomy and bilateral pelvic lymph node dissection. Of these, 46% received perioperative chemotherapy. The median age was 71 years old, and median follow-up was 11 months. On univariate analysis, margin status, pT stage, and pN stage, were all associated with LF (P<.05), however, on multivariate analysis, only pT and pN stages were significantly associated with LF (P<.05). Three strata of risk were defined, including low-risk patients with pT3N0 disease, intermediate-risk patients with pT3N1 or pT4N0 disease, and high-risk patients with pT4N1 disease, who had a 2-year incidence of LF of 12%, 33%, and 72%, respectively. The most common sites of pelvic relapse included the external and internal iliac lymph nodes (LNs) and obturator LN regions. Notably, 34% of patients with LF had local-regional only disease at the time of recurrence. Conclusions: Patients with pT4 or N1 disease have a 2-year risk of LF that exceeds 30%. These patients may be the most likely to benefit from local adjuvant therapies.

  5. Preoperative treatment of rectum cancers

    International Nuclear Information System (INIS)

    Mineur, L.; Serin, D.; Chauvet, B.; Reboul, F.; Molinari, N.; Guyot, T.; Ciornea, D.; Leignel, D.L.; Chapet, L.C.; Garaud, P.G.; Calais, G.C.; Calan, L.D.C. de; Viguier, J.V.; Boukerche, A.; Bechekat, C.; Dali-Youcef, A.F.; Larbaoui, B.; Djellali, L.; Safir, A.; Albarghach, M.N.; Malhaire, J.P.; Bouchekoua, M.; Muller, M.; Metges, J.P.; Pradier, O.; Robaszkiewicz, M.

    2007-01-01

    Five articles treat the question of rectum carcinoma through a combined therapy that associates radiotherapy ( pre or post operative), chemotherapy (concomitant before surgery) and surgery. The local control is also considered. (N.C.)

  6. Could a wait and see policy be justified in T3/4 rectal cancers after chemo-radiotherapy?

    International Nuclear Information System (INIS)

    Hughes, Robert; Harrison, Mark; Glynne-Jones, Robert

    2010-01-01

    Chemoradiotherapy (CRT) followed by total mesorectal excision is the standard when MRI staging demonstrates threatened surgical margins in locally advanced rectal cancer (LARC). Interest in non-surgical management of LARC as an alternative to a resection has been provoked by published excellent long-term outcomes of patients who achieve clinical complete responses (cCR) after CRT. The present retrospective study aimed to determine whether similar rates of local disease control are seen in a UK cancer centre in patients with T3-4 tumours, who obtained a cCR after preoperative CRT, but did not undergo surgery. Method. The outcome and treatment details of 266 patients who underwent CRT for clinically staged T3-4 rectal adenocarcinomas between 1993 and 2005 were reviewed. Results. Fifty-eight patients did not proceed to surgery, 10 of whom were identified as having a cCR. Six of these 10 patients subsequently developed intrapelvic recurrent disease with a median time to local progression of 20 months. Local relapse preceded the development of metastatic disease or occurred simultaneously. No patients underwent salvage resection. Conclusion. CRT alone in cT3/T4 rectal cancers has a high rate of local relapse even after cCR. Delaying or avoiding surgery might be appropriate for cT1 or cT2 tumours, or elderly and frail patients with co-morbidity, but these results do not support the current uncritical move to extrapolate this approach to all surgically fit patients with rectal cancer

  7. Pre-operative radio-chemo-thermotherapy for advanced (T3-4) and/or recurrent rectal carcinomas

    International Nuclear Information System (INIS)

    Wust, P.; Gremmler, M.; Rau, B.; Loeffel, J.; Gellermann, J.; Stahl, H.; Vogl, T.; Riess, H.; Schlag, P.; Felix, R.

    1995-01-01

    Objective: Recent studies suggest that pre-operative radio-chemotherapy in locally advanced rectal cancer can increase resectability and local control (T4 stages), and might facilitate sphincter-preserving surgery (T3 stages). However, response rates are still unsatisfactory for radiotherapy alone, and are only slightly better for radio-chemotherapy. Radiofrequency hyperthermia has now achieved a technical stage already suitable for treating this tumor entity effectively in clinical practice. Therefore, a trimodal pre-operative approach for T3-4 rectal carcinomas has been investigated in a phase I/II study. Materials and Methods: A phase I/II study was conducted on 30 pts with advanced and/or recurrent rectal cancer. (7(30)) pts had recurrences, (9(30)) uT3, (14(30)) T4-stage of the primary. Initial tumor stage was assessed by endosonography, CT and occasionally MRI (T1-w ± Echovist, T2-w, proton density). Radiotherapy was delivered in prone position using a belly-board, three-field technique, standard blocks, 5x1.8 → 45 Gy in 5 weeks. In parallel, 5-FU (300-350 mg/kg, dose escalation) and folinic acid (50 mg) on days 1-5 and days 22-28. Regional hyperthermia was administered using the annular phased array applicator SIGMA-60 once a week. Index temperatures T x were deduced from thermal mapping scans in endocavitary/intratumoral catheters. Re-staging was done by endosonography and CT. Four weeks after radiotherapy, surgery was performed with preference to continence preserving operations. If the tumor remained unresectable, a boost to a total tumor dose of 60 Gy was claimed. Results: (7(30)) pts (23%) did not undergo resection because their tumors remained technically non-resectable: 4 pts with persistent local control of 12-18 mts, 2 pts with progressive disease, 1 pt with too short observation time. (23(30)) pts underwent surgery: only 1 R2-resection, 22 R0-resections. The patho-histological analysis documented 4 CR (17%) at the primary tumor, 12 PR

  8. Rectum. Strategy for management of cancer of the rectum

    International Nuclear Information System (INIS)

    Rider, W.D.; Chenery, S.A.G.; Hawkins, N.V.; Cummings, B.J.

    1984-01-01

    Cancer of the rectum, with few exceptions, has in the past been treated surgically, with results which are now being questioned and with results which have demonstrated that there has been no improvement in the past 40 years. The concept that curative irradiation might be a real challenge to surgery is of very recent origin. Thus the pattern of referral to the Princess Margaret Hospital (PMH) has, in the past, been restricted to those patients considered unsuitable for surgery for one reason or another. The most common reason for referral to PMH has been ''inoperability''. Patients unfortunate enough to be diagnosed with surgically inoperable cancers are in the main, those with tumours which have already invaded pelvic structures, making surgical excision impossible. Another group of patients are those with associated medical conditions and of an age which would make a very large operation hazardous. These two groups can be considered to be technically inoperable and technically operable; the former group is younger (median age 66) than the latter (median age 72). The prognosis is much better in the older ''technically operable'' group, and it appears from preliminary studies that the results of irradiation are probably as good as surgery

  9. Metastasis of breast cancer rectum

    International Nuclear Information System (INIS)

    Suárez, L.; Santander, G.

    2004-01-01

    Introduction: Metastases to the breast are rare, corresponding approximately to 3% of breast cancers. Primary tumors that spread more commonly are own breast, often following them in melanomas, neuroendocrine, ovarian and lymphoma. Medical history: A 59-year consultation rectoragias repeated and thinning. It is studied and finally intervenes (low anterior resection) diagnosed with rectal cancer whose Histopathology revealed a poorly differentiated adenocarcinoma stage III. Concomitantly the patient has a left breast lump that was studied with mammography, which revealed a dense mass of larger diameter 4 cm in topografiada 3 hour left breast with well defined contours and ultrasonographic structure solid. MI lumpectomy is performed whose pathology reports a poorly differentiated adenocarcinoma with cytoarchitectural features matching the lesion of rectum. Hormone receptors were negative. The patient is treated as a rectal cancer with RT spread over QT (5FU i /c). Died 7 months after diagnosis. Discusion: In literature are reported only 3 cases of breast metastases secondary to rectal cancer; how unusual this presentation justify this report.In this event they occurred in patients with a previous diagnosis of rectal cancer and in the context of systemic lesion progression. In our case clinician early diagnosis of rectal and breast metastases was synchronous. The mammographic image consistent with those described for these cases in the literature.The development of metastases in breast tissue is associated with a poor prognosis as which correlates with the survival of the patient

  10. [Endoscopic dilatation of benign colon and rectum stenosis].

    Science.gov (United States)

    Rivera Vega, Juan; Frisancho Velarde, Oscar; Cervera, Zenón; Ruiz, Edwin; Yoza, Max; Larrea, Pedro

    2002-01-01

    To determine the usefulness of endoscopic dilatation in dealing with benign stenosis of the anus, rectum and colon. PATIENTS AND METHODS USED: Thirty six (36) patients with stenosis, anus (8), rectum (22) and colon (6) were given endoscopic treatment using hydroneumatic balloons, electro incision (radiated cuts) or a combination of both. Rigid equipment (metal) was used for distal stenosis. Age ranged between 30 and 82 years. Twelve (12) patients were male and 24 female. The diameter of the stenosis was less than 13 mm in 18 of the patients and 11 patients carried colostomy. All 36 patients were subjected to a total of 113 dilatation sessions. The average number of sessions per patient for patients with anal stenosis was 2.5 and for patients with colorectal stenosis, 3.32. One patient with rectal stenosis required 21 sessions to achieve final objective. The result achieved was good in 31 patients, less than satisfactory in 3 patients and bad in one patient, who presented a stenosis which was over 5 cm long. We lost track of a patient in the follow up stage. Success in closing the colostomy was achieved in 9 patients, while one presented a complication due to the procedure (cervical emphysema) which remitted with medical attention. Endoscopic dilatation offers, through its different techniques, a safe and efficient method for the treatment of benign stenosis of the anus, rectum and colon and must be considered as a first class tool for the treatment of this kind of pathologies.

  11. Preoperative treatment of rectum cancers; Traitement preoperatoire des cancers du rectum

    Energy Technology Data Exchange (ETDEWEB)

    Mineur, L.; Serin, D.; Chauvet, B.; Reboul, F. [Institut Sainte-Catherine, 84 - Avignon (France); Molinari, N. [Centre Hospitalier Universitaire, 30 - Nimes (France); Guyot, T. [Laboratoire Chugai, 75 - Paris (France); Ciornea, D. [Universite de la Medecine et Pharmacie GR.T.POPA, IASI, Dept. de la Radiotherapie-oncologie (Romania); Leignel, D.L.; Chapet, L.C.; Garaud, P.G.; Calais, G.C. [Centre Hospitalier Universitaire, Service de Radiotherapie, Hopital Bretonneau, 37 - Tours (France); Calan, L.D.C. de [Centre Hospitalier Universitaire, Hopital Trousseau, 37 - Tours (France); Viguier, J.V. [Centre Hospitalier Universitaire, Hopital Trousseau, Service de Gastroenterologie, 37 - Tours (France); Boukerche, A.; Bechekat, C.; Dali-Youcef, A.F. [Service de Radiotherapie, Oran (Algeria); Larbaoui, B.; Djellali, L. [Service d' Oncologie Medicale, Oran (Algeria); Safir, A. [Service de Gastroenterologie, Oran (Algeria); Albarghach, M.N.; Malhaire, J.P.; Bouchekoua, M.; Muller, M.; Metges, J.P.; Pradier, O. [Departement de Cancerologie, 29 - Brest (France); Robaszkiewicz, M. [Departement de Gastroenterologie, 29 - Brest (France)

    2007-11-15

    Five articles treat the question of rectum carcinoma through a combined therapy that associates radiotherapy ( pre or post operative), chemotherapy (concomitant before surgery) and surgery. The local control is also considered. (N.C.)

  12. Endometriosis of the rectum: CT findings

    International Nuclear Information System (INIS)

    Guo Yan; Huang Zhaomin; Liu Mingjuan; Zhong Juemin

    2004-01-01

    Objective: To investigate the CT manifestations of recto-endometriosis. Methods: Three pathologically proved cases of recto-endometriosis were reported, the CT features and clinical manifestations were investigated retrospectively with review of literatures. Results: The patients were all menstruating females (28, 34, and 45 years old, respectively), and anal pain emerged during menses in one case. Rectal examination revealed stiff immobile mass along the rectal wall in all three cases. All the cases showed solid masses on CT scan with moderate enhancement after contrast administration. Two of them confined to the rectal walls, another involved the rectum and peri-rectal aspect. One case was misdiagnosed as well-differentiated adenocarcinoma of rectum in frozen section by biopsy specimen. Conclusion: A solid mass was always found in recto-endometriosis. No characteristic CT feature was manifested. Attention should be paid to the differentiation from rectal tumors when making the diagnosis

  13. Paraneoplastic digital necrosis associated with rectum carcinoma

    Directory of Open Access Journals (Sweden)

    Ali Alkan

    2015-12-01

    Full Text Available Paraneoplastic vascular pathologies are rare in daily practice. There is limited data about this phenomenon. Patient with a diagnosis of metastatic rectum carcinoma presented with digital necrosis. The work up for vascular and rheumatological pathology was inconclusive. Lesions progressively improved with steroid therapy. Paraneoplastic vascular lesions are rare in oncology practice. Our case points out important parts of a rare clinical entity. J Clin Exp Invest 2015; 6 (4: 391-392

  14. Barium granuloma of the rectum: case report

    International Nuclear Information System (INIS)

    Kim, Dae Jin; Kim, Se Hyung; Jeoung, Ah Young; Lee, Kyoung Ho; Choi, Byung Ihn; Han, Joon Koo

    2003-01-01

    Barium granulomas usually occur after barium enema within 8 cm of the anal verge probably due to minute laceration of rectal wall by enema tip and extravasation of barium during barium enema. We report a case of barium granuloma of rectum in a 47-year-old man, who did not have history of barium enema. In rare instance, barium granuloma can occur without a history of barium enema and careful interpretation of radiologic image is essential to make a correct diagnosis

  15. Rare tumors of the rectum. Narrative review.

    Science.gov (United States)

    Errasti Alustiza, José; Espín Basany, Eloy; Reina Duarte, Angel

    2014-11-01

    Most rectal neoplasms are adenocarcinomas, but there is a small percentage of tumors which are of other histological cell lines such as neuroendocrine tumors, sarcomas, lymphomas and squamous cell carcinomas, which have special characteristics and different treatments. We have reviewed these rare tumors of the rectum from a clinical and surgical point of view. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  16. Aganglionosis of rectum present in the adult

    International Nuclear Information System (INIS)

    Lorenzo Rodriguez, Tulio; Marti Corunna, Maria; Ferreira Moreno, Victor

    2009-01-01

    We report the case a female patient referred with the diagnostic criterion of colon tumor. Patients had a marked abdominal distension from more than a month, without defecation, although with gases ejection, and neither reports of pain nor vomits. At admission and to study in depth the anamnesis, she expressed that during its childhood had a delay to defecate. She was operated on with a rectum biopsy, and its study defined la presence of aganglionosis. The non habitual documentation of this disease present in adults emphasizes the singularity of this case. (author)

  17. Iatrogen perforation of the rectum following barium enema; Iatrogen perforasjon av rectum ved roentgen colon

    Energy Technology Data Exchange (ETDEWEB)

    Eggum, R.; Kressner, U.; Haffner, J. [Buskerud Central Hospital, Drammen (Norway)

    1998-05-01

    Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment. 10 refs., 1 fig.

  18. Comparison of two radiotherapy schemes, conventional and fractionated, in elderly patients suffering from a locally advanced rectum cancer; Comparaison de deux schemas de radiotherapie, classique et hypofractionne, chez les patients ages atteints d'un cancer du rectum localement evolue

    Energy Technology Data Exchange (ETDEWEB)

    Guillerme, F.; Clavier, J.B.; Guihard, S.; Schumacher, C.; Nehme-Schuster, H.; Ben Abdelghani, M.; Noel, G. [Centre Paul-Strauss, Strasbourg (France); Kurtz, J.E.; Brigand, C. [Hopitaux universitaires, Strasbourg (France)

    2011-10-15

    Based on results obtained on 177 patients older than 65 and suffering from T3-4 rectum cancer, and treated either according to a conventional scheme (45 to 50,4 Gy by 1,8 to 2 Gy fractions) or according to a fractionated scheme (39 Gy by 3 Gy fractions), the authors report the comparison of these both methods in terms of toxicity, delay between end of radiotherapy and surgery), histological response, global survival. The hypo-fractionated treatment allows the treatment duration to be reduced, is therefore less constraining and seems more suitable for elderly people. Short communication

  19. The rectum: a window to irritable bowel syndrome?

    NARCIS (Netherlands)

    Coremans, G.; Azpiroz, F.; Collins, S.; Dapoigny, M.; Müller-Lissner, S. A.; Pace, F.; Smout, A.; Stockbrügger, R. W.; Whorwell, P. J.

    2002-01-01

    This report summarizes current concepts and information gathered to date about the rectum in the irritable bowel syndrome (IBS) that were presented at the 10th meeting of IBiS Club held in Leuven, Belgium. A working group of experts in the field of IBS discussed whether the rectum or the whole colon

  20. Stimulation of butyrate absorption in the human rectum in vivo

    DEFF Research Database (Denmark)

    Holtug, K; Hove, H; Mortensen, P B

    1995-01-01

    BACKGROUND: Models of short-chain fatty acid absorption have focused on the stimulation of sodium absorption, an effect mainly located in the proximal colon of man. With the present efforts to utilize butyrate enemas as a treatment of ulcerative colitis, it seemed important to assess the transport...... in the rectum. METHODS: Non-equilibrium dialysis of the rectum was applied by placing dialysis bags containing various electrolyte solutions in the rectum of volunteers for 30 min. In this period changes in ion concentrations were linear with time. Net absorption and secretion rates were calculated from...

  1. Gas in the rectum tends to reduce during radical external beam radiotherapy for localised prostate cancer

    International Nuclear Information System (INIS)

    Nakamura, Naoki; Mizuno, Norifumo; Endo, Haruna; Ogita, Mami; Kawamori, Jiro; Sekigucho, Kenji; Hatanaka, Shogo; Takahashi, Osamu; Tamaki, Seiichi; Shikama, Naoto

    2014-01-01

    This study aims to clarify the time-course of gas accumulation in the rectum during treatment as guidance for the management of rectal volumes. We reviewed 2042 sets (35.2 sets per patient) of anteroposterior and right–left mega voltage (MV) images obtained for daily set-up from 58 patients who underwent radical external beam radiotherapy for localised prostate cancer. The patients were instructed to take magnesium oxide tablets during radiotherapy. They were also encouraged to avoid foods that might cause intestinal gas during radiotherapy. Gas accumulation in the rectum was graded into three classes by the same radiation oncologist. If no gas was seen in the rectum, it was classified as grade 0. A small amount of gas was classified as grade 1, whereas a marked amount of gas that required removal was classified as grade 2. Of the 2042 sets of MV images, grades 1 and 2 gas accumulation were seen in 332 (16%) and 156 (8%), respectively. By the trend test, gas accumulation significantly decreased towards the end of treatment (P=0.02 for grade 1 or 2 and P=0.02 for grade 2). On multivariate analysis, we did not identify any significant independent predictors for either baseline gas accumulation or gas reduction. Gas accumulation tended to decrease until the end of treatment. This tendency should be reconfirmed by other institutions.

  2. Answer to preoperative chemie radiation in locally advanced rectum cancer

    International Nuclear Information System (INIS)

    Villegas Mendez, Silvia

    2006-01-01

    Study the pre-operative combined therapy effect in the treatment of the rectum cancer cases of the Servicio de Cirugia General 2 of the Hospital Mexico. The study covers since January of 2003 until December of 2005. It has like specific objectives to analyze the effect in the tumour stages, the sphincters preservation and the recurrence. In the conclusions, it notes that the pre-operative chemie-radiation in the rectum cancer is indicated in II and III stages, in which it has showed most advantages for the patient. It describes that the time between the end of pre-operative combined treatment and the surgery must has at least six weeks to guarantee the effect in the tumour and to reduce the treatment toxicity. It concludes besides, that the complication rate after the pre-operative combined therapy and the total meso rectum excision is approximately of 33%; however, the pelvic septic complications can reduce with an ostomy of protection. It focus that the technique of sphincters preservation has showed to be effective and secure if it does a previous selection to the patients in appropriate form. To get an suitable stages must count with trans rectum endoscopic ultrasound and a tomography of suitable quality. It concludes, also, in intervened tumours after of neo-adjuvancy they don't need free distal margins of illness higher to 2 cm. The total meso rectum excision is the updated surgical recommendation in the rectum cancer [es

  3. Concomitant chemo-radiotherapy for the locally advanced rectum cancer; Chimioradiotherapie concomitante dans le cancer du rectum localement evolue

    Energy Technology Data Exchange (ETDEWEB)

    Haoui, M.; Aksil, N.; Boualga, K.; Moussaoui, D.; Ladj, O. [Service de radiotherapie-oncologie, centre anti-cancer, Blida (Algeria)

    2010-10-15

    The authors report a retrospective study which aimed at assessing the use of a concomitant chemo-radiotherapy, its tolerance and its feasibility in the case of a locally advanced rectum cancer. Based on data obtained among 62 patients presenting a rectum cancer, they analyse the results in terms of tolerance (cases of leukopenia, anemia, diarrhea, radiodermatitis), of relapses, and survival. Toxicity is acceptable and the concomitant treatment renders the tumour operable in many cases. Short communication

  4. Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study

    Science.gov (United States)

    Zhen, Xin; Chen, Jiawei; Zhong, Zichun; Hrycushko, Brian; Zhou, Linghong; Jiang, Steve; Albuquerque, Kevin; Gu, Xuejun

    2017-11-01

    Better understanding of the dose-toxicity relationship is critical for safe dose escalation to improve local control in late-stage cervical cancer radiotherapy. In this study, we introduced a convolutional neural network (CNN) model to analyze rectum dose distribution and predict rectum toxicity. Forty-two cervical cancer patients treated with combined external beam radiotherapy (EBRT) and brachytherapy (BT) were retrospectively collected, including twelve toxicity patients and thirty non-toxicity patients. We adopted a transfer learning strategy to overcome the limited patient data issue. A 16-layers CNN developed by the visual geometry group (VGG-16) of the University of Oxford was pre-trained on a large-scale natural image database, ImageNet, and fine-tuned with patient rectum surface dose maps (RSDMs), which were accumulated EBRT  +  BT doses on the unfolded rectum surface. We used the adaptive synthetic sampling approach and the data augmentation method to address the two challenges, data imbalance and data scarcity. The gradient-weighted class activation maps (Grad-CAM) were also generated to highlight the discriminative regions on the RSDM along with the prediction model. We compare different CNN coefficients fine-tuning strategies, and compare the predictive performance using the traditional dose volume parameters, e.g. D 0.1/1/2cc, and the texture features extracted from the RSDM. Satisfactory prediction performance was achieved with the proposed scheme, and we found that the mean Grad-CAM over the toxicity patient group has geometric consistence of distribution with the statistical analysis result, which indicates possible rectum toxicity location. The evaluation results have demonstrated the feasibility of building a CNN-based rectum dose-toxicity prediction model with transfer learning for cervical cancer radiotherapy.

  5. Diagnostic role of barium enema in carcinoma rectum

    International Nuclear Information System (INIS)

    Asghar, M.

    2003-01-01

    Objective: The main aim of this barium enema study was to evaluate its role in patients suspected to have rectal pathologies with complaints of change in bowel habit, anorexia/weight loss, bleeding per rectum and acute/sub-acute colonic obstruction. Results: barium enema study as screening test for colo-rectal carcinoma was undertaken. Contrast outlined the colonic growth in 35 cases, out of which the cases of carcinoma colon were 24 including 13 patients suffering from carcinoma rectum. The percentage of carcinoma colon to total colonic growth was 68% while, carcinoma rectum to total carcinoma colon was 54%. Conclusion: On the basis of these investigations, it is concluded that patient's compliance is important factor in the early detection of colonic neoplasia. Though results of colonoscopy are more reliable but in practice, barium enema (double contrast) is performed initially to outline the lesion and then colonoscopy for biopsy purpose. (author)

  6. Asymptomatic gastric heterotopia in the rectum with Helicobacter pylori infection.

    Science.gov (United States)

    Swatek, Jarosław; Wronecki, Lech; Ciechanek, Roman; Szumiło, Justyna

    2015-12-01

    Gastric heterotopia is very rare in the rectum - less than 50 cases have been reported so far. Only in six of them Helicobacter pylori has been observed in heterotopic mucosa. We report a case of a 58-year-old woman with asymptomatic gastric heterotopia in the rectum, incidentally revealed during colonoscopy as a small, sessile polyp. The presence of H. pylori was confirmed by immunohistochemistry. This finding supports the opinion that H. pylori may pass along the gastrointestinal tract in a viable form and that the fecal-oral route of transmission is possible.

  7. Mucinous Adenocarcinoma of the Rectum with Breast and Ocular Metastases

    Directory of Open Access Journals (Sweden)

    Raja B. Hisham

    2006-04-01

    Full Text Available We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented.

  8. Case of unusual foreign body in the rectum

    International Nuclear Information System (INIS)

    Akhtar, Murtaza A; Arora, Pooja K

    2009-01-01

    A 44-year-old male patient with a foreign body in rectum (beverage bottle), introduced as sexual perversion, is presented with literature review. The management emphasis is on transanal retrieval and ruling out of the rectal and colonic perforation and the requirement for postremoval psychiatric treatment.(author)

  9. Duplication of the urethra with communication to the rectum

    International Nuclear Information System (INIS)

    Bruce, R.; Alton, D.

    1986-01-01

    The posterior channel of duplicated urethrae usually follows a straight course to end in the perineum just inside the anal verge. This unique urethra dipped into the perineum and then turned cephalad to enter the rectum above the anus. Delineation of the course of the urethra simplified management by assisting the urologist to convert the rectal passage to a hypospadiac urethra. (orig.)

  10. Iatrogen perforation of the rectum following barium enema

    International Nuclear Information System (INIS)

    Eggum, R.; Kressner, U.; Haffner, J.

    1998-01-01

    Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment. 10 refs., 1 fig

  11. [Iatrogen perforation of the rectum after colon radiography].

    Science.gov (United States)

    Eggum, R; Kressner, U; Haffner, J

    1998-05-10

    Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment.

  12. Results of the Accord 12/0405- prodige 2 randomized test in the rectum cancers of stage T(2) 3-4 NX M0; Resultat de l'essai randomise Accord 12/0405-prodige 2 dans les cancers du rectum de stade T(2) 3-4 NX M0

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, J.P.; Benezery, K. [Centre Antoine-Lacassagne, 06 - Nice (France); Azria, D.; Gourgou-Bourgade, S. [CRLCC Val d' Aurelle-Paul-Lamarque, 34 - Montpellier (France); Martel-Laffay, I. [Centre Leon-Berard, 69 - Lyon (France); Hennequin, C. [Hopital St-Louis, 75 - Paris (France); Etienne, P.L. [Clinique Armoricaine de Radiologie, 22 - Saint-Brieuc (France); Vendrely, V. [CHU, 33 - Bordeaux (France); Peiffert, D. [Centre Alexis-Vautrin, 54 - Nancy (France); Montoto-Grillot, C. [FNCLCC-BECT, 75 - Paris (France)

    2009-10-15

    The Capox 50 protocol increase the early toxicity without reducing the possibilities of surgery. It does not increase neither the sphincter conservation rate nor the surgery complications. It improves noticeably the histological tumor response (ypT) and the negative circumferential margin rate. The Star Italian protocol randomized for similar patients exclusively oxaliplatin, without increasing the histological tumor response rate and with 25% of grade 3 or 4 early toxicity. In comparison between the tests Accord 12 and Star it is possible to propose as neoadjuvant treatment of these rectum cancers (stage T3-4 Mo) a Cape 50 protocol associating a 50 Gy radiotherapy in 25 fractions and five weeks and a concomitant chemotherapy (capecitabine: 1600 mg/M{sup 2}/d). The oxaliplatin can be proposed out of radiotherapy to eradicate the infra clinical metastases. (N.C.)

  13. [Rectal tonsil or lymphoid follicular hyperplasia of the rectum].

    Science.gov (United States)

    Trillo Fandiño, L; Arias González, M; Iglesias Castañón, A; Fernández Eire, M P

    2014-01-01

    The rectal tonsil is a reactive proliferation of lymphoid tissue located in the rectum. The morphology of the lymphoid proliferation of the colon is usually polypoid or, less commonly, nodular. Only in exceptional cases does lymphoid proliferation of the colon present as a mass in the rectum (rectal tonsil), although this is the most common presentation in middle-aged patients. It is important to be familiar with the rectal tonsil because in cases of exuberant growth it can be difficult to distinguish it from other types of masses. We present the case of rectal tonsil in a four-year-old girl. We describe the magnetic resonance imaging findings and review the literature. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  14. Sphincter-saving procedure for radiation-injuried rectum

    International Nuclear Information System (INIS)

    Moriya, Yoshihiro; Koyama, Yasuo; Hojo, Keiichi

    1982-01-01

    Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter. (author)

  15. Two patients with rare mixed adenoneuroendocrine carcinomas of the rectum.

    Science.gov (United States)

    Gül-Klein, Safak; Sinn, Marianne; Jurmeister, Philipp Sebastian; Biebl, Matthias; Weiß, Sascha; Rau, Beate; Bläker, Hendrik; Pratschke, Johann; Aigner, Felix

    2018-01-01

    Mixed adenoneuroendocrine carcinomas of the gastrointestinal tract are until today poorly understood and thus very challenging for interdisciplinary therapy. We herewith report the first case series of patients with a primary mixed adenoneuroendocrine carcinoma of the rectum. Both cases were initially diagnosed as adenocarcinoma and only secondarily with mixed adenoneuroendocrine carcinoma and had a poor outcome due to a rapid tumor progression and resistance to chemotherapy. A 65-year-old female presented with local tumor recurrence and hepatopulmonary metastasis 1 year after primary surgery for adenocarcinoma of the rectum and consecutive radiochemotherapy regimen. Fluorouracil (5-FU) was followed by bevacizumab- and capecitabine-based chemotherapy but had to be discontinued due to side effects and progressive disease. Progressive local pain syndrome accompanied by recurrent bleeding episodes led to a local tumor-debulking operation. Afterward, mixed adenoneuroendocrine carcinoma as the underlying diagnosis in the final histopathological examination was detected. The patient died 3 months after the operation in the context of a fulminant tumor progress. A 63-year-old male patient underwent neoadjuvant radiochemotherapy and laparoscopic rectum resection. After 5 months, postoperative oxaliplatin/capecitabine-based adjuvant chemotherapy was switched to carboplatin/etopsid due to a progressive polyneuropathy and biopsy-proven pulmonary metastasis. The patient then had to be switched to local radiation of cerebral metastases and Topotecan due to cerebral bleeding episodes but died 18 months after the initial diagnosis. In conclusion of our case series, mixed adenoneuroendocrine carcinomas of the rectum should be considered as a rare but aggressive tumor entity. An early and detailed histopathological diagnosis is required in order to establish an individual interdisciplinary treatment concept.

  16. Mobilization of the rectum: anatomic concepts and the bookshelf revisited.

    Science.gov (United States)

    Chapuis, Pierre; Bokey, Les; Fahrer, Marius; Sinclair, Gael; Bogduk, Nikolai

    2002-01-01

    Sound surgical technique is based on accurate anatomic knowledge. In surgery for cancer, the anatomy of the perirectal fascia and the retrorectal plane is the basis for correct mobilization of the rectum to ensure clear surgical margins and to minimize the risk of local recurrence. This review of the literature on the perirectal fascia is based on a translation of the original description by Thoma Jonnesco and a later account by Wilhelm Waldeyer. The Jonnesco description, first published in 1896 in French, is compared with the German account of 1899. These were critically analyzed in the context of our own and other techniques of mobilizing the rectum. Mobilization of the rectum for cancer can be performed along anatomic planes with minimal blood loss, preservation of the pelvic autonomic nerves and a low prevalence of local recurrence. Different techniques including total mesorectal excision are based on the same anatomic principles, however, popular words have been used to replace accepted, established terminology. In particular, the description of total mesorectal excision has been confusing because of its emphasis on the words "total" and "mesorectum." The use of the word "mesorectum" anatomically is inaccurate and the implication that total excision of all the perirectal fat contained within the perirectal fascia "en bloc" in all patients with rectal cancer will minimize local recurrence remains contentious.

  17. Graphic and haptic simulation system for virtual laparoscopic rectum surgery.

    Science.gov (United States)

    Pan, Jun J; Chang, Jian; Yang, Xiaosong; Zhang, Jian J; Qureshi, Tahseen; Howell, Robert; Hickish, Tamas

    2011-09-01

    Medical simulators with vision and haptic feedback techniques offer a cost-effective and efficient alternative to the traditional medical trainings. They have been used to train doctors in many specialties of medicine, allowing tasks to be practised in a safe and repetitive manner. This paper describes a virtual-reality (VR) system which will help to influence surgeons' learning curves in the technically challenging field of laparoscopic surgery of the rectum. Data from MRI of the rectum and real operation videos are used to construct the virtual models. A haptic force filter based on radial basis functions is designed to offer realistic and smooth force feedback. To handle collision detection efficiently, a hybrid model is presented to compute the deformation of intestines. Finally, a real-time cutting technique based on mesh is employed to represent the incision operation. Despite numerous research efforts, fast and realistic solutions of soft tissues with large deformation, such as intestines, prove extremely challenging. This paper introduces our latest contribution to this endeavour. With this system, the user can haptically operate with the virtual rectum and simultaneously watch the soft tissue deformation. Our system has been tested by colorectal surgeons who believe that the simulated tactile and visual feedbacks are realistic. It could replace the traditional training process and effectively transfer surgical skills to novices. Copyright © 2011 John Wiley & Sons, Ltd.

  18. Rectum perforation during transanal irrigation: a case story

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bing, J; Berggreen, P

    2008-01-01

    STUDY DESIGN: Case report. OBJECTIVES: Report a case of rectum perforation during transanal irrigation (TAI). SETTING: Clinic for Spinal Cord Injuries, and Departments of Gastroenterological Surgery and Radiology. CASE REPORT: A 54-year-old woman with spinal cord lesion for 35 years emptied...... for years her bowel using oral laxative. This became more difficult and took more than 2 h three times a week with reflex stimulation after a chlysma. She wanted to try TAI, and went through the procedure with a nurse one time. The next time she performed the TAI by herself without difficulty. Two hours...

  19. Ectopic prostatic tissue in the rectum: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Myung Jin; Noh, Kyung Hee; Jeon, Doo Sung; Lee, Kwang Min [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2017-02-15

    Ectopic prostatic tissue (EPT) outside the male genitourinary tract is an unusual finding, and it is very rarely found in the rectum or around the peri-rectal region. In addition, the radiologic features of EPT are seldom reported. Also, it is difficult to differentiate EPT found in the rectal subepithelium from the other types of subepithelial tumors. We present here a unique case of EPT found in the retrorectal region, along with the radiologic findings of transrectal ultrasonography, computed tomography, and magnetic resonance imaging with their pathologic correlations.

  20. Pelvic Myxoid Leiomyoma Mass between Vagina and Rectum

    Directory of Open Access Journals (Sweden)

    Omar AlShalabi

    2016-01-01

    Full Text Available Leiomyomas are the most common pelvic tumors in women. About 20–30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17×12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

  1. Pelvic Myxoid Leiomyoma Mass between Vagina and Rectum.

    Science.gov (United States)

    AlShalabi, Omar; Alahmar, Fadi Obaied; Aljasem, Hazem; Alsaid, Bayan; AlShalabi, Abdulghani

    2016-01-01

    Leiomyomas are the most common pelvic tumors in women. About 20-30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17 × 12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

  2. Transanal endoscopic microsurgery for giant polyps of the rectum

    DEFF Research Database (Denmark)

    Levic, K; Bulut, O; Hesselfeldt, P

    2014-01-01

    in the rectum. We present our results with TEM in the removal of giant polyps equal or greater than 4 cm in diameter. METHODS: In the period between 1998 and 2012, TEM was performed in 39 patients with rectal polyps measuring at least 4 cm in diameter. Transrectal ultrasound and/or magnetic resonance imaging......, these recurrences were treated with endoscopic removal or re-TEM. The remaining 5 underwent total mesorectal excision and/or chemotherapy. CONCLUSIONS: Full-thickness TEM provides a safe and efficient treatment for excision of giant polyps. In case of unexpected cancer, TEM can be curative. Local recurrence can...

  3. Virtual reality training and assessment in laparoscopic rectum surgery.

    Science.gov (United States)

    Pan, Jun J; Chang, Jian; Yang, Xiaosong; Liang, Hui; Zhang, Jian J; Qureshi, Tahseen; Howell, Robert; Hickish, Tamas

    2015-06-01

    Virtual-reality (VR) based simulation techniques offer an efficient and low cost alternative to conventional surgery training. This article describes a VR training and assessment system in laparoscopic rectum surgery. To give a realistic visual performance of interaction between membrane tissue and surgery tools, a generalized cylinder based collision detection and a multi-layer mass-spring model are presented. A dynamic assessment model is also designed for hierarchy training evaluation. With this simulator, trainees can operate on the virtual rectum with both visual and haptic sensation feedback simultaneously. The system also offers surgeons instructions in real time when improper manipulation happens. The simulator has been tested and evaluated by ten subjects. This prototype system has been verified by colorectal surgeons through a pilot study. They believe the visual performance and the tactile feedback are realistic. It exhibits the potential to effectively improve the surgical skills of trainee surgeons and significantly shorten their learning curve. Copyright © 2014 John Wiley & Sons, Ltd.

  4. SU-E-J-83: CBCT Based Rectum and Bladder Dose Tracking in the Prostate Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Z; Wang, J; Yang, Z; Hu, W [Fudan University Shanghai Cancer Center, Shanghai (China)

    2015-06-15

    Purpose: The aim of this study is to monitor the volume changes of bladder and rectum and evaluate the dosimetric changes of bladder and rectum using daily cone-beam CT for prostate radiotherapy. Methods: The data of this study were obtained from 12 patients, totally 222 CBCTs. All the volume of the bladder and the rectum on the CBCT were normalized to the bladder and the rectum on their own original CT to monitory the volume changes. To evaluate dose delivered to the OARs, volumes that receive 70Gy (V70Gy), 60Gy, 50Gy, 40Gy and 30Gy are calculated for the bladder and the rectum, V20Gy and V10Gy for rectum additionally. And the deviation of the mean dose to the bladder and the rectum are also chosen as the evaluation parameter. Linear regression analysis was performed to identify the mean dose change of the volume change using SPSS 19. Results: The results show that the variances of the normalize volume of the bladder and the rectum are 0.15–0.58 and 0.13–0.50. The variances of V70Gy, V60Gy, V50Gy, V40Gy and V30Gy of bladder are bigger than rectum for 11 patients. The linear regression analysis indicated a negative correlation between the volume and the mean dose of the bladder (p < 0.05). A 10% increase in bladder volume will cause 5.1% (±4.3%) reduction in mean dose. Conclusion: The bladder volume change is more significant than that for rectum for the prostate cancer patient. The volume changes of rectum are not significant except air gap in the rectum. Bladder volume varies will cause significant dose change. The bladder volume monitoring before fractional treatment delivery would be crucial for accuracy dose delivery.

  5. Squamous cell carcinoma of the rectum 21 years after radiotherapy for cervical carcinoma

    International Nuclear Information System (INIS)

    Leung, Kevin K; Madan, Anand; Heitzman, Joseph

    2009-01-01

    Squamous cell carcinoma (SCC) of the rectum is an extremely rare malignancy, accounting for 0.1-0.2% of rectal malignancies. It is associated with ulcerative colitis, prior radiation, schistosomiasis, ovarian cancer, endometrial cancer, human papilloma virus, colocutaneous fistulas and colonic duplication. Prior reported cases of SCC of the rectum have involved treatment with brachytherapy and external beam radiation. This case is particularly interesting because of the remote exposure of radiation (21 years previously) and the subsequent development of SCC of the rectum. Although extremely rare, SCC of the rectum can occur decades after radiation exposure. (author)

  6. Early toxicity from preoperative radiotherapy with continuous infusion 5-fluorouracil for resectable adenocarcinoma of the rectum: a Phase II trial for the Trans-Tasman Radiation Oncology Group

    International Nuclear Information System (INIS)

    Ngan, Samuel Y.K.; Burmeister, Bryan H.; Fisher, Richard; Rischin, Danny; Schache, David J.; Kneebone, Andrew; MacKay, John R.; Joseph, David; Bell, Andrew; Goldstein, David

    2001-01-01

    Purpose: To assess the toxicity and the efficacy of preoperative radiotherapy with continuous infusion 5-fluorouracil (5-FU) for locally advanced adenocarcinoma of the rectum. Methods and Materials: Eligible patients had newly diagnosed localized adenocarcinoma of the rectum within 12 cm of the anal verge, Stage T3-4, and were suitable for curative resection. Eighty-two patients were treated with radiotherapy--50.4 Gy in 28 fractions in 5.6 weeks, given concurrently with continuous infusion 5-FU, using either 96-h/week infusion at 300 mg/m 2 /day or 7-days/week infusion at 225 mg/m 2 /day. Results: The median age was 59 years (range, 27-87), and 67% of patients were male. Pretreatment stages of the rectal cancer were T3, 89% and resectable T4, 11%, with endorectal ultrasound confirmation in 67% of patients. Grade 3 acute toxicity occurred in 5 of 82 patients (6%; 95% confidence interval [CI], 2-14%). Types of surgical resection were anterior resection, 61%; abdominoperineal resection, 35%; and other procedures, 4%. There was no operative mortality. Anastomotic leakage after low anterior resection occurred in 3 of 50 patients (6%; 95% CI, 1-17%). The pathologic complete response rate was 16% (95% CI, 9-26%). Pathologic Stages T2 or less occurred in 51%. Conclusion: Preoperative radiotherapy with continuous infusion 5-FU for locally advanced rectal cancer is a safe regimen, with a significant downstaging effect. It does not seem to lead to a significant increase in serious surgical complications

  7. Dose Distribution of Rectum and Bladder in Intracavitary Irradiation

    International Nuclear Information System (INIS)

    Chu, S. S.; Oh, W. Y.; Suh, C. O.; Kim, G. E.

    1984-01-01

    The intrauterine irradiation is essential to achieve adequate tumor dose to central tumor mass of uterine malignancy in radiotherapy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The simulation radiogram and medical records of 206 patients, who were treated with intrauterine irradiation from Feb. 1983 to Oct. 1983, were critically analyzed. The physical parameters to include distances between lateral walls of vaginal fornices, longitudinal and lateral cervix to the central axis of ovoid were measured for low dose rate irradiation system and high dose rate remote control after loading system. The radiation doses and dose distributions within cervical area including interesting points and bladder, rectum, according to sources arrangement and location of applicator, were estimated with personal computer. Followings were summary of study results; 1. In distances between lateral walls of vaginal fornices, the low dose rate system showed as 4-7cm width and high dose rate system showed as 5-6cm. 2. In Horizontal angulation of tandem to body axis, the low dose rate system revealed mid position 64.6%, left deviation 19.2% and right deviation 16.2%. 3. In longitudinal angulation of tandem to body axis, the mid position was 11.8% and anterior angulation 88.2% in low dose rate system but in high dose rate system, anterior angulation was 98.5%. 4. Down ward displacement of ovoid below external os was only 3% in low dose rate system and 66.6% in high dose rate system. 5. In radiation source arrangement, the most activities of tandem and ovoid were 35 by 30 in low dose rate system but 50 by 40 in high dose rate system. 6. In low and high dose rate system, the total doses and TDF were 80, 70 Gy and 131, 123 including 40 Gy external irradiation. 7. The doses and TDF in interesting points Co, B, were 98, 47 Gy and 230, 73 in high dose rate system but in low dose rate system 125, 52 Gy and 262, 75 respectively. 8. Doses

  8. [Colon and rectum histoplasmosis in a patient from Peru].

    Science.gov (United States)

    Alcántara Figueroa, Christian; Sánchez Cerna, Víctor

    2016-01-01

    We report a case of a male patient of 52 years old with a 3 months history of pushing, tenesmus, hematochezia, pain while defecating, lost of 18 kg of weight, fever, fecaloid and purulent discharge through an perianal hole. During the colonoscopy procedure, we found many ulcers in the ascending, transverse and descending colon.We also found an elevated lesion of about 5 cm in the rectum. We used hematoxylin - eosin and Gomori-Grocott stain in the biopsies and identified many microorganisms inside macrophages which were compatible with histoplasmosis. ELISA tests for HIV, HTLV I- II were negative. Colon and rectal histoplasmosis in an immunocompetent patient is extremely rare. There are few cases of colonic histoplasmosis reported.

  9. Definitive radiation therapy for selected cancers of the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Sischy, B.; Hinson, E.J.; Wilkinson, D.R.

    1988-09-01

    During the last 15 years, over 400 patients with adenocarcinoma of the rectum have undergone a course of endocavitary irradiation for cure or palliation of Dukes' A and B disease. This treatment method makes use of an unconventional fractionation scheme, by which the tumour receives 10000-12000 cGy in approximately four fractions over a period of about 60 days. The treatments are separated by an interval of 2 or 3 weeks. This method of definitive irradiation allows suitable patients to avoid abdominoperineal resection and its drawbacks. Hospitalization is avoided and the patients maintain a normal daily life. Approximately 15-20% of all rectal cancer patients may be expected to fulfil the criteria for selection, which are sufficiently strict that the local control (95%) and 5-year survival rates (94%) can exceed those of surgery for comparable disease.

  10. Oncological outcome after laparoscopic abdominoperineal excision of the rectum.

    Science.gov (United States)

    Jefferies, M T; Evans, M D; Hilton, J; Chandrasekaran, T V; Beynon, J; Khot, U

    2012-08-01

    Abdominoperineal excision of the rectum (APER) for cancer has been associated with higher circumferential resection margin (CRM) involvement and failure of local disease control. The aim of this study was to investigate whether the introduction of laparoscopic APER altered the incidence of CRM involvement. Consecutive patients undergoing open or laparoscopic APER for adenocarcinomas of the rectum were studied. Patient demographics, preoperative staging, neoadjuvant treatment, operative findings, length of stay and pathological details were collected from operative and radiology databases and compared. There were 16 laparoscopic and 25 open APER performed over a 3-year period. Neoadjuvant therapy was given to 43.8% (7/16) of the laparoscopic group and 56.0% (14/25) of the open group. Complete laparoscopic resection was possible in 14 (87.5%) of 16 patients. The median harvested number of nodes was 14 (4-33) in both groups. The median length of stay was 7 (3-13) and 15 (9-40) days in the laparoscopic and open groups (P CRM was clear in all cases. There was no local recurrence in either group at a median follow-up of 23 months. There were no in-hospital deaths and no significant differences in overall survival. There were no significant differences in preoperative or postoperative histopathological T stage between the two groups (P = 0.057 and P = 0.121). Laparoscopic APER for selected rectal cancers can achieve comparable oncological outcome to open surgery but is associated with a much shorter length of stay. Patient and tumour characteristics must be taken into consideration when deciding on a laparoscopic approach for low rectal cancer. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  11. Chronic inflammatory diseases of the rectum and prostate: a review of literature

    Directory of Open Access Journals (Sweden)

    Z. A. Kadyrov

    2016-01-01

    Full Text Available The paper analyzes the Russian and foreign literature on chronic inflammatory diseases of the rectum and chronic prostatitis. The universally known anatomic and vascular relationships of the prostate and rectum indicate that there is a correlation of the development of chronic prostatitis and rectal diseases.

  12. Ligation of the Rectum with an Extracorporeal Sliding Knot Facilitating Laparoscopic Cross-Stapling

    DEFF Research Database (Denmark)

    Bulut, Orhan

    2013-01-01

    : The extracorporeal ligation of the rectum just proximal to the cut end of the rectum before applying the linear stapling stapler facilitates the procedure and requires only a few firings of the stapler during the laparoscopic rectal resections. Results: Ten patients with a median age of 72 years underwent rectal...

  13. Gastric heterotopia in rectum: A literature review and its diagnostic pitfall.

    Science.gov (United States)

    Dinarvand, Peyman; Vareedayah, Ashley A; Phillips, Nancy J; Hachem, Christine; Lai, Jinping

    2017-01-01

    The term heterotopia, in pathology, refers to the presence of normal tissues at foreign sites. Gastric heterotopia has been reported anywhere in the gastrointestinal tract. However, the presence of gastric heterotopia in the rectum is very rare. We, here, report a rare case of a localized 2-cm area of cratered mucosa with heaped-up borders in the rectum of a 51-year-old, asymptomatic woman who underwent screening colonoscopy. Histologic examination of the biopsy from the lesional tissue in rectum demonstrated fragments of rectal mucosa co-mingling with oxyntic- and antral-type gastric mucosa. No intestinal metaplasia or Helicobacter pylori is identified. Patients with gastric heterotopia in rectum usually present with bleeding and/or abdominal pain. Definite treatment of choice is surgical or endoscopic resection, although the lesions also respond to histamine-2 receptor blockers. In this article, most recent literature about gastric heterotopia in rectum is reviewed, following a case presentation about it.

  14. Rectal bladder-type: ileum-sigma-rectum pouch

    International Nuclear Information System (INIS)

    Krajka, K.; Mikszewicz, A.; Stachurski, L.; Perkowski, D.

    1994-01-01

    The paper presents a method of creating rectal bladder by using the proximal part of rectum, the distal part of sigma and a 40 cm long segment of detubularized ileum. Ureters were attached to the proximal end of ileal segment by Wallace-I technique. Initially the retrograde pyelonephritis was to be prevented by intussuscepting a 4 cm long part of the uretero-ilea anastomosis and by positioning isoperistaltically a 15-16 cm long part of the ileal segment. Because of the insufficiency of such a mechanism, in 4 latest cases the intussuscepted segment was increased to 8 cm. 8 patients suffering from stage T3a and T3b invasive carcinoma of the bladder were treated by this procedure. The ureteral stens were led out via the rectal tube. They were removed days after the operation. The whole post-operative period was uneventful. The patients were under close follow-up from 5 to 22 months. Three of them died due to a progression of the disease. All the patients had 3-4 watery stools a day and one at night. Check-ups performed three and six months after the operation revealed a proper out flow of contrast medium from kidneys and a reduction in the dilatation of ureters. In one case the kidney that failed to function before the procedure, restored its secretion afterwards. The contrast medium reached colon descendens only when more than 350 ml of it were infused into the rectal bladder. (author)

  15. Adenocarcinoma of the rectum treated by radical external radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Catton, Charles N; Brierley, James D; Cummings, Bernard J; Wong, C Shun; Keane, Thomas J; O' Sullivan, Brian; Goodman, Phyllis

    1995-01-15

    Purpose: To assess the long-term survival and response rates of patients with primary rectal cancer to radical radiation therapy. Methods and Materials: Between 1978 and 1987, 229 patients were treated at the Princess Margaret Hospital with radical external radiation therapy for adenocarcinoma of the rectum. Patients were treated with radiation either because they were considered to have unresectable tumors, were medically unfit, or refused surgery, or for a combination of these factors. Doses ranged from 40 Gy in 10 fractions by a split course over 6 weeks to 60 Gy in 30 fractions in 6 weeks. The most commonly prescribed treatment was 52 Gy target absorbed dose in 20 daily fractions over 4 weeks. Results: The overall 5-year actuarial survival rate was 27%; for patients with mobile tumors, it was 48%, partially fixed 27%, and fixed tumor 4%. Forty-eight of the 97 patients (50%) with mobile tumors, 11 of the 37 patients (30%) with partially fixed tumors, and 7 of the 77 patients (9%) with fixed tumors had clinically complete tumor regression following radiation. Of these, 18 of the mobile, 6 of the partially fixed, and 5 of the fixed tumors later relapsed locally. Fifty patients had salvage surgery after failing to achieve complete remission or for local relapse, with a 5-year actuarial survival rate of 42% from the time of surgery. Conclusion: Although radiation therapy can cure some patients with mobile or partially fixed rectal adenocarcinomas who refuse or are unsuitable for surgery, local control remains a problem; salvage surgery should be considered in patients who relapse or fail to go into complete remission and who are fit to undergo surgery. For patients with fixed rectal cancers, high-dose external-beam radiation should be part of a planned preoperative regimen or be palliative in intent.

  16. Linfadectomy in cancer treatment colon rectum; Linfadectomia en el Tratamiento del Cancer colorrectal

    Energy Technology Data Exchange (ETDEWEB)

    Canesa, C

    2003-01-15

    The purpose of this revision is to describe the anatomical basic aspects and histopatologicos of interest in the lymphatic dissection and to discuss the list of the radical linfadectomy in the treatment of the cancer colon rectum.

  17. An adolescent with prolapsed omentum per rectum: Spontaneous rectal perforation managed laparoscopically

    Directory of Open Access Journals (Sweden)

    Ameet Kumar

    2017-01-01

    Full Text Available Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added. He made an uneventful post-operative recovery. Spontaneous rupture of the rectum can occur in younger age groups and even in the absence of significant trauma. One needs to diligently bring out a history of rectal trauma. Equally important is to rule out any underlying pathological condition. A laparoscopic approach is feasible, especially in early cases.

  18. Recto-sigmoid polypectomy by a handmade snare: Experience of 24 children with bleeding per rectum

    Directory of Open Access Journals (Sweden)

    Manoj Saha

    2014-01-01

    Full Text Available A handmade snare is designed from easily available materials to treat bleeding per rectum in children due to rectosigmoid polyps. A total of 29 polypectomies were done in 24 patients. It is simple, effective, safe and economic.

  19. New methods of X-ray study of the rectum and colon in patients with constipation

    International Nuclear Information System (INIS)

    Zarodnyuk, I.V.; Tikhonov, A.A.; Sinyaeva, L.M.

    1998-01-01

    Rectal and colonic X-ray findings of 100 patients with constipation are presented. Modified irrigoscopic procedure using barium enema was used. This made it possible not only to determine the shape, dimensions, and position of the rectum and colon, but to reveal a number of anatomic and functional changes in the rectum and pelvic floor, which was helpful in choosing a treatment policy for patients with colonic evacuator dysfunction

  20. EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum.

    Science.gov (United States)

    van de Velde, Cornelis J H; Boelens, Petra G; Borras, Josep M; Coebergh, Jan-Willem; Cervantes, Andres; Blomqvist, Lennart; Beets-Tan, Regina G H; van den Broek, Colette B M; Brown, Gina; Van Cutsem, Eric; Espin, Eloy; Haustermans, Karin; Glimelius, Bengt; Iversen, Lene H; van Krieken, J Han; Marijnen, Corrie A M; Henning, Geoffrey; Gore-Booth, Jola; Meldolesi, Elisa; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm; Schmoll, Hans J; Smith, Jason J; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Wiggers, Theo; Gambacorta, Maria A; Aristei, Cynthia; Valentini, Vincenzo

    2014-01-01

    Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Consensus was achieved using the Delphi method. For the Delphi process, multidisciplinary experts were invited to comment and vote three web-based online voting rounds and to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. This manuscript covers all sentences of the consensus document with the result of the voting. The consensus document represents sections on diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where

  1. Normal tissue complication probabilities correlated with late effects in the rectum after prostate conformal radiotherapy

    International Nuclear Information System (INIS)

    Dale, Einar; Olsen, Dag R.; Fossa, Sophie D.

    1999-01-01

    Purpose: Radiation therapy of deep-sited tumours will always result in normal tissue doses to some extent. The aim of this study was to calculate different risk estimates of late effects in the rectum for a group of cancer prostate patients treated with conformal radiation therapy (CRT) and correlate these estimates with the occurrences of late effects. Since the rectum is a hollow organ, several ways of generating dose-volume distributions over the organ are possible, and we wanted to investigate two of them. Methods and Materials: A mathematical model, known as the Lyman-Kutcher model, conventionally used to estimate normal tissue complication probabilities (NTCP) associated with radiation therapy, was applied to a material of 52 cancer prostate patients. The patients were treated with a four field box technique, with the rectum as organ at risk. Dose-volume histograms (DVH) were generated for the whole rectum (including the cavity) and of the rectum wall. One to two years after the treatment, the patients completed a questionnaire concerning bowel (rectum) related morbidity quantifying the extent of late effects. Results: A correlation analysis using Spearman's rank correlation coefficient, for NTCP values calculated from the DVHs and the patients' scores, gave correlation coefficients which were not statistically significant at the p max , of the whole rectum, correlated better to observed late toxicity than D max derived from histograms of the rectum wall. Correlation coefficients from 'high-dose' measures were larger than those calculated from the NTCP values. Accordingly, as the volume parameter of the Lyman-Kutcher model was reduced, raising the impact of small high-dose volumes on the NTCP values, the correlation between observed effects and NTCP values became significant at p < 0.01 level. Conclusions: 1) High-dose levels corresponding to small volume fractions of the cumulative dose-volume histograms were best correlated with the occurrences of late

  2. Reduction of rectal doses by removal of gas in the rectum during vaginal cuff brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sabater, S.; Sevillano, M.M.; Andres, I.; Berenguer, R. [Complejo Hospitalario Univ. de Albacete (CHUA) (Spain). Dept. of Radiation Oncology; Machin-Hamalainen, S. [C.S. General Ricardos, Madrid (Spain); Mueller, K.; Arenas, M. [Hospital Univ. Sant Joan, Reus (Spain). Dept. of Radiation Oncology

    2013-11-15

    Objective: The goal of this work was to evaluate whether the volume reduction related to removal of gas in the rectum could be translated in lower doses to organs at risk (OAR) during vaginal cuff brachytherapy (VBT). Material and methods: Fourteen pairs of brachytherapy planning CT scans derived from 11 patients were re-segmented and re-planned using the same parameters. The only difference between pairs of CTs was the presence or lack of gas in the rectum. The first CT showed the basal status and the second was carried out after gas removal with a tube. A set of values derived from bladder and rectum dose-volume histograms (DVH) and dose-surface histograms (DSH) were extracted. Moreover the cylinder position related to the patient craniocaudal axis was recorded. Results: Rectum volume decreased significantly from 77.8 {+-} 45 to 55.43 {+-} 17.6 ml (p = 0.0052) after gas removal. Such volume diminution represented a significant reduction on all rectal DVH parameters analyzed except D{sub 25%} and D{sub 50%}. DSH parameter results were similar to previous ones. A nonsignificant increase of the bladder volume was observed and was associated with an increase of the DVH metrics analyzed. Conclusion: Removal of gas pockets is a simple and inexpensive maneuver that decreases rectal dose parameters on VBT, which can be translated as a better therapeutic ratio. It also suggests that other actions directed to empty the rectum could have a similar effect. (orig.)

  3. Gastric heterotopia in rectum: A literature review and its diagnostic pitfall

    Directory of Open Access Journals (Sweden)

    Peyman Dinarvand

    2017-02-01

    Full Text Available Objectives: The term heterotopia, in pathology, refers to the presence of normal tissues at foreign sites. Gastric heterotopia has been reported anywhere in the gastrointestinal tract. However, the presence of gastric heterotopia in the rectum is very rare. Methods: We, here, report a rare case of a localized 2-cm area of cratered mucosa with heaped-up borders in the rectum of a 51-year-old, asymptomatic woman who underwent screening colonoscopy. Results: Histologic examination of the biopsy from the lesional tissue in rectum demonstrated fragments of rectal mucosa co-mingling with oxyntic- and antral-type gastric mucosa. No intestinal metaplasia or Helicobacter pylori is identified. Conclusion: Patients with gastric heterotopia in rectum usually present with bleeding and/or abdominal pain. Definite treatment of choice is surgical or endoscopic resection, although the lesions also respond to histamine-2 receptor blockers. In this article, most recent literature about gastric heterotopia in rectum is reviewed, following a case presentation about it.

  4. The action of sennosides and related compounds on human colon and rectum 1

    Science.gov (United States)

    Hardcastle, J. D.; Wilkins, J. L.

    1970-01-01

    The direct action of intraluminal senna and related compounds on the human colon and rectum has been investigated. Motility was recorded by balloon kymography with recording units inserted into well established transverse colostomies or into the rectum. The motility of the colon was not changed by intraluminal senna glycosides but the introduction of senna previously incubated with faeces or Esch. coli stimulated the colon to peristalt. The peristalsis was similar to that stimulated by rheinanthrone, an oxanthrone produced by chemical hydrolysis and reduction of senna. Both activated senna and rheinanthrone appeared to act in the colon by contact stimulation. No peristaltic response was stimulated in the rectum, either with activated senna or with rheinanthrone. PMID:4929273

  5. Indication for, and valuation of computed tomography following anterior resection of the rectum

    International Nuclear Information System (INIS)

    Bauer, W.M.; Sommer, B.; Rath, M.; Fenzl, G.; Lissner, J.; Wirsching, R.

    1982-01-01

    During a controlled study, 55 patients who had an anterior resection of the rectum were thoroughly examined, including by computed tomography. The results verified the following statements: 1. The use of CT as a screening-method for early detection of local tumour recurrence following anterior resection of the rectum appears not to be justified. 2. CT is indicated: a) if there is a laboratory or clinical suspiciaon of recurrence, despite normal findings on proctoscopy; b) to clarify the question of extramural extension if recurrence has been established by proctoscopy. 3. Following anterior resection of the rectum, CT normally demonstrates no remarkable development of scar tissue, unless the anastomosis is inadequate. 4. Following anterior rectal resection every indefinable tissue thickening in the pelvis must be considered a possible tumour recurrence and must be further investigated by needle biopsy. (orig.)

  6. Indication for, and valuation of computed tomography following anterior resection of the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, W.M.; Sommer, B.; Rath, M.; Fenzl, G.; Lissner, J.; Wirsching, R.

    1982-02-01

    During a controlled study, 55 patients who had an anterior resection of the rectum were thoroughly examined, including by computed tomography. The results verified the following statements: 1. The use of CT as a screening-method for early detection of local tumour recurrence following anterior resection of the rectum appears not to be justified. 2. CT is indicated: a) if there is a laboratory or clinical suspicion of recurrence, despite normal findings on proctoscopy; b) to clarify the question of extramural extension if recurrence has been established by proctoscopy. 3. Following anterior resection of the rectum, CT normally demonstrates no remarkable development of scar tissue, unless the anastomosis is inadequate. 4. Following anterior rectal resection every indefinable tissue thickening in the pelvis must be considered a possible tumour recurrence and must be further investigated by needle biopsy.

  7. Local hyperthermia and artificial hyperglycemia in combined treatment of patients with rectum cancer

    International Nuclear Information System (INIS)

    Bezmen, V.A.; Illarionov, A.A.; Novokhrost, V.I.; Shilov, N.I.; Ospishchev, A.A.; Kejs, G.D.

    1990-01-01

    To study prospects of application of local hyperthermia, artificial hyperglycemia and radiotherapy in a preoperative period, 31 patients with rectum cancer were studied. The treatment included 3-hour artificial hyperglycemia first, then local SHF hyperthermia and telegamma irradiation using large-fractioned doses (ROD is 5 Gy, COD is 20 Gy). No serious side-effects were observed during the preoperative treatment period. The immediate and early results of combined treatment promise to improve the effectiveness of treatment of patients with rectum cancer. 3 refs

  8. Testing the new ICRU 62 'Planning Organ at Risk Volume' concept for the rectum

    International Nuclear Information System (INIS)

    Muren, Ludvig Paul; Karlsdottir, Asa; Kvinnsland, Yngve; Wentzel-Larsen, Tore; Dahl, Olav

    2005-01-01

    Background and purpose: To study the impact of the new ICRU 62 'Planning organ at Risk Volume' (PRV) concept on the relationship between rectum dose-volume histogram (DVH) data and toxicity. Patients and methods: The acute gastro-intestinal (GI) RTOG toxicity in 127 prostate cancer patients prescribed a total dose of 70 Gy with conformal irradiation to either the prostate, the prostate and seminal vesicles or the whole pelvis (initial 50 Gy only) were analysed. DVHs were derived for the rectum only and for rectum extended with six PRV margin sets (narrow/intermediate/wide; anterior/anterior and posterior). The data was analysed using permutation tests, logistic regression and effective uniform dose (EUD) calculations. Results: Acute Grade 2 GI toxicity was seen in 22 of 127 cases (17%). Permutation tests showed that the difference between DVHs for patients with and without Grade 2 effects was significant, both for rectum only and rectum PRVs (P-value range: 0.02-0.04), with generally lower P-values for the PRVs. In the logistic regression, the fractional DVH variables (i.e. volumes) were significantly related to toxicity, with approximately 2-3 times as many significant dose levels for the PRVs as for rectum only. E.g. with wide anterior and posterior margins (16 and 11 mm, respectively) the relation was significant at 26 different dose levels (6-7, 13-14, 35-43, 60-71 and 73 Gy), compared to nine levels (38-40, 43-44 and 71-74 Gy) for rectum only. EUDs were significantly different for patients with and without Grade 2 effects both for rectum only and the PRVs (95% confidence interval for EUD increase with Grade 2 effects: 0.1-3.1 Gy). Conclusions: All statistical methods applied indicated a small, but definite difference in DVH parameters between patients with versus those without Grade 2 effects. The difference was most pronounced when margins of 16 mm anterior and 11 mm posterior were applied

  9. Clinical aspects of forecasting results of treatments of patients with rectum cancer

    International Nuclear Information System (INIS)

    Kas'yanova, T.S.; Rusinovich, V.M.; Mirilenko, L.V.; Kizina, L.I.

    1990-01-01

    To predict the outcome of surgical treatment of patients with rectum cancer and the efficiency of the radiation component of multimodality treatment, some clinical aspects, having the prognostic meaning, are proposed. It is established that the prognostically significant signs for rectum cancer are: the disease stage, the status of the regional lymphatic system, the invasion degree and tumor growth form, tumor differentiation degree, its propagation over the circle, the availability or absence of ileus symptoms, the anamnesis period and some hemogram characters. 8 refs.; 1 tab

  10. Bio-mechanical and morphometric evaluation of late radiation-induced changes in the mouse rectum

    International Nuclear Information System (INIS)

    Lundby, L.

    1998-01-01

    The overall aim of this thesis was to study the development of late radiation induced damage of the rectum and describe the histopathological and morphometric characteristics of the late injury. This required the design of a new, small probe for rectal measurements of cross-sectional area and distension pressure in mice. The impedance planimetric method was developed and validated in vitro and applied in in vivo studies of normal mice. The study of radiation induced damage of the rectum also required a new set-up for selective irradiation of a specific part of the rectum, shielding other organs. Mice were irradiated with varying single doses and followed with impedance planimetric measurements at regular intervals until death of the animals. In order to compare observed changes of the functional properties of the rectum following irradiation, a description of morphometric and morphologic characteristics by a stereolic technique was planned. A simplified stereological method has been applied to this study to describe late morphometric changes in the different intestinal layers after irradiation with varying single doses. (EG)

  11. Impact of knee support and shape of tabletop on rectum and prostate position

    NARCIS (Netherlands)

    Steenbakkers, Roel J. H. M.; Duppen, Joop C.; Betgen, Anja; Lotz, Heidi Th; Remeijer, Peter; Fitton, Isabelle; Nowak, Peter J. C. M.; van Herk, Marcel; Rasch, Coen R. N.

    2004-01-01

    PURPOSE: To evaluate the impact of different tabletops with or without a knee support on the position of the rectum, prostate, and bulb of the penis; and to evaluate the effect of these patient-positioning devices on treatment planning. METHODS AND MATERIALS: For 10 male volunteers, five MRI scans

  12. A model to simulate day-to-day variations in rectum shape

    NARCIS (Netherlands)

    Hoogeman, Mischa S.; van Herk, Marcel; Yan, Di; Boersma, Liesbeth J.; Koper, Peter C. M.; Lebesque, Joos V.

    2002-01-01

    PURPOSE: To develop a model that predicts possible rectum configurations that can occur during radiotherapy of prostate cancer on the basis of a planning CT scan and patient group data. MATERIALS AND METHODS: We used a stochastic shape description model with a limited number of parameters (area,

  13. Duplication of the urethra with communication to the rectum. Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Bruce, R.; Alton, D.

    1986-01-01

    The posterior channel of duplicated urethrae usually follows a straight course to end in the perineum just inside the anal verge. This unique urethra dipped into the perineum and then turned cephalad to enter the rectum above the anus. Delineation of the course of the urethra simplified management by assisting the urologist to convert the rectal passage to a hypospadiac urethra. (orig.).

  14. Primært planocellulært karcinom i rectum

    DEFF Research Database (Denmark)

    Matlub, Karam; Qvist, Niels

    2010-01-01

    Primary squamous cell carcinoma of the colon and rectum is rare. It presents clinically as other types of colorectal cancer and the treatment is primarily surgery. The pathogenesis is unclear, but several hypotheses have been suggested, including human papilloma virus infection. Gynaecological...

  15. Endocavitary radiotherapy of rectal tumours; Endokavitaer straalebehandling ved distale rectum tumorers

    Energy Technology Data Exchange (ETDEWEB)

    Tanum, G.; Wiig, J. [Norske Radiumhospital, Oslo (Norway); Andersen, O.K. [Sentralsykehuset i Akershus, Loerenskog (Norway)

    1997-02-01

    The authors describe their experience of endocavitary radiotherapy of adenomas and carcinomas of the lower rectum. The method is an alternative for patients who cannot undergo standard surgical procedure or do no want a permanent colostomy. This method is cheap, fast and causes little discomfort to the patients, gives reasonable long-term results and has low morbidity. 11 refs., 4 figs., 2 tabs.

  16. Definition of the rectum and level of the peritoneal reflection - still a matter of debate?

    Science.gov (United States)

    Kenig, Jakub; Richter, Piotr

    2013-09-01

    Pathological lesions of the rectum are common and their management requires detailed knowledge of pelvic anatomy. There has been considerable debate as to the definition of the rectum and the variability of the level of the peritoneal reflection. The lack of a clear consensus was proven in the research by McCullen et al. regarding the current pattern of practice for the investigation of primary rectal cancer by general surgeons. To carry out bibliographic research on the definition of the rectum and level of the peritoneal reflection. A web-based published literature search of PubMed, Ovid Medline, Science Direct and Springer was made. The paper presents the current definitions of proximal and distal margin of the rectum and level of peritoneal reflection based not only on the results of tests on cadavers but also on living humans. The results of tests on living humans allow more accurate qualification of patients for local excision, which is particularly important for patients with colorectal cancer.

  17. Bladder–Rectum Spacer Balloon in High-Dose-Rate Brachytherapy in Cervix Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Rai, Bhavana [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Patel, Firuza D., E-mail: firuzapatel@gmail.com [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Chakraborty, Santam; Sharma, Suresh C.; Kapoor, Rakesh [Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Aprem, Abi Santhosh [Corporate R and D Division, HLL Lifecare Limited, Karamana, Trivandrum (India)

    2013-04-01

    Purpose: To compare bladder and rectum doses with the use of a bladder–rectum spacer balloon (BRSB) versus standard gauze packing in the same patient receiving 2 high-dose-rate intracavitary brachytherapy fractions. Methods and Materials: This was a randomized study to compare the reduction in bladder and rectum doses with the use of a BRSB compared with standard gauze packing in patients with carcinoma of the cervix being treated with high-dose-rate intracavitary brachytherapy. The patients were randomized between 2 arms. In arm A, vaginal packing was done with standard gauze packing in the first application, and BRSB was used in the second application. Arm B was the reverse of arm A. The International Commission for Radiation Units and Measurement (ICRU) point doses and doses to 0.1-cm{sup 3}, 1-cm{sup 3}, 2-cm{sup 3}, 5-cm{sup 3}, and 10-cm{sup 3} volumes of bladder and rectum were compared. The patients were also subjectively assessed for the ease of application and the time taken for application. Statistical analysis was done using the paired t test. Results: A total of 43 patients were enrolled; however, 3 patients had to be excluded because the BRSB could not be inserted owing to unfavorable local anatomy. Thus 40 patients (80 plans) were evaluated. The application was difficult in 3 patients with BRSB, and in 2 patients with BRSB the application time was prolonged. There was no significant difference in bladder doses to 0.1 cm{sup 3}, 1 cm{sup 3}, 2 cm{sup 3}, 5 cm{sup 3}, and 10 cm{sup 3} and ICRU bladder point. Statistically significant dose reductions to 0.1-cm{sup 3}, 1-cm{sup 3}, and 2-cm{sup 3} volumes for rectum were observed with the BRSB. No significant differences in 5-cm{sup 3} and 10-cm{sup 3} volumes and ICRU rectum point were observed. Conclusion: A statistically significant dose reduction was observed for small high-dose volumes in rectum with the BRSB. The doses to bladder were comparable for BRSB and gauze packing. Transparent balloons of

  18. [Study on effect of pH on rectum permeability of active ingredients in Reduning suppositories in vitro].

    Science.gov (United States)

    Yan, Ming; Wei, Ying-chun; Meng, Jin; Xu, Dian-hong; Wu, Yun; Xiao, Wei

    2015-04-01

    To investigate the effect of different pH on rectum permeability of chlorogenic acid and geniposide. Four kinds of Reduning suppositories of different pH were separated and put into the rectum to study the suppositories in vitro and the content of chlorogenic acid and geniposide samples was determined by HPLC to calculate the permeation in 24 hours. With increase of pH within 2.5-7.4, the steady state flux of chlorogenic acid was increased, but the steady state flux of geniposidesamples was steady. Adjusted the pH can increase the rectum permeability of active ingredients in Reduning auppositories.

  19. Gastric heterotopia in the rectum. A rare cause of ectopic gastric tissue.

    Science.gov (United States)

    Salem, George A; Fazili, Javid; Ali, Tauseef

    2017-03-01

    Gastric heterotopia refers to the discovery of normal gastric tissue at foreign, unexpected sites. It has been described anywhere in the alimentary tract, even in the mediastinum, scrotum, and spinal cord. It is not uncommonly seen in the oesophagus or small intestine. However, large bowel lesions are rare, with the most common location of colonic lesions is the rectum. Although it is a rare entity, it may be the source for significant problems such as rectal bleeding, abdominal pain, deep rectal pain, and malignancy. Here, we report an additional case of gastric heterotopia in the rectum of a 56year old gentleman, and review the literature. Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  20. The spreading of radiolabelled fatty suppository bases in the human rectum

    International Nuclear Information System (INIS)

    Sugito, Keiko; Ogata, Hiroyasu; Noguchi, Masahiro; Kogure, Takahashi; Takano, Masaaki; Maruyama, Yuzo; Sasaki, Yasuhito

    1988-01-01

    The purpose of this study was to develop a radiolabelling method for assessing the spreading of fatty suppository bases (Witepsol H-5, W-35 and S-55), and to apply this technique to the evaluation of suppository disposition in the human rectum. 99m/Tc was bound chemically to the bases Witepsol H-5 and W-35, and mixed physically with Witepsol S-55. The spreading of each suppository base was monitored by gamma-scintigraphy following rectal administration. The mean radioactivity remaining at the inserted region 4 h after administration was 44.2% of total activity. The mean perpendicular maximum spreading distance from this region was 7.7 cm on the scintigram near to the sigmoid colon. Defecation was suggested to be a factor influencing the spread of suppository bases. However, there was no clear relationship between the type of suppository base used and the extent of its spread within the rectum. 6 refs.; 4 figs.; 1 table

  1. Abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools.

  2. The abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    International Nuclear Information System (INIS)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools. (orig.) [de

  3. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient

    DEFF Research Database (Denmark)

    Klarskov, Louise; Mogensen, Anne Mellon; Jespersen, Niels

    2011-01-01

    Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma in the i......Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma...... during the adenoma carcinoma sequence included the acquisition of CK7 expression in the malignant portion. Gastric mucin may play a role in the initial step of the neoplastic evolution and CK7 may denote neoplastic progression. This case confirms the notion of a widely variegated morphology of precursor...

  4. Differential roles of stretch-sensitive pelvic nerve afferents innervating mouse distal colon and rectum

    OpenAIRE

    Feng, Bin; Brumovsky, Pablo R.; Gebhart, Gerald F.

    2010-01-01

    Information about colorectal distension (i.e., colorectal dilation by increased intraluminal pressure) is primarily encoded by stretch-sensitive colorectal afferents in the pelvic nerve (PN). Despite anatomic differences between rectum and distal colon, little is known about the functional roles of colonic vs. rectal afferents in the PN pathway or the quantitative nature of mechanosensory encoding. We utilized an in vitro mouse colorectum-PN preparation to investigate pressure-encoding charac...

  5. Forward-viewing radial-array echoendoscope for staging of colon cancer beyond the rectum.

    Science.gov (United States)

    Kongkam, Pradermchai; Linlawan, Sittikorn; Aniwan, Satimai; Lakananurak, Narisorn; Khemnark, Suparat; Sahakitrungruang, Chucheep; Pattanaarun, Jirawat; Khomvilai, Supakij; Wisedopas, Naruemon; Ridtitid, Wiriyaporn; Bhutani, Manoop S; Kullavanijaya, Pinit; Rerknimitr, Rungsun

    2014-03-14

    To evaluate feasibility of the novel forward-viewing radial-array echoendoscope for staging of colon cancer beyond rectum as the first series. A retrospective study with prospectively entered database. From March 2012 to February 2013, a total of 21 patients (11 men) (mean age 64.2 years) with colon cancer beyond the rectum were recruited. The novel forward-viewing radial-array echoendoscope was used for ultrasonographic staging of colon cancer beyond rectum. Ultrasonographic T and N staging were recorded when surgical pathology was used as a gold standard. The mean time to reach the lesion and the mean time to complete the procedure were 3.5 and 7.1 min, respectively. The echoendoscope passed through the lesions in 13 patients (61.9%) and reached the cecum in 10 of 13 patients (76.9%). No adverse events were found. The lesions were located in the cecum (n = 2), ascending colon (n = 1), transverse colon (n = 2), descending colon (n = 2), and sigmoid colon (n = 14). The accuracy rate for T1 (n = 3), T2 (n = 4), T3 (n = 13) and T4 (n = 1) were 100%, 60.0%, 84.6% and 100%, respectively. The overall accuracy rates for the T and N staging of colon cancer were 81.0% and 52.4%, respectively. The accuracy rates among traversable lesions (n = 13) and obstructive lesions (n = 8) were 61.5% and 100%, respectively. Endoscopic ultrasound and computed tomography had overall accuracy rates of 81.0% and 68.4%, respectively. The echoendoscope is a feasible staging tool for colon cancer beyond rectum. However, accuracy of the echoendoscope needs to be verified by larger systematic studies.

  6. Single-access laparoscopic low anterior resection with vertical suspension of the rectum.

    Science.gov (United States)

    Uematsu, Dai; Akiyama, Gaku; Narita, Maiko; Magishi, Akiko

    2011-05-01

    Single-access laparoscopic surgery was first introduced for colectomy and later adapted for anterior resection. During single-access laparoscopic pelvic procedures, such as total mesorectal excision, it is often difficult to obtain an adequate operative field. By suspending the rectum vertically, we were able to execute a total mesorectal excision with single-access laparoscopy. We describe here the use of this new procedure to treat rectal cancer. The selected 7 patients (1 male and 6 female) with stage II or III rectal cancer underwent the procedure. Single-port access to the abdomen was provided by a 3.0-cm incision at the right iliac fossa. The descending mesocolon was dissected by use of a medial approach, and a columnar magnet was placed on the surface of the abdominal wall to restore triangulation. The inferior mesenteric artery was skeletonized and the superior rectal artery divided during lymph node dissection. The total mesorectal excision extended to the pelvic floor and the rectum was vertically retracted with a suspending bar in collaboration with an extracorporeal magnet tool. The rectum was then transected below the reflection of the peritoneum. Intracorporeal anastomosis was performed with the double-stapling technique. Two pelvic drains were inserted through the single incision and the anus, respectively, for all patients. A defunctioning ileostomy was not created in any patient. Median total surgical time was 205 minutes (range, 175-245 min). Intraoperative blood loss was minimal in all patients (range, 1-20 mL). None of the cases required conversion to open surgery or addition of a second port. The only preoperative or postoperative complication occurred in one patient with clinical anastomotic leakage. Low anterior single-access laparoscopic resection seems safe and feasible when the rectum is suspended like a swing to ensure an adequate operative field.

  7. Effect of age on radiation-induced early changes of rat rectum. A histological time sequence

    International Nuclear Information System (INIS)

    Olofsen-van Acht, Manouk J.J.; Hooije, Christel M.C. van; Aardweg, Gerard J.M.J. van den; Levendag, Peter C.; Velthuysen, Marie Louise F. van

    2001-01-01

    Background and purpose: Radiation treatment of the elderly (>75 years) is often modified due to an assumed decrease in normal tissue tolerance in this age group. Since more radiobiological data concerning normal tissue toxicity as a function of age are needed, a histological study of age-related radiation changes of the rectum was performed. Materials and methods: The rectum of young and old female Wistar rats (12 and 78 weeks, respectively) was irradiated with single doses of 22 and 39 Gy. The field size was 1.5x2.0 cm. The animals were sacrificed at 1, 2, 4 and 10 weeks after treatment. To evaluate radiation damage, 12 histological parameters were scored in four areas of the rectum. A total radiation injury score was calculated. The number of proliferative epithelial cells was evaluated by 5-bromo-2'-deoxyuridine labeling. Results: Some age-related histological differences were observed; especially, the incidence of ulceration and vascular occlusion was higher in the older group. In the low dose group of the older animals, 60% showed ulceration, which was 0% for the young low dose animals. Severe vascular changes occurred early and were more extensive in older animals (4 weeks) than in the younger group (10 weeks). In the area adjacent to the treatment field, cell proliferation increased significantly in older rats at 1 week after 22 Gy, which did not occur in the young group. Conclusions: Discrete radiation-induced histological differences were observed between the rectum of young and old Wistar rats, especially in the development of ulceration and vascular changes. Although the survival of these Wistar rats in earlier studies was not affected by age, the impact of the observed histological differences for their importance in the long-term is currently being investigated

  8. Interactive and scale invariant segmentation of the rectum/sigmoid via user-defined templates

    Science.gov (United States)

    Lüddemann, Tobias; Egger, Jan

    2016-03-01

    Among all types of cancer, gynecological malignancies belong to the 4th most frequent type of cancer among women. Besides chemotherapy and external beam radiation, brachytherapy is the standard procedure for the treatment of these malignancies. In the progress of treatment planning, localization of the tumor as the target volume and adjacent organs of risks by segmentation is crucial to accomplish an optimal radiation distribution to the tumor while simultaneously preserving healthy tissue. Segmentation is performed manually and represents a time-consuming task in clinical daily routine. This study focuses on the segmentation of the rectum/sigmoid colon as an Organ-At-Risk in gynecological brachytherapy. The proposed segmentation method uses an interactive, graph-based segmentation scheme with a user-defined template. The scheme creates a directed two dimensional graph, followed by the minimal cost closed set computation on the graph, resulting in an outlining of the rectum. The graphs outline is dynamically adapted to the last calculated cut. Evaluation was performed by comparing manual segmentations of the rectum/sigmoid colon to results achieved with the proposed method. The comparison of the algorithmic to manual results yielded to a Dice Similarity Coefficient value of 83.85+/-4.08%, in comparison to 83.97+/-8.08% for the comparison of two manual segmentations of the same physician. Utilizing the proposed methodology resulted in a median time of 128 seconds per dataset, compared to 300 seconds needed for pure manual segmentation.

  9. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study

    International Nuclear Information System (INIS)

    Kline, Robert W.; Smith, Alfred R.; Coia, Lawrence R.; Owen, Jean B.; Hanlon, Alexandra; Wallace, Marsha; Hanks, Gerald

    1997-01-01

    Purpose: To conduct a study of the process of treatment planning and treatment of adenocarcinoma of the rectum and sigmoid in the United States, and to compare survey results to consensus guidelines. Methods and Materials: A consensus committee developed guidelines for the radiotherapeutic management of adenocarcinoma of the rectum and sigmoid, and also developed a survey form that was used to gather data to evaluate the practice patterns for patients treated in 1989 and 1990 against the consensus guidelines. Seventy-three facilities were randomly selected for site visits from the 1321 radiation therapy facilities in the US: 21 academic, 26 hospital based, and 26 free standing. During the site visits, the radiotherapy records were examined by the surveyor physicist and radiation oncologist to extract and record the required data. Data collected included items related to treatment specific parameters, including treatment planning considerations. Analyses included stratification as to the types of institutions, academic, hospital based, or free standing. Results: For many treatment parameters there are discrepancies between the patterns of practice determined by the surveys and the consensus guidelines for radiotherapy treatment of adenocarcinoma of the rectum and sigmoid. Significant differences in practice among the stratified institution types were found in only a few parameters

  10. Water enema CT examination of rectum cancer by reduced amount of water

    International Nuclear Information System (INIS)

    Palko, A.; Gyulai, Cs.; Fedinecz, N.; Balogh, A.; Nagy, F.

    2000-01-01

    To define whether volume of water, administered during water enema CT (WE-CT) for local staging of rectal cancer, may be reduced without compromising the diagnostic value of the examination. Materials and Methods: 29 patients with rectum cancer underwent preoperative WE-CT. Contrast-enhanced CT (equilibrium phase) measurements were performed after i.v. injection of smooth muscle relaxant and rectal administration of 400 - 500 ml lukewarm tap water. Quality of the obtained scans was evaluated and the images were analyzed for depth of tumor invasion. Results of the CT examinations were compared to findings at surgery. Results: Despite reduced dose of water enema, 19/29 examinations were of excellent quality, 6/29 good, and 4/29 poor, but still diagnostic. We achieved sensitivity (90.1), specificity (70.1) and accuracy (86.2) in differentiating tumors confined to the bowel wall from those extending beyond it. Conclusion: Large volume of water enema administered during CT examination of the rectum may cause complaints and increases the risk of complications. Our results prove that using lower amount of water does not impair the quality of examination and accuracy of local staging of rectum carcinomas. (orig.) [de

  11. Laparoscopic radical prostatectomy and resection of rectum performed together: first experience.

    Science.gov (United States)

    Brodak, Milos; Orhalmi, Julius; Kosina, Josef; Balik, Michal; Pacovsky, Jaroslav

    2015-09-01

    Laparoscopy is an increasingly used approach in the surgical treatment of rectal cancer and prostate cancer. The anatomical proximity of the two organs is the main reason to consider performing both procedures simultaneously. To present our first experience of laparoscopic rectal resection and radical prostatectomy, performed simultaneously, in 3 patients. The first patient was diagnosed with locally advanced rectal cancer and tumor infiltration of the prostate and seminal vesicles. The other 2 patients were diagnosed with tumor duplicity. The surgery of the first patient started with laparoscopic prostatectomy except division of the prostate from the rectal wall. The next step was resection of the rectum, extralevator amputation of the rectum and vesicourethral anastomosis. In the other patients, resection of the rectum, followed by radical prostatectomy, was performed. The median follow-up was 12 months. The median operation time was 4 h 40 min, with blood loss of 300 ml. The operations and postoperative course were without incident in the case of 2 patients. However, 1 patient had stercoral peritonitis and a vesicorectal fistula in the early postoperative stage. Sigmoidostomy and postponed ureteroileal conduit were carried out. All patients were in oncologic remission. Combined laparoscopic rectal resection and radical prostatectomy is a viable option for selected patients with locally advanced rectal cancer or tumor duplication. The procedures were completed without complications in 2 out of 3 patients.

  12. Sensitivity of the sigmoid colon and rectum in children treated for chronic constipation.

    Science.gov (United States)

    Loening-Baucke, V A

    1984-06-01

    Sensations in the sigmoid and rectum and the response of the anal canal to balloon distension were measured with a latex balloon and pressure transducer in 15 chronically constipated and 15 healthy control children. The constipated children received milk of magnesia and bowel training. Thirteen constipated children were restudied 7-12 months later and 11 were restudied 3 years later. Although thresholds of transient sensation and of the rectosphincteric reflex were not different in constipated and control children, the threshold of fullness, the critical volume, and the volume for constant relaxation were significantly higher in constipated than in control children (p less than 0.05), and remained higher 1 year and 3 years later, even in the children who recovered. The initial data support the concept of a sigmoid and rectum so enlarged that a normal fecal bolus may not cause a sensation of fullness or a sensory stimulus for defecation. Despite improvement in clinical manifestations and normal rectal size, the abnormalities in sensitivity of the sigmoid and rectum persisted in five of eight recovered children. This may explain why these children are so vulnerable to recurrence of constipation and fecal soiling.

  13. [Covering stoma in anterior rectum resection with TME for rectal cancer in elderly patients].

    Science.gov (United States)

    Cirocchi, Roberto; Grassi, Veronica; Barillaro, Ivan; Cacurri, Alban; Koltraka, Bledar; Coccette, Marco; Sciannameo, Francesco

    2010-01-01

    The aim of our study is to evaluate the advisability of covering stoma in Anterior Rectum Resection with TME in elderly patients. A research of both the Ministry of Health and Terni Hospital databases has been conducted so as to collect information about patients with rectal tumor. Such research allowed to identify the amount of patients diagnosed with rectal cancer, the type of intervention, and the average hospitalization time. Between January 1997 and June 2008, 209 patients have undergone chirurgical surgery at Terni hospital's General and Emergency Surgical Clinic. An Anterior Rectum Resection with TME has been performed in 135 patients out of the sample (64.59%). The average hospitalization time of geriatric patients does not show significant differences compared to that of younger patients. An age-cohort analysis has been performed among patients who have been subject to stomia and those who have not. The former have been further split up between those who underwent ileostomy and those subject to colostomy. While ileostomy patients face a similar hospitalization time across all age cohorts, geriatric colostomy patients face longer hospitalizations than younger patients. Patients subject to Anterior Rectum Resection show no meaningful differences, in terms of hospitalization time, across all age cohorts. In geriatric patients the construction of covering stoma has resulted in longer hospitalizations only when a loop colostomy was executed, as opposed to loop ileostomy.

  14. Cervix-to-rectum measuring device in a radiation applicator for use in the treatment of cervical cancer

    International Nuclear Information System (INIS)

    Fischell, D.R.; Mazique, J.C.

    1981-10-01

    A cervix-to-rectum measuring device to be used in the treatment of cervical cancer is described. It includes a handle and a probe pivotably connected to the handle for insertion in the rectum. The measuring device further includes means for coupling the handle to an intrauterine radiation applicator when the latter is positioned in the uterine cervix and the probe is inserted in the rectum to pivot the handle about the probe. A gear is provided which is adapted to pivot with the probe. A pinion pivotably connected to the handle meshes with the gear. A pointer fixed to the pinion is displaced in response to the pivoting of the handle about the probe, and this displacement can be read from a scale on the handle, providing an indication of the cervix-to-rectum distance. Official Gazette of the U.S. Patent and Trademark Office

  15. Stem cell carcinoma of the colon and rectum. Report of two cases and review of the literature

    DEFF Research Database (Denmark)

    Palvio, D H; Sørensen, Flemming Brandt; Kløve-Mogensen, M

    1985-01-01

    Two cases of highly malignant tumors, one originating in the sigmoid colon and the other in the rectum, are presented. Both tumors showed light microscopic, electron microscopic, and immunohistochemical evidence of multidirectional differentiation. The tumors were composed mainly of undifferentia......Two cases of highly malignant tumors, one originating in the sigmoid colon and the other in the rectum, are presented. Both tumors showed light microscopic, electron microscopic, and immunohistochemical evidence of multidirectional differentiation. The tumors were composed mainly...

  16. Impact of knee support and shape of tabletop on rectum and prostate position

    International Nuclear Information System (INIS)

    Steenbakkers, Roel; Duppen, Joop C.; Betgen, Anja; Lotz, Heidi; Remeijer, Peter; Fitton, Isabelle; Nowak, Peter; Herk, Marcel van; Rasch, Coen

    2004-01-01

    Purpose: To evaluate the impact of different tabletops with or without a knee support on the position of the rectum, prostate, and bulb of the penis; and to evaluate the effect of these patient-positioning devices on treatment planning. Methods and materials: For 10 male volunteers, five MRI scans were made in four different positions: on a flat tabletop with knee support, on a flat tabletop without knee support, on a rounded tabletop with knee support, and on a rounded tabletop without knee support. The fifth scan was in the same position as the first. With image registration, the position differences of the rectum, prostate, and bulb of the penis were measured at several points in a sagittal plane through the central axis of the prostate. A planning target volume was generated from the delineated prostates with a margin of 10 mm in three dimensions. A three-field treatment plan with a prescribed dose of 78 Gy to the International Commission on Radiation Units and Measurements point was automatically generated from each planning target volume. Dose-volume histograms were calculated for all rectal walls. Results: The shape of the tabletop did not affect the rectum and prostate position. Addition of a knee support shifted the anterior and posterior rectal walls dorsally. For the anterior rectal wall, the maximum dorsal shift was 9.9 mm (standard error of the mean [SEM] 1.7 mm) at the top of the prostate. For the posterior rectal wall, the maximum dorsal shift was 10.2 mm (SEM 1.5 mm) at the middle of the prostate. Therefore, the rectal filling was pushed caudally when a knee support was added. The knee support caused a rotation of the prostate around the left-right axis at the apex (i.e., a dorsal rotation) by 5.6 deg (SEM 0.8 deg ) and shifts in the caudal and dorsal directions of 2.6 mm (SEM 0.4 cm) and 1.4 mm (SEM 0.6 mm), respectively. The position of the bulb of the penis was not influenced by the use of a knee support or rounded tabletop. The volume of the

  17. ROLE OF CT IN DIFFERENTIATION OF MUCINOUS AND NON-MUCINOUS CARCINOMAS OF THE RECTUM

    Directory of Open Access Journals (Sweden)

    Piyush Joshi

    2017-01-01

    Full Text Available BACKGROUND Colorectal carcinomas can broadly be classified as either non-mucinous or mucinous. Usually, mucinous adenocarcinomas present at a more advanced stage, have more aggressive local spread and have an increased incidence of lymph node involvement. Those cancers occurring in the rectum are considered more aggressive and require careful planning for treatment. Screening Computed Tomography (CT is widely used for the initial evaluation of these tumours. The aim of the study is to retrospectively analyse the CT images of rectal adenocarcinomas and suggest parameters to aid differentiation of mucinous and non-mucinous tumours. MATERIALS AND METHODS The CT images of 24 cases of mucinous and 26 cases of non-mucinous adenocarcinoma were retrospectively reviewed and evaluated for parameters like morphology, wall thickness, size, pattern and degree of enhancement and the presence or absence of calcification. Also, evaluated was involvement of adjacent structures, lymph nodes and distant metastases. RESULTS All the parameters were analysed for significance using the chi-square test. Mucinous adenocarcinomas of the rectum showed a greater propensity for eccentric bowel thickening, heterogenous enhancement and calcification with a p value less than 0.05. Heterogenous enhancement showed the greatest sensitivity (75% and calcification the greatest specificity (83.3%. The other parameters did not show any difference between the two groups. CONCLUSION CT features most likely to suggest rectal mucinous carcinoma are heterogenous contrast enhancement, eccentric wall thickening and intratumoural calcification. As mucinous carcinomas follow an aggressive course, if a diagnosis of mucinous carcinoma of the rectum can be suggested on the staging CT, it may influence patient management.

  18. The effect of anterior proton beams in the setting of a prostate-rectum spacer

    Energy Technology Data Exchange (ETDEWEB)

    Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Tang, Shikui [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Susil, Robert C.; McNutt, Todd R.; Song, Danny Y. [Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins Hospital, Baltimore, MD (United States); Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); DeWeese, Theodore L. [Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins Hospital, Baltimore, MD (United States); Lu, Hsiao-Ming [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Both, Stefan [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States)

    2013-10-01

    Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.

  19. The effect of anterior proton beams in the setting of a prostate-rectum spacer

    Science.gov (United States)

    Christodouleas, John P.; Tang, Shikui; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y.; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; DeWeese, Theodore L.; Lu, Hsiao-Ming; Both, Stefan

    2014-01-01

    Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS. PMID:23578497

  20. Treatment of postradiation structure of the rectum by the modified Duhamel procedure

    Energy Technology Data Exchange (ETDEWEB)

    Starr, D.S.; Lawrie, G.M.; Morris, G.C. Jr.

    1979-06-01

    Benign rectosigmoid stenosis secondary to pelvic radiation presents a difficult problem in management and is usually treated by permanent colostomy with its attendant discomfort and inconvenience. Other approaches include low anterior resection or even transsacral resection of the affected area of rectosigmoid, but they involve risk to rectal, bladder, and sexual function. The Martin modification of the Duhamel procedure is specifically designed to avoid these problems and was used successfully in the present case for treatment of rectosigmoid stenosis. The patient has been followed up 8 years and reports normal sensation and function of bladder and rectum and no disturbance of sexual function.

  1. Interstitial curietherapy with iridium 192 applied to small cancers of the rectum

    International Nuclear Information System (INIS)

    Papillon, J.; Montbarbon, J.F.; Gerard, J.P.

    1975-01-01

    Intracavity irradiation aimed at curing cancers of the rectum mainly calls on contact radiotherapy but also on interstitial curietherapy. Iridium curietherapy has replaced radium-therapy owing to the better homogeneousness of its action and precise method of assay. It uses a 2 pronged fork containing 2 iridium wires which can be very simply placed in position. It is applied on the one hand to the base of the ulcerated tumour, after abrasion by contactotherapy and on the other hand as a method of prophylactic irradiation after exeresis of a malignant or degenerated polyp where the scar is badly adapted to contactotherapy [fr

  2. Transanal endoscopic microsurgery for advanced polyps and early cancers in the rectum-Long-term outcome

    DEFF Research Database (Denmark)

    Al-Najami, Issam; Rancinger, Carl Philip; Larsen, Morten Kobaek

    2016-01-01

    procedures for adenomas and cancers with focus on local recurrence and complications.All 280 patients who had a TEM procedure between January 2008 and September 2015 were enrolled in a prospective cohort study. Outcome was described for benign and malignant tumors. Mortality, recurrence, and complications.......8% in the benign and malignant group, respectively.TEM seems to be a safe and viable procedure for removing both benign and malignant lesions from the rectum. TEM offers low mortality and complication rates also recurrence after resection of malignant tumors....

  3. Internal hemorrhoids - their typical radiological appearance and differential diagnosis to carcinoma of rectum and anus

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, V.; Koester, R.

    1984-11-01

    The main indication for colon barium enema examination is occult bleeding or bleeding noticed by the patient himself. The radiologist has to take into account all clinical details that could lead to bleeding and to document them. The most frequent causes of rectal bleeding are hemorrhoids and diverticulosis/itis which in marked cases may have a tumor-like appearance. A good double-contrast examination of the colon must not only exclude tumors, polyps or inflammatary diseases but also demonstrate other causes of bleeding. The presented paper describes typical roentgen signs and gives criteria to differentiate hemorrhoids from deeply situated cancer of the rectum or anus.

  4. Internal hemorrhoids - their typical radiological appearance and differential diagnosis to carcinoma of rectum and anus

    International Nuclear Information System (INIS)

    Fiedler, V.; Koester, R.

    1984-01-01

    The main indication for colon barium enema examination is occult bleeding or bleeding noticed by the patient himself. The radiologist has to take into account all clinical details that could lead to bleeding and to document them. The most frequent causes of rectal bleeding are hemorrhoids and diverticulosis/itis which in marked cases may have a tumor-like appearence. A good double-contrast examination of the colon must not only exclude tumors, polyps or inflammotary diseases but also demonstrate other causes of bleeding. The presented paper describes typical roentgen signs and gives criteria to differentiate hemorrhoids from deeply situated cancer of the rectum or anus. (orig.) [de

  5. Preoperative combination therapy of 5-fluorouracil suppository and radiation for carcinoma of the rectum

    International Nuclear Information System (INIS)

    Mizusawa, Hirokazu; Takahashi, Toshio

    1983-01-01

    Twelve cases of carcinoma of the rectum were treated preoperatively by combination therapy with 5-fluorouracil (5-FU) suppository (100 mg twice a day consecutively, a total dose of more than 4,000 mg) and irradiation (300 rad x 3/week, a total dose of 3,000 rad). This group was compared with 34 cases given single preoperative 5-FU therapy and 24 control cases given no preoperative adjuvant modality. The group treated by preoperative combination therapy showed marked antitumor effects macroscopically and histologically. In addition, decrease in local recurrence was expected for this group, compared with the other two groups. (Chiba, N.)

  6. [Progress in the early diagnosis of cancer of the colon and rectum].

    Science.gov (United States)

    Canessa, N; Roset, J; Boffi, A; Ferrara, J B; Galano, A; Albertengo, J C

    1978-09-01

    Our experience with the air contrast examination in the cancer of colon and rectum diagnoses is showed. The colaboration among radiologist, endoscopist, pathologist and surgeon is important. In the large bowel tumors diagnosis, the radiologic and endoscopic prodedures should be evaluated together. The double colonic contrast has showed in our experience, better results than with the barium enema. Over 31 patients with both studies, we obtained 13 false negatives (with barium enema, doing then the double colonic contrast became positive 12 (92.4%).

  7. A rectum shield for the circular applicator system of a selectron unit (HDR and LDR afterloading)

    International Nuclear Information System (INIS)

    Hetzel, H.; McCoy, M.; Kamleitner, H.; Frommhold, H.

    1987-01-01

    In order to decrease the morbidity rate after combined radiotherapy of the cervix carcinoma, a tungsten shield 3 and 5 mm thick for the rectum has been developed by the authors which is applied with the ring and pin applicator of the selectron unit (LDR and HDR afterloading). The isodose curves were measured in a plexiglas phantom, and the radiation dose at the reference points was determined by means of a ionization dosemeter. The phantom measurements were performed with the same arrangement of sources as applied in radiotherapy. The measurements showed a dose reduction at point Rmax of 33% (HDR) and 44% (LDR) with the tungsten shield 5 mm thick. (orig.) [de

  8. Radiation Therapy for Loco-Regional Recurrence of Adenocarcinoma of the Rectum

    International Nuclear Information System (INIS)

    Cho, K. H.; Seong, J. S.; Suh, C. O.; Kim, G. E.

    1984-01-01

    Thirty patients with loco-regional recurrence following curative surgery for adenocarcinoma of the rectum were retrospectively. Evaluated to determine factors influencing survival and the efficacy of radiation therapy. In this review of 30 patients undergoing radiation therapy, more than 50 percent (17/30) had definite symptomatic and objective response. Ninety percent of patients (27/30) received significant palliation. Over all 2-year survival rate was 7.4% and their median was 13.0 months. Grade of response and Sex were statistically related to survival

  9. Perceptions of phantom rectum syndrome and health-related quality of life in patients following abdominoperineal resection for rectal cancer.

    Science.gov (United States)

    Fingren, Jeanette; Lindholm, Elisabet; Carlsson, Eva

    2013-01-01

    The aim of the study was to investigate how patients described their perceptions of phantom rectum syndrome after abdominoperineal resection and ostomy creation, and its influence on daily living and health-related quality of life. A further aim was to find out strategies patients use to alleviate phantom rectum syndrome sensations. Twenty-five patients who underwent abdominoperineal resection and a colostomy (18 men and 7 women; median age 5 63 years; range, 40-78 years) at Sahlgrenska University Hospital, Göteborg, Sweden, participated in the study. At follow-up 8 months postsurgery, a WOC nurse interviewed patients with a structured questionnaire about the experience of nonpainful and painful sensations in the perineal area. Health-related quality of life was evaluated using a general cancer-specific instrument (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0). Twenty-four patients (96%) experienced painful or nonpainful phantom rectum syndrome at some point during the first 8 postoperative months. The nonpainful sensations (20 patients) occurred in connection with emptying of feces via the stoma, when performing colostomy irrigation, at rest, or in various positions. Fifteen patients experienced painful sensations, characterized as pins and needles, pain in the perineal area, stinging, and burning occurring mostly in sitting positions. Patients with painful sensations had statistically significant higher scores regarding pain and lower scores for social function than those without painful sensations (P < .031). Phantom rectum symptoms caused worries and concerns and influenced daily life in 29% (n = 5). Phantom rectum syndrome is prevalent in patients undergoing abdominoperineal resection and ostomy creation. Information about phantom rectum syndrome should be shared preoperatively and during follow-up in order to promote optimal quality of life and alleviate bothersome symptoms and concerns associated with

  10. Dose Volume Histogram analysis for rectum and urethral reaction of prostate cancer

    International Nuclear Information System (INIS)

    Yanagi, Takeshi; Tsuji, Hiroshi; Kamada, Tadashi; Tsujii, Hirohiko

    2005-01-01

    The aim of this study is to evaluate the clinically relevant parameters for rectum and urethral reaction using DVH (dose volume histogram) in carbon ion radiotherapy of prostate cancer. In this year, we studied the urinary reaction mainly. 35 patients with prostate cancer were treated with carbon ion beams between June 1995 and December 1997. The applied dose was escalated from 54.0 GyE to 72.0 GyE in fixed 20 fractions. Clinical urinary reaction and rectum reaction were reviewed using Radiation Therapy Oncology Group (RTOG) scoring system for acute reactions, RTOG/European Organization for Research and Treatment of Cancer (EORTC) scoring system for late reactions. Taking the ROI (region of interest) for DVH of urethra, we used surrogate one that was derived from the observation of MR images. 35 patients were analyzed for acute urinary reaction and 34 for late urinary reaction in the study of this year. DVH analysis suggested difference among the grades for acute and late reactions. These analysis appears to be a useful tool for predicting the urinary reactions. (author)

  11. Extramoucous transversal coloplasty – new method of reconstruction after rectum resection

    Directory of Open Access Journals (Sweden)

    Miran Rems

    2007-11-01

    Full Text Available Background: In patients, diagnosed with rectal cancer in lower thirds of rectum, a total mesorectal excision is warranted. The aim is to preserve of all vegetative functions as well. Because of better functional results anastomosis with J-pouch is preferred procedure. Formation of colonic J-pouch can not always be performed due to anatomic reasons. Transverse coloplasty have the same functional results and can be constructed almost always. In some studies there were more dehiscence reported in the group with transverse coloplasty, probably because of impaired vascularization. With sparing of submucous layer better vascularization can be achieved and all advantages of transverse coloplasty preserved.Methods: After preparing the patient following the principles of enhanced recovery surgery, resection of rectum by the oncologic principles is done. Colon is prepared for reconstruction and alongside of tenia the incision of muscular layer is done a few centimeters above the predicted anastomosis. The incision is 6 to 8 centimeters long. After the separation of muscular layer incision is sutured transversely. Submucous layer must not be opened or divided in order to obtained better vascularization of the terminal anastomosis and lower fecal inoculation. Postoperative treatment and follow-up is regular.Conclusions: Extramucous transverse coloplasty can obtain functions of reservoir for neorectum and improve quality of life in a same way transverse coloplasty can. With preservation of submucous layer the vascularization of anastomosis is better and therefore the rate of dehiscence lower. For final consent more randomized studies have to be performed.

  12. Diagnosis by computer-aided tomography in patients with carcinomas in the rectum-sigma area

    International Nuclear Information System (INIS)

    Gnann, H.; Huebener, K.H.; Ahlemann, L.M.; Harms, S.

    1984-01-01

    In a retrospective study on the patients at Tuebingen between 1977 and 1980, the diagnostic value of computer-aided tomography was investigated in 232 cases of carcinomas in the rectum-sigma area. 192 examinations were post-operative. Whether computer-aided tomography will catch on as a staging measure in the pre-operative phase must for now remain unanswered until prospective studies on a large number of patients have been carried through. However, it is useful as a decision-taking aid as regards the choice of the operation method and to clarify whether the carcinoma is operable. Far more important in view of the known high rate of recurvency and metastatic spread seems to be the role of computer-aided tomography in the aftercare especially of those patients who had their rectum removed: the diagnosis of the recidivation permits direct therapeutic action (a second operation, radiation therapy) at an early date. The search for clinically not previously known recidivations revealed that computer-aided tomography had in 124 patients with operated rectal carcinoma a high sensitivity of 98 per cent, a specificity of 87 per cent and an accuracy of 91.9 percent. How long after the operation CAT checks should be carried through is quite as uncertain at present as the role of CAT in the staging of those tumors. The authors recommend intervals of 2-3 months within the first two post-operative years. (orig.) [de

  13. Large Cell Neuroendocrine Carcinoma of the Rectum Presenting with Extensive Metastatic Disease

    Directory of Open Access Journals (Sweden)

    Vinay Minocha

    2014-01-01

    Full Text Available Introduction. Rectal large cell neuroendocrine carcinoma (LCNEC is a poorly differentiated neoplasm that is very rare and belongs within the poorest prognostic subgroup among primary colorectal neoplasms. Here, we describe a case of LCNEC of the rectum, which highlights the aggressive clinical course and poor prognosis associated with this disease. Case Presentation. We report a case of a 63-year-old male who presented to our hospital with a one-month history of lower abdominal pain, constipation, and weight loss. A computed tomography (CT scan of the chest, abdomen, and pelvis revealed a rectal mass as well as metastatic disease of the liver and lung. Flexible sigmoidoscopy revealed a fungating, ulcerated and partially obstructing rectal mass located 6 cm from the anal verge. This mass was biopsied and pathological examination of the resected specimen revealed features consistent with a large cell neuroendocrine carcinoma. Conclusion. Rectal large cell neuroendocrine carcinomas are rare and have a significantly worse prognosis than adenocarcinomas. At diagnosis, a higher stage and metastatic disease are likely to be found. It is important to differentiate large cell, poorly differentiated neuroendocrine carcinomas from adenocarcinomas of the colon and rectum pathologically because patients may benefit from alternative cytotoxic chemotherapeutic regimens.

  14. The forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

    International Nuclear Information System (INIS)

    Zharinov, G.M.; Gabelov, A.A.

    1984-01-01

    The frequency and degree of severity of radiation in unjuries of the urinary bladder and rectum after combined treatment of 725 patients with uterine cercix carcigoma are analysed. A quantitative index was worked out permi-- tting one to give an ob ective evaluation of the degree of early radiation reactions of the ad acent organs. The determination of the ''radiation injuries prognosis index'' (RIPI) makes it possible to forecast the occurence and degree of severity of late radiation injuries of the urinary bladder and rectum. The evaluation of RIPI mean values in the patients' groups provides an opportunity to oompare the damaging effect of different methods and regiment directly in the process of radiation therapy. The above method improves the potentialities of the forecasting of radiation injuries of the urinary bladder and rectum in patients with uterine cervix carcinoma

  15. Dependent Classes

    DEFF Research Database (Denmark)

    Gasiunas, Vaidas; Mezini, Mira; Ostermann, Klaus

    2007-01-01

    of dependent classes and a machine-checked type soundness proof in Isabelle/HOL [29], the first of this kind for a language with virtual classes and path-dependent types. [29] T.Nipkow, L.C. Poulson, and M. Wenzel. Isabelle/HOL -- A Proof Assistant for Higher-Order Logic, volume 2283 of LNCS, Springer, 2002......Virtual classes allow nested classes to be refined in subclasses. In this way nested classes can be seen as dependent abstractions of the objects of the enclosing classes. Expressing dependency via nesting, however, has two limitations: Abstractions that depend on more than one object cannot...... be modeled and a class must know all classes that depend on its objects. This paper presents dependent classes, a generalization of virtual classes that expresses similar semantics by parameterization rather than by nesting. This increases expressivity of class variations as well as the flexibility...

  16. Tl-201 per rectum scintigraphy in chronic liver disease: assessment of Tl-201 uptake indices

    International Nuclear Information System (INIS)

    Moon, Won Jin; Choi, Yun Young; Cho, Suk Shin; Lee, Min Ho

    1999-01-01

    Heart to liver ratio on Tl-201 per rectal scintigraphy (shunt index) is known to be useful in the assessment of portal systemic shunt. We assessed Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 and correlated with shunt index in patients with chronic active hepatitis (CAH) and liver cirrhosis (LC). Fifty eight patients with biopsy-proven chronic liver disease (35 with CAH, 23 with LC) underwent Tl-201 per rectum scintigraphy after instillation of 18.5 MBq of Tl-201 into the upper rectum. We evaluated hepatic uptake (type 1: homogeneous, 2: inhomogeneous segmental, 3: inhomogeneous nonsegmental) and extrahepatic uptake of spleen, heart and kidney (grade 0: no uptake, 1: less than liver, 2: equal to liver, 3: greater than liver). We measured the early liver/heart uptake rate (the slope of the liver to heart uptake ratio for 10 mim) and shunt index (heart to liver uptake ratio). Tl-201 uptake pattern and early liver/heart uptake rate of Tl-201 was correlated with the pathologic diagnosis and shunt index. Hepatic uptake patterns of type 1 and 2 were dominant in CAH (CAH: 27/35, LC: 8/23), and type 3 in LC (CAH: 8/35, LC: 15/23)(p<0.005). The grades of extrahepatic uptake were higher in LC than in CAH (spleen: p<0.001, other soft tissue: p<0.005). The early liver/heart uptake rate of CAH (0.110±0.111) was significantly higher than that of LC (0.014±0.090)(p<0.001). The sensitivity and specificity of the early liver/heart uptake rate were 77.7% and 67.7% in differentiating LC from CAH. There was negative correlation between early liver/heart uptake rate and shunt index (r=-0.3347, p<0.01). Hepatic and extrahepatic uptake pattern and early liver/heart uptake rate on Tl-201 per rectum scintigraphy are useful in the assessment of portal systemic shunt in patients with chronic liver disease

  17. Culture-Independent Evaluation of the Appendix and Rectum Microbiomes in Children with and without Appendicitis

    Science.gov (United States)

    Davenport, Katherine P.; Fraser, Claire M.; Sandler, Anthony D.; Zeichner, Steven L.

    2014-01-01

    Purpose The function of the appendix is largely unknown, but its microbiota likely contributes to function. Alterations in microbiota may contribute to appendicitis, but conventional culture studies have not yielded conclusive information. We conducted a pilot, culture-independent 16S rRNA-based microbiota study of paired appendix and rectal samples. Methods We collected appendix and rectal swabs from 21 children undergoing appendectomy, six with normal appendices and fifteen with appendicitis (nine perforated). After DNA extraction, we amplified and sequenced 16S rRNA genes and analyzed sequences using CLoVR. We identified organisms differing in relative abundance using ANOVA (pappendicitis vs. normal), and disease severity (perforated vs. non-perforated). Results We identified 290 taxa in the study's samples. Three taxa were significantly increased in normal appendices vs. normal rectal samples: Fusibacter (p = 0.009), Selenomonas (p = 0.026), and Peptostreptococcus (p = 0.049). Five taxa were increased in abundance in normal vs. diseased appendices: Paenibacillaceae (p = 0.005), Acidobacteriaceae GP4 (p = 0.019), Pseudonocardinae (p = 0.019), Bergeyella (p = 0.019) and Rhizobium (p = 0.045). Twelve taxa were increased in the appendices of appendicitis patients vs. normal appendix: Peptostreptococcus (p = 0.0003), Bilophila (p = 0.0004), Bulleidia (p = 0.012), Fusobacterium (p = 0.018), Parvimonas (p = 0.003), Mogibacterium (p = 0.012), Aminobacterium (p = 0.019), Proteus (p = 0.028), Actinomycineae (p = 0.028), Anaerovorax (p = 0.041), Anaerofilum (p = 0.045), Porphyromonas (p = 0.010). Five taxa were increased in appendices in patients with perforated vs. nonperforated appendicitis: Bulleidia (p = 0.004), Fusibacter (p = 0.005), Prevotella (p = 0.021), Porphyromonas (p = 0.030), Dialister (p = 0.035). Three taxa were increased in rectum samples of patients with

  18. Anorectal function following colo-anal sleeve anastomosis for chronic radiation injury to the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Varma, J S; Smith, A N

    1986-04-01

    This paper reports the results of anorectal manometry and electrophysiological studies of the pelvic floor in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. The group comprised six women and two men (age range 61-84 years, mean 71 years). Six bladder carcinoma patients had received small field (10 x 10 cm) external beam radiotherapy (5500 cGy in 20 treatments over 4 weeks); two cervical cancer patients had been given whole pelvis, external beam radiotherapy supplemented by a single caesium implant (cumulative dosage of 9500 cGy to the vaginal vault, equivalent to 7500 cG to point A).

  19. Dysmenorrhoea is associated with hypersensitivity in the sigmoid colon and rectum

    DEFF Research Database (Denmark)

    Brinkert, Willem; Dimcevski, Georg; Arendt-Nielsen, Lars

    2007-01-01

    if dysmenorrhoea is associated with hypersensitivity in the referred somatic skin area or in the large bowel, i.e., viscero-visceral hyperalgesia. We measured skin sensitivity in the referred area of the sigmoid colon as well as stimulus-response relationships in the sigmoid colon and rectum. The latter were...... measured using mechanical (balloon) distension applied via a Barostat in 11 dysmenorrhoea patients without gastro-intestinal complaints and 10 healthy and age matched women, again without gastrointestinal complaints. We found no skin hypersensitivity in the colonic referred area. In contrast, significantly...... lower distension volumes were seen at each threshold in dysmenorrhoea patients, particularly in the sigmoid colon. The mean reduction in colonic distension volume thresholds for dysmenorrhoea patients vs. controls was 57% at the detection threshold and 39% at the pain threshold. There were...

  20. Anorectal function following colo-anal sleeve anastomosis for chronic radiation injury to the rectum

    International Nuclear Information System (INIS)

    Varma, J.S.; Smith, A.N.

    1986-01-01

    This paper reports the results of anorectal manometry and electrophysiological studies of the pelvic floor in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. The group comprised six women and two men (age range 61-84 years, mean 71 years). Six bladder carcinoma patients had received small field (10 x 10 cm) external beam radiotherapy (5500 cGy in 20 treatments over 4 weeks); two cervical cancer patients had been given whole pelvis, external beam radiotherapy supplemented by a single caesium implant (cumulative dosage of 9500 cGy to the vaginal vault, equivalent to 7500 cG to point A). (UK)

  1. Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum

    Directory of Open Access Journals (Sweden)

    Joana Soares

    2017-09-01

    Full Text Available Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

  2. Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum.

    Science.gov (United States)

    Soares, Joana; Ferreira, Carla; Marques, Margarida; Corujeira, Susana; Tavares, Marta; Lopes, Joanne; Carneiro, Fátima; Amil Dias, Jorge; Trindade, Eunice

    2017-11-01

    Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

  3. Dieulafoy's Lesions of the Rectum: A Rare Cause of Lower Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Robert Enns

    2001-01-01

    Full Text Available Dieulafoy's lesions located outside of the stomach are rare occurrences. Lesions found within the colon typically present with painless, massive hematochezia (ie, greater than 5 U. If they can be accurately located, endoscopic therapy in the form of adrenaline injection, sclerotherapy or cauterization appears to have long term success. The present report details the case of a 72-year-old man who presented with massive hematochezia and who was discovered to have a Dieulafoy's lesion within the rectum. The lesion was located just distal to a previous surgical anastomosis, and was successfully treated with adrenaline and electrocautery. Colonic Dieulafoy's lesions are rare but should always be considered in the differential diagnosis of massive hematochezia, because endoscopic therapy appears to result in complete cessation of bleeding.

  4. Histological changes in rectum following radiotherapy in cases of carcinoma cervix uteri

    Energy Technology Data Exchange (ETDEWEB)

    Gill, J K; Rohatgi, V K; Lahiri, B; Aggarwal, B M [S.N. Medical Coll., Agra (India)

    1978-05-01

    Rectal biopsy was done in 39 follow-up cases of squamous cell carcinoma of cervix treated with radiotherapy who clinically presented as cases of radiation proctitis. On histological examination, definite evidence of radiation injury was found in 23 cases. In rectal mucosa, radiation ulcers, broken epithelial lining, glandular atrophy, inflammatory cell infiltration, and edema of stroma were seen. Muscularis mucosa was either intact or partially broken. In submucosa, blood vessels showed endarteritis, plasma cell infiltration, fibrinoid necrosis, and hyalinization of vessel wall. In a few cases, hyalinization, edema, and vacuolation of muscle fibres were seen in muscle layer. In one case, squamous cell carcinoma of rectum was diagnosed. During follow-up examinations no complication due to rectal biopsy was observed.

  5. Evaluation of spiral CT in staging of colon and rectum carcinoma

    International Nuclear Information System (INIS)

    Hundt, W.; Braunschweig, R.; Reiser, M.

    1999-01-01

    The purpose of our study was to evaluate the capability of a subsecond spiral-CT scanner using two contrast medium phases in staging of colorectal cancer. In our study we included 37 patients with proven rectum or colon carcinoma. Spiral CT was performed following tap-water enema of the colon in the arterial and venous phases of contrast medium enhancement. Our results were compared with the findings of pathological examination after surgery. The tumor's size and extension were evaluated in the arterial and venous phases, the lymph nodes in the venous phase of the CT scan. The tumor was in the rectum (n = 14), sigma (n = 11), descending colon (n = 6), and cecum (n = 6). Two-phase spiral CT had a sensitivity of 97.2 % in the arterial phase and 89.1 % in the venous phase in detecting the carcinoma. The staging results were in the arterial phase in 30 of 37 cases (81.0 %) and in the venous phase in 24 of 37 cases (64.8 %) according to pathology. In 27 of 32 patients (84.3 %) lymph nodes were detected. The correct classification of the N-stage was possible in 23 of 34 cases (67.6 %). The combined use of arterial and venous phases in staging of colorectal cancer can improve the T- and N-stage classification in comparison with using only one contrast medium phase. The arterial phase is superior compared with the venous phase for local tumor staging and the venous phase is used for lymph node assessment. (orig.) (orig.)

  6. The Outlet Patch: Gastric Heterotopia of the Colo-rectum and Anus.

    Science.gov (United States)

    Mannan, Abul Ala Syed Rifat; Vieth, Michael; Khararjian, Armen; Khandakar, Binny; Lam-Himlin, Dora; Heydt, David; Bhaijee, Feriyl; Venbrux, Henry J; Byrnes, Kathleen; Voltaggio, Lysandra; Barker, Norman; Yuan, Songyang; Montgomery, Elizabeth

    2018-04-18

    Gastric heterotopia (GH) has been described throughout the gastrointestinal tract. However, the colorectal region is an extremely rare location for it. We describe the clinicopathologic features of GH of the colon, rectum, and anus. We identified 33 cases in 20 males and 13 females (median age 54 years; range, 4 months to 73 years). Sites included the rectum (N=26), anus (N=4), ileocecal junction (N=1), ascending colon (N=1) and descending colon (N=1). Presenting symptoms(N=27) included hematochezia (41%) and altered bowel habits (4%); 15 patients (55%) were asymptomatic. On colonoscopy (N=31), all appeared as solitary lesions, (median size 6.5 mm, range 2 mm - 55 mm), either as polyps (61%), raised erythematous patches (23%), an ulcer(10%), within a rectal diverticulum (3%), or a hemorrhoid (3%). Patients were managed by polypectomy. One with an associated carcinoma in the area of GH underwent resection. No morbidity related to GH itself was reported following excision. Histologically, heterotopic gastric mucosa was oxyntic type (85%), mixed oxyntic and non-oxyntic type (12%), and not specified (3%). In 5 patients a pyloric gland adenoma (PGA) arose from heterotopic gastric mucosa, two of which contained a focus of invasive adenocarcinoma. One case had associated surface foveolar type low-grade dysplasia. Another had associated adenocarcinoma arising from the heterotopic mucosa. One example harbored Helicobacter pylori organisms. We highlight the features of GH in the distal GIT - the 'outlet patch'. Association with PGA, surface dysplasia and adenocarcinoma suggests that lower tract GH can undergo neoplastic transformation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Determination of dose received by bladder and rectum in external cervical irradiation

    International Nuclear Information System (INIS)

    Omer, Mohamed Ahmed Ali

    2001-12-01

    The cervical carcinoma is the common type of malignant tumor among sudanese females during the last years. The conventional external irradiation therapy is the common model of treatment for cervical carcinoma in (RICK). The irradiation of such cases implemented via four fields (box technique), two anterior and posterior and two lateral opposed fields, as central dose calculation, giving a dose of 5000 c Gy fractionated into 25 to 30 fractions. The parameter of the fields lie at the promontory of the sacral cephalic and at the obturators foramen caudally and laterally at the bony pelvic by one centimeter. The aim of the research is to determine the dose received by the rectum and bladder (critical organs), out of central dose calculation versus off axis dose calculation to (Day's method). The data obtained by using simulator and radiation oncological computerized system (Rocs). The results are analyzed by using statistical processing for social science program (SPSS) that shows the mean dose received by the bladder is 3821 cGy, due to central dose calculation that accompanied by an un-optimum encompassment of treatment line and 4210.6 c Gy. due to Off Axis Dose calculation dose 3324.4 c Gy and 3712.1 c Gy due to central dose calculation. The increment of dose received by the rectum and the bladder is due to utilizing of wider width of the filed size for lateral irradiation. To score the aim of International Atomic Energy Agency (IAEA) and (ALARA) principle A s Low As As Reasonable Available , we have to use the simulator to obtain the anatomical structures on the contour, or will be better to use CT. Scan for calculation of dose at the side of interest. (Author)

  8. Implantation of a biodegradable rectum balloon implant: Tips, Tricks and Pitfalls

    Directory of Open Access Journals (Sweden)

    Ben G. L. Vanneste

    Full Text Available ABSTRACT Introduction: A rectum balloon implant (RBI is a new device to spare rectal structures during prostate cancer radiotherapy. The theoretical advantages of a RBI are to reduce the high radiation dose to the anterior rectum wall, the possibility of a post-implant correction, and their predetermined shape with consequent predictable position. Objective: To describe, step-by-step, our mini-invasive technique for hands-free transperineal implantation of a RBI before start of radiotherapy treatment. Materials and Methods: We provide step-by-step instructions for optimization of the transperineal implantation procedure performed by urologists and/or radiation oncologists experienced with prostate brachytherapy and the use of the real-time bi-plane transrectal ultrasonography (TRUS probe. A RBI was performed in 15 patients with localised prostate cancer. Perioperative side-effects were reported. Results: We provide ‘tips and tricks’ for optimizing the procedure and proper positioning of the RBI. Please watch the animation, see video in https://vimeo.com/205852376/789df4fae4. The side-effects included mild discomfort to slight pain at the perineal region in 8 out of 15 patients. Seven patients (47% had no complaints at all. Two patients developed redness of the skin, where prompt antibiotic regimen was started with no further sequelae. One patient revealed a temporary urine retention, which resolved in a few hours following conservative treatment. Further no perioperative complications occurred. Conclusion: This paper describes in detail the implantation procedure for an RBI. It is a feasible, safe and very well-tolerated procedure.

  9. Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators.

    Science.gov (United States)

    Connolly, James G; Goldstone, Stephen E

    2017-05-01

    Anal canal high-grade squamous intraepithelial lesion (HSIL) is the precursor to anal cancer. Immunocompromised patients are at increased risk and disease is usually within 3 cm from the anal verge. High-resolution anoscopy (HRA) with an 8-cm anoscope is used to identify and guide cautery treatment of HSIL. We report three patients with a long-term history of ulcerative colitis (UC) treated with systemic immunomodulators who developed proximally located rectal HSIL. Two patients were HIV-negative women, 63 and 48 years old, and the third was a 51-year-old HIV-positive man with underlying UC for 10, 16, and 3 years, respectively. They each presented with a HPV-positive HSIL visibly extending above the limits of the anoscope used for HRA. None developed cancer. All had episodes of active UC. It is unclear what causative role systemic immunomodulators play in predisposing UC patients to proximal HSIL. HSIL probably developed on a tongue of HPV-infected squamous epithelium growing proximally over the inflamed rectum. Islands developed when areas of squamous epithelium degenerated, creating skip areas. This study highlights the potential for HSIL to extend into the rectum either as a contiguous patch or isolated islands and the need for heightened surveillance in patients with extensive anal canal HSIL treated with immunodulator therapy. HSIL identified at the limit of the anoscope should be investigated further with colonoscopy, and argon plasma coagulation (APC) ablation can serve as an effective treatment option. Patients are at risk for stricture, but it is unclear what role the UC or the ablation played in stricture formation.

  10. Effect of Chang Run Tong on the Biomechanical and Morphometric Remodeling of Colon and Rectum in STZ Induced Diabetic Rats

    DEFF Research Database (Denmark)

    Sha, Hong; Zhao, Dong; Zhao, Jingbo

    2013-01-01

    The present study investigates the effect of Chang Run Tong (CRT) on the biomechanical and morphometrical remodeling of colon and rectum in streptozotocin-induced diabetic rats. The colonic and rectal segments were obtained from diabetic (DM), CRT-treated diabetic (T1, high dosage: 50 g/kg/day; T2...

  11. In vitro study of acetylcholine and histamine induced contractions in colon and rectum of adult and neonate rats.

    Science.gov (United States)

    Singh, Shuchita; Mandal, Maloy B

    2013-01-01

    Contractile mechanisms of different parts of the gut in adult and neonate may not be identical due to developmental processes. The present study was undertaken to investigate acetylcholine (ACh) and histamine induced contractile responses of colon and rectum in adult and neonatal albino rats. Contractile responses were recorded from isolated in vitro preparations. The dose-response curve for ACh (0.001-100 microM) revealed dose dependent increase in contractile responses. A significantly (P pheniramine (100 microM) in adult rectum. This potentiating response of pheniramine was absent in neonate rectum. Such effect was also not seen in colon of both adult and neonate. The present investigation indicates that the contractile responses induced by ACh are similar in both adult and neonate, excepting that the blocking effect of atropine in colon was more pronounced in adult as compared to neonate. Further, the results also indicated different mechanism of histamine action in adults and neonates as evidenced by the significant enhancement of contractions by pheniramine only in adult rectum. Therefore, the present results indicate the existence of a different cholinergic and histaminergic activity in adult and neonate as well as in rectal and colonic tissue.

  12. Cutting Classes

    Science.gov (United States)

    Hacker, Andrew

    1976-01-01

    Provides critical reviews of three books, "The Political Economy of Social Class", "Ethnicity: Theory and Experience," and "Ethnicity in the United States," focusing on the political economy of social class and ethnicity. (Author/AM)

  13. Strategies for Online Organ Motion Correction for Intensity-Modulated Radiotherapy of Prostate Cancer: Prostate, Rectum, and Bladder Dose Effects

    International Nuclear Information System (INIS)

    Rijkhorst, Erik-Jan; Lakeman, Annemarie; Nijkamp, Jasper; Bois, Josien de; Herk, Marcel van; Lebesque, Joos V.; Sonke, Jan-Jakob

    2009-01-01

    Purpose: To quantify and evaluate the accumulated prostate, rectum, and bladder dose for several strategies including rotational organ motion correction for intensity-modulated radiotherapy (IMRT) of prostate cancer using realistic organ motion data. Methods and Materials: Repeat computed tomography (CT) scans of 19 prostate patients were used. Per patient, two IMRT plans with different uniform margins were created. To quantify prostate and seminal vesicle motion, repeat CT clinical target volumes (CTVs) were matched onto the planning CTV using deformable registration. Four different strategies, from online setup to full motion correction, were simulated. Rotations were corrected for using gantry and collimator angle adjustments. Prostate, rectum, and bladder doses were accumulated for each patient, plan, and strategy. Minimum CTV dose (D min ), rectum equivalent uniform dose (EUD, n = 0.13), and bladder surface receiving ≥78 Gy (S78), were calculated. Results: With online CTV translation correction, a 7-mm margin was sufficient (i.e., D min ≥ 95% of the prescribed dose for all patients). A 4-mm margin required additional rotational correction. Margin reduction lowered the rectum EUD(n = 0.13) by ∼2.6 Gy, and the bladder S78 by ∼1.9%. Conclusions: With online correction of both translations and rotations, a 4-mm margin was sufficient for 15 of 19 patients, whereas the remaining four patients had an underdosed CTV volume <1%. Margin reduction combined with online corrections resulted in a similar or lower dose to the rectum and bladder. The more advanced the correction strategy, the better the planned and accumulated dose agreed.

  14. Nerve supply to the internal anal sphincter differs from that to the distal rectum: an immunohistochemical study of cadavers.

    Science.gov (United States)

    Kinugasa, Yusuke; Arakawa, Takashi; Murakami, Gen; Fujimiya, Mineko; Sugihara, Kenichi

    2014-04-01

    Fecal incontinence is a common problem after anal sphincter-preserving operations. The intersphincteric autonomic nerves supplying the internal anal sphincter (IAS) are formed by the union of: (1) nerve fibers from Auerbach's nerve plexus of the most distal part of the rectum and (2) the inferior rectal branches of the pelvic plexus (IRB-PX) running along the conjoint longitudinal muscle coat. The aim of the present study is to identify the detailed morphology of nerves to the IAS. The study comprised histological and immunohistochemical evaluations of paraffin-embedded sections from a large block of anal canal from the preserved 10 cadavers. The IRB-PX came from the superior aspect of the levator ani and ran into the anal canal on the anterolateral side. These nerves contained both sympathetic and parasympathetic fibers, but the sympathetic content was much higher than in nerves from the distal rectum. All intramural ganglion cells in the distal rectum were neuronal nitric oxide synthase-positive and tyrosine hydroxylase-negative and were restricted to above the squamous-columnar epithelial junction. Parasympathetic nerves formed a lattice-like plexus in the circular smooth muscles of the distal rectum, whereas the IAS contained short, longitudinally running sympathetic and parasympathetic nerves, although sympathetic nerves were dominant. The major autonomic nerve input to the IAS seemed not to originate from the distal rectum but from the IRB-PX. Injury to the IRB-PX during surgery seemed to result in loss of innervation to the major part of the IAS.

  15. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Directory of Open Access Journals (Sweden)

    Leila Ghahramani

    2014-03-01

    Full Text Available Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty. In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03. Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. Please cite this article as: Ghahramani L, Yazdani S, Derakhshani S, Rezaianzadeh A, Jalli R, Geramizadeh B, Safarpour AR, Rahimikazerooni S, Hosseini SV. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog. Iran J Med Sci. 2014;39(2:117-122.

  16. Strategies to reduce the systematic error due to tumor and rectum motion in radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Hoogeman, Mischa S.; Herk, Marcel van; Bois, Josien de; Lebesque, Joos V.

    2005-01-01

    Background and purpose: The goal of this work is to develop and evaluate strategies to reduce the uncertainty in the prostate position and rectum shape that arises in the preparation stage of the radiation treatment of prostate cancer. Patients and methods: Nineteen prostate cancer patients, who were treated with 3-dimensional conformal radiotherapy, received each a planning CT scan and 8-13 repeat CT scans during the treatment period. We quantified prostate motion relative to the pelvic bone by first matching the repeat CT scans on the planning CT scan using the bony anatomy. Subsequently, each contoured prostate, including seminal vesicles, was matched on the prostate in the planning CT scan to obtain the translations and rotations. The variation in prostate position was determined in terms of the systematic, random and group mean error. We tested the performance of two correction strategies to reduce the systematic error due to prostate motion. The first strategy, the pre-treatment strategy, used only the initial rectum volume in the planning CT scan to adjust the angle of the prostate with respect to the left-right (LR) axis and the shape and position of the rectum. The second strategy, the adaptive strategy, used the data of repeat CT scans to improve the estimate of the prostate position and rectum shape during the treatment. Results: The largest component of prostate motion was a rotation around the LR axis. The systematic error (1 SD) was 5.1 deg and the random error was 3.6 deg (1 SD). The average LR-axis rotation between the planning and the repeat CT scans correlated significantly with the rectum volume in the planning CT scan (r=0.86, P<0.0001). Correction of the rotational position on the basis of the planning rectum volume alone reduced the systematic error by 28%. A correction, based on the data of the planning CT scan and 4 repeat CT scans reduced the systematic error over the complete treatment period by a factor of 2. When the correction was

  17. Late radiation injury of the colon and rectum. Surgical management and outcome

    International Nuclear Information System (INIS)

    Kimose, H.H.; Fischer, L.; Spjeldnaes, N.; Wara, P.

    1989-01-01

    After a median latency of 2 years, the initial late colorectal radiation injuries in 182 patients were: stricture (37 percent), minor lesions (36 percent), rectovaginal fistula (22 percent), and gangrene or other fistulas (5 percent). Due to progression, new colorectal injuries, primarily stricture (55 percent) and fistula (42 percent), occurred in 68 patients (37 percent). Resection provided the best results. However, the resectability rate was low (46 percent) and resection was primarily performed in patients with a circumscript well-defined stricture of the proximal rectum or sigmoid colon with an anastomotic leakage rate of 5 percent. The prevailing management of 78 patients with fistula or stricture with synchronous fistula was defunctioning colostomy, primarily end-sigmoidostomy, providing fair results in half of the patients. Stomal complications occurred in 15 percent. The radiation-induced colorectal mortality was 8 percent. Colorectal fistula and associated radiation injuries of the urinary tract, and especially of the small bowel, were the major determinants of fatal outcome, yielding an overall radiation-induced mortality of 25 percent. After a median observation time of 13 years, half of the patients were alive at follow-up; 56 percent of these had a fair outcome whereas the remaining patients continued to have mild symptoms responding to conservative measures (34 percent) or disabling symptoms (10 percent)

  18. The role of tumor markers (CEA, TPA, CA 19-9) in colon and rectum carcinomas

    International Nuclear Information System (INIS)

    Cangemi, V.; Volpino, P.; Fiori, E.; Giammarco, A.; Piat, G.

    1987-01-01

    We have evaluated the diagnostic efficacy (sensitivity, specificity, accuracy, predictive malignancy index) of CEA, TPA, CA 19-9 in colon and rectum tumors (56 cases), the difference in behaviour of these markers in relation to the stage and grading of the cancer, their reliability regarding postsurgical relapses and/or metastases. The sensitivity of CEA (>10 ng/ml), TPA (>130 U/L), CA 19-9 (>37 u/ml) for diagnostic purpose was rather limited (28.6% - 30% - 18.5%) with a malignancy prediction value of 100% - 81.8% - 62.5%. With regard to relapses and/or metastases, the diagnostic efficacy of the marker proved to be evident only for CEA, TPA, CA 19-9 value greater than 25 ng/ml, 250 U/L and 100 u/ml. The use of thethree markers together was certainly an advantage both for primitive tumors (sensitivity: 52.8%) and relapses and/or metastases after surgery (sensitivity: 66.7%)

  19. Detecting sentinel lymph nodes in caner cases of lower and middle rectum following lymphoscintigraphy

    International Nuclear Information System (INIS)

    Dontshev, M.; Dimitrov, D.; Deliysky, T.; Tsarowska, T.; Slavova, M.; Dekova, M.

    2006-01-01

    Full text: The lymphoscintigraphy and the interoperative gamma probing for through detection of the marked with radiocolloid sentinel lymph nodes (SLN) in the cases of patients having cancer in the lower and middle third of the rectum (CLMTR) are with minimum clinical experience in Bulgaria. The aim of the study is to examine the elaboration on the subject and introduction of nuclear medical methods for preoperative marking and representation of SLN and their interoperative finding thanks to gamma probing in the cases of CLMTR. This research covers 14 patients having CLMTR (3 females and 11 males) at the age of 55 - 80 (average 76,5), of whom 17 - 20 hours before the operation was carried out lymphoscintigraphy of two-headed SPECT gamma camera Toshiba CGA7200UI with 99mTc colloid applied transanal submycotic. The interoperative finding of SLN was made by the means of detection with manual gamma probe Silicone instruments. The lymphoscintigraphy visualized in 13 patients 11 SLN, and in one patient the examination was negative. The interoperative gamma sounding established the presence of activity in 12 SLN, 8 of them mezenterial and 4 of them - extramezenterial. The immunohistological examination of the biopsied 12 SLN found metastasis in two mezenterial SLN. In the rest 10 SLN there were no indications for metastatic process. The preliminary results show that the used from us nuclear medical methods are applicable for marking and finding of SLN in the cases of CLMTR aiming improvement the staging of the illness

  20. Metastatic Malignancy to the Colon and Rectum: A Report of 14 Cases from One Single Institute.

    Science.gov (United States)

    Lin, Chi-Chun; Lin, Chun-Chi; Chen, Wei-Shone; Lin, Tzu-Chen; Lin, Jen-Kou; Jiang, Jeng-Kai

    2017-10-31

    Metastatic malignancy occurs rarely in the colon or rectum. We presented 14 patients with colorectal metastasis (CRM). A retrospective review was conducted on a computerized colorectal tumor database at the Taipei Veterans General Hospital from January 2000 to June 2013. The incidence of CRM was 0.19% (14 in 7,524 patients). There were 6 males and 8 females with a mean age of 66.9 ± 13.6 years. Origins of the CRM included lung cancers (n = 3), prostate cancers (n = 2), and others (n = 1, respectively). Clinical presentations were not specific and colonoscopic pictures were indistinguishable from primary colorectal cancers; 5 of the 9 biopsies identified metastasis. Eight patients had extracolonic metastasis and 6 patients had CRM only. Significantly better survival was observed in the CRM-only group (p = 0.037). The mean interval from the treatment of primary tumor to the diagnosis of CRM was 30.2 ± 49.0 months. The mean survival time after CRM was 24.9 ± 30.8 months. Clinical features and colonoscopic findings of CRM were indistinguishable from primary colorectal cancer. Histopathological review of the biopsy could be helpful in identifying the primary lesion. Surgical resection with curative intent provided longer survival in CRM-only patients. © 2017 S. Karger AG, Basel.

  1. A noninvasive method for evaluating portal circulation by administration of Tl-201 per rectum

    International Nuclear Information System (INIS)

    Tonami, N.; Nakajima, K.; Hisada, K.; Tanaka, N.; Kobayashi, K.

    1982-01-01

    A new method for evaluating portal systemic circulation by administration of Tl-201 per rectum was performed in 13 control subjects and in 65 patients with various liver diseases. In normal controls, the liver was visualized on the 0-5-min image whereas the images of other organs such as the heart, spleen, and lungs were very poor. In patients with liver cirrhosis associated with portal-systemic shunt, and in many other patients with hepatocellular damage, the liver was not so clearly visualized, whereas radioactivity in other organs, especially the heart, became evident. The heart-to-liver uptake ratio at 20 min after administration (H/L ratio) was significantly higher in liver cirrhosis than in normals and patients with chronic hepatitis (p<0.001). The patients with esophageal varices showed a significantly higher H/L ratio compared with that in cirrhotic patients without esophageal varices (p<0.001). The H/L ratio also showed a significant difference (p<0.01) between Stage 1 and Stage 3 esophageal varices. Since there were many other patients with hepatocellular damage who had high H/L ratios similar to those in liver cirrhosis, the effect that hepatocellular damage has on the liver uptake of T1-201 is also considered. Our present data suggest that this noninvasive method seems to be useful in evaluating portal-to-systemic shunting

  2. Abscess of the iliopsoas muscle associated external fistula of the rectum caused by radiation proctitis. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Shigeru; Imazu, Hiroki; Matubara, Toshiki; Sakurai, Yoichi; Ochiai, Masahiro; Funabiki, Takahiko [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine

    1999-12-01

    This paper deals with a case of abscess of the iliopsoas muscle, an intractable external fistula of the rectum caused by radiation proctitis in a 68-year-old man. There were previous histories of undergoing an A-C bypass operation for coronary stricture 10 years before; and undergoing aportial resection of the bladder with radiation therapy for urinary bladder cancer, followed by colostomy for hemorrhage and stricture of the rectum for radiation proctitis 2 years before admission. In April, 1997 when he had been treated at outpatient clinic, exhumation of pusfrom the sacurred that was diagnosed external fistula of the rectum on a fistulography and he was continuously treated on an ambulant basis. On November 17, 1997, the patient had a temperature 38.7deg C, the white blood cell count increased to 35 x 10{sup 4} /ml, inflammation reaction increased, and unconsciousness appeared. An emergency CT revealed retention of fluid in the retroperitoneum covering from the fistulation through the iliopsoas muscle to pelvis. An abscess of the iliopsoas muscle was diagnosed. It was determined that any operations under general anesthesia were impossible due to poor general condition, and an emergency incision drainage was performed under local anesthesia. Thereafter, the patient developed MRSA septicemia which demanded redrainage and strict general management, but he was successfully freed from the management. Although the intractable fistula in persistently present, he was discharged after a resection of sequestrum and is followed on an ambulant basis. (author)

  3. Rectum separation in patients with cervical cancer for treatment planning in primary chemo-radiation

    International Nuclear Information System (INIS)

    Marnitz, Simone; Budach, Volker; Weißer, Friederike; Burova, Elena; Gebauer, Bernhard; Vercellino, Filiberto Guiseppe; Köhler, Christhardt

    2012-01-01

    To proof feasibility of hydrogel application in patients with advanced cervical cancer undergoing chemo-radiation in order to reduce rectal toxicity from external beam radiation as well as brachytherapy. Under transrectal sonographic guidance five patients with proven cervical cancer underwent hydro gel (20 cc) instillation into the tip of rectovaginal septum adherent to posterior part of the visible cervical tumor. Five days after this procedure all patients underwent T2 weighted transversal and sagittal MRI for brachytherapy planning. MRI protocol included T2 weighted fast spin echo (FSE) imaging in sagittal, coronal and para-axial orientation using an 1.5 Tesla MRI. Separation of anterior rectal wall and cervix was documented. Hydrogel application was uneventful in all patients and no toxicity was reported. Separation ranged from 7 to 26 mm in width (median 10 mm). The length of the separation varied between 18 and 38 mm (median 32 mm). In all patients displacement was seen in the posterior vaginal fornix, and/or at the deepest part of uterine cervix depending on the extension of the cul-de-sac in correlation to the posterior wall of the uterus. In patients with bulky tumor and/or deep (vaginal) extend of peritoneal cavity tumour was seen mainly cranial from the rectovaginal space and therefore above the hydrogeI application. Only in the extra-peritoneal (lower) part of the cervix a good separation could be achieved between the rectum and cervix. Hydrgel instillation in patients with cervial cancer undergoing chemoradiation is safe and feasible. Because of the loose tissue of the cul-de-sac and its intra- and extraperitoneal part, hydrogel instillation of 20 cc did not result in a sufficient separation of the cervix from anterior wall

  4. Preoperative combination therapy of 5-fluorouracil suppository and radiation for carcinoma of the rectum

    International Nuclear Information System (INIS)

    Mizusawa, Hirokazu

    1986-01-01

    The effect of adjuvant preoperative treatments with radiation and 5-fluorouracil (5-FU) on rectal carcinomas was investigated. The radiation therapy was administered in the area including the rectum and regional lymph nodes up to the level of the promontorium with 10 doses of 300 rad in three-week periods (a total dose of 3,000 rad). The suppository containing 100 mg of 5-FU was given intrarectally twice daily in the same period (a total dose of 4,000 mg of 5-FU). The surgical procedure with either abdominoperineal excision or anterior resection was performed within 14 days after the last preoperative treatment. The resected specimens were examined microscopically. The mean thickness of excised tumor-free tissue around the rectal wall having the most extended tumor growth was 6.2 mm in 16 patients receiving the treatment with radiation and 5-FU, 3.9 mm in 31 patients with 5-FU alone and 3.7 mm in 19 patients without preoperative treatments. Lymph node metastases were detected in 3 of 17 patients (19 %) with radiation and 5-FU, in 18 of 33 patients (55 %) with 5-FU alone, and in 11 of 24 patients (46 %) without preoperative treatments. The extensive degenerative pictures of cancer cells such as nuclear picnosis, and the growth of collagen fibers in carcinoma foci were observed in resected specimens with radiation and 5-FU treatments. Those findings suggest that preoperative adjuvant therapy with moderate dose of radiation and 5-FU affected significantly rectal carcinomas. There were no adverse effects. It seems likely, thus, that this combined therapy could prevent postoperative local or intrapelvic recurrence, which was the most frequent form of recurrence after curative surgery in rectal cancer. (author)

  5. Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum.

    Science.gov (United States)

    Roman, Horace; Vassilieff, Maud; Tuech, Jean Jacques; Huet, Emmanuel; Savoye, Guillaume; Marpeau, Loïc; Puscasiu, Lucian

    2013-05-01

    To compare delayed digestive outcomes in women managed by two different surgical philosophies: a radical approach mainly related to colorectal resection, and a conservative approach involving rectal shaving and rectal nodule excision. "Before and after" comparative retrospective study. University tertiary referral center. Seventy-five patients managed by surgery for deep endometriosis infiltrating the rectum. Twenty-four women were managed during a period when surgeons pursued a radical philosophy toward treatment, and 51 women were managed during a period when a conservative philosophy was adopted. Standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index, the Knowles-Eccersley-Scott Symptom Questionnaire, the Bristol Stool Score, and the Fecal Incontinence Quality of Life Score. Preoperative patient characteristics, rectal nodule features, and associated localizations of the disease were comparable between the two groups. During the radical period, colorectal resection was carried out in 67% of patients, whereas during the second period only 20% of women underwent colorectal resection. Women managed according to the conservative philosophy had significantly improved results on the Knowles-Eccersley-Scott Symptom Questionnaire, Gastrointestinal Quality of Life Index, and depression/self-perception Fecal Incontinence Quality of Life Score, and significantly improved values for various items related to postoperative constipation: unsuccessful evacuatory attempts, feeling incomplete evacuation, abdominal pain, time taken to evacuate, difficulty evacuating causing a painful effort, and stool consistency. It seems that reducing the rate of colorectal resection leads to better functional outcomes in women presenting with rectal endometriosis, lending support to the conservative surgical philosophy over mandatory colorectal resection. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights

  6. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-01-01

    Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. PMID:24644380

  7. Interposition of ileal j-pouch for rectum reconstruction in dog.

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-03-01

    The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases.

  8. Bibliographical review of laparoscopic surgery in malignant pathology of the colon and rectum

    International Nuclear Information System (INIS)

    Peraza Solis, Yerald

    2010-01-01

    An exhaustive bibliographic review was performed on laparoscopic surgery in malignant pathology of the colon and rectum. Colorectal cancer has accounted for 13% of all human cancers and has accounted for 10% of deaths from malignant neoplasms. In Costa Rica it has had the fifth most frequent cancer in women and also in men. Mortality in Costa Rican women, contrary to the developed countries, has increased between 1985 and 2000. Mortality in Costa Rican men has remained stable. The incidence has begun to be high in patients aged 40-45 years and has increased incidence until age 75. Certain group has developed cancer at an early age due to a form of familial cancer. Rectal cancer has been a treatable and curable disease if it is managed in the early stages. Many of the features of colon cancer have been applicable to rectal cancer, it only changes the association of radiotherapy and the sequence of the same. Surgery has been the primary treatment and has resulted in healing in approximately 45% of all patients. Patients with rectal cancer usually have had a chronic history of bleeding or constipation, foreign body sensation and perianal or perineal pain, low weight only when has existed advanced or metastatic disease. The US endoscopy has been a precise method to evaluate the tumor stage and the status of the perirectal nodules. The treatment of rectal cancer has had as aim: 1. healing, 2. local control, 3. restoration of intestinal continuity and 4. prevention of urinary, sexual and anorectal sphincter function. Adjuvant treatment with radiotherapy and/or chemotherapy has been only necessary for tumors T3 and T4. The treatment by stage: Stage I: preoperative radiotherapy and one of the surgical modalities described according to the case; Stage II and III: preoperative radiotherapy and one of the surgical modalities according to the case; Stage IV: palliative extirpation of the tumor with restoration of the intestinal transit through anastomosis or definitive

  9. The management of patients with T1 adenocarcinoma of the low rectum: a decision analysis.

    Science.gov (United States)

    Johnston, Calvin F; Tomlinson, George; Temple, Larissa K; Baxter, Nancy N

    2013-04-01

    Decision making for patients with T1 adenocarcinoma of the low rectum, when treatment options are limited to a transanal local excision or abdominoperineal resection, is challenging. The aim of this study was to develop a contemporary decision analysis to assist patients and clinicians in balancing the goals of maximizing life expectancy and quality of life in this situation. We constructed a Markov-type microsimulation in open-source software. Recurrence rates and quality-of-life parameters were elicited by systematic literature reviews. Sensitivity analyses were performed on key model parameters. Our base case for analysis was a 65-year-old man with low-lying T1N0 rectal cancer. We determined the sensitivity of our model for sex, age up to 80, and T stage. The main outcome measured was quality-adjusted life-years. In the base case, selecting transanal local excision over abdominoperineal resection resulted in a loss of 0.53 years of life expectancy but a gain of 0.97 quality-adjusted life-years. One-way sensitivity analysis demonstrated a health state utility value threshold for permanent colostomy of 0.93. This value ranged from 0.88 to 1.0 based on tumor recurrence risk. There were no other model sensitivities. Some model parameter estimates were based on weak data. In our model, transanal local excision was found to be the preferable approach for most patients. An abdominoperineal resection has a 3.5% longer life expectancy, but this advantage is lost when the quality-of-life reduction reported by stoma patients is weighed in. The minority group in whom abdominoperineal resection is preferred are those who are unwilling to sacrifice 7% of their life expectancy to avoid a permanent stoma. This is estimated to be approximately 25% of all patients. The threshold increases to 12% of life expectancy in high-risk tumors. No other factors are found to be relevant to the decision.

  10. Surgical management of colorectal cancer for the aging population—A survey by the Japanese Society for Cancer of Colon and Rectum

    Directory of Open Access Journals (Sweden)

    Hiroshi Matsuoka

    2018-03-01

    Conclusion: Japanese Society for Cancer of the Colon and Rectum member institutions often used the same surgical treatment strategies for both elderly and younger patients with the exception of performing intersphincteric resection.

  11. A study on planning organ at risk volume for the rectum using cone beam computed tomography in the treatment of prostate cancer

    International Nuclear Information System (INIS)

    Prabhakar, Ramachandran; Oates, Richard; Jones, Daryl; Kron, Tomas; Cramb, Jim; Foroudi, Farshad; Geso, Moshi; Gill, Suki

    2014-01-01

    In this study, we analyzed planning organ at risk volume (PRV) for the rectum using a series of cone beam computed tomographies (CBCTs) acquired during the treatment of prostate cancer and evaluated the dosimetric effect of different PRV definitions. Overall, 21 patients with prostate cancer were treated radically with 78 Gy in 39 fractions had in total 418 CBCTs, each acquired at the end of the first 5 fractions and then every alternate fraction. The PRV was generated from the Boolean sum volume of the rectum obtained from first 5 fractions (PRV-CBCT-5) and from all CBCTs (PRV-CBCT-All). The PRV margin was compared at the superior, middle, and inferior slices of the contoured rectum to compare PRV-CBCT-5 and PRV-CBCT-All. We also compared the dose received by the planned rectum (Rectum-computed tomography [CT]), PRV-CBCT-5, PRV-CBCT-All, and average rectum (CBCT-AV-dose-volume histogram [DVH]) at critical dose levels. The average measured rectal volume for all 21 patients for Rectum-CT, PRV-CBCT-5, and PRV-CBCT-All was 44.3 ± 15.0, 92.8 ± 40.40, and 121.5 ± 36.7 cm 3 , respectively. For PRV-CBCT-All, the mean ± standard deviation displacement in the anterior, posterior, right, and left lateral directions in centimeters was 2.1 ± 1.1, 0.9 ± 0.5, 0.9 ± 0.8, and 1.1 ± 0.7 for the superior rectum; 0.8 ± 0.5, 1.1 ± 0.5, 1.0 ± 0.5, and 1.0 ± 0.5 for the middle rectum; and 0.3 ± 0.3; 0.9 ± 0.5; 0.4 ± 0.2, and 0.5 ± 0.3 for the inferior rectum, respectively. The first 5 CBCTs did not predict the PRV for individual patients. Our study shows that the PRV margin is different for superior, middle, and the inferior parts of the rectum, it is wider superiorly and narrower inferiorly. A uniform PRV margin does not represent the actual rectal variations during treatment for all treatment fractions. The large variation in interpatient rectal size implies a potential role for adaptive radiotherapy for prostate cancer

  12. Analysis of motion of the rectum during preoperative intensity modulated radiation therapy for rectal cancer using cone-beam computed tomography

    International Nuclear Information System (INIS)

    Yamashita, Hideomi; Takenaka, Ryousuke; Sakumi, Akira; Haga, Akihiro; Otomo, Kuni; Nakagawa, Keiichi

    2015-01-01

    The purpose of the present study was to quantify the inter-fractional motion of the rectum and the rectal and bladder volumes using CBCT scans taken during chemoradiation therapy (CRT) for rectal cancer. Also, assessment was made for a better margin for simultaneous integrated boost - intensity modulated radiation therapy (SIB-IMRT) for rectal cancer. There were 32 patients in this study undergoing preoperative CRT for rectal cancer. Each rectum and bladder was contoured on all planning CTs and CBCTs (day 1, 7, 13, 19, 25). The target volume was configured by adding margins (0, 3, 5, 7, 10, and 15 mm) to the rectum on planning CT. The respective percentage of rectal volume that exceeds the target volume was calculated for each of these margins. The percentage of bladder volume that exceeds the bladder volume in the planning CT and motion of the center of gravity of rectum were also analyzed. Planning CTs and series of each 5 CBCTs for 32 patients were analyzed in this study. The rectal volume tended to shrink week after week. The mean values (± SD) in the 32 series per patient of the percentage of rectum on the CBCTs exceeding target volume in which the margins of 0, 3, 5, 7, 10, and 15 mm were added to the rectum on planning CT were 20.7 ± 12.5%, 7.2 ± 8.3%, 3.9 ± 5.9%, 2.1 ± 3.9%, 0.7 ± 1.8%, and 0.1 ± 0.3%, respectively. No association was seen between the percentage of changes of bladder volume and motion of rectal centroid. In this study, we estimated the motion of the rectum using planning CT and CBCT. Ten to fifteen mm is a sufficient margin for the rectum during SIB-IMRT for rectal cancer in the supine position

  13. Word classes

    DEFF Research Database (Denmark)

    Rijkhoff, Jan

    2007-01-01

    in grammatical descriptions of some 50 languages, which together constitute a representative sample of the world’s languages (Hengeveld et al. 2004: 529). It appears that there are both quantitative and qualitative differences between word class systems of individual languages. Whereas some languages employ...... a parts-of-speech system that includes the categories Verb, Noun, Adjective and Adverb, other languages may use only a subset of these four lexical categories. Furthermore, quite a few languages have a major word class whose members cannot be classified in terms of the categories Verb – Noun – Adjective...... – Adverb, because they have properties that are strongly associated with at least two of these four traditional word classes (e.g. Adjective and Adverb). Finally, this article discusses some of the ways in which word class distinctions interact with other grammatical domains, such as syntax and morphology....

  14. Class size versus class composition

    DEFF Research Database (Denmark)

    Jones, Sam

    Raising schooling quality in low-income countries is a pressing challenge. Substantial research has considered the impact of cutting class sizes on skills acquisition. Considerably less attention has been given to the extent to which peer effects, which refer to class composition, also may affect...... bias from omitted variables, the preferred IV results indicate considerable negative effects due to larger class sizes and larger numbers of overage-for-grade peers. The latter, driven by the highly prevalent practices of grade repetition and academic redshirting, should be considered an important...

  15. Primary squamous cell carcinoma of the rectum: An update and implications for treatment

    Science.gov (United States)

    Guerra, Glen R; Kong, Cherng H; Warrier, Satish K; Lynch, Andrew C; Heriot, Alexander G; Ngan, Samuel Y

    2016-01-01

    AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma (SCC). METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert. RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC’s are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-node-metastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external site of primary SCC with metastasis to the rectum. While the

  16. Answer to preoperative chemie radiation in locally advanced rectum cancer; Respuesta a quimioradiacion preoperatoria en cancer de recto localmente avanzado

    Energy Technology Data Exchange (ETDEWEB)

    Villegas Mendez, Silvia [Costa Rica

    2006-07-01

    Study the pre-operative combined therapy effect in the treatment of the rectum cancer cases of the Servicio de Cirugia General 2 of the Hospital Mexico. The study covers since January of 2003 until December of 2005. It has like specific objectives to analyze the effect in the tumour stages, the sphincters preservation and the recurrence. In the conclusions, it notes that the pre-operative chemie-radiation in the rectum cancer is indicated in II and III stages, in which it has showed most advantages for the patient. It describes that the time between the end of pre-operative combined treatment and the surgery must has at least six weeks to guarantee the effect in the tumour and to reduce the treatment toxicity. It concludes besides, that the complication rate after the pre-operative combined therapy and the total meso rectum excision is approximately of 33%; however, the pelvic septic complications can reduce with an ostomy of protection. It focus that the technique of sphincters preservation has showed to be effective and secure if it does a previous selection to the patients in appropriate form. To get an suitable stages must count with trans rectum endoscopic ultrasound and a tomography of suitable quality. It concludes, also, in intervened tumours after of neo-adjuvancy they don't need free distal margins of illness higher to 2 cm. The total meso rectum excision is the updated surgical recommendation in the rectum cancer. [Spanish] Estudia el efecto de la terapia combinada preoperatoria en el tratamiento de los casos de cancer rectal del Servicio de Cirugia General 2 del Hospital Mexico; desde enero del 2003 hasta diciembre del 2005. Tiene como objetivos especificos analizar el efecto en el estadiaje del tumor, la preservacion de esfinteres y la recurrencia. Entre las conclusiones anota que la quimioradiacion preoperatoria en el cancer rectal esta indicada en estadios II y III, en los cuales ha demostrado mayores ventajas para el paciente. Describe que el tiempo

  17. Social Classes

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2018-01-01

    . Although this social structure was ideal in nature and not equally confirmed in other genres of ancient and medieval literature, it has nevertheless had an immense impact on Indian society. The chapter presents an overview of the system with its three privileged classes, the Brahmins, the Kṣatriyas......The notions of class (varṇa) and caste (jāti) run through the dharmaśāstra literature (i.e. Hindu Law Books) on all levels. They regulate marriage, economic transactions, work, punishment, penance, entitlement to rituals, identity markers like the sacred thread, and social interaction in general...

  18. Technical Note: System for evaluating local hypothermia as a radioprotector of the rectum in a small animal model.

    Science.gov (United States)

    Hrycushko, Brian A; Bing, Chenchen; Futch, Cecil; Wodzak, Michelle; Stojadinovic, Strahinja; Medin, Paul M; Chopra, Rajiv

    2017-08-01

    The protective effects of induced or even accidental hypothermia on the human body are widespread with several medical uses currently under active research. In vitro experiments using human cell lines have shown hypothermia provides a radioprotective effect that becomes more pronounced at large, single-fraction doses common to stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) treatments. This work describes the development of a system to evaluate local hypothermia for a radioprotective effect of the rat rectum during a large dose of radiation relevant to prostate SBRT. This includes the evaluation of a 3D-printed small animal rectal cooling device and the integration with a small animal irradiator. A 3-cm long, dual-lumen rectal temperature control apparatus (RTCA) was designed in SOLIDWORKS CAD for 3D printing. The RTCA was capable of recirculating flow in a device small enough for insertion into the rat rectum, with a metal support rod for strength as well as visibility during radiation treatment planning. The outer walls of the RTCA comprised of thin heat shrink plastic, achieving efficient heat transfer into adjacent tissues. Following leak-proof testing, fiber optic temperature probes were used to evaluate the temperature over time when placed adjacent to the cooling device within the rat rectum. MRI thermometry characterized the relative temperature distribution in concentric ROIs surrounding the probe. Integration with an image-guided small animal irradiator and associated treatment planning system included evaluation for imaging artifacts and effect of brass tubing on dose calculation. The rectal temperature adjacent to the cooling device decreased from body temperature to 15°C within 10-20 min from device insertion and was maintained at 15 ± 3°C during active cooling for the evaluated time of one hour. MR thermometry revealed a steep temperature gradient with increasing distance from the cooling device with the desired

  19. Effect of Tangweian Jianji on the Biomechanical and Morphometric Remodeling of Colon and Rectum in STZ Induced Diabetic Rats

    DEFF Research Database (Denmark)

    Sha, Hong; Tong, Xiao-Lin; Liu, Gui-Fang

    2012-01-01

    .01). Furthermore, the circumferential and longitudinal stiffness of the colonic wall increased in DM group compared those with CON group. TH but not TL treatment could significantly decrease the colonic wall stiffness in both directions (P...AIM: The aim of the study was to investigate the effect of TWAJJ on the biomechanical and morphometrical remodeling of colon and rectum in streptozotocin (STZ) induced diabetic rats. METHODS: The colonic and rectal segments obtained from diabetic (DM), TWAJJ treated diabetic (TH, high dosage: 10 g...

  20. A three-dimensional computed tomography-assisted Monte Carlo evaluation of ovoid shielding on the dose to the bladder and rectum in intracavitary radiotherapy for cervical cancer

    International Nuclear Information System (INIS)

    Gifford, Kent A.; Horton, John L.; Pelloski, Christopher E.; Jhingran, Anuja; Court, Laurence E.; Mourtada, Firas; Eifel, Patricia J.

    2005-01-01

    Purpose: To determine the effects of Fletcher Suit Delclos ovoid shielding on dose to the bladder and rectum during intracavitary radiotherapy for cervical cancer. Methods and Materials: The Monte Carlo method was used to calculate the dose in 12 patients receiving low-dose-rate intracavitary radiotherapy with both shielded and unshielded ovoids. Cumulative dose-difference surface histograms were computed for the bladder and rectum. Doses to the 2-cm 3 and 5-cm 3 volumes of highest dose were computed for the bladder and rectum with and without shielding. Results: Shielding affected dose to the 2-cm 3 and 5-cm 3 volumes of highest dose for the rectum (10.1% and 11.1% differences, respectively). Shielding did not have a major impact on the dose to the 2-cm 3 and 5-cm 3 volumes of highest dose for the bladder. The average dose reduction to 5% of the surface area of the bladder was 53 cGy. Reductions as large as 150 cGy were observed to 5% of the surface area of the bladder. The average dose reduction to 5% of the surface area of the rectum was 195 cGy. Reductions as large as 405 cGy were observed to 5% of the surface area of the rectum. Conclusions: Our data suggest that the ovoid shields can greatly reduce the radiation dose delivered to the rectum. We did not find the same degree of effect on the dose to the bladder. To calculate the dose accurately, however, the ovoid shields must be included in the dose model

  1. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  2. A cost-effectiveness analysis of adjuvant therapies for resected adenocarcinoma of the rectum

    International Nuclear Information System (INIS)

    Lee, Jason H.

    1997-01-01

    PURPOSE: Several prospective randomized trials have shown a significant survival advantage with adjuvant chemotherapy and radiation therapy following surgical resection of adenocarcinoma of the rectum. Recent and ongoing trials are evaluating the role of modulated and/or protracted venous infusion [PVI] chemotherapy with pelvic irradiation [PRT]. The economic implications of additional therapies compared with their incremental benefits have not been rigorously analyzed. This study attempts to assess the incremental cost effectiveness of adjuvant therapy over surgery alone, and secondly, adjuvant therapy with PVI delivery systems versus rapid infusion. METHODS: A Markov model was constructed to describe the natural history of rectal carcinoma [stage B2, C] following surgical resection in a hypothetical cohort of 60 year old patients. This model was used to perform two sets of comparisons: [1] surgery alone versus adjuvant bolus fluorouracil [5-FU] with PRT, and [2] bolus 5-FU with PRT versus PVI 5-FU with PRT. Relapse rates and overall survival were derived from an early GITSG trial for the first comparison and from the NCCTG 86-47-51 trial for the second comparison. Medicare reimbursement rates and reports from health maintenance organizations were used to obtain net medical costs of adjuvant treatments, routine follow-up, advanced recurrent disease, and terminal illness as a result of rectal carcinoma. Total years of life and medical costs were projected over an 8-year time horizon for the first comparison [GITSG data] and over a 5-year time horizon for the second comparison [NCCTG data]. Monetary and nonmonetary benefits were discounted at 5% per year. Adjustments for quality of life, costs of adverse effects from treatment, and indirect costs of disease or treatment were not included in this current analysis. RESULTS: The main survival and economic outcomes for each treatment arm in the two comparisons are reported in the table below. For the first comparison

  3. A Monte Carlo study of the impact of the choice of rectum volume definition on estimates of equivalent uniform doses and the volume parameter

    International Nuclear Information System (INIS)

    Kvinnsland, Yngve; Muren, Ludvig Paul; Dahl, Olav

    2004-01-01

    Calculations of normal tissue complication probability (NTCP) values for the rectum are difficult because it is a hollow, non-rigid, organ. Finding the true cumulative dose distribution for a number of treatment fractions requires a CT scan before each treatment fraction. This is labour intensive, and several surrogate distributions have therefore been suggested, such as dose wall histograms, dose surface histograms and histograms for the solid rectum, with and without margins. In this study, a Monte Carlo method is used to investigate the relationships between the cumulative dose distributions based on all treatment fractions and the above-mentioned histograms that are based on one CT scan only, in terms of equivalent uniform dose. Furthermore, the effect of a specific choice of histogram on estimates of the volume parameter of the probit NTCP model was investigated. It was found that the solid rectum and the rectum wall histograms (without margins) gave equivalent uniform doses with an expected value close to the values calculated from the cumulative dose distributions in the rectum wall. With the number of patients available in this study the standard deviations of the estimates of the volume parameter were large, and it was not possible to decide which volume gave the best estimates of the volume parameter, but there were distinct differences in the mean values of the values obtained

  4. Defining probabilities of bowel resection in deep endometriosis of the rectum: Prediction with preoperative magnetic resonance imaging.

    Science.gov (United States)

    Perandini, Alessio; Perandini, Simone; Montemezzi, Stefania; Bonin, Cecilia; Bellini, Gaia; Bergamini, Valentino

    2018-02-01

    Deep endometriosis of the rectum is a highly challenging disease, and a surgical approach is often needed to restore anatomy and function. Two kinds of surgeries may be performed: radical with segmental bowel resection or conservative without resection. Most patients undergo magnetic resonance imaging (MRI) before surgery, but there is currently no method to predict if conservative surgery is feasible or whether bowel resection is required. The aim of this study was to create an algorithm that could predict bowel resection using MRI images, that was easy to apply and could be useful in a clinical setting, in order to adequately discuss informed consent with the patient and plan the an appropriate and efficient surgical session. We collected medical records from 2010 to 2016 and reviewed the MRI results of 52 patients to detect any parameters that could predict bowel resection. Parameters that were reproducible and with a significant correlation to radical surgery were investigated by statistical regression and combined in an algorithm to give the best prediction of resection. The calculation of two parameters in MRI, impact angle and lesion size, and their use in a mathematical algorithm permit us to predict bowel resection with a positive predictive value of 87% and a negative predictive value of 83%. MRI could be of value in predicting the need for bowel resection in deep endometriosis of the rectum. Further research is required to assess the possibility of a wider application of this algorithm outside our single-center study. © 2017 Japan Society of Obstetrics and Gynecology.

  5. Total mesorectum resection and coloanal anastomosis with J colonic reservoir for treatment of medium and low rectum cancer

    International Nuclear Information System (INIS)

    Guerra Mesa, Jose Luis; Vazquez Gonzalez, Jose Manuel; Diaz Salas, Carlos; Perez Penna, Lourdes; Naranjo Hernandez, Daisy

    2010-01-01

    INTRODUCTION: Proctosigmoidectomy with total mesorectum resection, reservoir in J and colorectal is useful in patients with low and middle rectum cancer, to avoid the definite terminal colostomy. The aim of present paper was to analyze the feasibility of such surgical technique, the multidisciplinary integral treatment and the results obtained. METHODS: Fifteen patients were studied suffering of low and middle adenocarcinoma treated between January, 1996 and December, 2002 in Splanchnic Surgery Service of National Institute of Oncology and Radiobiology of La Habana City. Treatment included a combination of radiotherapy plus neocoadjuvant concurrent chemotherapy, followed by adjuvant chemotherapy and surgery. RESULTS: Mean age of patients was of 56 years. The adenocarcinoma was the histological type diagnosed in all patients. Tumor staging the following: T1 and T2, in four patients (27%, respectively); T3 in seven patients (46%). Four patients (20%) had complications due to radiation treatment and five (33,3%), by surgical treatment. Surgical mortality occurred in one patient (6,6%) and eleven patients (73,3%) survived over 5 years. Neither patient had pelvic tumor relapse or by colorectal anastomosis. There was good sphincter continence. CONCLUSIONS: Total mesorectum resection and colorectal anastomosis with a colonic reservoir in J prevent the definite terminal colostomy, to cure a high percentage of patients with low and middle rectum cancer without respecting the oncology surgery principles, is well accepted by patients and it is feasible in our practice. (author)

  6. Major Anaerobic Bacteria Responsible for the Production of Carcinogenic Acetaldehyde from Ethanol in the Colon and Rectum.

    Science.gov (United States)

    Tsuruya, Atsuki; Kuwahara, Akika; Saito, Yuta; Yamaguchi, Haruhiko; Tenma, Natsuki; Inai, Makoto; Takahashi, Seiji; Tsutsumi, Eri; Suwa, Yoshihide; Totsuka, Yukari; Suda, Wataru; Oshima, Kenshiro; Hattori, Masahira; Mizukami, Takeshi; Yokoyama, Akira; Shimoyama, Takefumi; Nakayama, Toru

    2016-07-01

    The importance of ethanol oxidation by intestinal aerobes and facultative anaerobes under aerobic conditions in the pathogenesis of ethanol-related colorectal cancer has been proposed. However, the role of obligate anaerobes therein remains to be established, and it is still unclear which bacterial species, if any, are most important in the production and/or elimination of carcinogenic acetaldehyde under such conditions. This study was undertaken to address these issues. More than 500 bacterial strains were isolated from the faeces of Japanese alcoholics and phylogenetically characterized, and their aerobic ethanol metabolism was studied in vitro to examine their ability to accumulate acetaldehyde beyond the minimum mutagenic concentration (MMC, 50 µM). Bacterial strains that were considered to potentially accumulate acetaldehyde beyond the MMC under aerobic conditions in the colon and rectum were identified and referred to as 'potential acetaldehyde accumulators' (PAAs). Ruminococcus, an obligate anaerobe, was identified as a genus that includes a large number of PAAs. Other obligate anaerobes were also found to include PAAs. The accumulation of acetaldehyde by PAAs colonizing the colorectal mucosal surface could be described, at least in part, as the response of PAAs to oxidative stress. Ethanol oxidation by intestinal obligate anaerobes under aerobic conditions in the colon and rectum could also play an important role in the pathogenesis of ethanol-related colorectal cancer. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  7. Coding Class

    DEFF Research Database (Denmark)

    Ejsing-Duun, Stine; Hansbøl, Mikala

    Denne rapport rummer evaluering og dokumentation af Coding Class projektet1. Coding Class projektet blev igangsat i skoleåret 2016/2017 af IT-Branchen i samarbejde med en række medlemsvirksomheder, Københavns kommune, Vejle Kommune, Styrelsen for IT- og Læring (STIL) og den frivillige forening...... Coding Pirates2. Rapporten er forfattet af Docent i digitale læringsressourcer og forskningskoordinator for forsknings- og udviklingsmiljøet Digitalisering i Skolen (DiS), Mikala Hansbøl, fra Institut for Skole og Læring ved Professionshøjskolen Metropol; og Lektor i læringsteknologi, interaktionsdesign......, design tænkning og design-pædagogik, Stine Ejsing-Duun fra Forskningslab: It og Læringsdesign (ILD-LAB) ved Institut for kommunikation og psykologi, Aalborg Universitet i København. Vi har fulgt og gennemført evaluering og dokumentation af Coding Class projektet i perioden november 2016 til maj 2017...

  8. A new type of defecation disorder due to insufficient fixation of the rectum to the sacrum is improved by rectopexy: A report of three cases

    Directory of Open Access Journals (Sweden)

    Wataru Sumida

    2016-07-01

    Full Text Available Chronic constipation is the most common clinical disorder in children. However, some cases of constipation do not meet the criteria defined by Rome III. We encountered such defecation disorders in three patients who presented with constipation as a chief complaint along with excessive strain and bleeding hemorrhoids during defecation despite normal stools. Contrast enema revealed that the rectum was separated from the sacrum in each patient, which may have been caused by insufficient fixation of the rectum. Conservative treatment with laxatives and suppositories failed to achieve improvement. Therefore, all underwent a laparoscopic rectopexy. After surgery, each patient was able to evacuate without strain and the hemorrhoids disappeared. Insufficient fixation of the rectum should be considered as a potential cause of defecation disorders. Rectopexy is effective for this type of defecation disorder.

  9. {sup 18}F-FDG-Avid Adenocarcinoma of the Rectum Presenting as a Subtle Filling Defect on Maximum Intensity Projection Image: Report of a Case

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee; Lee, Kwang Chan [SungAe General Hospital, Seoul (Korea, Republic of)

    2009-04-15

    {sup 18}F-FDG avid polypoid or tumefacient carcinomas of the gastrointestinal (GI) tract including the rectum are characteristically featured on PET-CT as an intraluminal tumor surrounded by completely or partially cleared background. However, the carcinomas of intramural or sessile variant may not so easily be detected especially when tumors are obliterated by feces or mucus retained in the host bowel loop. Recently, we observed a case of cauliflower-like adenocarcinoma of the rectum that was diagnosed by noting a subtle, flat filling defect created against the background of 'black' feces-mucus filled rectum. To our knowledge such a 'filling defect' produced by sessile tumor has not previously been reported as a useful diagnostic sign of GI tract carcinoma on PET-CT.

  10. Neoadjuvant chemoradiotherapy in the advanced rectum cancers. Results of a retrospective study. Rate of sphincter preservation; Chimioradiotherapie neoadjuvante dans les cancers avances du rectum. Resultats d'une etude retrospective. Taux de preservation sphincterienne

    Energy Technology Data Exchange (ETDEWEB)

    Ayad, M.; Rabahi, K.; Mesli, S.; Boualga, K. [Centre anticancer, Blida (Algeria)

    2009-10-15

    Objectives: the concomitant chemoradiotherapy given before surgery improves the therapeutic results in the evolved cancers of the rectum v( classified T3-T4 clinically and/or N+). We report our experience for 114 patients that received a preoperative radiotherapy associated to the 5-fluoro-uracil-folinic acid (fufol) or 5-fluoro-uracil-oxaliplatin (Folfox) type chemotherapy. The other objective of this study was to determine the sphincter preservation rate for the patients suffering of a low rectal tumor. This retrospective study showed a good tolerance and an acceptable toxicity for the patient. The adjuvant chemoradiotherapy allowed a down staging and a conservation of the sphincter function for the patient suffering of a very low tumor. (N.C.)

  11. Preoperative irradiation for carcinoma of the rectum and rectosigmoid colon: report of a national veterans adminstration randomized study

    International Nuclear Information System (INIS)

    Roswit, B.; Higgins, G.A.; Keehn, R.J.

    1975-01-01

    In 1964 the Veterans Administration Surgical Adjuvant Group (VASAG) initiated a large-scale, controlled, randomized protocol to study the role of low-dose preoperative irradiation (2000 to 2500 rads/10 fractions/12 days) in patients with operable adenocarcinoma of the sigmoid colon and rectum. This report analyzes the data in 700 patients, all at 5-year risk. There appears to be a definite benefit to irradiated patients who undergo abdominoperineal resections, when compared with the controls. This advantage is reflected in improvement of 5-year survival, and reductions in lymph node invasion, local recurrence, and distant metastases. A second protocol has been initiated in 30 VA hospitals employing a higher dose (3150 rads) to extended portals (to L2) to male patients who require abdominoperineal resections. (U.S.)

  12. Wandering Fish Bone: a Case of Pelvic Abscess due to Rectum Perforation Resulting from an Accidental Fish Bone Ingestion

    Directory of Open Access Journals (Sweden)

    Sirous Abbasi

    2010-09-01

    Full Text Available Fish bone is the most common foreign body that is ingested accidentally and can be caused gastrointestinal complications such as perforation, abstraction, and abscess. We describe a 75-year-old man who suffered from constipation, diarrhea, and fever and chills for 3 months. He had mild tenderness in hypogasteric region and also mild tenderness and swelling on anterior rectal wall and prostate upon clinical examination. The abdominal and pelvic sonography and CT scan findings suggested existence of abscess in the space of between bladder and rectum. The patient underwent laparotomy to drainage the pelvic abscess. The surgeon found a 6-cm fish bone which was embedded in the abscess. The presented case indicated the importance of accidental fish bone ingestion and its possible complications. In addition, the patients with abdominal pain, GI bleeding, and fever of unknown origin living in the seaside regions, the wandering fish bone as a differential diagnosis should be kept in mind.

  13. Effect of various methods for rectum delineation on relative and absolute dose-volume histograms for prostate IMRT treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Kusumoto, Chiaki [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ohira, Shingo [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita (Japan); Miyazaki, Masayoshi [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ueda, Yoshihiro [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Radiation Oncology, Graduate School of Medicine, Osaka University, Suita (Japan); Isono, Masaru [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Teshima, Teruki, E-mail: teshima-te@mc.pref.osaka.jp [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)

    2016-07-01

    Several reports have dealt with correlations of late rectal toxicity with rectal dose-volume histograms (DVHs) for high dose levels. There are 2 techniques to assess rectal volume for reception of a specific dose: relative-DVH (R-DVH, %) that indicates relative volume for a vertical axis, and absolute-DVH (A-DVH, cc) with its vertical axis showing absolute volume of the rectum. The parameters of DVH vary depending on the rectum delineation method, but the literature does not present any standardization of such methods. The aim of the present study was to evaluate the effects of different delineation methods on rectal DVHs. The enrollment for this study comprised 28 patients with high-risk localized prostate cancer, who had undergone intensity-modulated radiation therapy (IMRT) with the prescription dose of 78 Gy. The rectum was contoured with 4 different methods using 2 lengths, short (Sh) and long (Lg), and 2 cross sections, rectum (Rec) and rectal wall (Rw). Sh means the length from 1 cm above the seminal vesicles to 1 cm below the prostate and Lg the length from the rectosigmoid junction to the anus. Rec represents the entire rectal volume including the rectal contents and Rw the rectal volume of the area with a wall thickness of 4 mm. We compared dose-volume parameters by using 4 rectal contour methods for the same plan with the R-DVHs as well as the A-DVHs. For the high dose levels, the R-DVH parameters varied widely. The mean of V{sub 70} for Sh-Rw was the highest (19.4%) and nearly twice as high as that for Lg-Rec (10.4%). On the contrary, only small variations were observed in the A-DVH parameters (4.3, 4.3, 5.5, and 5.5 cc for Sh-Rw, Lg-Rw, Sh-Rec, and Lg-Rec, respectively). As for R-DVHs, the parameters of V{sub 70} varied depending on the rectal lengths (Sh-Rec vs Lg-Rec: R = 0.76; Sh-Rw vs Lg-Rw: R = 0.85) and cross sections (Sh-Rec vs Sh-Rw: R = 0.49; Lg-Rec vs Lg-Rw: R = 0.65). For A-DVHs, however, the parameters of Sh rectal A-DVHs hardly changed

  14. Toward a definition of a threshold for harmless doses to the anal-sphincter region and the rectum

    International Nuclear Information System (INIS)

    Al-Abany, Massoud; Helgason, Asgeir R.; Agren Cronqvist, Anna-Karin; Lind, Bengt; Mavroidis, Panayiotis; Wersaell, Peter; Lind, Helena; Qvanta, Eva; Steineck, Gunnar

    2005-01-01

    Purpose: To investigate dysfunction caused by unwanted radiation to the anal-sphincter region and the rectum. Methods and materials: A questionnaire assessing bowel symptoms, sexual function, and urinary symptoms was sent to 72 patients with clinically localized prostatic adenocarcinoma treated by external beam radiation therapy at the Radiumhemmet, Karolinska Hospital, in Stockholm, Sweden, 2-4 years after treatment. The mean percentage dose-volume histograms for patients with and without the specific symptom were calculated. Results: Of the 65 patients providing information, 9 reported fecal leakage, 10 blood and mucus in stools, 10 defecation urgency, and 7 diarrhea or loose stools. None of the 19 and 13 patients who received, respectively, a dose of ≥35 Gy to ≤60% or ≥40 Gy to ≤40% of the anal-sphincter region volume reported fecal leakage (p < 0.05). In dose-volume histograms, a statistically significant correlation was found between radiation to the anal-sphincter region and the risk of fecal leakage in the interval 45-55 Gy. There was also a statistically significant correlation between radiation to the rectum and the risk of defecation urgency and diarrhea or loose stools in the interval 25-42 Gy. No relationship was found between anatomic rectal wall volume and the investigated late effects. Conclusions: Although the limited data in this study prevent the definition of a conclusive threshold regarding volume and dose to the anal-sphincter region and untoward morbidity, it seems that careful monitoring of unnecessary irradiation to this area should be done because it can potentially help reduce the risk of adverse effects, such as fecal leakage. Future studies should pay more attention to the anal-sphincter region and help to more rigorously define its radiotherapeutic tolerance

  15. Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem.

    Science.gov (United States)

    Felt-Bersma, R J; Sloots, C E; Poen, A C; Cuesta, M A; Meuwissen, S G

    2000-12-01

    The clinical impact of rectal compliance and sensitivity measurement is not clear. The aim of this study was to measure the rectal compliance in different patient groups compared with controls and to establish the clinical effect of rectal compliance. Anorectal function tests were performed in 974 consecutive patients (284 men). Normal values were obtained from 24 controls. Rectal compliance measurement was performed by filling a latex rectal balloon with water at a rate of 60 ml per minute. Volume and intraballoon pressure were measured. Volume and pressure at three sensitivity thresholds were recorded for analysis: first sensation, urge, and maximal toleration. At maximal toleration, the rectal compliance (volume/pressure) was calculated. Proctoscopy, anal manometry, anal mucosal sensitivity, and anal endosonography were also performed as part of our anorectal function tests. No effect of age or gender was observed in either controls or patients. Patients with fecal incontinence had a higher volume at first sensation and a higher pressure at maximal toleration (P = 0.03), the presence of a sphincter defect or low or normal anal pressures made no difference. Patients with constipation had a larger volume at first sensation and urge (P 500 ml had complaints of constipation. No correlation between rectal and anal mucosal sensitivity was found. Rectal compliance measurement with a latex balloon is easily feasible. In this series of 974 patients, some patient groups showed an abnormal rectal visceral sensitivity and compliance, but there was an overlap with controls. Rectal compliance measurement gave a good clinical impression about the contribution of the rectum to the anorectal problem. Patients with proctitis and pouchitis had the smallest rectal compliance. A maximal toleration volume 500 ml was only seen in constipated patients, and therapy should be given to prevent further damage to the pelvic floor. Values close to or within the normal range rule out the

  16. MANUAL COLON-ANAL OR MECHANICAL COLORECTAL ANASTOMOSIS? COMPARATIVE ANALYSIS OF LAPAROSCOPIC LOW RESECTIONS OF THE RECTUM

    Directory of Open Access Journals (Sweden)

    I. L. Chernikovsky

    2015-01-01

    Full Text Available The purpose of the study was to compare immediate surgical outcomes of low anterior resections (LAR and intersphincteric resections (ISR of the rectum. Materials and methods. Treatment outcomes of 42 patients operated on between March, 2014 and January, 2015 were presented. Group I consisted of 24 patients who underwent laparoscopic ultra-low anterior resection (uLAR for rectal cancer. Group II comprised 18 patients who underwent laparoscopic ISR. Results. No significant differences in the median length of surgery and blood loss between two groups were observed. Circular and distal resection margins were negative in all cases. In 18 (75 % patients of Group I and in 14 (77.7 % patients of Group II, total mesorectumectomy(TME was assessed as grade 3 (p=0.83. The frequency of postoperative complications in uLAR-treated group was 20.8 %, not requiring a secondary revision procedure, and 27.8 % in ISR-treated group, requiring repeated surgery. The mean value of the fecal incontinence according to the Wechsler scale in a month after surgery was significantly higher in group II than in Group I patients (9.3 versus 6.2, р=0.01. The average treatment cost for uLAR was higher by 45,000 rubles than that for ISR. Conclusion. Both surgical procedures were matched by the duration of operation, amount of blood loss and the quality of mesorectumectomy. The complication rate was not significantly different between two groups, however, 16.8 % of Group II patients required relaparotomy, likely due to the mastering of the ISR technique. Ultra-low anterior resections of the rectum are functionally preferred. When performing ISR, the technique of reservoir colo-anal anastomosis with preservation of the portion of the internal sphincter provides functional results comparable with those obtained using LAR.

  17. Modeling volume effects of experimental brachytherapy in the rat rectum: uncovering the limitations of a radiobiologic concept

    International Nuclear Information System (INIS)

    Johannessen, Hans-Olaf; Dale, Einar; Hellebust, Taran P.; Olsen, Dag R.; Nesland, Jahn M.; Giercksky, Karl-Erik

    2002-01-01

    Purpose: To analyze the significance of volume effects in experimental brachytherapy, based on modeling normal tissue complication probability. Methods and Materials: Experimental brachytherapy in the rat rectum was based on an eight-step 2.5-mm step size source configuration for 192 Ir, afterloaded into an unshielded polystyrene applicator. Volume effects were studied using a half-circumferential lead-shielded applicator and a shorter (two-step) source configuration. The main end point was rectal stenosis. Results: Rectal stenosis was always caused by a radiation ulcer. With the shielded configuration, single-dose ED 50 (50% incidence of rectal stenosis) increased from 23 Gy to 36.5 Gy. Single-dose ED 50 for the short configuration was 77.9 Gy. The data showed a reasonable fit to a three-parameter version of the biophysical model described by Jackson et al. (1995). This model assumes that organs consist of a large number of radiobiologically independent subunits and that radiation causes a complication if the fraction of the organ damaged is greater than its functional reserve. The fraction of the organ damaged is calculated summing over fractions of the organ damaged at each dose level. The calculated mean functional reserve (ν 50 ) of the rat rectum, assuming a cumulative functional reserve distribution in the group of experimental rats, was 0.53. Conclusions: The volume effect observed within small brachytherapy volumes agreed well with clinical experience of large tolerance doses in contact X-ray therapy. However, the ν 50 value was comparable to the high functional reserve value reported for liver. Experimental volume effects probably reflect repair processes originating in the areas adjacent to small radiation fields of brachytherapy more than the radiobiologic characteristics of the cells in the irradiated volume

  18. Pneumaturia signaling a fistula between the rectum anastomosis and seminal vesicle as a complication after transanal endorectal pull-through operation for Hirschsprung's disease. A method of repair

    Directory of Open Access Journals (Sweden)

    Christina Granéli

    2014-09-01

    Full Text Available A 2-year-old boy underwent an uneventful transanal endorectal pull-through for Hirschsprung's disease. Postoperatively he suffered from pneumaturia which prompted surgical evaluation. He was found to have a rectum to seminal vesicle fistula. He was re-operated closing the fistula through an anterior transperineal approach with a successful operative outcome.

  19. Magnetic Resonance Imaging (MRI) with retrograde intralumen contrast enhancement of the rectum in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer. Experience of application

    Science.gov (United States)

    Usova, A.; Frolova, I.; Afanasev, S.; Tarasova, A.; Molchanov, S.

    2016-02-01

    Experiment of use of MRI in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer is shown on clinical examples. We used retrograde contrasting of a rectum with 150ml ultrasonic gel to make MRI more informative in case of low diagnostic efficiency of ultrasound, colonoscopy and gynecological examination.

  20. Influence of volumes of prostate, rectum, and bladder on treatment planning CT on interfraction prostate shifts during ultrasound image-guided IMRT

    International Nuclear Information System (INIS)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Sartin, William; Maiorano, Samuel; Modena, Jennifer; Mazur, Andrej; Osian, Adrian; Sood, Brijmohan; Ravi, Akkamma; Sampath, Seshadri; Lange, Christopher S.

    2009-01-01

    Purpose: The purpose of this study was to analyze the relationship between prostate, bladder, and rectum volumes on treatment planning CT day and prostate shifts in the XYZ directions on treatment days. Methods: Prostate, seminal vesicles, bladder, and rectum were contoured on CT images obtained in supine position. Intensity modulated radiation therapy plans was prepared. Contours were exported to BAT-ultrasound imaging system. Patients were positioned on the couch using skin marks. An ultrasound probe was used to obtain ultrasound images of prostate, bladder, and rectum, which were aligned with CT images. Couch shifts in the XYZ directions as recommended by BAT system were made and recorded. 4698 couch shifts for 42 patients were analyzed to study the correlations between interfraction prostate shifts vs bladder, rectum, and prostate volumes on planning CT. Results: Mean and range of volumes (cc): Bladder: 179 (42-582), rectum: 108 (28-223), and prostate: 55 (21-154). Mean systematic prostate shifts were (cm, ±SD) right and left lateral: -0.047±0.16 (-0.361-0.251), anterior and posterior: 0.14±0.3 (-0.466-0.669), and superior and inferior: 0.19±0.26 (-0.342-0.633). Bladder volume was not correlated with lateral, anterior/posterior, and superior/inferior prostate shifts (P>0.2). Rectal volume was correlated with anterior/posterior (P 0.2). The smaller the rectal volume or cross sectional area, the larger was the prostate shift anteriorly and vice versa (P 0.2). The smaller the prostate volume, the larger was prostate shift superiorly and vice versa (P<0.05). Conclusions: Prostate and rectal volumes, but not bladder volumes, on treatment planning CT influenced prostate position on treatment fractions. Daily image-guided adoptive radiotherapy would be required for patients with distended or empty rectum on planning CT to reduce rectal toxicity in the case of empty rectum and to minimize geometric miss of prostate.

  1. SU-E-J-103: Propagation of Rectum and Bladder Contours for Tandem and Ring (T&R) HDR Treatment Using Deformable Image Registration

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Y; Chao, M; Sheu, R; Dumane, V; Gupta, V; Lo, Y [Mount Sinai Medical Center, New York, NY (United States)

    2015-06-15

    Purpose: To investigate the feasibility of using DIR to propagate the manually contoured rectum and bladder from the 1st insertion to the new CT images on subsequent insertions and evaluate the segmentation performance. Methods: Ten cervical cancer patients, who were treated by T&R brachytherapy in 3–4 insertions, were retrospectively collected. In each insertion, rectum and bladder were manually delineated on the planning CT by a physicist and verified by a radiation oncologist. Using VelocityAI (Velocity Medical Solutions, Atlanta, GA), a rigid registration was firstly employed to match the bony structures between the first insertion and each of the following insertions, then a multi-pass B-spine DIR was carried out to further map the sub volume that encompasses rectum and bladder. The resultant deformation fields propagated contours, and dice similarity coefficient (DSC) was used to quantitatively evaluate the agreement between the propagated contours and the manually-delineated organs. For the 3rd insertion, we also evaluated if the segmentation performance could be improved by propagating the contours from the most recent insertion, i.e., the 2nd insertion. Results: On average, the contour propagation took about 1 minute. The average and standard deviation of DSC over all insertions and patients was 0.67±0.10 (range: 0.44–0.81) for rectum, and 0.78±0.07 (range: 0.63–0.87) for bladder. For the 3rd insertion, propagating contours from the 2nd insertion could improve the segmentation performance in terms of DSC from 0.63±0.10 to 0.72±0.08 for rectum, and from 0.77±0.07 to 0.79±0.06 for bladder. A Wilcoxon signed rank test indicated that the improvement was statistically significant for rectum (p = 0.004). Conclusion: The preliminary results demonstrate that deformable image registration could efficiently and accurately propagate rectum and bladder contours between CT images in different T&R brachytherapy fractions. We are incorporating the propagated

  2. SU-F-J-217: Accurate Dose Volume Parameters Calculation for Revealing Rectum Dose-Toxicity Effect Using Deformable Registration in Cervical Cancer Brachytherapy: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Zhen, X; Chen, H; Liao, Y; Zhou, L [Southern Medical University, Guangzhou, Guangdong (China); Hrycushko, B; Albuquerque, K; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: To study the feasibility of employing deformable registration methods for accurate rectum dose volume parameters calculation and their potentials in revealing rectum dose-toxicity between complication and non-complication cervical cancer patients with brachytherapy treatment. Method and Materials: Data from 60 patients treated with BT including planning images, treatment plans, and follow-up clinical exam were retrospectively collected. Among them, 12 patients complained about hematochezia were further examined with colonoscopy and scored as Grade 1–3 complication (CP). Meanwhile, another 12 non-complication (NCP) patients were selected as a reference group. To seek for potential gains in rectum toxicity prediction when fractional anatomical deformations are account for, the rectum dose volume parameters D0.1/1/2cc of the selected patients were retrospectively computed by three different approaches: the simple “worstcase scenario” (WS) addition method, an intensity-based deformable image registration (DIR) algorithm-Demons, and a more accurate, recent developed local topology preserved non-rigid point matching algorithm (TOP). Statistical significance of the differences between rectum doses of the CP group and the NCP group were tested by a two-tailed t-test and results were considered to be statistically significant if p < 0.05. Results: For the D0.1cc, no statistical differences are found between the CP and NCP group in all three methods. For the D1cc, dose difference is not detected by the WS method, however, statistical differences between the two groups are observed by both Demons and TOP, and more evident in TOP. For the D2cc, the CP and NCP cases are statistically significance of the difference for all three methods but more pronounced with TOP. Conclusion: In this study, we calculated the rectum D0.1/1/2cc by simple WS addition and two DIR methods and seek for gains in rectum toxicity prediction. The results favor the claim that accurate dose

  3. Effect of the γ-IFN on radiation damage and radiation fibrosis of the rabbit rectum after cavitas pelvisrute fractionated irradiation

    International Nuclear Information System (INIS)

    Yang Yunyi; Zhang Li; Wang Juan; Zhao Hengfang; Dai Li; Liu Zi

    2009-01-01

    Objective: To investigate the effect of γ-IFN on the radiation-induced injury and fibrosis of the rabbit rectum after the fractionated irradiation to pelvic cavity. Methods: The animal model of radiation rectum injury was established. 52 New Zealand rabbits were divided into 3 groups as the normal control group, the conventional radiation group, and γ-IFN group. Except the normal control group, the pelvic cavity of the two other groups were irradiated with 6 MV X-rays. At 5 d post-irradiatio the γ-IFN group was administered with 250 000 U/kg of γ-IFN once a week, while the conventional radiation group with 5 ml of saline solution. The rabbits were executed after 4, 8, 12 and 16 weeks, and the recta in the irradiated field were taken out. HE dyeing, in-situ hybridization and immuno-histochemical methods were used to analyze the radiation-induced rectrum injury and fibrosis. Results: At 4, 8, and 12 weeks post-irradiation, the radiation rectum injury and fibrosis were significantly different between the conventional radiation group and γ-IFN group(P 0.05) . At 4, 8, 12 and 16 weeks post-irradiation, the expression of TGF-β1 mRNA in-situ hybridization in the γ-IFN group were significantly different compared to the conventional radiation group and the normal control group (P <0.05) . The immuno-histochemical results of Col III showed the significant difference among the γ-IFN group and both the normal control group and conventional radiation group ( P < 0.05). Conclusions: γ-IFN could reduce the radiation rectum injury, suppress the expression of TGF-β1 mRNA in the rectum mucosa, inhibit the expression of Col III, and delay the formation of radiation-induced fibrosis. (authors)

  4. Dosimetric evaluation of rectum and bladder using image-based CT planning and orthogonal radiographs with ICRU 38 recommendations in intracavitary brachytherapy

    Directory of Open Access Journals (Sweden)

    Jamema Swamidas

    2008-01-01

    Full Text Available The purpose is to compare CT-based dosimetry with International Commission on Radiation Units and Measurements (ICRU 38 bladder and rectum reference points in patients of carcinoma of uterine cervix treated with intracavitary brachytherapy (ICA. Twenty-two consecutive patients were evaluated. Orthogonal radiographs and CT images were acquired and transferred to PLATO planning system. Bladder and rectal reference points were identified according to ICRU 38 recommendations. Dosimetry was carried out based on Manchester system. Patient treatment was done using 192 Iridium high dose rate (HDR remote after-loading machine based on the conventional radiograph-based dosimetry. ICRU rectal and bladder point doses from the radiograph plans were compared with D 2 , dose received by 2 cm 3 of the organ receiving maximum dose from CT plan. V 2 , volume of organ receiving dose more than the ICRU reference point, was evaluated. The mean (±standard deviation volume of rectum and bladder was 60 (±28 cm 3 and 138 (±41 cm 3 respectively. The mean reference volume in radiograph and CT plan was 105 (±7 cm 3 and 107 (±7 cm 3 respectively. It was found that 6 (±4 cm3 of rectum and 16 (±10 cm 3 of bladder received dose more than the prescription dose. V2 of rectum and bladder was 7 (±1.7 cm 3 and 20.8 (±6 cm 3 respectively. Mean D 2 of rectum and bladder was found to be 1.11 (±0.2 and 1.56 (±0.6 times the mean ICRU reference points respectively. This dosimteric study suggests that comparison of orthogonal X-ray-based and CT-based HDR ICA planning is feasible. ICRU rectal point dose correlates well with maximum rectal dose, while ICRU bladder point underestimates the maximum bladder dose.

  5. SU-F-T-447: The Impact of Treatment Planning Methods On RapidPlan Modeling for Rectum Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lu, S; Peng, J; Li, K; Wang, J; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

    2016-06-15

    Purpose: To investigate the dose volume histogram (DVH) prediction varieties based on intensity modulate radiotherapy (IMRT) plan or volume arc modulate radiotherapy (VMAT) plan models on the RapidPlan. Methods: Two DVH prediction models were generated in this study, including an IMRT model trained from 83 IMRT rectum plans and a VMAT model trained from 60 VMAT rectum plans. In the internal validation, 20 plans from each training database were selected to verify the clinical feasibility of the model. Then, 10 IMRT plans (PIMRT-by-IMRT-model) generated from IMRT model and 10 IMRT plans generated from VMAT model (PIMRT-by-VMAT-model) were compared on the dose to organs at risk (OAR), which included bladder, left and right femoral heads. The similar comparison was also performed on the VMAT plans generated from IMRT model (PVMAT-by-IMRT-model) and VMAT plans generated from VMAT (PVMAT-by-VMAT-model) model. Results: For the internal validation, all plans from IMRT or VMAT model shows significantly improvement on OAR sparing compared with the corresponded clinical ones. Compared to the PIMRT-by-VMAT-model, the PIMRT-by-IMRT-model has a reduction of 6.90±3.87%(p<0.001) on V40 6.63±3.62%(p<0.001) on V45 and 4.74±2.26%(p<0.001) on V50 in bladder; and a mean dose reduction of 2.12±1.75Gy(p=0.004) and 2.84±1.53Gy(p<0.001) in right and left femoral head, respectively. There was no significant difference on OAR sparing between PVMAT-by-IMRT-model and PVMAT-by-VMAT-model. Conclusion: The IMRT model for the rectal cancer in the RapidPlan can be applied to for VMAT planning. However, the VMAT model is not suggested to use in the IMRT planning. Cautions should be taken that the planning model based on some technique may not feasible to other planning techniques.

  6. SU-E-T-284: Dose Plan Optimization When Using Hydrogel Prostate-Rectum Spacer: A Single Institution Experience

    Energy Technology Data Exchange (ETDEWEB)

    Rajecki, M; Thurber, A; Catalfamo, F; Duff, M; Shah, D [Cancer Care of Western New York, Cheektowaga, NY (United States)

    2015-06-15

    Purpose: To describe rectal dose reduction achieved and techniques used to take advantage of the increased peri-rectal spacing provided by injected polyethylene-glycol. Methods: Thirty prostate cancer patents were 2:1 randomized during a clinical trial to evaluate the effectiveness of injected poly-ethylene glycol hydrogel (SpaceOAR System) in creating space between the prostate and the anterior rectal wall. All patients received a baseline CT/MR scan and baseline IMRT treatment plan. Patients were randomized to receive hydrogel injection (n=20) or Control (n=10), followed by another CT/MR scan and treatment plan (single arc VMAT, 6 MV photons, 79.2 Gy, 44 fractions). Additional optimization structures were employed to constrain the dose to the rectum; specifically an avoidance structure to limit V75 <15%, and a control structure to limit the maximum relative dose <105% in the interface region of the anterior rectal wall and the prostate planning target volume. Dose volumetric data was analyzed for rectal volumes receiving 60 through 80 Gy. Results: Rectal dose reduction was observed in all patients who received the hydrogel. Volumetric analysis indicates a median rectal volume and (reduction from baseline plan) following spacer application of 4.9% (8.9%) at V60Gy, 3.8% (8.1%) at V65Gy, 2.5% (7.2%) at V70Gy, 1.6% (5.8%) at V75Gy, and 0.5% (2.5%) at V80Gy. Conclusion: Relative to planning without spacers, rectal dose constraints of 5%, 4%, 3%, 2%, 1% for V60, V65, V70, V75, and V80, should be obtainable when peri-rectal spacers are used. The combined effect of increased peri-rectal space provided by the hydrogel, with strict optimization objectives, resulted in reduced dose to the rectum. To maximize benefit, strict optimization objectives and reduced rectal dose constraints should be employed when creating plans for patients with perirectal spacers. Clinical Trial for SpaceOAR product conducted by Augmenix,Inc. The research site was paid to be a participating site.

  7. A PROSPECTIVE STUDY ON PREOPERATIVE CONCURRENT CHEMORADIATION WITH CAPECITABINE IN STAGE II/III CARCINOMA OF RECTUM

    Directory of Open Access Journals (Sweden)

    Anish Kuttappan Soman

    2017-09-01

    Full Text Available BACKGROUND Fluorouracil (5-FU based chemoradiotherapy represents the standard treatment option for the preoperative treatment of advanced rectal cancer. Capecitabine is an oral precursor of 5-FU with the advantage of delivering the chemotherapy in an outpatient setup. NSABP R-04 & a German phase 3 trial by Hofheinz et al showed that Capecitabine was equivalent to 5-FU. The primary objective of this study was to evaluate pathological response (PR, clinical & surgical outcomes of stage II & III patients treated with chemoradiation with Capecitabine. The secondary objective was to evaluate toxicity and compliance to treatment. MATERIALS AND METHODS This single arm prospective study included 35 patients with stages II & III adenocarcinoma of rectum who after evaluation were treated with pelvic radiotherapy and concurrent Capecitabine. Toxicities were graded using RTOG scoring criteria. Clinical response was assessed after EBRT completion, and patients were referred for surgery after 4-6 weeks. Pathologic response and completeness of resection were assessed from the histopathology report. RESULTS Growth located within 5 cm from anal verge was seen in 24 (68.5% patients and 6 were inoperable upfront. All patients completed the intended preoperative treatment and 88.6% did not have any toxicity related break in RT. Clinical response was seen in 80% of patients after Chemoradiation. Out of 35 treated 80% of them underwent surgery. APR was performed in 64.2% and 35.7% had LAR. Out of 6 upfront inoperable patients, 3 were converted to operable. Out of 23 APR cases, 7 were converted to anterior resection (30.4%, p=0.046. 96% of operated patients had an R0 resection, including all the 3 upfront inoperable patients. Minimal pathologic response was seen in 89.2% of patients and 7.14% had complete pathologic response. There were no Grade 4 or 5 toxicities. Only 2.9% had a Grade 3 event. 45.7% had maximum of Grade 1 events and 48.6% had maximum of Grade 2

  8. SU-E-T-284: Dose Plan Optimization When Using Hydrogel Prostate-Rectum Spacer: A Single Institution Experience

    International Nuclear Information System (INIS)

    Rajecki, M; Thurber, A; Catalfamo, F; Duff, M; Shah, D

    2015-01-01

    Purpose: To describe rectal dose reduction achieved and techniques used to take advantage of the increased peri-rectal spacing provided by injected polyethylene-glycol. Methods: Thirty prostate cancer patents were 2:1 randomized during a clinical trial to evaluate the effectiveness of injected poly-ethylene glycol hydrogel (SpaceOAR System) in creating space between the prostate and the anterior rectal wall. All patients received a baseline CT/MR scan and baseline IMRT treatment plan. Patients were randomized to receive hydrogel injection (n=20) or Control (n=10), followed by another CT/MR scan and treatment plan (single arc VMAT, 6 MV photons, 79.2 Gy, 44 fractions). Additional optimization structures were employed to constrain the dose to the rectum; specifically an avoidance structure to limit V75 <15%, and a control structure to limit the maximum relative dose <105% in the interface region of the anterior rectal wall and the prostate planning target volume. Dose volumetric data was analyzed for rectal volumes receiving 60 through 80 Gy. Results: Rectal dose reduction was observed in all patients who received the hydrogel. Volumetric analysis indicates a median rectal volume and (reduction from baseline plan) following spacer application of 4.9% (8.9%) at V60Gy, 3.8% (8.1%) at V65Gy, 2.5% (7.2%) at V70Gy, 1.6% (5.8%) at V75Gy, and 0.5% (2.5%) at V80Gy. Conclusion: Relative to planning without spacers, rectal dose constraints of 5%, 4%, 3%, 2%, 1% for V60, V65, V70, V75, and V80, should be obtainable when peri-rectal spacers are used. The combined effect of increased peri-rectal space provided by the hydrogel, with strict optimization objectives, resulted in reduced dose to the rectum. To maximize benefit, strict optimization objectives and reduced rectal dose constraints should be employed when creating plans for patients with perirectal spacers. Clinical Trial for SpaceOAR product conducted by Augmenix,Inc. The research site was paid to be a participating site

  9. Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Crevoisier, Renaud de; Tucker, Susan L.; Dong Lei; Mohan, Radhe; Cheung, Rex; Cox, James D.; Kuban, Deborah A.

    2005-01-01

    Purpose: To retrospectively test the hypothesis that rectal distension on the planning computed tomography (CT) scan is associated with an increased risk of biochemical and local failure among patients irradiated for prostate carcinoma when a daily repositioning technique based on direct prostate-organ localization is not used. Methods and Materials: This study included 127 patients who received definitive three-dimensional conformal radiotherapy for prostate cancer to a total dose of 78 Gy at University of Texas M.D. Anderson Cancer Center. Rectal distension was assessed by calculation of the average cross-sectional rectal area (CSA; defined as the rectal volume divided by length) and measuring three rectal diameters on the planning CT. The impact of rectal distension on biochemical control, 2-year prostate biopsy results, and incidence of Grade 2 or greater late rectal bleeding was assessed. Results: The incidence of biochemical failure was significantly higher among patients with distended rectums (CSA >11.2 cm 2 ) on the planning CT scan (p 0.0009, log-rank test). Multivariate analysis indicates that rectal distension and high-risk disease are independent risk factors for biochemical failure, with hazard ratios of 3.89 (95% C.I. 1.58 to 9.56, p = 0.003) and 2.45 (95% C.I. 1.18 to 5.08, p = 0.016), respectively. The probability of residual tumor without evidence of radiation treatment (as scored by the pathologist) increased significantly with rectal distension (p = 0.010, logistic analysis), and a lower incidence of Grade 2 or greater late rectal bleeding within 2 years was simultaneously observed with higher CSA values (p = 0.031, logistic analysis). Conclusions: We found strong evidence that rectal distension on the treatment-planning CT scan decreased the probability of biochemical control, local control, and rectal toxicity in patients who were treated without daily image-guided prostate localization, presumably because of geographic misses. Therefore, an

  10. A Virtual Class Calculus

    DEFF Research Database (Denmark)

    Ernst, Erik; Ostermann, Klaus; Cook, William Randall

    2006-01-01

    Virtual classes are class-valued attributes of objects. Like virtual methods, virtual classes are defined in an object's class and may be redefined within subclasses. They resemble inner classes, which are also defined within a class, but virtual classes are accessed through object instances...... model for virtual classes has been a long-standing open question. This paper presents a virtual class calculus, vc, that captures the essence of virtual classes in these full-fledged programming languages. The key contributions of the paper are a formalization of the dynamic and static semantics of vc...

  11. An improved distance-to-dose correlation for predicting bladder and rectum dose-volumes in knowledge-based VMAT planning for prostate cancer

    Science.gov (United States)

    Wall, Phillip D. H.; Carver, Robert L.; Fontenot, Jonas D.

    2018-01-01

    The overlap volume histogram (OVH) is an anatomical metric commonly used to quantify the geometric relationship between an organ at risk (OAR) and target volume when predicting expected dose-volumes in knowledge-based planning (KBP). This work investigated the influence of additional variables contributing to variations in the assumed linear DVH-OVH correlation for the bladder and rectum in VMAT plans of prostate patients, with the goal of increasing prediction accuracy and achievability of knowledge-based planning methods. VMAT plans were retrospectively generated for 124 prostate patients using multi-criteria optimization. DVHs quantified patient dosimetric data while OVHs quantified patient anatomical information. The DVH-OVH correlations were calculated for fractional bladder and rectum volumes of 30, 50, 65, and 80%. Correlations between potential influencing factors and dose were quantified using the Pearson product-moment correlation coefficient (R). Factors analyzed included the derivative of the OVH, prescribed dose, PTV volume, bladder volume, rectum volume, and in-field OAR volume. Out of the selected factors, only the in-field bladder volume (mean R  =  0.86) showed a strong correlation with bladder doses. Similarly, only the in-field rectal volume (mean R  =  0.76) showed a strong correlation with rectal doses. Therefore, an OVH formalism accounting for in-field OAR volumes was developed to determine the extent to which it improved the DVH-OVH correlation. Including the in-field factor improved the DVH-OVH correlation, with the mean R values over the fractional volumes studied improving from  -0.79 to  -0.85 and  -0.82 to  -0.86 for the bladder and rectum, respectively. A re-planning study was performed on 31 randomly selected database patients to verify the increased accuracy of KBP dose predictions by accounting for bladder and rectum volume within treatment fields. The in-field OVH led to significantly more precise

  12. Value of liver scan in the follow-up study of patients with adenocarcinoma of the colon and rectum

    International Nuclear Information System (INIS)

    Cedermark, B.J.; Schultz, S.S.; Bakshi, S.; Parthasarathy, K.L.; Mittelman, A.; Evans, J.T.

    1977-01-01

    Seventy consecutive patients with adenocarcinoma of the colon and rectum had a liver scan followed by surgical exploration of the liver. Preoperatively, blood chemistry studies were done in addition to palpation of the abdomen. Surgical findings were correlated to results of the liver scans, function tests and palpation of the liver. The overall concordance of liver scans with surgical findings was 78 percent. Thirty percent had false-positive results and 15 percent, false-negative results. The correlation of the liver scan with surgical findings was improved with increasing extent of metastases. When less than 25 percent of the liver was replaced by tumor, there was a random correlation of scan to surgical findings. By combining liver scans and liver function tests, metastases could be predicted with increased reliability only in patients who had severe metastatic disease of the liver. It is strongly recommended that patients with liver scans suggestive of metastatic disease and with most liver function tests within normal limits undergo exploration to establish the diagnosis. Exploratory laparotomy seems to be the only way to avoid chemotherapeutic treatment of patients with false-positive scans and still allow detection and treatment of metastases to the liver to occur at earlier stages

  13. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer.

    Science.gov (United States)

    Watanabe, Toshiaki; Muro, Kei; Ajioka, Yoichi; Hashiguchi, Yojiro; Ito, Yoshinori; Saito, Yutaka; Hamaguchi, Tetsuya; Ishida, Hideyuki; Ishiguro, Megumi; Ishihara, Soichiro; Kanemitsu, Yukihide; Kawano, Hiroshi; Kinugasa, Yusuke; Kokudo, Norihiro; Murofushi, Keiko; Nakajima, Takako; Oka, Shiro; Sakai, Yoshiharu; Tsuji, Akihito; Uehara, Keisuke; Ueno, Hideki; Yamazaki, Kentaro; Yoshida, Masahiro; Yoshino, Takayuki; Boku, Narikazu; Fujimori, Takahiro; Itabashi, Michio; Koinuma, Nobuo; Morita, Takayuki; Nishimura, Genichi; Sakata, Yuh; Shimada, Yasuhiro; Takahashi, Keiichi; Tanaka, Shinji; Tsuruta, Osamu; Yamaguchi, Toshiharu; Yamaguchi, Naohiko; Tanaka, Toshiaki; Kotake, Kenjiro; Sugihara, Kenichi

    2018-02-01

    Japanese mortality due to colorectal cancer is on the rise, surpassing 49,000 in 2015. Many new treatment methods have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2016 for the treatment of colorectal cancer (JSCCR Guidelines 2016) were prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding between health-care professionals and patients by making these Guidelines available to the general public. These Guidelines were prepared by consensus reached by the JSCCR Guideline Committee, based on a careful review of the evidence retrieved by literature searches, and in view of the medical health insurance system and actual clinical practice settings in Japan. Therefore, these Guidelines can be used as a tool for treating colorectal cancer in actual clinical practice settings. More specifically, they can be used as a guide to obtaining informed consent from patients and choosing the method of treatment for each patient. As a result of the discussions held by the Guideline Committee, controversial issues were selected as Clinical Questions, and recommendations were made. Each recommendation is accompanied by a classification of the evidence and a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here we present the English version of the JSCCR Guidelines 2016.

  14. Comment on 'Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study'.

    Science.gov (United States)

    Valdes, Gilmer; Interian, Yannet

    2018-03-15

    The application of machine learning (ML) presents tremendous opportunities for the field of oncology, thus we read 'Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study' with great interest. In this article, the authors used state of the art techniques: a pre-trained convolutional neural network (VGG-16 CNN), transfer learning, data augmentation, drop out and early stopping, all of which are directly responsible for the success and the excitement that these algorithms have created in other fields. We believe that the use of these techniques can offer tremendous opportunities in the field of Medical Physics and as such we would like to praise the authors for their pioneering application to the field of Radiation Oncology. That being said, given that the field of Medical Physics has unique characteristics that differentiate us from those fields where these techniques have been applied successfully, we would like to raise some points for future discussion and follow up studies that could help the community understand the limitations and nuances of deep learning techniques.

  15. Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method.

    Science.gov (United States)

    Weidenhagen, Rolf; Gruetzner, Klaus Uwe; Wiecken, Timm; Spelsberg, Fritz; Jauch, Karl-Walter

    2008-08-01

    Conservative treatment of anastomotic leakage after anterior resection of the rectum seems to be possible in patients who have no occurrence of generalized peritonitis. This report describes a new method of endoscopic management of large anastomotic leakage in these patients. The main feature of this new method is the endoscopically assisted placement of an open-cell sponge connected to a vacuum device into the abscess cavity via an introducer device. The sponge system is changed every 48-72 h. Twenty-nine patients with an anastomotic leakage after anterior resection were treated with the endoscopic vacuum therapy. The total duration of endovac therapy was 34.4 +/- 19.4 days. The total number of endoscopic sessions per patient was 11.4 +/- 6.3. In 21 of the 29 patients, a protecting stoma was created at the primary operation. Four patients were treated successfully without the need of a secondary stoma. Definitive healing was achieved in 28 of the 29 patients. Endoscopic vacuum-assisted closure is a new efficacious modality for treating anastomotic leakage following anterior resection due to an effective control of the septic focus. Further studies will show if it is possible to reduce the high mortality rate of patients with anastomotic leakage through the avoidance of surgical reinterventions while at the same time preserving the sphincter function.

  16. Clinical value of Tl per rectum scintigraphy in the work-up of patients with alcoholic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Urbain, D.; Reding, P.; Georges, B.; Thys, O.; Ham, H.R.

    1986-09-01

    The clinical value of thallium 201 per rectum scintigraphy in the work-up of patients with alcoholic liver disease was evaluated using data obtained in 104 patients. The 25th min ratio of heart to liver activities was used as an index of portal systemic shunting. This ratio was found to be normal in alcoholic patients with normal liver biopsy and also in those presenting only steatosis. It was slightly higher in patients with liver fibrosis and significantly higher values were observed in patients with liver cirrhosis. High values of the ratio were associated with a higher risk of portal systemic encephalopathy and/or gastrointestinal bleeding. The prognostic value of the test was supported by the fact that good correlations were observed between the ratio and widely accepted prognostic scores such as the Child score or the Orrego index. Moreover, high ratios were associated with an increased mortality risk at one year. We conclude that this simple test is interesting in the screening of cirrhotics at risk of encephalopathy, gastrointestinal hemorrhage, or early death.

  17. The clinical value of 201Tl per rectum scintigraphy in the work-up of patients with alcoholic liver disease

    International Nuclear Information System (INIS)

    Urbain, D.; Reding, P.; Georges, B.; Thys, O.; Ham, H.R.; Vrije Univ., Brussels

    1986-01-01

    The clinical value of thallium 201 per rectum scintigraphy in the work-up of patients with alcoholic liver disease was evaluated using data obtained in 104 patients. The 25th min ratio of heart to liver activities was used as an index of portal systemic shunting. This ratio was found to be normal in alcoholic patients with normal liver biopsy and also in those presenting only steatosis. It was slightly higher in patients with liver fibrosis and significantly higher values were observed in patients with liver cirrhosis. High values of the ratio were associated with a higher risk of portal systemic encephalopathy and/or gastrointestinal bleeding. The prognostic value of the test was supported by the fact that good correlations were observed between the ratio and widely accepted prognostic scores such as the Child score or the Orrego index. Moreover, high ratios were associated with an increased mortality risk at one year. We conclude that this simple test is interesting in the screening of cirrhotics at risk of encephalopathy, gastrointestinal hemorrhage, or early death. (orig.)

  18. Perfusion CT assessment of the colon and rectum: Feasibility of quantification of bowel wall perfusion and vascularization

    International Nuclear Information System (INIS)

    Khan, Sairah; Goh, Vicky; Tam, Emily; Wellsted, David; Halligan, Steve

    2012-01-01

    The aim was to determine the feasibility of vascular quantification of the bowel wall for different anatomical segments of the colorectum. Following institutional ethical approval and informed consent, 39 patients with colorectal cancer underwent perfusion CT. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface area product (PS) were assessed for different segments of the colorectum: ascending, transverse, descending colon, sigmoid, or rectum, that were distant from the tumor, and which were proven normal on contemporary colonoscopy, and subsequent imaging and clinical follow up. Mean (SD) for BF, BV, MTT and PS for the different anatomical colorectal segments were obtained and compared using a pooled t-test. Significance was at 5%. Assessment was not possible in 9 of 39 (23%) patients as the bowel wall was ≤5 mm precluding quantitative analysis. Forty-four segments were evaluated in the remaining 30 patients. Mean BF was higher in the proximal than distal colon: 24.0 versus 17.8 mL/min/100 g tissue; p = 0.009; BV, MTT and PS were not significantly different; BV: 3.46 versus 3.15 mL/100 g tissue, p = 0.45; MTT: 15.1 versus 18.3 s; p = 0.10; PS: 6.84 versus 8.97 mL/min/100 tissue, p = 0.13, respectively. In conclusion, assessment of bowel wall perfusion may fail in 23% of patients. The colorectum demonstrates segmental differences in perfusion.

  19. Rectal cancer: The radiation basis of radiotherapy, target volume; Cancers du rectum: volumes cible de la radiotherapie, bases rationnelles

    Energy Technology Data Exchange (ETDEWEB)

    Bosset, J.F.; Servagi-Vernat, S. [Service oncologie-radiotherapie, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besancon (France); Crehange, G. [Service oncologie-radiotherapie, centre Georges-Francois-Leclerc, 1, rue du Pr-Marion, 21079 Dijon cedex (France); Azria, D. [Service oncologie-radiotherapie, centre Val-d' Aurelle, rue Croix-Verte, 34298 Montpellier cedex 5 (France); Gerard, J.P. [Service oncologie-radiotherapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice (France); Hennequin, C. [Service oncologie-radiotherapie, hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris (France)

    2011-10-15

    Since the implementation of preoperative chemo-radiotherapy and meso-rectal excision, the 5-year rates of locoregional failures in T3-T4 N0-N1M0 rectal cancer fell from 25-30% thirty years ago to 5-8% nowadays. A critical analysis of the locoregional failures sites and mechanisms, as well as the identification of nodal extension, helps the radiation oncologist to optimize the radiotherapy target definition. The upper limit of the clinical target volume is usually set at the top of the third sacral vertebra. The lateral pelvic nodes should be included when the tumor is located in the distal part of the rectum. The anal sphincter and the levator muscles should be spared when a conservative surgery is planned. In case of abdomino-perineal excision, the ischio-rectal fossa and the sphincters should be included in the clinical target volume. A confrontation with radiologist and surgeon is mandatory to improve the definition of the target volumes to be treated. (authors)

  20. Sphincter-saving reconstruction for radiation-injured rectum. A report of four cases with special reference to the pull-through procedure

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Yasuo; Moriya, Yoshihiro; Hojo, Keiichi (National Cancer Center, Tokyo (Japan). Hospital)

    1982-12-01

    Up to now sigmoid colostomy has been a widely accepted and conventional treatment for the radiation-injured rectum, but patients without residual malignancy strongly desire to live without a colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, the pull-through procedure was the most adequate. Provided the following five conditions are fulfilled, the pull-through procedure should be considered for the severely radiation-injured rectum. (1) No recurrence of the initial malignancy in the pelvis. (2) Preferably, a more than 2 cm intact rectal segment above the dentate line preserved. (3) No radiation-injured segment in the upper sigmoid. (4) No severe radiation damage in the small intestine. (5) Normal anal function.

  1. Sphincter-saving procedure for radiation-injuried rectum. A report of four cases with special reference to pull-through procedure

    Energy Technology Data Exchange (ETDEWEB)

    Moriya, Y.; Koyama, Y.; Hojo, K. (National Cancer Center, Tokyo (Japan))

    1982-09-01

    Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter.

  2. Late radiation effects to the rectum and bladder in gynecologic cancer patients: the comparison of LENT/SOMA and RTOG/EORTC late-effects scoring systems

    International Nuclear Information System (INIS)

    Anacak, Yavuz; Yalman, Deniz; Oezsaran, Zeynep; Haydaroglu, Ayfer

    2001-01-01

    Purpose: To test the correlation of LENT/SOMA and RTOG/EORTC late-effect scales for rectum and bladder, 116 cases with gynecologic malignancies that were treated with radiotherapy were assessed with both scales. Methods and Materials: All cases had been treated at least 6 months before the date of assessment with external beam radiotherapy (50-54 Gy to midline) and 1-2 fractions of HDR brachytherapy (2x8.5 Gy to point-A for 32 inoperable cases; 1x9.25 Gy to 5-9 mm from the ovoid surface for 84 postoperative cases). The patients were questioned with both scales, and the correlation between the two scales was analyzed by Spearman's rho (rank correlation) test. Results: There were 64 cases with uterine cervix carcinoma and 52 cases with endometrium carcinoma, The overall (external + brachy) doses to ICRU points were 57.8±3.8 Gy for rectum and 59.3±4.9 Gy for bladder. The statistical analysis of LENT/SOMA and RTOG/EORTC scales revealed a very good correlation for rectum (r=0.81; p<0.01) and a good correlation for bladder (r=0.72; p<0.01). Conclusion: The LENT/SOMA system is a further step on the reporting of late radiation effects. Some modifications will improve its precision, and multicentric randomized studies are needed to test its validity

  3. RxClass

    Data.gov (United States)

    U.S. Department of Health & Human Services — The RxClass Browser is a web application for exploring and navigating through the class hierarchies to find the RxNorm drug members associated with each class....

  4. Hypoxia-response plasmid vector producing bcl-2 shRNA enhances the apoptotic cell death of mouse rectum carcinoma.

    Science.gov (United States)

    Fujioka, Takashi; Matsunaga, Naoya; Okazaki, Hiroyuki; Koyanagi, Satoru; Ohdo, Shigehiro

    2010-01-01

    Hypoxia-induced gene expression frequently occurs in malignant solid tumors because they often have hypoxic areas in which circulation is compromised due to structurally disorganized blood vessels. Hypoxia-response elements (HREs) are responsible for activating gene transcription in response to hypoxia. In this study, we constructed a hypoxia-response plasmid vector producing short hairpin RNA (shRNA) against B-cell leukemia/lymphoma-2 (bcl-2), an anti-apoptotic factor. The hypoxia-response promoter was made by inserting tandem repeats of HREs upstream of cytomegalovirus (CMV) promoter (HRE-CMV). HRE-CMV shbcl-2 vector consisted of bcl-2 shRNA under the control of HRE-CMV promoter. In hypoxic mouse rectum carcinoma cells (colon-26), the production of bcl-2 shRNA driven by HRE-CMV promoter was approximately 2-fold greater than that driven by CMV promoter. A single intratumoral (i.t.) injection of 40 microg HRE-CMV shbcl-2 to colon-26 tumor-bearing mice caused apoptotic cell death, and repetitive treatment with HRE-CMV shbcl-2 (40 microg/mouse, i.t.) also significantly suppressed the growth of colon-26 tumor cells implanted in mice. Apoptotic and anti-tumor effects were not observed in tumor-bearing mice treated with CMV shbcl-2. These results reveal the ability of HRE-CMV shbcl-2 vector to suppress the expression of bcl-2 in hypoxic tumor cells and suggest the usefulness of our constructed hypoxia-response plasmid vector to treat malignant tumors. [Supplementary Figures: available only at http://dx.doi.org/10.1254/jphs.10054FP].

  5. A randomised trial of preoperative radiotherapy for stage T3 adenocarcinoma of rectum (TROG 01.04): a progress report

    International Nuclear Information System (INIS)

    Ngan, S.; Fisher, R.; McKay, M.J.; McClure, B.; Burmeister, B.H.; Schache, D.; Joseph, D.; Solomon, M.; Ackland, S.P.; Goldstein, D.; McLachlan, S.; Dhillon, H.; Thompson, P.

    2003-01-01

    To provide a progress report of the conduct of the randomised trial TROG 01.04. This is a randomised Australian and New Zealand multi-centre trial of preoperative radiotherapy for rectal cancer currently being conducted under the auspices of Trans-Tasman Radiation Oncology Group, Australasian Gastrointestinal Trials Group, Colorectal Surgical Society of Australasia, and Royal Australasian College of Surgeons. The trial comprises two studies, each with its own main objective. These objectives are, in patients with T3 clinically resectable carcinoma of the rectum, to demonstrate that (Study 1) the local recurrence rate in patients treated with a long course (LC) of pre-operative radiotherapy with continuous infusion 5-FU is lower than that in patients treated with a short course (SC) of pre-operative radiotherapy with early surgery; and (Study 2) the local recurrence rate in patients given pre-operative radiotherapy and chemotherapy is lower than that in patients treated with initial surgery. Over 150 patients have been accrued from 21 centres in the first 21 months. All patients were enrolled on Study 1, SC versus LC pre-operative radiotherapy. Study 2 has enrolled no patients in 15 months and has been discontinued. There was no obvious difference in rates of serious adverse events of SC and LC. An Independent Data Monitoring Committee is monitoring these and other aspects of the trial. The trial of SC versus LC is progressing well: such a trial is clearly feasible in Australia and New Zealand. It is however not feasible to compare initial surgery with preoperative radiotherapy

  6. Carcinoid of the Rectum

    African Journals Online (AJOL)

    1974-06-01

    Jun 1, 1974 ... MacDonald' regarded all extra-appendiceal carcinoids as malignant and described a classification of invasiveness. CASE REPORT. A Black male aged 60 years was admitted to hospital in. January 1973 complaining of discomfort on defaecation. Department of Surgery and Gastro-intestinal Unit, University.

  7. Reduced dose to urethra and rectum with the use of variable needle spacing in prostate brachytherapy: a potential role for robotic technology

    Science.gov (United States)

    Vyas, Shilpa; Le, Yi; Zhang, Zhe; Armour, Woody

    2015-01-01

    Purpose Several robotic delivery systems for prostate brachytherapy are under development or in pre-clinical testing. One of the features of robotic brachytherapy is the ability to vary spacing of needles at non-fixed intervals. This feature may play an important role in prostate brachytherapy, which is traditionally template-based with fixed needle spacing of 0.5 cm. We sought to quantify potential reductions in the dose to urethra and rectum by utilizing variable needle spacing, as compared to fixed needle spacing. Material and methods Transrectal ultrasound images from 10 patients were used by 3 experienced planners to create 120 treatment plans. Each planner created 4 plan variations per patient with respect to needle positions: 125I fixed spacing, 125I variable spacing, 103Pd fixed spacing, and 103Pd variable spacing. The primary planning objective was to achieve a prostate V100 of 100% while minimizing dose to urethra and rectum. Results All plans met the objective of achieving prostate V100 of 100%. Combined results for all plans show statistically significant improvements in all assessed dosimetric variables for urethra (Umax, Umean, D30, D5) and rectum (Rmax, Rmean, RV100) when using variable spacing. The dose reductions for mean and maximum urethra dose using variable spacing had p values of 0.011 and 0.024 with 103Pd, and 0.007 and 0.029 with 125I plans. Similarly dose reductions for mean and maximum rectal dose using variable spacing had p values of 0.007 and 0.052 with 103Pd, and 0.012 and 0.037 with 125I plans. Conclusions The variable needle spacing achievable by the use of robotics in prostate brachytherapy allows for reductions in both urethral and rectal planned doses while maintaining prostate dose coverage. Such dosimetric advantages have the potential in translating to significant clinical benefits with the use of robotic brachytherapy. PMID:26622227

  8. Reduced dose to urethra and rectum with the use of variable needle spacing in prostate brachytherapy: a potential role for robotic technology.

    Science.gov (United States)

    Vyas, Shilpa; Le, Yi; Zhang, Zhe; Armour, Woody; Song, Daniel Y

    2015-08-01

    Several robotic delivery systems for prostate brachytherapy are under development or in pre-clinical testing. One of the features of robotic brachytherapy is the ability to vary spacing of needles at non-fixed intervals. This feature may play an important role in prostate brachytherapy, which is traditionally template-based with fixed needle spacing of 0.5 cm. We sought to quantify potential reductions in the dose to urethra and rectum by utilizing variable needle spacing, as compared to fixed needle spacing. Transrectal ultrasound images from 10 patients were used by 3 experienced planners to create 120 treatment plans. Each planner created 4 plan variations per patient with respect to needle positions: (125)I fixed spacing, (125)I variable spacing, (103)Pd fixed spacing, and (103)Pd variable spacing. The primary planning objective was to achieve a prostate V100 of 100% while minimizing dose to urethra and rectum. All plans met the objective of achieving prostate V100 of 100%. Combined results for all plans show statistically significant improvements in all assessed dosimetric variables for urethra (Umax, Umean, D30, D5) and rectum (Rmax, Rmean, RV100) when using variable spacing. The dose reductions for mean and maximum urethra dose using variable spacing had p values of 0.011 and 0.024 with (103)Pd, and 0.007 and 0.029 with (125)I plans. Similarly dose reductions for mean and maximum rectal dose using variable spacing had p values of 0.007 and 0.052 with (103)Pd, and 0.012 and 0.037 with (125)I plans. The variable needle spacing achievable by the use of robotics in prostate brachytherapy allows for reductions in both urethral and rectal planned doses while maintaining prostate dose coverage. Such dosimetric advantages have the potential in translating to significant clinical benefits with the use of robotic brachytherapy.

  9. Inter fraction variations in rectum and bladder volumes and dose distributions during high dose rate brachytherapy treatment of the uterine cervix investigated by repetitive CT-examinations

    International Nuclear Information System (INIS)

    Hellebust, Taran Paulsen; Dale, Einar; Skjoensberg, Ane; Olsen, Dag Rune

    2001-01-01

    Purpose: To evaluate variation of dose to organs at risk for patients receiving fractionated high dose rate gynaecological brachytherapy by using CT-based 3D treatment planning and dose-volume histograms (DVH). Materials and methods: Fourteen patients with cancer of the uterine cervix underwent three to six CT examinations (mean 4.9) during their course of high-dose-rate brachytherapy using radiographically compatible applicators. The rectal and bladder walls were delineated and DVHs were calculated. Results: Inter fraction variation of the bladder volume (CV mean =44.1%) was significantly larger than the inter fraction variation of the mean dose (CV mean =19.9%, P=0.005) and the maximum dose (CV mean =17.5%, P=0.003) of the bladder wall. The same trend was seen for rectum, although the figures were not significantly different. Performing CT examinations at four of seven brachytherapy fractions reduced the uncertainty to 4 and 7% for the bladder and rectal doses, respectively. A linear regression analysis showed a significant, negative relationship between time after treatment start and the whole bladder volume (P=0.018), whereas no correlation was found for the rectum. For both rectum and bladder a linear regression analysis revealed a significant, negative relationship between the whole volume and median dose (P<0.05). Conclusion: Preferably a CT examination should be provided at every fraction. However, this is logistically unfeasible in most institutions. To obtain reliable DVHs the patients will in the future undergo 3-4 CT examinations during the course of brachytherapy at our institution. Since this study showed an association between large bladder volumes and dose reductions, the patients will be treated with a standardized bladder volume

  10. Clinical results after ten years of the Lyon R96-02 trial: improving rectum conservation by increasing irradiation dose; Resultats cliniques a dix ans de l'essai Lyon R96-02: ameliorer la conservation du rectum en augmentant la dose d'irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, J.P. [Centre Antoine-Lacassagne, Nice (France); Ortholan, C. [Hopital Princesse-Grace, Monaco (Monaco); Chapet, O. [Centre hospitalier de Lyon-Sud, Pierre-Benite (France); Romestaing, P. [Hopital prive J.-Mermoz, Lyon (France)

    2011-10-15

    The author report and comments the results after ten years of a trial which aimed at testing the influence of a boost by pre-operative 50 kV contact radiotherapy on the sphincter or rectum conservation rate. Patient had been treated by external radiotherapy with or without this contact radiotherapy. Results are analysed in terms of complete or partial clinical response, global survival, local recurrence, and absence of colostomy. Short communication

  11. Class 1 Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — A "Class 1" area is a geographic area recognized by the EPA as being of the highest environmental quality and requiring maximum protection. Class I areas are areas...

  12. PRCR Classes and Activities

    Data.gov (United States)

    Town of Cary, North Carolina — This data is specific to Parks and Recreation classes, workshops, and activities within the course catalog. It contains an entry for upcoming classes.*This data set...

  13. Class Notes for "Class-Y-News."

    Science.gov (United States)

    Stuart, Judy L.

    1991-01-01

    A self-contained class of students with mild to moderate disabilities published a monthly newsletter which was distributed to students' families. Students became involved in writing, typing, drawing, folding, basic editing, and disseminating. (JDD)

  14. Classed identities in adolescence

    OpenAIRE

    Jay, Sarah

    2015-01-01

    peer-reviewed The central argument of this thesis is that social class remains a persistent system of inequality in education, health, life chances and opportunities. Therefore class matters. But why is it that so little attention has been paid to class in the psychological literature? Three papers are presented here which draw together theoretical advances in psychological understandings of group processes and sociological understandings of the complexity of class. As western labour marke...

  15. Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature

    Directory of Open Access Journals (Sweden)

    Carvounis Eleni E

    2006-08-01

    Full Text Available Abstract Background Rectal squamous cell carcinoma (SCC is a rare tumor. The incidence of this malignancy has been reported to be 0.25 to 1 per 1000 colorectal carcinomas. From a review of the English literature 55 cases of SCC of the rectum have been published. In this study we report a rectal metastatic SCC to the liver, discussing the efficacy of aggressive adjuvant and neo-adjuvant therapies on survival and prognosis. Case presentation A 39-year-old female patient with a pure SCC of the rectum diagnosed endoscopically is presented. The patient underwent initially neoadjuvant chemo-radiotherapy and then abdominoperineal resection with concomitant bilateral oophorectomy and hysterectomy, followed by adjuvant chemo-radiotherapy. Five months after the initial operation liver metastasis was demonstrated and a liver resection was carried out, followed by adjuvant chemotherapy. Eighteen months after the initial operation the patient is alive. Conclusion Although prognosis of rectal SCC is worse than that of adenocarcinoma, an aggressive therapeutic approach with surgery as the primary treatment, followed by combined neo- and adjuvant chemo-radiotherapy, may be necessary in order to improve survival and prognosis.

  16. The effect of tandem-ovoid titanium applicator on points A, B, bladder, and rectum doses in gynecological brachytherapy using 192Ir.

    Science.gov (United States)

    Sadeghi, Mohammad Hosein; Sina, Sedigheh; Mehdizadeh, Amir; Faghihi, Reza; Moharramzadeh, Vahed; Meigooni, Ali Soleimani

    2018-02-01

    The dosimetry procedure by simple superposition accounts only for the self-shielding of the source and does not take into account the attenuation of photons by the applicators. The purpose of this investigation is an estimation of the effects of the tandem and ovoid applicator on dose distribution inside the phantom by MCNP5 Monte Carlo simulations. In this study, the superposition method is used for obtaining the dose distribution in the phantom without using the applicator for a typical gynecological brachytherapy (superposition-1). Then, the sources are simulated inside the tandem and ovoid applicator to identify the effect of applicator attenuation (superposition-2), and the dose at points A, B, bladder, and rectum were compared with the results of superposition. The exact dwell positions, times of the source, and positions of the dosimetry points were determined in images of a patient and treatment data of an adult woman patient from a cancer center. The MCNP5 Monte Carlo (MC) code was used for simulation of the phantoms, applicators, and the sources. The results of this study showed no significant differences between the results of superposition method and the MC simulations for different dosimetry points. The difference in all important dosimetry points was found to be less than 5%. According to the results, applicator attenuation has no significant effect on the calculated points dose, the superposition method, adding the dose of each source obtained by the MC simulation, can estimate the dose to points A, B, bladder, and rectum with good accuracy.

  17. Is early detection of anastomotic leakage possible by intraperitoneal microdialysis and intraperitoneal cytokines after anterior resection of the rectum for cancer?

    Science.gov (United States)

    Matthiessen, Peter; Strand, Ida; Jansson, Kjell; Törnquist, Cathrine; Andersson, Magnus; Rutegård, Jörgen; Norgren, Lars

    2007-11-01

    This prospective study assessed methods of detecting intraperitoneal ischemia and inflammatory response in patients with and without postoperative complications after anterior resection of the rectum. In 23 patients operated on with anterior resection of the rectum for rectal carcinoma, intraperitoneal lactate, pyruvate, and glucose levels were monitored postoperatively for six days by using microdialysis with catheters applied in two locations: intraperitoneally near the anastomosis, and in the central abdominal cavity. A reference catheter was placed subcutaneously in the pectoral region. Cytokines, interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-alpha, were measured in intraperitoneal fluid by means of a pelvic drain for two postoperative days. The intraperitoneal lactate/pyruvate ratio near the anastomosis was higher on postoperative Day 5 (P = 0.029) and Day 6 (P = 0.009) in patients with clinical anastomotic leakage (n = 7) compared with patients without leakage (n = 16). The intraperitoneal levels of IL-6 (P = 0.002; P = 0.012, respectively) and IL-10 (P = 0.002; P = 0.041, respectively) were higher on postoperative Days 1 and 2 in the leakage group, and TNF-alpha was higher in the leakage group on Day 1 (P = 0.011). In-hospital clinical anastomotic leakage was diagnosed on median Day 6, and leakage after hospital discharge on median Day 20. The intraperitoneal lactate/pyruvate ratio and cytokines, IL-6, IL-10, and TNF-alpha, were increased in patients who developed symptomatic anastomotic leakage before clinical symptoms were evident.

  18. Loosely coupled class families

    DEFF Research Database (Denmark)

    Ernst, Erik

    2001-01-01

    are expressed using virtual classes seem to be very tightly coupled internally. While clients have achieved the freedom to dynamically use one or the other family, it seems that any given family contains a xed set of classes and we will need to create an entire family of its own just in order to replace one...... of the members with another class. This paper shows how to express class families in such a manner that the classes in these families can be used in many dierent combinations, still enabling family polymorphism and ensuring type safety....

  19. Class, Culture and Politics

    DEFF Research Database (Denmark)

    Harrits, Gitte Sommer

    2013-01-01

    Even though contemporary discussions of class have moved forward towards recognizing a multidimensional concept of class, empirical analyses tend to focus on cultural practices in a rather narrow sense, that is, as practices of cultural consumption or practices of education. As a result......, discussions within political sociology have not yet utilized the merits of a multidimensional conception of class. In light of this, the article suggests a comprehensive Bourdieusian framework for class analysis, integrating culture as both a structural phenomenon co-constitutive of class and as symbolic...... practice. Further, the article explores this theoretical framework in a multiple correspondence analysis of a Danish survey, demonstrating how class and political practices are indeed homologous. However, the analysis also points at several elements of field autonomy, and the concluding discussion...

  20. Class network routing

    Science.gov (United States)

    Bhanot, Gyan [Princeton, NJ; Blumrich, Matthias A [Ridgefield, CT; Chen, Dong [Croton On Hudson, NY; Coteus, Paul W [Yorktown Heights, NY; Gara, Alan G [Mount Kisco, NY; Giampapa, Mark E [Irvington, NY; Heidelberger, Philip [Cortlandt Manor, NY; Steinmacher-Burow, Burkhard D [Mount Kisco, NY; Takken, Todd E [Mount Kisco, NY; Vranas, Pavlos M [Bedford Hills, NY

    2009-09-08

    Class network routing is implemented in a network such as a computer network comprising a plurality of parallel compute processors at nodes thereof. Class network routing allows a compute processor to broadcast a message to a range (one or more) of other compute processors in the computer network, such as processors in a column or a row. Normally this type of operation requires a separate message to be sent to each processor. With class network routing pursuant to the invention, a single message is sufficient, which generally reduces the total number of messages in the network as well as the latency to do a broadcast. Class network routing is also applied to dense matrix inversion algorithms on distributed memory parallel supercomputers with hardware class function (multicast) capability. This is achieved by exploiting the fact that the communication patterns of dense matrix inversion can be served by hardware class functions, which results in faster execution times.

  1. Culture and social class.

    Science.gov (United States)

    Miyamoto, Yuri

    2017-12-01

    A large body of research in Western cultures has demonstrated the psychological and health effects of social class. This review outlines a cultural psychological approach to social stratification by comparing psychological and health manifestations of social class across Western and East Asian cultures. These comparisons suggest that cultural meaning systems shape how people make meaning and respond to material/structural conditions associated with social class, thereby leading to culturally divergent manifestations of social class. Specifically, unlike their counterparts in Western cultures, individuals of high social class in East Asian cultures tend to show high conformity and other-orientated psychological attributes. In addition, cultures differ in how social class impacts health (i.e. on which bases, through which pathways, and to what extent). Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Semantic Analysis of Virtual Classes and Nested Classes

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann

    1999-01-01

    Virtual classes and nested classes are distinguishing features of BETA. Nested classes originated from Simula, but until recently they have not been part of main stream object- oriented languages. C++ has a restricted form of nested classes and they were included in Java 1.1. Virtual classes...... classes and parameterized classes have been made. Although virtual classes and nested classes have been used in BETA for more than a decade, their implementation has not been published. The purpose of this paper is to contribute to the understanding of virtual classes and nested classes by presenting...

  3. Class in disguise

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Prieur, Annick

    This paper asks how class can have importance in one of the worlds’ most equal societies: Denmark. The answer is that class here appears in disguised forms. The field under study is a city, Aalborg, in the midst of transition from a stronghold of industrialism to a post industrial economy. The pa....... The paper also raises questions about how sociological discourses may contribute to the veiling of class....

  4. Role of surgery in Stade cT3-4 N0M0 prostate cancer

    International Nuclear Information System (INIS)

    Van Poppel, H.; Joniau, S.; Haustermans, K.

    2007-01-01

    The surgical treatment of locally advanced prostate cancer has often been discouraged and in many cases a combined treatment with radiotherapy and hormone-therapy is proposed. Nevertheless, radical prostatectomy is efficient in mono-therapy in the majority of patients with a P.S.A. lower than 20 μg/l, a unilateral stage T3a and a Gleason score lower than 8. Patients with a more advanced local stage or with a less well differentiated tumour should not be excluded from a surgical treatment as an initial option. The majority of them will benefit from a multimodal treatment. This can consist of adjuvant radiotherapy in case of obvious margin positive disease, a salvage radiotherapy in case of P.S.A. relapse during follow-up, or a hormonal treatment in case of P.S.A. persistence after surgery or in cases of advanced lymph node invasion. The urologist must utilize the results of the definitive pathology and of the post-operative P.S.A. levels in order to find the indications where and when additional treatment can be applied. The results obtained after 10-15 years with a radical prostatectomy, eventually combined with radiation or hormonal treatment are excellent concerning the cancer specific survival at long term. Therefore radiotherapy and hormones is not the treatment of choice for all clinical T3 prostate cancers. (authors)

  5. Can we Save the rectum by watchful waiting or TransAnal microsurgery following (chemo) Radiotherapy versus Total mesorectal excision for early REctal Cancer (STAR-TREC study)?

    DEFF Research Database (Denmark)

    Rombouts, Anouk J M; Al-Najami, Issam; Abbott, Natalie L

    2017-01-01

    INTRODUCTION: Total mesorectal excision (TME) is the highly effective standard treatment for rectal cancer but is associated with significant morbidity and may be overtreatment for low-risk cancers. This study is designed to determine the feasibility of international recruitment in a study...... comparing organ-saving approaches versus standard TME surgery. METHODS AND ANALYSIS: STAR-TREC trial is a multicentre international randomised, three-arm parallel, phase II feasibility study in patients with biopsy-proven adenocarcinoma of the rectum. The trial is coordinated from Birmingham, UK...... endpoint of this phase II study is to demonstrate sufficient international recruitment in order to sustain a phase III study incorporating pelvic failure as the primary endpoint. Success in phase II is defined as randomisation of at least four cases per month internationally in year 1, rising to at least...

  6. Teaching Social Class

    Science.gov (United States)

    Tablante, Courtney B.; Fiske, Susan T.

    2015-01-01

    Discussing socioeconomic status in college classes can be challenging. Both teachers and students feel uncomfortable, yet social class matters more than ever. This is especially true, given increased income inequality in the United States and indications that higher education does not reduce this inequality as much as many people hope. Resources…

  7. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen

    2002-01-01

    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory...

  8. Cutting Class Harms Grades

    Science.gov (United States)

    Taylor, Lewis A., III

    2012-01-01

    An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…

  9. A Modified Spontaneously Closed Defunctioning Tube Ileostomy After Anterior Resection of the Rectum for Rectal Cancer with a Low Colorectal Anastomosis.

    Science.gov (United States)

    Sheng, Qin-Song; Hua, Han-Ju; Cheng, Xiao-Bin; Wang, Wei-Bing; Chen, Wen-Bin; Xu, Jia-He; Lin, Jian-Jiang

    2016-04-01

    The aim of this study is to introduce a new technique of modified spontaneously closed defunctioning tube ileostomy after anterior resection of the rectum for rectal cancer with a low colorectal anastomosis. Patients with rectal cancer who underwent anterior resection of rectum with a low colorectal anastomosis and chose a modified defunctioning tube ileostomy between March 2012 and August 2013 were retrospectively reviewed. Data on the success of the operation procedures, post-operative hospital stay, and post-operative tube ileostomy-related complications were analyzed. One hundred fifty-two patients (87 males and 65 females; 57.1 ± 17.4 years) undergoing the modified defunctioning tube ileostomy after anterior resection for rectal cancer were included. The post-operative hospital stay was 11.9 ± 3.2 days. The tube was removed on days 22.6 ± 4.1 after operation and the ileostomy wound closed spontaneously within 13.1 ± 1.9 days. Twenty-five patients felt tube-associated pain or discomfort, which was relieved after a period of adaptation and appropriate tube adjustment. Nine patients suffered from tube blockage and were treated successfully with saline irrigation. Two patients had intestinal obstruction, which was resolved with conservative treatment. Three patients developed leakage of the distal anastomosis: two were successfully treated with conservative measures and the other completely recovered after reoperation. The modified spontaneously closed defunctioning tube ileostomy appears efficacious and safe. This technique may be used to protect the distal anastomosis and simultaneously decrease the ileostomy complications, and minimize the morbidity and mortality associated with stoma takedown.

  10. Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy

    International Nuclear Information System (INIS)

    Fiorino, Claudio Ph.D.; Di Muzio, Nadia; Broggi, Sara; Cozzarini, Cesare; Maggiulli, Eleonora M.Sc.; Alongi, Filippo; Valdagni, Riccardo; Fazio, Ferruccio; Calandrino, Riccardo

    2008-01-01

    Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy

  11. Classes of modules

    CERN Document Server

    Dauns, John

    2006-01-01

    Because traditional ring theory places restrictive hypotheses on all submodules of a module, its results apply only to small classes of already well understood examples. Often, modules with infinite Goldie dimension have finite-type dimension, making them amenable to use with type dimension, but not Goldie dimension. By working with natural classes and type submodules (TS), Classes of Modules develops the foundations and tools for the next generation of ring and module theory. It shows how to achieve positive results by placing restrictive hypotheses on a small subset of the complement submodules, Furthermore, it explains the existence of various direct sum decompositions merely as special cases of type direct sum decompositions. Carefully developing the foundations of the subject, the authors begin by providing background on the terminology and introducing the different module classes. The modules classes consist of torsion, torsion-free, s[M], natural, and prenatural. They expand the discussion by exploring...

  12. Social Class Dialogues and the Fostering of Class Consciousness

    Science.gov (United States)

    Madden, Meredith

    2015-01-01

    How do critical pedagogies promote undergraduate students' awareness of social class, social class identity, and social class inequalities in education? How do undergraduate students experience class consciousness-raising in the intergroup dialogue classroom? This qualitative study explores undergraduate students' class consciousness-raising in an…

  13. Optimizing UML Class Diagrams

    Directory of Open Access Journals (Sweden)

    Sergievskiy Maxim

    2018-01-01

    Full Text Available Most of object-oriented development technologies rely on the use of the universal modeling language UML; class diagrams play a very important role in the design process play, used to build a software system model. Modern CASE tools, which are the basic tools for object-oriented development, can’t be used to optimize UML diagrams. In this manuscript we will explain how, based on the use of design patterns and anti-patterns, class diagrams could be verified and optimized. Certain transformations can be carried out automatically; in other cases, potential inefficiencies will be indicated and recommendations given. This study also discusses additional CASE tools for validating and optimizing of UML class diagrams. For this purpose, a plugin has been developed that analyzes an XMI file containing a description of class diagrams.

  14. Classes of Heart Failure

    Science.gov (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

  15. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen

    2002-01-01

    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory foll...... follows that integral transform with kernels which are products of a Bessel and a Hankel function or which is of a certain general hypergeometric type have inverse transforms of the same structure....

  16. Nordic Walking Classes

    CERN Multimedia

    Fitness Club

    2015-01-01

    Four classes of one hour each are held on Tuesdays. RDV barracks parking at Entrance A, 10 minutes before class time. Spring Course 2015: 05.05/12.05/19.05/26.05 Prices 40 CHF per session + 10 CHF club membership 5 CHF/hour pole rental Check out our schedule and enroll at: https://espace.cern.ch/club-fitness/Lists/Nordic%20Walking/NewForm.aspx? Hope to see you among us! fitness.club@cern.ch

  17. Safety class methodology

    International Nuclear Information System (INIS)

    Donner, E.B.; Low, J.M.; Lux, C.R.

    1992-01-01

    DOE Order 6430.1A, General Design Criteria (GDC), requires that DOE facilities be evaluated with respect to ''safety class items.'' Although the GDC defines safety class items, it does not provide a methodology for selecting safety class items. The methodology described in this paper was developed to assure that Safety Class Items at the Savannah River Site (SRS) are selected in a consistent and technically defensible manner. Safety class items are those in the highest of four categories determined to be of special importance to nuclear safety and, merit appropriately higher-quality design, fabrication, and industrial test standards and codes. The identification of safety class items is approached using a cascading strategy that begins at the 'safety function' level (i.e., a cooling function, ventilation function, etc.) and proceeds down to the system, component, or structure level. Thus, the items that are required to support a safety function are SCls. The basic steps in this procedure apply to the determination of SCls for both new project activities, and for operating facilities. The GDC lists six characteristics of SCls to be considered as a starting point for safety item classification. They are as follows: 1. Those items whose failure would produce exposure consequences that would exceed the guidelines in Section 1300-1.4, ''Guidance on Limiting Exposure of the Public,'' at the site boundary or nearest point of public access 2. Those items required to maintain operating parameters within the safety limits specified in the Operational Safety Requirements during normal operations and anticipated operational occurrences. 3. Those items required for nuclear criticality safety. 4. Those items required to monitor the release of radioactive material to the environment during and after a Design Basis Accident. Those items required to achieve, and maintain the facility in a safe shutdown condition 6. Those items that control Safety Class Item listed above

  18. Association of a XRCC3 polymorphism and rectum mean dose with the risk of acute radio-induced gastrointestinal toxicity in prostate cancer patients

    International Nuclear Information System (INIS)

    Fachal, Laura; Gómez-Caamaño, Antonio; Peleteiro, Paula; Carballo, Ana; Calvo-Crespo, Patricia; Sánchez-García, Manuel; Lobato-Busto, Ramón; Carracedo, Ángel; Vega, Ana

    2012-01-01

    Background and purpose: We have performed a case–control study among prostate cancer patients treated with three-dimensional conformational radiotherapy (3D-CRT) in order to investigate the association between single nucleotide polymorphisms (SNPs), treatment and patient features with gastrointestinal and genitourinary acute toxicity. Material and methods: A total of 698 patients were screened for 14 SNPs located in the ATM, ERCC2, LIG4, MLH1 and XRCC3 genes. Gastrointestinal and genitourinary toxicities were recorded prospectively using the Common Terminology Criteria for Adverse Events v3.0. Results: The XRCC3 SNP rs1799794 (G/G OR = 5.65; 95% CI: 1.95–16.38; G/A OR = 2.75; 95% CI: 1.25–6.05; uncorrected p-value = 2.8 × 10 −03 ; corrected p-value = 0.03; FDR q-value = 0.06) as well as the mean dose received by the rectum (OR = 1.06; 95% CI: 1.02–1.1; uncorrected p-value = 2.49 × 10 −03 ; corrected p-value = 0.03; FDR q-value = 0.06) were significantly associated with gastrointestinal toxicity after correction for multiple testing. Those patients who undergone previous prostatectomy were less prone to develop genitourinary toxicity (OR = 0.38; 95% CI: 0.18–0.71; uncorrected p-value = 4.95 × 10 −03 ; corrected p-value = 0.03; FDR q-value = 0.08). Our study excludes the possibility of a >2-fold risk increase in genitourinary acute toxicity being due to rs1801516 ATM SNP, the rs1805386 and rs1805388 LIG4 markers, as well as all the SNPs evaluated in the ERCC2, MLH1 and XRCC3 genes. Conclusions: The XRCC3 rs1799794 SNP and the mean dose received by the rectum are associated with the development of gastrointestinal toxicity after 3D-CRT.

  19. Concordance of gonorrhoea of the rectum, pharynx and urethra in same-sex male partnerships attending a sexual health service in Melbourne, Australia.

    Science.gov (United States)

    Cornelisse, Vincent J; Zhang, Lei; Law, Matthew; Chen, Marcus Y; Bradshaw, Catriona S; Bellhouse, Clare; Fairley, Christopher K; Chow, Eric P F

    2018-02-27

    We aimed to describe anatomic site-specific concordance of gonococcal infections in partnerships of men who have sex with men (MSM). We conducted a cross-sectional analysis of data from MSM partnerships attending Melbourne Sexual Health Centre between March 2011 and February 2015. Logistic regression models (random effect) were used to examine the association between gonococcal infections of the urethra, rectum and pharynx. Gonococci were detected by culture at all anatomic sites. The analysis included 495 partnerships. Of the men with urethral gonorrhoea, 33% (95% CI 18-52) had partners with pharyngeal gonorrhoea and 67% (95% CI 48-82) had partners with rectal gonorrhoea. The adjusted odds of having urethral gonorrhoea was 4.6 (95% CI 1.2-17.1) for a man whose partner had pharyngeal gonorrhoea, and 48.1 (95% CI 18.3-126.7) for a man whose partner had rectal gonorrhoea. Of the men with rectal gonorrhoea, 46% (95% CI 31-61) had a partner with urethral gonorrhoea and 23% (95% CI 12-37) had a partner with pharyngeal gonorrhoea. The adjusted odds of having rectal gonorrhoea was 63.9 (95% CI 24.7-165.6) for a man whose partner had urethral gonorrhoea. Of the men with pharyngeal gonorrhoea, 42% (95% CI 23-63) had a partner with rectal gonorrhoea and 23% (95% CI 9-44) had a partner with had a partner with pharyngeal gonorrhoea. The adjusted odds of having pharyngeal gonorrhoea was 8.9 (95% CI 3.2-24.6) for a man whose partner had rectal gonorrhoea. The crude odds of having pharyngeal gonorrhoea was 14.2 (95% CI 5.1-39.0) for a man whose partner had pharyngeal gonorrhoea. These data provide the first estimates of concordance of anatomic site-specific gonococcal infections in MSM partnerships, and confirm that urethral gonorrhoea is contracted from both rectal and pharyngeal sites, and suggest that gonococci transmit between the rectum and pharynx. However, due to use of culture rather than NAAT, our analysis was not adequately powered to assess pharynx

  20. Translation in ESL Classes

    Directory of Open Access Journals (Sweden)

    Nagy Imola Katalin

    2015-12-01

    Full Text Available The problem of translation in foreign language classes cannot be dealt with unless we attempt to make an overview of what translation meant for language teaching in different periods of language pedagogy. From the translation-oriented grammar-translation method through the complete ban on translation and mother tongue during the times of the audio-lingual approaches, we have come today to reconsider the role and status of translation in ESL classes. This article attempts to advocate for translation as a useful ESL class activity, which can completely fulfil the requirements of communicativeness. We also attempt to identify some activities and games, which rely on translation in some books published in the 1990s and the 2000s.

  1. MIDDLE CLASS MOVEMENTS

    OpenAIRE

    Dr. K. Sravana Kumar

    2016-01-01

    The middle class is placed between labour and capital. It neither directly awns the means of production that pumps out the surplus generated by wage labour power, nor does it, by its own labour, produce the surplus which has use and exchange value. Broadly speaking, this class consists of the petty bourgeoisie and the white-collar workers. The former are either self-employed or involved in the distribution of commodities and the latter are non-manual office workers, supervisors and profession...

  2. Talking Class in Tehroon

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian; Rezakhani, Khodadad

    2016-01-01

    Persian, like any other language, is laced with references to class, both blatant and subtle. With idioms and metaphors, Iranians can identify and situate others, and thus themselves, within hierarchies of social status and privilege, both real and imagined. Some class-related terms can be traced...... back to medieval times, whereas others are of modern vintage, the linguistic legacy of television shows, pop songs, social media memes or street vernacular. Every day, it seems, an infectious set of phrases appears that make yesterday’s seem embarrassingly antiquated....

  3. Comment on ‘Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study’

    Science.gov (United States)

    Valdes, Gilmer; Interian, Yannet

    2018-03-01

    The application of machine learning (ML) presents tremendous opportunities for the field of oncology, thus we read ‘Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study’ with great interest. In this article, the authors used state of the art techniques: a pre-trained convolutional neural network (VGG-16 CNN), transfer learning, data augmentation, drop out and early stopping, all of which are directly responsible for the success and the excitement that these algorithms have created in other fields. We believe that the use of these techniques can offer tremendous opportunities in the field of Medical Physics and as such we would like to praise the authors for their pioneering application to the field of Radiation Oncology. That being said, given that the field of Medical Physics has unique characteristics that differentiate us from those fields where these techniques have been applied successfully, we would like to raise some points for future discussion and follow up studies that could help the community understand the limitations and nuances of deep learning techniques.

  4. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer.

    Science.gov (United States)

    Rahbari, Nuh N; Weitz, Jürgen; Hohenberger, Werner; Heald, Richard J; Moran, Brendan; Ulrich, Alexis; Holm, Torbjörn; Wong, W Douglas; Tiret, Emmanuel; Moriya, Yoshihiro; Laurberg, Søren; den Dulk, Marcel; van de Velde, Cornelis; Büchler, Markus W

    2010-03-01

    Anastomotic leakage represents a major complication after anterior resection of the rectum. The incidence of anastomotic leakage varies considerably among clinical studies in part owing to the lack of a standardized definition of this complication. The aim of the present article was to propose a definition and severity grading of anastomotic leakage after anterior rectal resection. After a literature review a consensus definition and severity grading of anastomotic leakage was developed within the International Study Group of Rectal Cancer. Anastomotic leakage should be defined as a defect of the intestinal wall at the anastomotic site (including suture and staple lines of neorectal reservoirs) leading to a communication between the intra- and extraluminal compartments. Severity of anastomotic leakage should be graded according to the impact on clinical management. Grade A anastomotic leakage results in no change in patients' management, whereas grade B leakage requires active therapeutic intervention but is manageable without re-laparotomy. Grade C anastomotic leakage requires re-laparotomy. The proposed definition and clinical grading is applicable easily in the setting of clinical studies. It should be applied in future reports to facilitate valid comparison of the results of different studies. Copyright 2010 Mosby, Inc. All rights reserved.

  5. Morphometric sexual maturity and allometric growth of the crab Sesarma rectum Randall, 1840 (Crustacea: Sesarmidae in an impacted tropical mangrove in northeast Brazil

    Directory of Open Access Journals (Sweden)

    Felipe Bezerra Ribeiro

    2013-04-01

    Full Text Available The size at sexual maturity and the allometric growth of the semi-terrestrial crab Sesarma rectum were studied in an impacted tropical mangrove in northeast Brazil. Crabs were monthly collected during spring low-tide periods, from October 2009 through September 2010. A catch-per-unit-effort (CPUE technique was used to sample the crab population, with two-hour sampling periods, by two people. A total of 492 crabs were obtained, being 262 males and 230 females. The specimens were measured at carapace width (CW, the left and right propodus length and height (RPL, RPH, LPL and LPH, and the gonopod length of males (GL, and abdomen width (AW of females. In males, the inflection point was at 27.14 mm CW in the relationship between CW and the length of right propodus (LRP, considering the morphological size at the onset of maturity. Based on the relationship between CW and AW, the size at sexual maturity in females was 22.97 mm. In spite of living in an impacted area, this population attained the maturity onset at a bigger size than other localities.

  6. A clinical study of 14 patients with radiation colitis; A case of radiation colitis treated by abdominoperineal resection of the rectum and lumbar plasty

    Energy Technology Data Exchange (ETDEWEB)

    Futamura, Manabu; Tanaka, Sengai; Oshita, Hiroo; Nagao, Naritoshi (Gifu City Hospital (Japan))

    1991-12-01

    Clinical study of 14 patients with radiation colitis who were treated surgically at our clinic in the past 16-year period and a patient whose treatment was very difficult are reported. Primary lesions included 13 cervical carcinomas and one ovarian cancer. Ten cases received surgery combined with radiation and 4 did radiation. Radiation dose was 6055 rad on average. Latent time ranged from 6 months to 25 years with the average of 8 years and 9 months. No significant correlation between radiation dose and latent time was noted. Symptoms included obstruction and stenosis in 56% (8/14), hematoemesis in 46% (5/14), and fistula in 46% (5/14). All lesions presented as remarkably adhesion and stenosis, and resection with anastomosis was performed in 9 (64%), colostomy in 5 (46%), and urostomy in 2 (14%). Lumbar plasty was added in one case. A 65-year-old female patient who had undergone radiation therapy 13 years before had a rectal perforation and pelvic fistula. Abdominoperineal resection of the rectum and closure of the fistula by transferring the major gluteal muscle pedicle were performed. The patient is followed on ambulant basis for more than one year, and no evidence of recurrence has been observed. (author).

  7. Preoperative assessment of intestinal endometriosis: A comparison of transvaginal sonography with water-contrast in the rectum, transrectal sonography, and barium enema.

    Science.gov (United States)

    Bergamini, Valentino; Ghezzi, Fabio; Scarperi, Stefano; Raffaelli, Ricciarda; Cromi, Antonella; Franchi, Massimo

    2010-12-01

    To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.

  8. Development and clinical use of a software for the analysis of the diagnosis and the features of polypoid lesions of the colon and rectum

    International Nuclear Information System (INIS)

    Bellomi, M.; Pestalozza, M.A.; Bellegotti, L.; Gardani, G.S.; Graziano, M.

    1987-01-01

    Double contrast enema and endoscopy are very important in the diagnosis of adenomas and early cancer of the colon and rectum. These exams can not only detect the presence, but also suggest the histologic diagnosis, of polypoid lesions of the colon. An Olivetti M24 Personal Computer was used to create a software to study the results obtained by double contrast enema, and to compare them with endoscopy and pathology. The data base is formed by 7 files: one anagraphic, 3 collecting the characteristics of the diagnosis - namely the radiologic, the endoscopic and the pathologic one - and 3 multiple files featuring each lesion, as defined by the three diagnostic techniques. The software allows to evaluate the different lesions that can be detected by three techniques in the same patient and to compare the diagnosis of presence to the morphologic features of each lesion. False negatives and false positive of each technique are easily recognized. It is also possible to characterize the single morphological feature leading the radiologist and/or the endoscopist to express an opinion about the histologic diagnosis of each lesion and to compare them with pathological features. The first experience in clinical use of the software, in the analysis of the characters of 336 lesions in 218 patients, is described

  9. Second class weak currents

    International Nuclear Information System (INIS)

    Delorme, J.

    1978-01-01

    The definition and general properties of weak second class currents are recalled and various detection possibilities briefly reviewed. It is shown that the existing data on nuclear beta decay can be consistently analysed in terms of a phenomenological model. Their implication on the fundamental structure of weak interactions is discussed [fr

  10. World Class Teachers.

    Science.gov (United States)

    Mitchell, Rosalita

    1998-01-01

    School communities are challenged to find ways to identify good teachers and give other teachers a chance to learn from them. The New Mexico World Class Teacher Project is encouraging teachers to pursue certification by the National Board for Professional Teaching Standards. This process sharpens teachers' student assessment skills and encourages…

  11. EPA Web Training Classes

    Science.gov (United States)

    Scheduled webinars can help you better manage EPA web content. Class topics include Drupal basics, creating different types of pages in the WebCMS such as document pages and forms, using Google Analytics, and best practices for metadata and accessibility.

  12. Class Actions in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2009-01-01

    The article deals with the relatively new Danish Act on Class Action (Danish: gruppesøgsmål) which was suggested by The Permanent Council on Civil procedure (Retsplejerådet) of which the article's author is a member. The operability of the new provisions is illustrated through some wellknown Danish...

  13. Coming out in Class

    Science.gov (United States)

    McKinnon, Rachel

    2012-01-01

    This article shares how the author explained her trans status to her students. Everyone has been extremely supportive of her decision to come out in class and to completely mask the male secondary-sex characteristics, especially in the workplace. The department chair and the faculty in general have been willing to do whatever they can to assist…

  14. Working Together in Class

    Directory of Open Access Journals (Sweden)

    Pateşan Marioara

    2017-12-01

    Full Text Available The scores obtained by the military students are very important as a lot of opportunities depend on them: the choice of the branch, selection for different in and off-campus activities, the appointment to the workplace and so on. A qualifier, regardless of its form of effective expression, can make a difference in a given context of issuing a value judgment, in relation to the student's performance assessment. In our research we tried to find out what motives students, what determines them to get actively involved in the tasks they are given and the ways we can improve their participation in classes and assignments. In order to have an educated generation we need to have not only well prepared teachers but ones that are open-minded, flexible and in pace with the methodological novelties that can improve the teaching learning process in class. Along the years we have noticed that in classes where students constituted a cohesive group with an increasing degree of interaction between members, the results were better than in a group that did not appreciate team-work. In this article we want to highlight the fact that a teacher can bring to class the appropriate methods and procedures can contribute decisively to the strengthening of the group cohesion and high scores.

  15. Adeus à classe trabalhadora?

    Directory of Open Access Journals (Sweden)

    Geoff Eley

    2013-12-01

    Full Text Available No início da década de 1980, a política centrada em classes da tradição socialista estava em crise, e comentadores importantes adotaram tons apocalípticos. No final da década, a esquerda permanecia profundamente dividida entre os advogados da mudança e os defensores da fé. Em meados dos anos 1990, os primeiros tinham, de modo geral, ganhado a batalha. O artigo busca apresentar essa mudança contemporânea não como a 'morte da classe', mas como o desa­parecimento de um tipo particular de ­sociedade de classes, marcado pelo ­processo de formação da classe trabalhadora entre os anos 1880 e 1940 e pelo alinhamento político daí resultante, atingindo seu apogeu na construção social-democrata do acordo do pós-guerra. Quando mudanças de longo prazo na economia se combinaram com o ataque ao keynesianismo na política de recessão a partir de meados da década de 1970, a unidade da classe trabalhadora deixou de estar disponível da forma antiga e bastante utilizada, como o terreno natural da política de esquerda. Enquanto uma coletividade dominante da classe trabalhadora entrou em declínio, outra se corporificou de modo lento e desigual para tomar o lugar daquela. Mas a unidade operacional dessa nova agregação da classe trabalhadora ainda está, em grande parte, em formação. Para recuperar a eficácia política da tradição socialista, alguma nova visão de agência política coletiva será necessária, uma visão imaginativamente ajustada às condições emergentes da produção e acumulação capitalista no início do século XXI.

  16. Flexible Word Classes

    DEFF Research Database (Denmark)

    • First major publication on the phenomenon • Offers cross-linguistic, descriptive, and diverse theoretical approaches • Includes analysis of data from different language families and from lesser studied languages This book is the first major cross-linguistic study of 'flexible words', i.e. words...... that cannot be classified in terms of the traditional lexical categories Verb, Noun, Adjective or Adverb. Flexible words can - without special morphosyntactic marking - serve in functions for which other languages must employ members of two or more of the four traditional, 'specialised' word classes. Thus......, flexible words are underspecified for communicative functions like 'predicating' (verbal function), 'referring' (nominal function) or 'modifying' (a function typically associated with adjectives and e.g. manner adverbs). Even though linguists have been aware of flexible world classes for more than...

  17. Storytelling in EFL Classes

    Directory of Open Access Journals (Sweden)

    Emine Bala

    2015-12-01

    Full Text Available Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytelling is mainly regarded to be grounded on imitation and repetition; nevertheless many creative activities can be implemented in the classroom since this method directs learners to use their imaginations. This study discusses the importance of storytelling as a teaching method, and it outlines the advantages of storytelling in EFL classes.

  18. Queen elizabeth class battleships

    CERN Document Server

    Brown, Les

    2010-01-01

    The 'ShipCraft' series provides in-depth information about building and modifying model kits of famous warship types. Lavishly illustrated, each book takes the modeller through a brief history of the subject class, highlighting differences between sister-ships and changes in their appearance over their careers. This includes paint schemes and camouflage, featuring colour profiles and highly detailed line drawings and scale plans. The modelling section reviews the strengths and weaknesses of available kits, lists commercial accessory sets for super-detailing of the ships, and provides hints on modifying and improving the basic kit. This is followed by an extensive photographic survey of selected high-quality models in a variety of scales, and the book concludes with a section on research references - books, monographs, large-scale plans and relevant websites.This volume covers the five ships of the highly successful Queen Elizabeth class, a design of fast battleship that set the benchmark for the last generati...

  19. World Class Facilities Management

    DEFF Research Database (Denmark)

    Malmstrøm, Ole Emil; Jensen, Per Anker

    2013-01-01

    Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet.......Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet....

  20. Storytelling in EFL Classes

    OpenAIRE

    Emine Bala

    2015-01-01

    Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytel...

  1. Esmeraldas-Class Corvettes,

    Science.gov (United States)

    1983-04-25

    The series of ships, named after all the provinces of Ecuador , include: --CA 11 ESMERALDAS, laid down 27 September 1979, launched 11 October 1980... LOJA , laid down 25 March 1981, launched 27 February 1982; fitting out at CNR Ancona. The building program, on schedule so far, calls for the entire class...built and are still building in 16 units for foreign navies (Libya, Ecuador , Iraq) with four possible armament alternatives. In particular, they

  2. [Social classes and poverty].

    Science.gov (United States)

    Benach, Joan; Amable, Marcelo

    2004-05-01

    Social classes and poverty are two key social determinants fundamental to understand how disease and health inequalities are produced. During the 90's in Spain there has been a notable oscillation in the inequality and poverty levels, with an increase in the middle of the decade when new forms of social exclusion, high levels of unemployment and great difficulties in accessing the labour market, especially for those workers with less resources, emerged. Today society is still characterized by a clear social stratification and the existence of social classes with a predominance of high levels of unemployment and precarious jobs, and where poverty is an endemic social problem much worse than the EU average. To diminish health inequalities and to improve the quality of life will depend very much on the reduction of the poverty levels and the improvement of equal opportunities and quality of employment. To increase understanding of how social class and poverty affect public health, there is a need to improve the quality of both information and research, and furthermore planners and political decision makers must take into account those determinants when undertaking disease prevention and health promotion.

  3. High-dose-rate-intracavitary brachytherapy applications and the difference in the bladder and rectum doses: A study from rural centre of Maharashatra, India

    Directory of Open Access Journals (Sweden)

    Jain Vandana

    2007-01-01

    Full Text Available Aim : To report the difference in the bladder and rectum doses with different applications by the radiotherapists in the same patient of the carcinoma of the uterine cervix treated by multiple fractions of high-dose-rate (HDR intracavitary brachytherapy (ICBT. Materials and Methods : Between January 2003 to December 2004, a total of 60 cases of the carcinoma uterine cervix were selected randomly for the retrospective analyses. All 60 cases were grouped in six groups according to the treating radiotherapist who did the HDR-ICBT application. Three radiotherapists were considered for this study, named A, B and C. Ten cases for each radiotherapist in whom all three applications were done by the same radiotherapist. And 10 cases for each radiotherapist with shared applications in the same patient (A+B, A+C and B+C. The bladder and rectal doses were calculated in reference to point "A" dose and were limited to 80% of prescribed point "A" dose, as per ICRU-38 recommendations. Received dose grouped in three groups- less then 80% (< 80%, 80-100% and above 100% (>100%. A total of 180 applications for 60 patients were calculated for the above analyses. Results : There is a lot of difference in the bladder and rectal doses with the application by the different radiotherapists, even in the same patient with multiple fractions of HDR-ICBT. Applications by ′A′ radiotherapist were within the limits in the self as well as in the shared groups more number of times, by ′B′ radiotherapist was more times exceeding the limit and by ′C′ radiotherapist doses were in between the A and B. Discussion and Conclusion : For the rectal and bladder doses most important factors are patient′s age, disease stage, duration between EBRT and HDR-ICRT and patient anatomy, but these differences can be minimized to some extent by careful application, proper packing and proper fixation.

  4. Increased Risk of Biochemical and Clinical Failure for Prostate Patients with a Large Rectum at Radiotherapy Planning: Results from the Dutch Trial of 68 GY Versus 78 Gy

    International Nuclear Information System (INIS)

    Heemsbergen, Wilma D.; Hoogeman, Mischa S.; Witte, Marnix G.; Peeters, Stephanie T.H.; Incrocci, Luca; Lebesque, Joos V.

    2007-01-01

    Purpose: To investigate whether a large rectum filling visible on the planning CT scan was associated with a decrease in freedom from any failure (FFF) and freedom from clinical failure (FFCF) for prostate cancer patients. Methods and Materials: Patients from the Dutch trial (78 Gy vs. 68 Gy) with available acute toxicity data were analyzed (n = 549). A 10-mm margin was applied for the first 68 Gy and 0-5 mm for the 10-Gy boost. The dose in the seminal vesicles (SVs) was prescribed within four treatment groups according to the estimated risk of SV involvement. Two potential risk factors (RFs) for a geometric miss were defined: (1) an anorectal volume ≥ 90 cm 3 and ≥ 25% of treatment-time diarrhea (RF1); and (2) the mean cross-sectional area of the anorectum (RF2). We tested whether these were significant predictors for FFF and FFCF within each treatment group. Results: Significant results were observed only for patients with a risk of SV involvement > 25% (dose of 68-78 Gy to the SVs, n = 349). We found a decrease in FFF (p = 0.001) and FFCF (p = 0.01) for the 87 patients with RF1 (for RF2, p = 0.02 and p = 0.01, respectively). The estimated decrease in the FFCF rate at 5 years was 15%. Conclusion: Tumor control was significantly decreased in patients with a risk of SV involvement > 25% and at risk of geometric miss. Current image guidance techniques offer several solutions to geometrically optimize the treatment. Additional research is needed to evaluate whether geometric misses can be prevented using these techniques

  5. Detection of up to 65% of Precancerous Lesions of the Human Colon and Rectum by Mutation Analysis of APC, K-Ras, B-Raf and CTNNB1

    International Nuclear Information System (INIS)

    Schneider, Mandy; Scholtka, Bettina; Gottschalk, Uwe; Faiss, Siegbert; Schatz, Daniela; Berghof-Jäger, Kornelia; Steinberg, Pablo

    2010-01-01

    In the present study a recently conceived 4-gene marker panel covering the Wnt and Ras-Raf-MEK-MAPK signaling pathways was used to analyze 20 colorectal serrated lesions and 41 colorectal adenoma samples and to determine the percentage of each of the above-mentioned potentially precancerous lesions carrying at least one of the four above-mentioned genes in a mutated form. CTNNB1 and B-Raf were screened by PCR-single-strand conformation polymorphism analysis, K-Ras by restriction fragment length polymorphism analysis and the APC gene mutation cluster region (codons 1243–1567) by direct DNA sequencing. APC mutations were only detected in 10% of the serrated lesions but in 34% of the adenomas. Twenty percent of the serrated lesions and 14% of the adenomas carried a mutated K-Ras. B-Raf was found to be mutated in 50% of the serrated lesions and in 22% of the adenomas. CTNNB1 was altered in 12% of the adenomas, but not in serrated lesions. By using the above gene marker panel it could be shown that 65% of the serrated lesions and 61% of the adenomas carried at least one of the four genes in a mutated form. Based on its excellent performance in detecting mutations in sporadic preneoplastic (in this study) and neoplastic lesions (in a previous study) of the human colon and rectum, this primer combination might also be suited to efficiently and non-invasively detect genetic alterations in stool DNA of patients with early colorectal cancer

  6. Geometrical Sparing Factors for the Rectum and Bladder in the Prediction of Grade 2 and Higher Complications After High-Dose-Rate Brachytherapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Chen, S.-W.; Liang, J.-A.; Hung, Y.-C.; Yeh, L.-S.; Chang, W.-C.; Yang, S.-N.; Lin, F.-J.

    2009-01-01

    Purpose: This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. Methods: A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. Results: A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). Conclusion: This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  7. Oncological strategies for locally advanced rectal cancer with synchronous liver metastases, interval strategy versus rectum first strategy: a comparison of short-term outcomes.

    Science.gov (United States)

    Salvador-Rosés, H; López-Ben, S; Casellas-Robert, M; Planellas, P; Gómez-Romeu, N; Farrés, R; Ramos, E; Codina-Cazador, A; Figueras, J

    2017-12-22

    The goal of treatment for patients with synchronous liver metastases (SLM) from rectal cancer is to achieve a complete resection of both tumor locations. For patients with symptomatic locally advanced rectal cancer with resectable SLM at diagnosis, our usual strategy has been the rectum first approach (RF). However, since 2014, we advocate for the interval approach (IS) that involves the administration of chemo-radiotherapy followed by the resection of the SLM in the interval of time between rectal cancer radiation and rectal surgery. From 2010 to 2016, 16 patients were treated according to this new strategy and 19 were treated according RF strategy. Data were collected prospectively and analyzed with an intention-to-treat perspective. Complete resection rate, duration of the treatment and morbi-mortality were the main outcomes. The complete resection rate in the IS was higher (100%, n = 16) compared to the RF (74%, n = 14, p = 0.049) and the duration of the strategy was shorter (6 vs. 9 months, respectively, p = 0.006). The incidence of severe complications after liver surgery was 14% (n = 2) in the RF and 0% in the IS (p = 1.000), and after rectal surgery was 24% (n = 4) and 12% (n = 2), respectively (p = 1.000). The IS is a feasible and safe strategy that procures higher level of complete resection rate in a shorter period of time compared to RF strategy.

  8. Detection of up to 65% of Precancerous Lesions of the Human Colon and Rectum by Mutation Analysis of APC, K-Ras, B-Raf and CTNNB1

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Mandy; Scholtka, Bettina, E-mail: scholtka@uni-potsdam.de [Chair of Nutritional Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur- Scheunert-Allee 114-116, 14558 Nuthetal (Germany); Gottschalk, Uwe [Maria Heimsuchung Caritas-Klinik Pankow, Breite Straße 46/47, 13187 Berlin (Germany); Faiss, Siegbert [III. Medizinische Abteilung - Gastroenterologie und Hepatologie, Asklepios Klinik Barmbek, Rubenkamp 220, 22291 Hamburg (Germany); Schatz, Daniela; Berghof-Jäger, Kornelia [BIOTECON Diagnostics GmbH, Hermannswerder Haus 17, 14473 Potsdam (Germany); Steinberg, Pablo, E-mail: scholtka@uni-potsdam.de [Chair of Nutritional Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur- Scheunert-Allee 114-116, 14558 Nuthetal (Germany); Institute for Food Toxicology and Analytical Chemistry, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173 Hannover (Germany)

    2010-12-29

    In the present study a recently conceived 4-gene marker panel covering the Wnt and Ras-Raf-MEK-MAPK signaling pathways was used to analyze 20 colorectal serrated lesions and 41 colorectal adenoma samples and to determine the percentage of each of the above-mentioned potentially precancerous lesions carrying at least one of the four above-mentioned genes in a mutated form. CTNNB1 and B-Raf were screened by PCR-single-strand conformation polymorphism analysis, K-Ras by restriction fragment length polymorphism analysis and the APC gene mutation cluster region (codons 1243–1567) by direct DNA sequencing. APC mutations were only detected in 10% of the serrated lesions but in 34% of the adenomas. Twenty percent of the serrated lesions and 14% of the adenomas carried a mutated K-Ras. B-Raf was found to be mutated in 50% of the serrated lesions and in 22% of the adenomas. CTNNB1 was altered in 12% of the adenomas, but not in serrated lesions. By using the above gene marker panel it could be shown that 65% of the serrated lesions and 61% of the adenomas carried at least one of the four genes in a mutated form. Based on its excellent performance in detecting mutations in sporadic preneoplastic (in this study) and neoplastic lesions (in a previous study) of the human colon and rectum, this primer combination might also be suited to efficiently and non-invasively detect genetic alterations in stool DNA of patients with early colorectal cancer.

  9. Geometrical sparing factors for the rectum and bladder in the prediction of grade 2 and higher complications after high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Chen, Shang-Wen; Liang, Ji-An; Hung, Yao-Ching; Yeh, Lian-Shung; Chang, Wei-Chun; Yang, Shih-Neng; Lin, Fang-Jen

    2009-12-01

    This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  10. Class impressions : Higher social class elicits lower prosociality

    NARCIS (Netherlands)

    Van Doesum, Niels J.; Tybur, Joshua M.; Van Lange, Paul A.M.

    2017-01-01

    Social class predicts numerous important life outcomes and social orientations. To date, literature has mainly examined how an individual's own class shapes interactions with others. But how prosocially do people treat others they perceive as coming from lower, middle, or higher social classes?

  11. Class Action and Class Settlement in a European Perspective

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2013-01-01

    The article analyses the options for introducing common European rules on class action lawsuits with an opt-out-model in individual cases. An analysis is made of how the risks of misuse of class actions can be prevented. The article considers the Dutch rules on class settlements (the WCAM procedure...

  12. An "expanded" class perspective

    DEFF Research Database (Denmark)

    Steur, Luisa Johanna

    2014-01-01

    Following the police raid on the ‘Muthanga’ land occupation by Adivasi (‘indigenous’) activists in Kerala, India, in February 2003, intense public debate erupted about the fate of Adivasis in this ‘model’ development state. Most commentators saw the land occupation either as the fight...... analysis, as elaborated in Marxian anthropology, this article provides an alternative to the liberal-culturalist explanation of indigenism in Kerala, arguing instead that contemporary class processes—as experienced close to the skin by the people who decided to participate in the Muthanga struggle......—were what shaped their decision to embrace indigenism....

  13. Class prediction for high-dimensional class-imbalanced data

    Directory of Open Access Journals (Sweden)

    Lusa Lara

    2010-10-01

    Full Text Available Abstract Background The goal of class prediction studies is to develop rules to accurately predict the class membership of new samples. The rules are derived using the values of the variables available for each subject: the main characteristic of high-dimensional data is that the number of variables greatly exceeds the number of samples. Frequently the classifiers are developed using class-imbalanced data, i.e., data sets where the number of samples in each class is not equal. Standard classification methods used on class-imbalanced data often produce classifiers that do not accurately predict the minority class; the prediction is biased towards the majority class. In this paper we investigate if the high-dimensionality poses additional challenges when dealing with class-imbalanced prediction. We evaluate the performance of six types of classifiers on class-imbalanced data, using simulated data and a publicly available data set from a breast cancer gene-expression microarray study. We also investigate the effectiveness of some strategies that are available to overcome the effect of class imbalance. Results Our results show that the evaluated classifiers are highly sensitive to class imbalance and that variable selection introduces an additional bias towards classification into the majority class. Most new samples are assigned to the majority class from the training set, unless the difference between the classes is very large. As a consequence, the class-specific predictive accuracies differ considerably. When the class imbalance is not too severe, down-sizing and asymmetric bagging embedding variable selection work well, while over-sampling does not. Variable normalization can further worsen the performance of the classifiers. Conclusions Our results show that matching the prevalence of the classes in training and test set does not guarantee good performance of classifiers and that the problems related to classification with class

  14. Impact of socio-economic class on colorectal cancer patient outcomes in Kuala Lumpur and Kuching, Malaysia.

    Science.gov (United States)

    Kong, Chee-Kwan; Roslani, April Camilla; Law, Chee-Wei; Law, Suk-Chin Diana; Arumugam, Kulenthran

    2010-01-01

    Research over the past several decades has indicated that low socioeconomic class has a direct effect on health outcomes. In Malaysia, class distribution may differ with the region. The objective of this study was to compare the presentation and survival of colorectal cancer patients in two dissimilar cities, Kuala Lumpur and Kuching, Sarawak. All patients diagnosed with a malignancy of the colon or rectum in Sarawak General Hospital and University of Malaya Medical Center from 1st Jan 2000-31st Dec 2006 were recruited. Data on presentation, socio-economic class and survival were obtained. The survival duration was categorized into more than three years or three years and less. Testing for significance was performed using the chi-square test, with p values less than 0.05 considered statistically significant. A total of 565 patients in UMMC and 642 patients in SGH had a new diagnosis of colorectal carcinoma. Patients in Kuching had a longer duration of symptoms and more advanced stage at presentation, but this was not statistically significant. Lower socio-economic class was a significant factor for late and more advanced stage at diagnosis, as well as poorer three and five year survival rates. However, survival was lower for patients in Kuching compared to Kuala Lumpur, even after matching for socio-economic class. There is near-zero awareness of colorectal cancer screening in Malaysia. These findings support reaching out to communities of lower socioeconomic backgrounds to improve the colorectal cancer survival rates.

  15. Teachers, Social Class and Underachievement

    Science.gov (United States)

    Dunne, Mairead; Gazeley, Louise

    2008-01-01

    Addressing the "the social class attainment gap" in education has become a government priority in England. Despite multiple initiatives, however, little has effectively addressed the underachievement of working-class pupils within the classroom. In order to develop clearer understandings of working-class underachievement at this level,…

  16. Mapping the Social Class Structure

    DEFF Research Database (Denmark)

    Toubøl, Jonas; Grau Larsen, Anton

    2017-01-01

    This article develops a new explorative method for deriving social class categories from patterns of occupational mobility. In line with Max Weber, our research is based on the notion that, if class boundaries do not inhibit social mobility then the class categories are of little value. Thus...

  17. Pseudo Class III malocclusion

    Directory of Open Access Journals (Sweden)

    Fadia M. Al-Hummayani

    2016-04-01

    Full Text Available The treatment of deep anterior crossbite is technically challenging due to the difficulty of placing traditional brackets with fixed appliances. This case report represents a none traditional treatment modality to treat deep anterior crossbite in an adult pseudo class III malocclusion complicated by severely retruded, supraerupted upper and lower incisors. Treatment was carried out in 2 phases. Phase I treatment was performed by removable appliance “modified Hawley appliance with inverted labial bow,” some modifications were carried out to it to suit the presented case. Positive overbite and overjet was accomplished in one month, in this phase with minimal forces exerted on the lower incisors. Whereas, phase II treatment was performed with fixed appliances (braces to align teeth and have proper over bite and overjet and to close posterior open bite, this phase was accomplished within 11 month.

  18. [Economy class syndrome].

    Science.gov (United States)

    Morio, Hiroshi

    2003-10-01

    Economy class syndrome is venous thromboembolism following air travel. This syndrome was firstly reported in 1946, and many cases have been reported since 1990s. Low air pressure and low humidity in the aircraft cabin may contribute to the mechanism of this syndrome. Risk factors for venous thrombosis in the plane were old age, small height, obesity, hormonal therapy, malignancy, smoking, pregnancy or recent parturition, recent trauma or operation, chronic disease and history of venous thrombosis. In Japan, the feminine gender is also risk factor though reason was not well known. For prophylaxis, adequate fluid intake and leg exercise are recommended to all passengers. For passengers with high risk, prophylactic measures such as compression stockings, aspirin or low molecular weight heparin should be considered.

  19. Network class superposition analyses.

    Directory of Open Access Journals (Sweden)

    Carl A B Pearson

    Full Text Available Networks are often used to understand a whole system by modeling the interactions among its pieces. Examples include biomolecules in a cell interacting to provide some primary function, or species in an environment forming a stable community. However, these interactions are often unknown; instead, the pieces' dynamic states are known, and network structure must be inferred. Because observed function may be explained by many different networks (e.g., ≈ 10(30 for the yeast cell cycle process, considering dynamics beyond this primary function means picking a single network or suitable sample: measuring over all networks exhibiting the primary function is computationally infeasible. We circumvent that obstacle by calculating the network class ensemble. We represent the ensemble by a stochastic matrix T, which is a transition-by-transition superposition of the system dynamics for each member of the class. We present concrete results for T derived from boolean time series dynamics on networks obeying the Strong Inhibition rule, by applying T to several traditional questions about network dynamics. We show that the distribution of the number of point attractors can be accurately estimated with T. We show how to generate Derrida plots based on T. We show that T-based Shannon entropy outperforms other methods at selecting experiments to further narrow the network structure. We also outline an experimental test of predictions based on T. We motivate all of these results in terms of a popular molecular biology boolean network model for the yeast cell cycle, but the methods and analyses we introduce are general. We conclude with open questions for T, for example, application to other models, computational considerations when scaling up to larger systems, and other potential analyses.

  20. Damascus steel ledeburite class

    Science.gov (United States)

    Sukhanov, D. A.; Arkhangelsky, L. B.; Plotnikova, N. V.

    2017-02-01

    Discovered that some of blades Damascus steel has an unusual nature of origin of the excess cementite, which different from the redundant phases of secondary cementite, cementite of ledeburite and primary cementite in iron-carbon alloys. It is revealed that the morphological features of separate particles of cementite in Damascus steels lies in the abnormal size of excess carbides having the shape of irregular prisms. Considered three hypotheses for the formation of excess cementite in the form of faceted prismatic of excess carbides. The first hypothesis is based on thermal fission of cementite of a few isolated grains. The second hypothesis is based on the process of fragmentation cementite during deformation to the separate the pieces. The third hypothesis is based on the transformation of metastable cementite in the stable of angular eutectic carbide. It is shown that the angular carbides are formed within the original metastable colony ledeburite, so they are called “eutectic carbide”. It is established that high-purity white cast iron is converted into of Damascus steel during isothermal soaking at the annealing. It was revealed that some of blades Damascus steel ledeburite class do not contain in its microstructure of crushed ledeburite. It is shown that the pattern of carbide heterogeneity of Damascus steel consists entirely of angular eutectic carbides. Believe that Damascus steel refers to non-heat-resistant steel of ledeburite class, which have similar structural characteristics with semi-heat-resistant die steel or heat-resistant high speed steel, differing from them only in the nature of excess carbide phase.

  1. Understanding Class in Contemporary Societies

    DEFF Research Database (Denmark)

    Harrits, Gitte Sommer

    2007-01-01

    In this paper, I argue that claims about the death of class and the coming of the classless society are premature. Such claims are seldom genuinely empirical, and the theoretical argument often refers to a simple and therefore easily dismissible concept of class. By rejecting the concept of class...... altogether, sociological theory runs the risk of loosing the capacity for analysing stratification and vertical differentiation of power and freedom, which in late modernity seem to be a of continuing importance. Hence, I argue that although class analysis faces a number of serious challenges, it is possible...... to reinvent class analysis. The sociology of Pierre Bourdieu in many ways introduces an appropriate paradigm, and the paper therefore critically discusses Bourdieu's concept of class. Since the "Bourdieuan" class concept is primarily epistemological, i.e. a research strategy more than a theory, empirical...

  2. Exploring social class: voices of inter-class couples.

    Science.gov (United States)

    McDowell, Teresa; Melendez-Rhodes, Tatiana; Althusius, Erin; Hergic, Sara; Sleeman, Gillian; Ton, Nicky Kieu My; Zimpfer-Bak, A J

    2013-01-01

    Social class is not often discussed or examined in-depth in couple and family therapy research and literature even though social class shapes familial relationships and is considered an important variable in marital satisfaction. In this qualitative study, we explored the perceptions of eight couples who made lasting commitments across class lines by asking them about the impact of their social class backgrounds on their relationships. Three categories of themes emerged including: (a) differences and similarities in values and attitudes toward education, work, money, and class awareness/classism, (b) relationship issues involving families of origin, friends, and class-based couple conflict, and (c) differences in economic resources, social capital and privileges/opportunities. Implications for assessment and treatment of couples are included. © 2012 American Association for Marriage and Family Therapy.

  3. Reconciling Virtual Classes with Genericity

    DEFF Research Database (Denmark)

    Ernst, Erik

    2006-01-01

    is functional abstraction, yielding more precise knowledge about the outcome; the prime ex- ample is type parameterized classes. This paper argues that they should be clearly separated to work optimally. We have applied this design philosophy to a lan- guage based on an extension mechanism, namely virtual...... classes. As a result, a kind of type parameters have been introduced, but they are simple and only used where they excel. Conversely, final definitions of virtual classes have been re- moved from the language, thus making virtual classes more flexible. The result- ing language presents a clearer and more...

  4. Class Counts: Education, Inequality, and the Shrinking Middle Class

    Science.gov (United States)

    Ornstein, Allan

    2007-01-01

    Class differences and class warfare have existed since the beginning of western civilization, but the gap in income and wealth between the rich (top 10 percent) and the rest has increased steadily in the last twenty-five years. The U.S. is heading for a financial oligarchy much worse than the aristocratic old world that our Founding Fathers feared…

  5. Type Families with Class, Type Classes with Family

    DEFF Research Database (Denmark)

    Serrano, Alejandro; Hage, Jurriaan; Bahr, Patrick

    2015-01-01

    Type classes and type families are key ingredients in Haskell programming. Type classes were introduced to deal with ad-hoc polymorphism, although with the introduction of functional dependencies, their use expanded to type-level programming. Type families also allow encoding type-level functions......, now as rewrite rules. This paper looks at the interplay of type classes and type families, and how to deal with shortcomings in both of them. Furthermore, we show how to use families to simulate classes at the type level. However, type families alone are not enough for simulating a central feature...... of type classes: elaboration, that is, generating code from the derivation of a rewriting. We look at ways to solve this problem in current Haskell, and propose an extension to allow elaboration during the rewriting phase....

  6. Subaltern Classes, Class Struggles and Hegemony : a Gramscian Approach

    Directory of Open Access Journals (Sweden)

    Ivete Simionatto

    2009-01-01

    Full Text Available This article sought to revive the concept of subaltern classes and their relation with other categories, particularly the State, civil society and hegemony in the thinking of Antonio Gramsci, as a support for contemporary class struggles. It also analyzes the relations between subaltern classes, common sense and ideology, as well as the forms of “overcoming” conceptualized by Gramsci, through the culture and philosophy of praxis. The paper revives the discussion of the subaltern classes, based on the original Gramscian formulation in the realm of Marxism, through the dialectic interaction between structure and superstructure, economy and politics. In addition to the conceptual revival, it indicates some elements that can support the discussion of the forms of subalternity found in contemporary reality and the possibilities for strengthening the struggles of these class layers, above all in moments of strong demobilization of popular participation.

  7. Context-sensitive intra-class clustering

    KAUST Repository

    Yu, Yingwei; Gutierrez-Osuna, Ricardo; Choe, Yoonsuck

    2014-01-01

    This paper describes a new semi-supervised learning algorithm for intra-class clustering (ICC). ICC partitions each class into sub-classes in order to minimize overlap across clusters from different classes. This is achieved by allowing partitioning

  8. On uniqueness of characteristic classes

    DEFF Research Database (Denmark)

    Feliu, Elisenda

    2011-01-01

    We give an axiomatic characterization of maps from algebraic K-theory. The results apply to a large class of maps from algebraic K-theory to any suitable cohomology theory or to algebraic K-theory. In particular, we obtain comparison theorems for the Chern character and Chern classes and for the ...

  9. Race and Class on Campus

    Science.gov (United States)

    Perez, Angel B.

    2016-01-01

    Colleges and universities have a significant role to play in shaping the future of race and class relations in America. As exhibited in this year's presidential election, race and class continue to divide. Black Lives Matter movements, campus protests, and police shootings are just a few examples of the proliferation of intolerance, and higher…

  10. Propagating Class and Method Combination

    DEFF Research Database (Denmark)

    Ernst, Erik

    1999-01-01

    number of implicit combinations. For example, it is possible to specify separate aspects of a family of classes, and then combine several aspects into a full-fledged class family. The combination expressions would explicitly combine whole-family aspects, and by propagation implicitly combine the aspects...

  11. Social Class and the Extracurriculum

    Science.gov (United States)

    Barratt, Will

    2012-01-01

    Social class is a powerful and often unrecognized influence on student participation in the extracurriculum. Spontaneous student-created extracurricular experiences depend on students affiliating and interacting with each other; student social class is a powerful influence on student affiliations. Students tend to exercise consciousness of kind-…

  12. Translanguaging in a Reading Class

    Science.gov (United States)

    Vaish, Viniti; Subhan, Aidil

    2015-01-01

    Using translanguaging as a theoretical foundation, this paper analyses findings from a Grade 2 reading class for low achieving students, where Malay was used as a scaffold to teach English. Data come from one class in one school in Singapore and its Learning Support Programme (LSP), which is part of a larger research project on biliteracy. The LSP…

  13. A Touch of...Class!

    Science.gov (United States)

    Netten, Joan W., Ed.

    1984-01-01

    A collection of ideas for class activities in elementary and secondary language classes includes a vocabulary review exercise and games of memory, counting, vocabulary, flashcard tic-tac-toe, dice, trashcans, questioning, and spelling. Some are designed specifically for French. (MSE)

  14. Comparison of different contouring definitions of the rectum as organ at risk (OAR) and dose-volume parameters predicting rectal inflammation in radiotherapy of prostate cancer: which definition to use?

    Science.gov (United States)

    Nitsche, Mirko; Brannath, Werner; Brückner, Matthias; Wagner, Dirk; Kaltenborn, Alexander; Temme, Nils; Hermann, Robert M

    2017-02-01

    The objective of this retrospective planning study was to find a contouring definition for the rectum as an organ at risk (OAR) in curative three-dimensional external beam radiotherapy (EBRT) for prostate cancer (PCa) with a predictive correlation between the dose-volume histogram (DVH) and rectal toxicity. In a pre-study, the planning CT scans of 23 patients with PCa receiving definitive EBRT were analyzed. The rectum was contoured according to 13 different definitions, and the dose distribution was correlated with the respective rectal volumes by generating DVH curves. Three definitions were identified to represent the most distinct differences in the shapes of the DVH curves: one anatomical definition recommended by the Radiation Therapy Oncology Group (RTOG) and two functional definitions based on the target volume. In the main study, the correlation between different relative DVH parameters derived from these three contouring definitions and the occurrence of rectal toxicity during and after EBRT was studied in two consecutive collectives. The first cohort consisted of 97 patients receiving primary curative EBRT and the second cohort consisted of 66 patients treated for biochemical recurrence after prostatectomy. Rectal toxicity was investigated by clinical investigation and scored according to the Common Terminology Criteria for Adverse Events. Candidate parameters were the volume of the rectum, mean dose, maximal dose, volume receiving at least 60 Gy (V 60 ), area under the DVH curve up to 25 Gy and area under the DVH curve up to 75 Gy in dependence of each chosen rectum definition. Multivariable logistic regression considered other clinical factors such as pelvine lymphatics vs local target volume, diabetes, prior rectal surgery, anticoagulation or haemorrhoids too. In Cohort 1 (primary EBRT), the mean rectal volumes for definitions "RTOG", planning target volume "(PTV)-based" and "PTV-linked" were 100 cm 3 [standard deviation (SD) 43 cm 3 ], 60

  15. Consumer Education in Any Class

    Science.gov (United States)

    Wingo, Rosetta F.

    1977-01-01

    Examples are offered of how the classroom teacher can blend consumer education into typewriting, business English, business math, and other classes by intentionally focusing on principles and concepts or by including it incidentally when the opportunity arises. (TA)

  16. Ethnicity, class, and civil war

    DEFF Research Database (Denmark)

    Hechter, Michael Norman; Siroky, David

    2016-01-01

    of political instability. These two types of conflict result from distinct principles of group solidarity – ethnicity and class – and since each individual is simultaneously a member of an ethnic group (or many such groups) and a particular class, these two principles vary in the degree to which......Why are some countries prone to ethno-nationalist conflict, whereas others are plagued by class conflict? This is a question that has seldom been raised and rarely been examined empirically. This paper presents a social-structural theory to account for the variable incidence of these two forms......-group inequalities are high, and within-group inequalities low, ethnicity should be the dominant principle of group solidarity and serve as the primary basis of group conflict. By contrast, in countries where between-group inequalities are low, and within-group inequalities high, class is more likely to serve...

  17. Imbalanced Class Learning in Epigenetics

    OpenAIRE

    Haque, M. Muksitul; Skinner, Michael K.; Holder, Lawrence B.

    2014-01-01

    In machine learning, one of the important criteria for higher classification accuracy is a balanced dataset. Datasets with a large ratio between minority and majority classes face hindrance in learning using any classifier. Datasets having a magnitude difference in number of instances between the target concept result in an imbalanced class distribution. Such datasets can range from biological data, sensor data, medical diagnostics, or any other domain where labeling any instances of the mino...

  18. Imbalanced class learning in epigenetics.

    Science.gov (United States)

    Haque, M Muksitul; Skinner, Michael K; Holder, Lawrence B

    2014-07-01

    In machine learning, one of the important criteria for higher classification accuracy is a balanced dataset. Datasets with a large ratio between minority and majority classes face hindrance in learning using any classifier. Datasets having a magnitude difference in number of instances between the target concept result in an imbalanced class distribution. Such datasets can range from biological data, sensor data, medical diagnostics, or any other domain where labeling any instances of the minority class can be time-consuming or costly or the data may not be easily available. The current study investigates a number of imbalanced class algorithms for solving the imbalanced class distribution present in epigenetic datasets. Epigenetic (DNA methylation) datasets inherently come with few differentially DNA methylated regions (DMR) and with a higher number of non-DMR sites. For this class imbalance problem, a number of algorithms are compared, including the TAN+AdaBoost algorithm. Experiments performed on four epigenetic datasets and several known datasets show that an imbalanced dataset can have similar accuracy as a regular learner on a balanced dataset.

  19. The theory of social classes Maurice Halbwachs

    OpenAIRE

    L. V. Kozlova

    2014-01-01

    The article considers the basic thesis of Maurice Halbwachs’s theory of social classes outlined in the “Social classes and morphology” (1942): the concept of class is revealed as the object of collective representation, the main characteristics of classes, the criteria for its selection and conditions for classes formation are analyzed.

  20. Tumor de reto e cárdia sincrônicos: relato de caso e revisão da literatura Rectum and cardia cynchronous tumor: case report and literature review

    Directory of Open Access Journals (Sweden)

    Robson Luis Silveira Jara

    2007-03-01

    Full Text Available Os autores relatam um caso raro de um paciente de 77 anos, que desenvolveu dois tumores sincrônicos do trato gastrintestinal, localizados em topografia de reto e cárdia. Feito o diagnóstico de ambos simultaneamente. Foi submetido à cirurgia em dois tempos e evoluiu bem, realizando a reconstrução do trato gastrintestinal três meses após a primeira intervenção. Não encontramos na literatura nenhum outro relato desta combinação de tumores.We discuss a 77-year-old man who developed two cancers: adenocarcinoma of the stomach and adenocarcinoma of the rectum. He was submitted at the surgery developed for two interventions and evolved aright. To the best of our knowledge, no other patient with the combination of these two cancers has been reported in the literature.

  1. Finishing occlusion in Class II or Class III molar relation: therapeutic Class II and III.

    Science.gov (United States)

    Nangia, A; Darendeliler, M A

    2001-11-01

    The most frequent extraction regime consists of the removal of upper and lower premolars. Depending on anchorage requirements, camouflage treatment options, surgical intervention, or the absence of teeth in only one arch, it may become necessary to finalize the occlusion with a one-dental-unit discrepancy between the upper and lower dental arches. Guidelines are presented for finishing occlusions in Class II or Class III molar relation.

  2. The challenge in treating locally recurrent T3-4 nasopharyngeal carcinoma: the survival benefit and severe late toxicities of re-irradiation with intensity-modulated radiotherapy.

    Science.gov (United States)

    Tian, Yun-Ming; Huang, Wei-Zeng; Yuan, Xia; Bai, Li; Zhao, Chong; Han, Fei

    2017-06-27

    Effective treatments for patients with advanced locally recurrent nasopharyngeal carcinoma (NPC) are limited. This investigation was to determine the potential benefits from re-irradiation by intensity-modulated radiotherapy (IMRT) on survival and the effects of severe late toxicities. A retrospective study was conducted in 245 patients diagnosed with locally recurrent T3-T4 NPC who had undergone re-irradiation with IMRT. Follow-up data was colletedand factors associated with survival and severe late toxicities were analyzed. The 5-year local-regional failure-free survival, distant failure-free survival and overall survival rates were 60.9%, 78.3% and 27.5%, respectively. The presence of severe late complications, recurrent T4 disease and gross tumor volume >30 cm3 were associated with poor survival. The incidences of mucosal necrosis, temporal lobe necrosis, cranial neuropathy and trismus were 22.0%, 14.6%, 27.0% and 14.6% respectively. Re-irradiation with IMRT is an effective choice in patients with locally recurrent T3-T4 NPC. However, the survival benefits can be partly offset by severe late complications and optimum treatments in these patients remain a challenge.

  3. Imagining class : A study into material social class position, subjective identification, and voting behavior across Europe

    NARCIS (Netherlands)

    D'Hooge, L.; Achterberg, P.H.J.; Reeskens, T.

    2018-01-01

    The traditional approach to class voting has largely ignored the question whether material class positions coincide with subjective class identification. Following Sosnaud et al. (2013), this study evaluates party preferences when Europeans’ material and subjective social class do not coincide.

  4. Parametric embedding for class visualization.

    Science.gov (United States)

    Iwata, Tomoharu; Saito, Kazumi; Ueda, Naonori; Stromsten, Sean; Griffiths, Thomas L; Tenenbaum, Joshua B

    2007-09-01

    We propose a new method, parametric embedding (PE), that embeds objects with the class structure into a low-dimensional visualization space. PE takes as input a set of class conditional probabilities for given data points and tries to preserve the structure in an embedding space by minimizing a sum of Kullback-Leibler divergences, under the assumption that samples are generated by a gaussian mixture with equal covariances in the embedding space. PE has many potential uses depending on the source of the input data, providing insight into the classifier's behavior in supervised, semisupervised, and unsupervised settings. The PE algorithm has a computational advantage over conventional embedding methods based on pairwise object relations since its complexity scales with the product of the number of objects and the number of classes. We demonstrate PE by visualizing supervised categorization of Web pages, semisupervised categorization of digits, and the relations of words and latent topics found by an unsupervised algorithm, latent Dirichlet allocation.

  5. Parenting classes: focus on discipline.

    Science.gov (United States)

    Campbell, J M

    1992-01-01

    Nurses in community settings have an opportunity to provide instruction related to health and life-style needs. An important consideration is the parental role. A particularly controversial and opinion-laden aspect of parenting is disciplining children. Discipline provides children with the security of clearly enforced rules to help them learn self-control and social standards. Parenting classes are worthwhile for people who have little formal or informal preparation. A survey of middle-class elementary school district parents' and childrens' attitudes toward discipline was conducted to develop meaningful parenting classes. Parents' feelings about being a mother or father were surprisingly negative. A parent educational program was developed to cover child growth and development and disciplinary practices. Parent evaluations led to continuation and an expansion of this program to other schools within the area.

  6. Gender, social class, and women's employment.

    Science.gov (United States)

    McGinn, Kathleen L; Oh, Eunsil

    2017-12-01

    People in low-power positions, whether due to gender or class, tend to exhibit other-oriented rather than self-oriented behavior. Women's experiences at work and at home are shaped by social class, heightening identification with gender for relatively upper class women and identification with class for relatively lower class women, potentially mitigating, or even reversing, class-based differences documented in past research. Gender-class differences are reflected in women's employment beliefs and behaviors. Research integrating social class with gendered experiences in homes and workplaces deepens our understanding of the complex interplay between sources of power and status in society. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Are Ghanaian Diaspora Middle Class? Linking Middle Class to ...

    African Journals Online (AJOL)

    2015-06-24

    Jun 24, 2015 ... Enfin, nous analyserons l'influence de cette élite dans le .... In other words, many people who are considered middle class, sometimes in a month ..... the same area, will in future help my children to have a network of friends .... Ghanaian politics since 1992, where the ruling party does not win an election to.

  8. Class Cuisine: Food in the Foreign Language Class.

    Science.gov (United States)

    Rauschenberg, Gretchen S.

    1984-01-01

    Food can both interest students in a foreign culture and motivate them to broaden their interests. Cooking with students can take many forms. The students can cook in class if adequate preparations are made and permission is granted. Students can contribute toward the purchase of food for snacks and meals, and the cost can be kept to the price of…

  9. Social Class Matters: Class Identities and Discourses in Educational Contexts

    Science.gov (United States)

    Hunt, Carolyn S.; Seiver, Machele

    2018-01-01

    In this conceptual literature review, the authors analyze research from the last 20 years to explore how social class discourses are reproduced, resisted, and appropriated within Kindergarten through Grade 12 classrooms in the United States. The findings challenge commonly held deficit discourses about students and families from economically…

  10. Chiral algebras of class S

    CERN Document Server

    Beem, Christopher; Rastelli, Leonardo; van Rees, Balt C.

    2015-01-01

    Four-dimensional N=2 superconformal field theories have families of protected correlation functions that possess the structure of two-dimensional chiral algebras. In this paper, we explore the chiral algebras that arise in this manner in the context of theories of class S. The class S duality web implies nontrivial associativity properties for the corresponding chiral algebras, the structure of which is best summarized in the language of generalized topological quantum field theory. We make a number of conjectures regarding the chiral algebras associated to various strongly coupled fixed points.

  11. Enzymatic Browning: a practical class

    Directory of Open Access Journals (Sweden)

    Maria Teresa Pedrosa Silva Clerici

    2014-10-01

    Full Text Available This paper presents a practical class about the enzymes polyphenol oxidases, which have been shown to be responsible for the enzymatic browning of fruits and vegetables. Vegetables samples were submitted to enzymatic inactivation process with chemical reagents, as well as by bleaching methods of applying heat by conventional oven and microwave oven. Process efficiency was assessed qualitatively by both observing the guaiacol peroxidase activity and after the storage period under refrigeration or freezing. The practical results obtained in this class allow exploring multidisciplinary knowledge in food science, with practical applications in everyday life.

  12. Mappings on Neutrosophic Soft Classes

    Directory of Open Access Journals (Sweden)

    Shawkat Alkhazaleh

    2014-03-01

    Full Text Available In 1995 Smarandache introduced the concept of neutrosophic set which is a mathematical tool for handling problems involving imprecise, indeterminacy and inconsistent data. In 2013 Maji introduced the concept of neutrosophic soft set theory as a general mathematical tool for dealing with uncertainty. In this paper we define the notion of a mapping on classes where the neutrosophic soft classes are collections of neutrosophic soft set. We also define and study the properties of neutrosophic soft images and neutrosophic soft inverse images of neutrosophic soft sets.

  13. Two classes of metric spaces

    Directory of Open Access Journals (Sweden)

    Isabel Garrido

    2016-04-01

    Full Text Available The class of metric spaces (X,d known as small-determined spaces, introduced by Garrido and Jaramillo, are properly defined by means of some type of real-valued Lipschitz functions on X. On the other hand, B-simple metric spaces introduced by Hejcman are defined in terms of some kind of bornologies of bounded subsets of X. In this note we present a common framework where both classes of metric spaces can be studied which allows us to see not only the relationships between them but also to obtain new internal characterizations of these metric properties.

  14. 47 CFR 74.708 - Class A TV and digital Class A TV station protection.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Class A TV and digital Class A TV station... SERVICES Low Power TV, TV Translator, and TV Booster Stations § 74.708 Class A TV and digital Class A TV station protection. (a) The Class A TV and digital Class A TV station protected contours are specified in...

  15. Filters in Fuzzy Class Theory

    Czech Academy of Sciences Publication Activity Database

    Kroupa, Tomáš

    2008-01-01

    Roč. 159, č. 14 (2008), s. 1773-1787 ISSN 0165-0114 R&D Projects: GA MŠk 1M0572; GA AV ČR KJB100300502 Institutional research plan: CEZ:AV0Z10750506 Keywords : filter * prime filter * fuzzy class theory Subject RIV: BA - General Mathematics Impact factor: 1.833, year: 2008

  16. Exploring Class-Based Intersectionality

    Science.gov (United States)

    Block, David; Corona, Victor

    2014-01-01

    This paper argues that language, culture and identity researchers need to take the intersectionality of identity inscriptions seriously and, further to this, that an intersectional approach which emanates from an interest in social class provides a productive way to examine the lives and experience of individuals living in multicultural societies.…

  17. Human Relations Class. A Syllabus.

    Science.gov (United States)

    Guillen, Mary A.

    A junior high level human relations class develops human interaction and oral communication skills. A week-by-week syllabus contains the following components: introduction of the students to each other and to the principles of body language, transactional analysis, and group interaction; behavior contracts; group dynamics topics and exercises;…

  18. Professional Elites in "Classes" Societies

    NARCIS (Netherlands)

    S.J. Magala (Slawomir)

    2003-01-01

    textabstractModern European identity has been forged in class struggles between the French revolution and fall of the Berlin Wall, which fell twice. Once, with the rest of the city in May 1945, when a national socialist alternative to a modernizing mix of parliamentary democracy and market economy

  19. Active Learning in Large Classes

    DEFF Research Database (Denmark)

    Gørtz, Inge Li

    2011-01-01

    teaching large classes (more than 50 students), and describe how we successfully have in a second semester course in the Bachelor of Engineering (BEng) and Bachelor of Science Engineering (BSc Eng) program at the Technical University of Denmark (DTU). Approximately 200 students is attending...

  20. Achieving world class maintenance status

    Energy Technology Data Exchange (ETDEWEB)

    Tomlingson, P.D. [Paul D. Tomingson Associates (United States)

    2007-08-15

    The article written by a management consultant, discusses the art of successful planning and operation of maintenance in mines considering factors such as benchmaking, key performance indices (KPIs) and frequency of procedures which can help achieve 'world class maintenance'. 1 fig.

  1. Social Class and School Music

    Science.gov (United States)

    Bates, Vincent C.

    2012-01-01

    This article takes a practical look at social class in school music by exploring the manifestations and impact of three of its dimensions: financial resources, cultural practices, and social networks. Three suggestions are discussed: provide a free and equal music education for all students, understand and respect each student's cultural…

  2. Small Classes 1, Vouchers 0.

    Science.gov (United States)

    Bracey, Gerald W.

    2000-01-01

    Alan Krueger's reanalyses of Eric Hanushek's school-productivity data show that Hanushek's "money doesn't matter" conclusions (influential in several states' education-finance hearings) have no factual basis. Hanushek excluded Tennessee's student/teacher ratio study (Project STAR). Also, class size is influencing students' success in…

  3. Latent class models for classification

    NARCIS (Netherlands)

    Vermunt, J.K.; Magidson, J.

    2003-01-01

    An overview is provided of recent developments in the use of latent class (LC) and other types of finite mixture models for classification purposes. Several extensions of existing models are presented. Two basic types of LC models for classification are defined: supervised and unsupervised

  4. Trabalho e classes sociais Work and social classes

    Directory of Open Access Journals (Sweden)

    Fernando Haddad

    1997-10-01

    Full Text Available Exposição, discussão e refutação das principais tentativas de atualizar a teoria marxista de classes e posterior reavaliação dessa teoria à luz da transformação da ciência em fator de produção e da possível perda de centralidade do trabalho no processo produtivo, tendo por base as interpretações lógicas da obra de Marx feitas por Ruy Fausto.Exposition, discussion and refutation of the main attempts of actualizing marxist class theory and a posterior reevaluation of this theory taking into account the transformation of Science into a factor of production and of the possible centrality-loss of work in the productive process, based on the logic interpretations of Marx's work made by Ruy Fausto.

  5. Student versus Faculty Perceptions of Missing Class.

    Science.gov (United States)

    Sleigh, Merry J.; Ritzer, Darren R.; Casey, Michael B.

    2002-01-01

    Examines and compares student and faculty attitudes towards students missing classes and class attendance. Surveys undergraduate students (n=231) in lower and upper level psychology courses and psychology faculty. Reports that students found more reasons acceptable for missing classes and that the amount of in-class material on the examinations…

  6. Concurrence classes for general pure multipartite states

    International Nuclear Information System (INIS)

    Heydari, Hoshang

    2005-01-01

    We propose concurrence classes for general pure multipartite states based on an orthogonal complement of a positive operator-valued measure on quantum phase. In particular, we construct W m class, GHZ m , and GHZ m-1 class concurrences for general pure m-partite states. We give explicit expressions for W 3 and GHZ 3 class concurrences for general pure three-partite states and for W 4 , GHZ 4 and GHZ 3 class concurrences for general pure four-partite states

  7. Understanding Intra-Class Knowledge Inside CNN

    OpenAIRE

    Wei, Donglai; Zhou, Bolei; Torrabla, Antonio; Freeman, William

    2015-01-01

    Convolutional Neural Network (CNN) has been successful in image recognition tasks, and recent works shed lights on how CNN separates different classes with the learned inter-class knowledge through visualization. In this work, we instead visualize the intra-class knowledge inside CNN to better understand how an object class is represented in the fully-connected layers. To invert the intra-class knowledge into more interpretable images, we propose a non-parametric patch prior upon previous CNN...

  8. The Fermilab physics class library

    International Nuclear Information System (INIS)

    Fischler, M.; Brown, W.; Gaines, I.; Kennedy, R.D.; Marraffino, J.; Michelotti, L.; Sexton-Kennedy, E.; Yoh, J.; Adams, D.; Paterno, M.

    1997-02-01

    The Fermilab Physics Class Library Task Force has been formed to supply classes and utilities, primarily in support of efforts by CDF and D0 toward using C++. A collection of libraries and tools will be assembled via development by the task force, collaboration with other HEP developers, and acquisition of existing modules. The main emphasis is on a kit of resources which physics coders can incorporate into their programs, with confidence in robustness and correct behavior. The task force is drawn from CDF, DO and the FNAL Computing and Beams Divisions. Modules-containers, linear algebra, histograms, etc.-have been assigned priority, based on immediate Run II coding activity, and will be available at times ranging from now to late May

  9. Supervised Object Class Colour Normalisation

    DEFF Research Database (Denmark)

    Riabchenko, Ekatarina; Lankinen, Jukka; Buch, Anders Glent

    2013-01-01

    . In this work, we develop a such colour normalisation technique, where true colours are not important per se but where examples of same classes have photometrically consistent appearance. This is achieved by supervised estimation of a class specic canonical colour space where the examples have minimal variation......Colour is an important cue in many applications of computer vision and image processing, but robust usage often requires estimation of the unknown illuminant colour. Usually, to obtain images invariant to the illumination conditions under which they were taken, color normalisation is used...... in their colours. We demonstrate the effectiveness of our method with qualitative and quantitative examples from the Caltech-101 data set and a real application of 3D pose estimation for robot grasping....

  10. Class renormalization: islands around islands

    International Nuclear Information System (INIS)

    Meiss, J.D.

    1986-01-01

    An orbit of 'class' is one that rotates about a periodic orbit of one lower class with definite frequency. This contrasts to the 'level' of a periodic orbit which is the number of elements in its continued fraction expansion. Level renormalization is conventionally used to study the structure of quasi-periodic orbits. The scaling structure of periodic orbits encircling other periodic orbits in area preserving maps is discussed here. Fixed points corresponding to the accumulation of p/q bifurcations are found and scaling exponents determined. Fixed points for q > 2 correspond to self-similar islands around islands. Frequencies of the island boundary circles at the fixed points are obtained. Importance of this scaling for the motion of particles in stochastic regions is emphasized. (author)

  11. QUALITY IN WORLD CLASS MANUFACTURING

    Directory of Open Access Journals (Sweden)

    Slavko Arsovski

    2011-12-01

    Full Text Available The World Class Manufacturing (WCM is a contemporary concept that is applied by the world leaders in the business. In this concept, one of the nine pillars is directly related to the quality and the other eight are related to it indirectly. That is why is very important to investigate relations between this concept and concept of model of quality. In the end of this paper are appointed the examples of best practice.

  12. Class of regular bouncing cosmologies

    Science.gov (United States)

    Vasilić, Milovan

    2017-06-01

    In this paper, I construct a class of everywhere regular geometric sigma models that possess bouncing solutions. Precisely, I show that every bouncing metric can be made a solution of such a model. My previous attempt to do so by employing one scalar field has failed due to the appearance of harmful singularities near the bounce. In this work, I use four scalar fields to construct a class of geometric sigma models which are free of singularities. The models within the class are parametrized by their background geometries. I prove that, whatever background is chosen, the dynamics of its small perturbations is classically stable on the whole time axis. Contrary to what one expects from the structure of the initial Lagrangian, the physics of background fluctuations is found to carry two tensor, two vector, and two scalar degrees of freedom. The graviton mass, which naturally appears in these models, is shown to be several orders of magnitude smaller than its experimental bound. I provide three simple examples to demonstrate how this is done in practice. In particular, I show that graviton mass can be made arbitrarily small.

  13. Luminosity class of neutron reflectometers

    Energy Technology Data Exchange (ETDEWEB)

    Pleshanov, N.K., E-mail: pnk@pnpi.spb.ru

    2016-10-21

    The formulas that relate neutron fluxes at reflectometers with differing q-resolutions are derived. The reference luminosity is defined as a maximum flux for measurements with a standard resolution. The methods of assessing the reference luminosity of neutron reflectometers are presented for monochromatic and white beams, which are collimated with either double diaphragm or small angle Soller systems. The values of the reference luminosity for unified parameters define luminosity class of reflectometers. The luminosity class characterizes (each operation mode of) the instrument by one number and can be used to classify operating reflectometers and optimize designed reflectometers. As an example the luminosity class of the neutron reflectometer NR-4M (reactor WWR-M, Gatchina) is found for four operation modes: 2.1 (monochromatic non-polarized beam), 1.9 (monochromatic polarized beam), 1.5 (white non-polarized beam), 1.1 (white polarized beam); it is shown that optimization of measurements may increase the flux at the sample up to two orders of magnitude with monochromatic beams and up to one order of magnitude with white beams. A fan beam reflectometry scheme with monochromatic neutrons is suggested, and the expected increase in luminosity is evaluated. A tuned-phase chopper with a variable TOF resolution is recommended for reflectometry with white beams.

  14. 75 FR 51171 - Amendment of Class D and Class E Airspace; Kaneohe, HI

    Science.gov (United States)

    2010-08-19

    ...; Airspace Docket No. 10-AWP-10] Amendment of Class D and Class E Airspace; Kaneohe, HI AGENCY: Federal... Class D and Class E airspace at Kaneohe Bay Marine Corps Air Station (MCAS), Kaneohe, HI. The FAA is... airspace and Class E airspace upward from 700 feet above the surface at Kaneohe Bay MCAS, Kaneohe Bay, HI...

  15. Do class size effects differ across grades?

    DEFF Research Database (Denmark)

    Nandrup, Anne Brink

    size cap that creates exogenous variation in class sizes. Significant (albeit modest) negative effects of class size increases are found for children on primary school levels. The effects on math abilities are statistically different across primary and secondary school. Larger classes do not affect......This paper contributes to the class size literature by analyzing whether short-run class size effects are constant across grade levels in compulsory school. Results are based on administrative data on all pupils enroled in Danish public schools. Identification is based on a government-imposed class...

  16. Importância da dieta na epidemiologia do câncer de colon e reto The importance of diet in the epidemiology of cancer of the colon and rectum

    Directory of Open Access Journals (Sweden)

    Eliza da Conceição da Fonseca Lopes

    1984-10-01

    Full Text Available Foi feita atualização de estudos realizados com o objetivo de verificar a relação entre o fator ambiental, destacando-se a alimentação caracterizada por uma dieta pobre em fibra e rica em gordura e a distribuição epidemiológica do câncer de colon e reto. São enfatizadas as diferenças apresentadas pelas dietas dos países industrializados e dos países em desenvolvimento e a influência da religião e do fluxo migratório no hábito alimentar, associadas com as taxas de incidência da doença.Studies have been made to verify the relation between the environmental factor, diet rich in fat and deficient in fibre, and the epidemiologic distribution of cancer of the colon and rectum. The research emphasizes the differences between the diets of the industrialized and the developing countries, and the influence of religion and migratory movements on the diet usualy associated with incidence of the disease.

  17. Adenocarcinoma de recto y ano en paciente con enfermedad de Crohn tratado con infliximab Adenocarcinoma of the rectum and anus in a patient with Crohn´s disease treated with infliximab

    Directory of Open Access Journals (Sweden)

    J. Egea Valenzuela

    2010-08-01

    Full Text Available In the present paper, we report the case of a patient with long-standing Crohn´s disease and multiple complications that, after receiving treatment with infliximab, was diagnosed with an adenocarcinoma of the rectum and anus that required radical surgery, later presenting multiple metastases. In the discussion, characteristics and major risk factors for colorectal cancer in patients with inflammatory bowel disease will be largely reviewed, and current studies will be analyzed in connection with the appearance of neoplasms in patients being treated with biologics.Presentamos el caso de un paciente con enfermedad de Crohn de larga evolución y con múltiples complicaciones de su enfermedad que, tras recibir tratamiento con infliximab, es diagnosticado de un adenocarcinoma de recto y ano que precisa cirugía radical, presentando posteriormente metástasis múltiples. Se repasarán durante la discusión las características y los factores de riesgo más importantes del cáncer colorrectal en pacientes con enfermedad inflamatoria intestinal, y se analizarán los trabajos existentes hasta la fecha en relación con la aparición de neoplasias en pacientes tratados con fármacos biológicos.

  18. Class, Race and American Labor

    Directory of Open Access Journals (Sweden)

    Catherine Collomp

    2006-03-01

    Full Text Available Labor history in the United States is well‑chartered territory. It is the object of countless scholarly books, appears in many college and university curricula and it is the subject of on‑going revisions and debates. Although labor history has always implied a form of at least implicit social commitment, it has been commented upon and written about as abundantly as other aspects of social history and often with more stamina or vindication. Nineteenth and early twentieth‑century working class ...

  19. First-Class Object Sets

    DEFF Research Database (Denmark)

    Ernst, Erik

    Typically, objects are monolithic entities with a fixed interface. To increase the flexibility in this area, this paper presents first-class object sets as a language construct. An object set offers an interface which is a disjoint union of the interfaces of its member objects. It may also be used...... for a special kind of method invocation involving multiple objects in a dynamic lookup process. With support for feature access and late-bound method calls object sets are similar to ordinary objects, only more flexible. The approach is made precise by means of a small calculus, and the soundness of its type...

  20. EFFICIENCY OF CURRENCY ASSET CLASSES

    Directory of Open Access Journals (Sweden)

    Mohammad R. Safarzadeh

    2013-04-01

    Full Text Available Analyzing the risk and return for the S&P Currency Index Arbitrage and the Merk Absolute Return Currency Fund, this study intends to find whether currency asset classes are worthwhile investments. To determine where the efficient currency portfolios lie in the risk and return spectrum, this paper compares the two portfolios to fixed income and equity asset portfolios. The results lead to a baffling conclusion that, in general, the returns to low-risk currency asset portfolios are higher than the equity asset portfolios of same risk level.

  1. New class of combustion processes

    International Nuclear Information System (INIS)

    Merzhanov, A.G.; Borovinskaya, I.P.

    1975-01-01

    A short review is given of the results of work carried out since 1967 on studying the combustion processes caused by the interaction of chemical elements in the condensed phase and leading to the formation of refractory compounds. New phenomena and processes are described which are revealed when investigating the combustion of the systems of this class, viz solid-phase combustion, fast combustion in the condensed phase, filtering combustion, combustion in liquid nitrogen, spinning combustion, self-oscillating combustion, and repeated combustion. A new direction in employment of combustion processes is discussed, viz. a self-propagating high-temperature synthesis of refractory nitrides, carbides, borides, silicides and other compounds

  2. What Is Middle Class about the Middle Classes around the World?

    OpenAIRE

    Abhijit V. Banerjee; Esther Duflo

    2008-01-01

    We expect a lot from the middle classes. At least three distinct arguments about the special economic role of the middle class are traditionally made. In one, new entrepreneurs armed with a capacity and a tolerance for delayed gratification emerge from the middle class and create employment and productivity growth for the rest of society. In a second, perhaps more conventional view, the middle class is primarily a source of vital inputs for the entrepreneurial class: it is their "middle class...

  3. Mandatory Class 1 Federal Areas Web Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web service contains the following layers: Mandatory Class 1 Federal Area polygons and Mandatory Class 1 Federal Area labels in the United States. The polygon...

  4. Investment Company Series and Class Information

    Data.gov (United States)

    Securities and Exchange Commission — The Series and Class Report provides basic identification information for all active registered investment company series and classes that have been issued IDs by...

  5. King george V class battleships

    CERN Document Server

    Chesneau, Roger

    2011-01-01

    The 'ShipCraft' series provides in-depth information about building and modifying model kits of famous warship types. Lavishly illustrated, each book takes the modeller through a brief history of the subject class, highlighting differences between sister-ships and changes in their appearance over their careers. This includes paint schemes and camouflage, featuring colour profiles and highly-detailed line drawings and scale plans. The modelling section reviews the strengths and weaknesses of available kits, lists commercial accessory sets for super-detailing of the ships, and provides hints on modifying and improving the basic kit. This is followed by an extensive photographic gallery of selected high-quality models in a variety of scales, and the book concludes with a section on research references - books, monographs, large-scale plans and relevant websites.The five battleships of the class covered by this volume were the most modern British capital ships to serve in the Second World War. They were involved ...

  6. Comprehending text in literature class

    Directory of Open Access Journals (Sweden)

    Purić Daliborka S.

    2016-01-01

    Full Text Available The paper discusses the problem of understanding a text and the contribution of methodological apparatus in the reader book to comprehension of a text being read in junior classes of elementary school. By using the technique of content analysis from methodological apparatuses in eight reader books for the fourth grade of elementary school, approved for usage in 2014/2015 academic year, and surveying 350 teachers in 33 elementary schools and 11 administrative districts in the Republic of Serbia we examined: (a to what extent the Serbian language text book contents enable junior students to understand a literary text; (b to what extent teachers accept the suggestions offered in the textbook for preparing literature teaching. The results show that a large number of suggestions relate to reading comprehension, but some of categories of understanding are unevenly distributed in the methodological apparatus. On the other hand, the majority of teachers use the methodological apparatus given in a textbook for preparing classes, not only the textbook he or she selected for teaching but also other textbooks for the same grade.

  7. Class teacher’s gender culture

    OpenAIRE

    GOGOL-SAVRIY M.V.

    2012-01-01

    The article considers the gender approach in the professional culture of a class teacher. The nature, levels and sublevels of class teacher’s gender culture development are defined. Taking into consideration the concepts of leading researchers, the essence of components of class teacher’s gender culture is discovered according to the levels of its development as professional and educational activity. Proceeding from the results of the diagnostics of class teachers’ gender culture at comprehen...

  8. Do Class Size Effects Differ across Grades?

    Science.gov (United States)

    Nandrup, Anne Brink

    2016-01-01

    This paper contributes to the class size literature by analysing whether short-run class size effects are constant across grade levels in compulsory school. Results are based on administrative data on all pupils enrolled in Danish public schools. Identification is based on a government-imposed class size cap that creates exogenous variation in…

  9. Software extension and integration with type classes

    DEFF Research Database (Denmark)

    Lämmel, Ralf; Ostermann, Klaus

    2006-01-01

    expressiveness, by using the language concept of \\emph{type classes}, as it is available in the functional programming language Haskell. A detailed comparison with related work shows that type classes provide a powerful framework in which solutions to known software extension and integration problems can...... be provided. We also pinpoint several limitations of type classes in this context....

  10. Making the Most of Your Class Website

    Science.gov (United States)

    Dunn, Lemoyne S.

    2011-01-01

    Students today are electronically connected, and they expect their learning to be connected as well. Many college students prefer online classes, even if they live on campus. Students who do take face-to-face classes often expect the class to have an online communication component (such as a discussion board). However, despite the fact that K-12…

  11. Reflections on Teaching a Large Class.

    Science.gov (United States)

    Miner, Rick

    1992-01-01

    Uses an analysis of small- and large-class differences as a framework for planning for and teaching a large class. Analyzes the process of developing and offering an organizational behavior class to 141 college students. Suggests ways to improve teaching effectiveness by minimizing psychological and physical distances, redistributing resources,…

  12. Application of TBT in Reading Class

    Science.gov (United States)

    Yu, Hong-qin

    2007-01-01

    "TBT" means "task-based teaching". In a TBT class, students play the central role. In the class where students are provided with plenty of chances to be engaged in activities, the teacher is more like a patient listener rather than a talkative speaker. This paper mainly explores how task-based teaching is used in English reading class.

  13. Conceptualizing "Homework" in Flipped Mathematics Classes

    Science.gov (United States)

    de Araujo, Zandra; Otten, Samuel; Birisci, Salih

    2017-01-01

    Flipped instruction is becoming more common in the United States, particularly in mathematics classes. One of the defining characteristics of this increasingly popular instructional format is the homework teachers assign. In contrast to traditional mathematics classes in which homework consists of problem sets, homework in flipped classes often…

  14. Regular extensions of some classes of grammars

    NARCIS (Netherlands)

    Nijholt, Antinus

    Culik and Cohen introduced the class of LR-regular grammars, an extension of the LR(k) grammars. In this report we consider the analogous extension of the LL(k) grammers, called the LL-regular grammars. The relations of this class of grammars to other classes of grammars are shown. Every LL-regular

  15. Factors Related to In-Class Spiritual Experience: Relationship between Pre-Class Scripture Reading, In-Class Note-Taking, and Perceived In-Class Spiritual Experiences

    Science.gov (United States)

    Hilton, John, III; Sweat, Anthony R.; Plummer, Kenneth

    2015-01-01

    The purpose of this study is to examine the relationship between student in-class note-taking and pre-class reading with perceived in-class spiritual and religious outcomes. This study surveyed 620 students enrolled in six different sections of an introductory religion course at a private religious university. Full-time religious faculty members…

  16. Class composition influences on pupils' cognitive development

    NARCIS (Netherlands)

    Peetsma, T.; van der Veen, I.; Koopman, P.; van Schooten, E.

    2006-01-01

    The proportion of low-achieving children in a class can affect the progress of individual pupils in that class. Having a large proportion of low achievers in a class could slow down growth in cognitive achievement but, might also boost such growth, due to the effects of specialist teaching geared to

  17. The Social Psychology of Class and Classism

    Science.gov (United States)

    Lott, Bernice

    2012-01-01

    In the United States, one is born into a family that can be identified as working class, middle class, or affluent--divisions that denote status and power, as defined by access to resources. This article explores the relationships between social class membership and a wide array of personal and social daily life experiences. It concludes with a…

  18. A class of Yang-Mills solutions

    International Nuclear Information System (INIS)

    Castillejo, L.; Kugler, M.

    1980-09-01

    We investigate a class of solutions of the classical SU(2) Yang-Mills equations. The symmetry of this class prescribes a natural set of gauge invariant degrees of freedom. Using these degrees of freedom we obtain a simple set of equations which enables us to find all the solutions belonging to the class under discussion. (Author)

  19. Imagining class: A study into material social class position, subjective identification, and voting behavior across Europe.

    Science.gov (United States)

    D'Hooge, Lorenzo; Achterberg, Peter; Reeskens, Tim

    2018-02-01

    The traditional approach to class voting has largely ignored the question whether material class positions coincide with subjective class identification. Following Sosnaud et al. (2013), this study evaluates party preferences when Europeans' material and subjective social class do not coincide. Seminal studies on voting behavior have suggested that members of lower classes are more likely to vote for the economic left and cultural right and that higher classes demonstrate the opposite pattern. Yet, these studies have on the one hand overlooked the possibility that there is a mismatch between the material class people can be classified in and the class they think they are part of, and on the other hand the consequences of this discordant class identification on voting behavior. Analyzing the 2009 wave of the European Elections Study, we find that the majority of the Europeans discordantly identify with the middle class, whereas only a minority of the lower and higher classes concordantly identify with their material social class. Further, material class only seems to predict economic voting behavior when it coincides with subjective class; for instance, individuals who have an inflated class identification are more likely to vote for the economic left, even when they materially can be classified as middle or high class. We conclude this paper with a discussion on scholarly debates concerning class and politics. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The Character Strengths of Class Clowns

    Directory of Open Access Journals (Sweden)

    Willibald F. Ruch

    2014-09-01

    Full Text Available Class clowns traditionally were studied as a type concept and identified via sociometric procedures. In the present study a variable-centered approach was favored and class clown behaviors were studied in the context of character strengths, orientations to happiness and satisfaction with life. A sample of 672 Swiss children and adolescents filled in an 18 item self-report instrument depicting class clown behaviors. A hierarchical model of class clown behaviors was developed distinguishing a general factor and the four positively correlated dimensions of identified as a class clown, comic talent, disruptive rule-breaker, and subversive joker. Analysis of the general factor showed that class clowns were primarily male, and tended to be seen as class clowns by the teacher. Analyses of the 24 character strengths of the VIA-Youth (Park & Peterson, 2006 showed that class clowns were high in humor and leadership, and low in strengths like prudence, self-regulation, modesty, honesty, fairness, perseverance, and love of learning. An inspection of signature strengths revealed that 75% of class clowns had humor as a signature strength. Furthermore, generally class clown behaviors were shown by students indulging in a life of pleasure, but low life of engagement. The four dimensions yielded different character strengths profiles. While all dimensions of class clowns behaviors were low in temperance strengths, the factors identified as the class clown and comic talent were correlated with leadership strengths and the two negative factors (disruptive rule-breaker, subversive joker were low in other directed strengths. The disruptive rule breaking class clown was additionally low in intellectual strengths. While humor predicted life satisfaction, class clowning tended to go along with diminished satisfaction with life. It is concluded that different types of class clowns need to be kept apart and need different attention by teachers.

  1. The character strengths of class clowns.

    Science.gov (United States)

    Ruch, Willibald; Platt, Tracey; Hofmann, Jennifer

    2014-01-01

    Class clowns traditionally were studied as a type concept and identified via sociometric procedures. In the present study a variable-centered approach was favored and class clown behaviors were studied in the context of character strengths, orientations to happiness and satisfaction with life. A sample of 672 Swiss children and adolescents filled in an 18 item self-report instrument depicting class clown behaviors. A hierarchical model of class clown behaviors was developed distinguishing a general factor and the four positively correlated dimensions of "identified as a class clown," "comic talent," "disruptive rule-breaker," and "subversive joker." Analysis of the general factor showed that class clowns were primarily male, and tended to be seen as class clowns by the teacher. Analyses of the 24 character strengths of the VIA-Youth (Park and Peterson, 2006) showed that class clowns were high in humor and leadership, and low in strengths like prudence, self-regulation, modesty, honesty, fairness, perseverance, and love of learning. An inspection of signature strengths revealed that 75% of class clowns had humor as a signature strength. Furthermore, class clown behaviors were generally shown by students indulging in a life of pleasure, but low life of engagement. The four dimensions yielded different character strengths profiles. While all dimensions of class clowns behaviors were low in temperance strengths, the factors "identified as the class clown" and "comic talent" were correlated with leadership strengths and the two negative factors ("disruptive rule-breaker," "subversive joker") were low in other directed strengths. The disruptive rule breaking class clown was additionally low in intellectual strengths. While humor predicted life satisfaction, class clowning tended to go along with diminished satisfaction with life. It is concluded that different types of class clowns need to be kept apart and need different attention by teachers.

  2. A Class-Specific Optimizing Compiler

    Directory of Open Access Journals (Sweden)

    Michael D. Sharp

    1993-01-01

    Full Text Available Class-specific optimizations are compiler optimizations specified by the class implementor to the compiler. They allow the compiler to take advantage of the semantics of the particular class so as to produce better code. Optimizations of interest include the strength reduction of class:: array address calculations, elimination of large temporaries, and the placement of asynchronous send/recv calls so as to achieve computation/communication overlap. We will outline our progress towards the implementation of a C++ compiler capable of incorporating class-specific optimizations.

  3. Middle-class projects in modern Malaysia

    DEFF Research Database (Denmark)

    Fischer, Johan

    2017-01-01

    picture surrounding this class and its relationship to Malaysian national repertoires such as Islamic revivalism, politics, consumer culture, social mobility and the state-market nexus. I understand middle-class projects to be the making of local class culture in Malaysia and explore these in four...... research projects that each in their own way examine how Malay Muslim informants understand and practice “middle-classness” in different spatial and temporal contexts. In short, my findings show how Malay Muslim middle-class projects such as Islamic consumption shape local class culture in Malaysia....

  4. Master classes - What do they offer?

    OpenAIRE

    Hanken, Ingrid Maria; Long, Marion

    2012-01-01

    Master classes are a common way to teach music performance, but how useful are they in helping young musicians in their musical development? Based on his experiences of master classes Lali (2003:24) states that “For better or for worse, master classes can be life-changing events.” Anecdotal evidence confirm that master classes can provide vital learning opportunities, but also that they can be of little use to the student, or worse, detrimental. Since master classes are a common component in ...

  5. LISTENING CLASS AND MORAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Stella Prancisca

    2018-04-01

    Full Text Available Since some students including in my class become more self-oriented and less aware on group, there is a need to integrate online teaching material which contains values in society into English language course. We believe that English language teaching, in some extents, could facilitate this necessity. A good choice of material, for example, is not only beneficial to promote students’ language skill, but also could inspire students to become a better individual. This paper aims to examine whether online materials could promote students’ English language skill, especially in listening comprehension. In addition, it is keen to better understand how these resources could influence and develop their moral values. The paper is designed as a classroom action research. To collect data, we employ two tests (pre-and post-test, questionnaires, and interview. Since this paper is still a research design, it should be noted that there is no finding and discussion yet here.

  6. Teacher's Questions in Reading Classes

    Directory of Open Access Journals (Sweden)

    Zuliati Rohmah

    2002-01-01

    Full Text Available Abstract: The present paper discusses an English teacher's questions in Reading classes at MAN Malang III. Types of questions, functions of teacher's questions, question levels and the strategies applied by the teacher were put as the research problems. Non-participant observa­tion was applied to collect the data with the researcher as the main in­strument aided by field-notes and a tape recorder. It was found that the distribution of the questions did not allow the students to talk longer and to think more analytically. Meanwhile, the strategies applied by the teacher helped the students to respond to the questions previously unanswered. The teacher is suggested to produce more open and refer­ential question as well as inference and evaluation questions as to give more chances for the students to think aloud more.

  7. First-Class Object Sets

    DEFF Research Database (Denmark)

    Ernst, Erik

    2009-01-01

    Typically, an object is a monolithic entity with a fixed interface.  To increase flexibility in this area, this paper presents first-class object sets as a language construct.  An object set offers an interface which is a disjoint union of the interfaces of its member objects.  It may also be use...... to a mainstream virtual machine in order to improve on the support for family polymorphism.  The approach is made precise by means of a small calculus, and the soundness of its type system has been shown by a mechanically checked proof in Coq....

  8. Debate on class issue in contemporary sociology

    Directory of Open Access Journals (Sweden)

    Antonić Slobodan

    2008-01-01

    Full Text Available The contemporary debate on class issue within the sociology in English speaking countries focuses on two questions. The first question is whether the crisis of the Marxist class analysis, which arose as a consequence of weakening of class identity and class behavior, is at the same time a sign of crisis of sociological class conception. There are American, British and Australian sociologists whose answer to this question is affirmative. However, others have been claiming that the Marxist class analysis could be replaced by the Weberian concept of stratification. The second question in this debate is on the exploratory importance of class for sociological analysis. Some sociologists have been claiming that its explanatory capacity is exhausted. However, there are others who argue that classes remain one of the most important tools a modern sociologist has. Finally, this paper points to the third way of saving the class analysis. It is about focusing on collective identity and collective action of the members of "developed" professions, as a kind of "small" classes or "proto-classes".

  9. Context-sensitive intra-class clustering

    KAUST Repository

    Yu, Yingwei

    2014-02-01

    This paper describes a new semi-supervised learning algorithm for intra-class clustering (ICC). ICC partitions each class into sub-classes in order to minimize overlap across clusters from different classes. This is achieved by allowing partitioning of a certain class to be assisted by data points from other classes in a context-dependent fashion. The result is that overlap across sub-classes (both within- and across class) is greatly reduced. ICC is particularly useful when combined with algorithms that assume that each class has a unimodal Gaussian distribution (e.g., Linear Discriminant Analysis (LDA), quadratic classifiers), an assumption that is not always true in many real-world situations. ICC can help partition non-Gaussian, multimodal distributions to overcome such a problem. In this sense, ICC works as a preprocessor. Experiments with our ICC algorithm on synthetic data sets and real-world data sets indicated that it can significantly improve the performance of LDA and quadratic classifiers. We expect our approach to be applicable to a broader class of pattern recognition problems where class-conditional densities are significantly non-Gaussian or multi-modal. © 2013 Elsevier Ltd. All rights reserved.

  10. Social class, contextualism, and empathic accuracy.

    Science.gov (United States)

    Kraus, Michael W; Côté, Stéphane; Keltner, Dacher

    2010-11-01

    Recent research suggests that lower-class individuals favor explanations of personal and political outcomes that are oriented to features of the external environment. We extended this work by testing the hypothesis that, as a result, individuals of a lower social class are more empathically accurate in judging the emotions of other people. In three studies, lower-class individuals (compared with upper-class individuals) received higher scores on a test of empathic accuracy (Study 1), judged the emotions of an interaction partner more accurately (Study 2), and made more accurate inferences about emotion from static images of muscle movements in the eyes (Study 3). Moreover, the association between social class and empathic accuracy was explained by the tendency for lower-class individuals to explain social events in terms of features of the external environment. The implications of class-based patterns in empathic accuracy for well-being and relationship outcomes are discussed.

  11. Describing three-class task performance: three-class linear discriminant analysis and three-class ROC analysis

    Science.gov (United States)

    He, Xin; Frey, Eric C.

    2007-03-01

    Binary ROC analysis has solid decision-theoretic foundations and a close relationship to linear discriminant analysis (LDA). In particular, for the case of Gaussian equal covariance input data, the area under the ROC curve (AUC) value has a direct relationship to the Hotelling trace. Many attempts have been made to extend binary classification methods to multi-class. For example, Fukunaga extended binary LDA to obtain multi-class LDA, which uses the multi-class Hotelling trace as a figure-of-merit, and we have previously developed a three-class ROC analysis method. This work explores the relationship between conventional multi-class LDA and three-class ROC analysis. First, we developed a linear observer, the three-class Hotelling observer (3-HO). For Gaussian equal covariance data, the 3- HO provides equivalent performance to the three-class ideal observer and, under less strict conditions, maximizes the signal to noise ratio for classification of all pairs of the three classes simultaneously. The 3-HO templates are not the eigenvectors obtained from multi-class LDA. Second, we show that the three-class Hotelling trace, which is the figureof- merit in the conventional three-class extension of LDA, has significant limitations. Third, we demonstrate that, under certain conditions, there is a linear relationship between the eigenvectors obtained from multi-class LDA and 3-HO templates. We conclude that the 3-HO based on decision theory has advantages both in its decision theoretic background and in the usefulness of its figure-of-merit. Additionally, there exists the possibility of interpreting the two linear features extracted by the conventional extension of LDA from a decision theoretic point of view.

  12. We are all ordinary people : Perceptions of class and class differences in personal relationships

    NARCIS (Netherlands)

    Van Eijk, G.

    2009-01-01

    This paper examines people’s perceptions of class and class differences—in general and with regard to personal relationships. Data from an original survey on personal networks (n=195) shows that most people think they are middle class, although many lower class respondents classify themselves as

  13. High-dose (70-78 GY) conformal radiotherapy for prostate cancer; the relation between observed late bladder and rectum complications and parameters derived from the dose volume histograms

    International Nuclear Information System (INIS)

    Lebesque, J.V.; Bruce, A.; Boersma, L.J.; Velde, A. te

    1996-01-01

    Purpose: To determine the incidence of late gastrointestinal (GI) and genitourinary (GU) complications after conformal radiotherapy for prostate cancer, and to investigate the relation between these observed incidences and parameters derived from the Dose Volume Histograms (DVHs) of rectum and bladder wall. Patients and Methods: Hundred and thirty patients with T 2-4 G 1-3 N 0 M 0 prostate cancer were treated with conformal radiotherapy with the simultaneous boost technique in a dose-escalating protocol; 78 patients received a total dose of 70 Gy, 11 patients 74 - 76 Gy and 41 patients 78 Gy, each with a dose of 2 Gy per fraction. DVHs of the rectal wall were used to calculate NTCPs according to the model of Kutcher et al. with the estimated parameter values (n = 0.12, m = 0.15, TD 50 = 80 Gy) according to Burman et al. The median follow-up was 17 months (range 6 - 72 months). The crude and actuarial incidence of late (> 6 months) GI and GU complications were determined using the RTOG/EORTC morbidity scoring system (Grade I to IV). Results: Neither for late GI nor for GU complaints, a grade IV complication was observed. GU complaints occurred in 90 patients (69%): 54 patients (42%) only experienced grade I toxicity, 26 patients (20%) had grade II toxicity, and 10 patients (8%) had grade III complications, of which 8 patients (6%) developed a urethral (7 pts) or ureteric stenosis (1 pt). The actuarial incidence of grade III GU complications was 10% at 2 years. Since bladder wall DVHs are unreliable and most grade III complications were not related to the bladder, the grade II and/or III complications were analyzed in terms of the total prescribed dose only, but no correlation could be demonstrated. GI complications occurred in 71 patients (55%): 59 patients (45%) developed a grade I complication, 11 a grade II complication and only 1 patient required laser treatment twice and blood transfusion because of rectal bleeding (grade III). The actuarial incidence of GI

  14. Class-E Amplifier Design Improvements for GSM Frequencies

    Directory of Open Access Journals (Sweden)

    Z. Nadir

    2011-06-01

    Full Text Available Efficient power amplifiers are essential in portable battery-operated systems such as mobile phones. Also, the power amplifier (PA is the most power-consuming building block in the transmitter of a portable system. This paper investigates how the efficiency of the power amplifier (which is beneficial for multiple applications in communcation sector can be improved by increasing the efficiency of switching mode class E power amplifiers for frequencies of 900 MHz and 1800 MHz. The paper tackles modeling, design improvements and verification through simulation for higher efficiencies. This is the continuation of previous work by the authors. These nonlinear power amplifiers can only amplify constant-envelope RF signals without introducing significant distortion. Mobile systems such as Advanced Mobile Phone System (AMPS and Global System for Mobile communications (GSM use modulation schemes which generate constant amplitude RF outputs in order to use efficient but nonlinear power amplifiers. Improvements in designs are suggested and higher efficiencies are achieved, to the tune of 67.1% (for 900 MHz and 67.0% (1800 MHz.

  15. Class 2 piping rules in elevated temperature applications compared with Class 1 prescriptions for LMFBRs

    International Nuclear Information System (INIS)

    Capello, R.; Stretti, G.; Cesari, F.G.

    1989-01-01

    An LMFBR plant has many piping systems subjected to elevated temperature (> 427 o C) which, depending on their function and safety criteria, are classified as of quality level 1 or 2. The design of class 1 and class 2 piping for elevated temperatures is performed in accordance with ASME CCN-47 and CCN-253 respectively. This paper discusses what level of knowledge and analysis is necessary, to apply the rules of class 2 (CCN-253) rather than those of class 1 (CCN-47) for the design analysis of piping systems. From the designer viewpoint the burden of verification is much greater in class 1 than in class 2. This paper also examines the reliability of class 2 rules for elevated temperature when used to obtain structural results and justify the design of class 1 systems. In fact it can be shown that in some cases it is possible to design class 1 piping systems using class 2 rules. (author)

  16. Tratamiento del prolapso rectal en la infancia con infiltración de solución salina al 16,5 % Treatment of the prolapse of the rectum in childhood with 16,5 % saline solution infiltration

    Directory of Open Access Journals (Sweden)

    Carlos Ramírez Pérez

    2011-09-01

    el grupo experimental (6,2 %, un caso más. La recurrencia se comportó de forma inversa, predominó en un 6,2 % en el grupo control. Para disminuir el número de complicaciones se estipuló el uso profiláctico de antimicrobianos, el día del procedimiento y 2 días más. Conclusiones: quedó demostrado que el tratamiento de elección del prolapso rectal en la infancia es la infiltración, y que una sola sesión con 20 mL de solución salina al 16,5 % en cada paciente es un efectivo agente esclerosante.Introduction: when the conservative medical treatment fails in children with prolapse of the rectum it is necessary the perirrectal infiltration with irritant substances. In 1990s these infiltrations in our center were carried out using glycerin, but due to be scarce in the market we must to find other alternative infiltrating agent. The objective of present paper is to describe the experience with the use of 16,5 % saline solution. Methods: an experimental, prospective, longitudinal and interventional study of non-controlled clinical trial was conducted. It consists of a second part in which we used the randomization with a control group for validation. Universe included 27 patients and sample included 16 patients with prolapse of the rectum over 2003-2007, seen in service of gastroenterology of the Provincial Children Hospital of Holguín province. The variables developed were: a concentration suitable for treatment, amount of substance to be infiltrated, complications, recurrence, number of infiltrations and the cure at a year. Results are showed in percentage tables. Results: the effectiveness of the 16,5 % saline solution was of 100 %, all patients cured and any had relapse, thus there were not necessary two or more treatment sessions. There was a comment on a child that, after failure of breast milk infiltration like a first option and also of the cerclage, finally, resolved with this method. Complications were relatively few (18,9 %: an abscess, a cellulitis

  17. 47 CFR 73.6017 - Digital Class A TV station protection of Class A TV and digital Class A TV stations.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Digital Class A TV station protection of Class A TV and digital Class A TV stations. 73.6017 Section 73.6017 Telecommunication FEDERAL... Broadcast Stations § 73.6017 Digital Class A TV station protection of Class A TV and digital Class A TV...

  18. Social class rank, essentialism, and punitive judgment.

    Science.gov (United States)

    Kraus, Michael W; Keltner, Dacher

    2013-08-01

    Recent evidence suggests that perceptions of social class rank influence a variety of social cognitive tendencies, from patterns of causal attribution to moral judgment. In the present studies we tested the hypotheses that upper-class rank individuals would be more likely to endorse essentialist lay theories of social class categories (i.e., that social class is founded in genetically based, biological differences) than would lower-class rank individuals and that these beliefs would decrease support for restorative justice--which seeks to rehabilitate offenders, rather than punish unlawful action. Across studies, higher social class rank was associated with increased essentialism of social class categories (Studies 1, 2, and 4) and decreased support for restorative justice (Study 4). Moreover, manipulated essentialist beliefs decreased preferences for restorative justice (Study 3), and the association between social class rank and class-based essentialist theories was explained by the tendency to endorse beliefs in a just world (Study 2). Implications for how class-based essentialist beliefs potentially constrain social opportunity and mobility are discussed.

  19. What are lay theories of social class?

    Science.gov (United States)

    Varnum, Michael E W

    2013-01-01

    Numerous studies have documented the effects of social class on psychological and behavioral variables. However, lay beliefs about how social class affects these dimensions have not been systematically tested. Studies 1 and 2 assessed lay beliefs about the association between social class and 8 variables (including psychological and behavioral tendencies and cognitive ability). Study 3 assessed lay beliefs about the Big five personality traits and social class, and study 4 reframed the 8 variables from study 1 in opposite terms and yielded similar results. Study 5 contained the variables framed as in both studies 1 and 4, and replicated those results suggesting that framing effects were not responsible for the effects observed. Interestingly, for the most part lay beliefs about social class did not differ as a function of participants' own social class. In general people held relatively accurate and consistent stereotypes about the relationship between social class and well-being, health, intelligence, and neuroticism. In contrast lay beliefs regarding social class and reasoning styles, as well as relational, social, and emotional tendencies were less consistent and coherent. This work suggests that on the whole people's beliefs about social class are not particularly accurate, and further that in some domains there are contradictory stereotypes about the consequences of social class.

  20. Class B0631+519: Last of the Class Lenses

    Energy Technology Data Exchange (ETDEWEB)

    York, Tom; Jackson, N.; Browne, I.W.A.; Koopmans, L.V.E.; McKean, J.P.; Norbury, M.A.; Biggs, A.D.; Blandford, R.D.; de Bruyn, A.G.; Fassnacht, C.D.; Myers, S.T.; Pearson, T.J.; Phillips, P.M.; Readhead, A.C.S.; Rusin, D.; Wilkinson, P.N.; /Jodrell Bank /Kapteyn Astron. Inst., Groningen /UC, Davis /JIVE, Dwingeloo /KIPAC, Menlo Park /NFRA,

    2005-05-31

    We report the discovery of the new gravitational lens system CLASS B0631+519. Imaging with the VLA, MERLIN and the VLBA reveals a doubly-imaged flat-spectrum radio core, a doubly-imaged steep-spectrum radio lobe and possible quadruply-imaged emission from a second lobe. The maximum separation between the lensed images is 1.16 arcsec. High resolution mapping with the VLBA at 5 GHz resolves the most magnified image of the radio core into a number of sub-components spread across approximately 20 mas. No emission from the lensing galaxy or an odd image is detected down to 0.31 mJy (5{sigma}) at 8.4 GHz. Optical and near-infrared imaging with the ACS and NICMOS cameras on the HST show that there are two galaxies along the line of sight to the lensed source, as previously discovered by optical spectroscopy. We find that the foreground galaxy at z=0.0896 is a small irregular, and that the other, at z=0.6196 is a massive elliptical which appears to contribute the majority of the lensing effect. The host galaxy of the lensed source is detected in the HST near-infrared imaging as a set of arcs, which form a nearly complete Einstein ring. Mass modeling using non-parametric techniques can reproduce the near-infrared observations and indicates that the small irregular galaxy has a (localized) effect on the flux density distribution in the Einstein ring at the 5-10% level.

  1. Bayesian Latent Class Analysis Tutorial.

    Science.gov (United States)

    Li, Yuelin; Lord-Bessen, Jennifer; Shiyko, Mariya; Loeb, Rebecca

    2018-01-01

    This article is a how-to guide on Bayesian computation using Gibbs sampling, demonstrated in the context of Latent Class Analysis (LCA). It is written for students in quantitative psychology or related fields who have a working knowledge of Bayes Theorem and conditional probability and have experience in writing computer programs in the statistical language R . The overall goals are to provide an accessible and self-contained tutorial, along with a practical computation tool. We begin with how Bayesian computation is typically described in academic articles. Technical difficulties are addressed by a hypothetical, worked-out example. We show how Bayesian computation can be broken down into a series of simpler calculations, which can then be assembled together to complete a computationally more complex model. The details are described much more explicitly than what is typically available in elementary introductions to Bayesian modeling so that readers are not overwhelmed by the mathematics. Moreover, the provided computer program shows how Bayesian LCA can be implemented with relative ease. The computer program is then applied in a large, real-world data set and explained line-by-line. We outline the general steps in how to extend these considerations to other methodological applications. We conclude with suggestions for further readings.

  2. Integrals of the Ising class

    International Nuclear Information System (INIS)

    Bailey, D H; Borwein, J M; Crandall, R E

    2006-01-01

    From an experimental-mathematical perspective we analyse 'Ising-class' integrals. These are structurally related n-dimensional integrals we call C n , D n , E n , where D n is a magnetic susceptibility integral central to the Ising theory of solid-state physics. We first analyse C n := 4/(n factorial) ∫ 0 ∞ ... ∫ 0 ∞ 1/(Σ j=1 n (u j + 1/u j )) 2 du 1 /u 1 ... du n /u n . We had conjectured-on the basis of extreme-precision numerical quadrature-that C n has a finite large-n limit, namely C ∞ = 2 e -2γ , with γ being the Euler constant. On such a numerological clue we are able to prove the conjecture. We then show that integrals D n and E n both decay exponentially with n, in a certain rigorous sense. While C n , D n remain unresolved for n ≥ 5, we were able to conjecture a closed form for E 5 . Our experimental results involved extreme-precision, multidimensional quadrature on intricate integrands; thus, a highly parallel computation was required

  3. Speech-based Class Attendance

    Science.gov (United States)

    Faizel Amri, Umar; Nur Wahidah Nik Hashim, Nik; Hazrin Hany Mohamad Hanif, Noor

    2017-11-01

    In the department of engineering, students are required to fulfil at least 80 percent of class attendance. Conventional method requires student to sign his/her initial on the attendance sheet. However, this method is prone to cheating by having another student signing for their fellow classmate that is absent. We develop our hypothesis according to a verse in the Holy Qur’an (95:4), “We have created men in the best of mould”. Based on the verse, we believe each psychological characteristic of human being is unique and thus, their speech characteristic should be unique. In this paper we present the development of speech biometric-based attendance system. The system requires user’s voice to be installed in the system as trained data and it is saved in the system for registration of the user. The following voice of the user will be the test data in order to verify with the trained data stored in the system. The system uses PSD (Power Spectral Density) and Transition Parameter as the method for feature extraction of the voices. Euclidean and Mahalanobis distances are used in order to verified the user’s voice. For this research, ten subjects of five females and five males were chosen to be tested for the performance of the system. The system performance in term of recognition rate is found to be 60% correct identification of individuals.

  4. Classes evaluation: Methods and tools

    Directory of Open Access Journals (Sweden)

    Grabiński Tadeusz

    2013-01-01

    Full Text Available This study presents a method, tools, course and results of foreign language classes evaluation conducted in the summer semester 2012/2013 in the Andrzej Frycz - Modrzewski Krakow University. Because a new evaluation procedure has been implemented at the University, the former method - based on paper forms filled in by the students - was abandoned. On the surveyanyplace.com website, a free account has been registered and the form of the evaluation questionnaire has been inserted. This coverage presents results of a taxometric analysis aimed at checking the degree of mutual correspondence (correlation between certain criteria and instancing a graphic presentation of the evaluation results in a multidimensional perspective. In order to classify the grading criteria, the Ward's agglomerative method, along with Euclidean metric as a measure of criteria similarity, have been used. Calculations have been made with the use of Statistica package. Results of the questionnaire show that foreign language teaching at the Andrzej Frycz Modrzewski Krakow University is conducted professionally and on a high factual level.

  5. Polyps of the Colon and Rectum

    Science.gov (United States)

    ... Library Quality Assessment and Safety Committee Initiatives Healthcare Economics Committee Resources Past Presidents Search form Search Online Learning Center Login Join Now Find a Surgeon You are here Patients / Resources / ...

  6. Functional disorders of the anus and rectum

    OpenAIRE

    Whitehead, W; Wald, A; Diamant, N; Enck, P; Pemberton, J; Rao, S

    1999-01-01

    In this report the functional anorectal disorders, the etiology of which is currently unknown or related to the abnormal functioning of normally innervated and structurally intact muscles, are discussed. These disorders include functional fecal incontinence, functional anorectal pain, including levator ani syndrome and proctalgia fugax, and pelvic floor dyssynergia. The epidemiology of each disorder is defined and discussed, their pathophysiology is summarized and diagnostic approaches and tr...

  7. Functional disorders of the anus and rectum

    Science.gov (United States)

    Whitehead, W; Wald, A; Diamant, N; Enck, P; Pemberton, J; Rao, S

    1999-01-01

    In this report the functional anorectal disorders, the etiology of which is currently unknown or related to the abnormal functioning of normally innervated and structurally intact muscles, are discussed. These disorders include functional fecal incontinence, functional anorectal pain, including levator ani syndrome and proctalgia fugax, and pelvic floor dyssynergia. The epidemiology of each disorder is defined and discussed, their pathophysiology is summarized and diagnostic approaches and treatment are suggested. Some suggestions for the direction of future research on these disorders are also given.


Keywords: fecal incontinence; pelvic floor dyssynergia; anismus; proctalgia fugax; levator ani syndrome; constipation; Rome II PMID:10457046

  8. Transrectal echography in cancer of the rectum

    International Nuclear Information System (INIS)

    Lozano Barriga, Mauricio; Mejia Pineres, Fernando; Uriza, Felipe

    1996-01-01

    Study of the accuracy of trans rectal sonography for the establishment of tumour invasion to the rectal wall and detection of peri rectal ganglia, in patients with known rectal carcinoma and surgical confirmation of findings. Trans rectal sonography is the method of choice for the evaluation of rectal cancer

  9. Management of Acute Bleeding Per Rectum

    Directory of Open Access Journals (Sweden)

    Benita K.T. Tan

    2004-01-01

    Conclusion: Perianal conditions contributed to the majority of acute patient admissions. Colonic causes of bleeding were less common and were most stable. There were differences in the frequencies of aetiologies in our population compared to Western populations. Understanding the common pathologies and outcomes guides the management of our patients.

  10. Livstruende haemorrhagia per rectum postoperativt efter appendektomi

    DEFF Research Database (Denmark)

    Nørgaard, M A; Lindholt, Jes Sanddal

    1994-01-01

    A case of life-threatening haemorrhage nine days after appendicectomy is described in a 51 year old previously healthy man. Coecotomy revealed a bleeding artery near the invaginated appendiceal stump. The bleeding artery was presumably an intramural branch to the appendix from the posterior coeca...

  11. Primary linitis plastica of the rectum

    International Nuclear Information System (INIS)

    Oliver, T.W. Jr.; Somogyi, J.; Gaffney, E.F.

    1983-01-01

    The term linitis plastica describes an infiltrating, anaplastic, scirrhous adenocarcinoma that generally occurs in a hollow viscus resulting in a relatively rigid, shrunken organ. Although the stomach is the most common site of linitis plastica, accounting for 99% of these lesions, the colon can be similarly affected. Primary colonic linitis plastica is a rare entity with only about 40 unequivocal reported cases in the literature. A recent case of primary colonic linitis plastica is described with emphasis on the computed tomographic (CT) findings

  12. A new Class of Extremal Composites

    DEFF Research Database (Denmark)

    Sigmund, Ole

    2000-01-01

    microstructure belonging to the new class of composites has maximum bulk modulus and lower shear modulus than any previously known composite. Inspiration for the new composite class comes from a numerical topology design procedure which solves the inverse homogenization problem of distributing two isotropic......The paper presents a new class of two-phase isotropic composites with extremal bulk modulus. The new class consists of micro geometrics for which exact solutions can be proven and their bulk moduli are shown to coincide with the Hashin-Shtrikman bounds. The results hold for two and three dimensions...... and for both well- and non-well-ordered isotropic constituent phases. The new class of composites constitutes an alternative to the three previously known extremal composite classes: finite rank laminates, composite sphere assemblages and Vigdergauz microstructures. An isotropic honeycomb-like hexagonal...

  13. Stability of latent class segments over time

    DEFF Research Database (Denmark)

    Mueller, Simone

    2011-01-01

    Dynamic stability, as the degree to which identified segments at a given time remain unchanged over time in terms of number, size and profile, is a desirable segment property which has received limited attention so far. This study addresses the question to what degree latent classes identified from...... logit model suggests significant changes in the price sensitivity and the utility from environmental claims between both experimental waves. A pooled scale adjusted latent class model is estimated jointly over both waves and the relative size of latent classes is compared across waves, resulting...... in significant differences in the size of two out of seven classes. These differences can largely be accounted for by the changes on the aggregated level. The relative size of latent classes is correlated at 0.52, suggesting a fair robustness. An ex-post characterisation of latent classes by behavioural...

  14. Type classes for mathematics in type theory

    OpenAIRE

    Spitters, Bas; Van der Weegen, Eelis

    2011-01-01

    The introduction of first-class type classes in the Coq system calls for re-examination of the basic interfaces used for mathematical formalization in type theory. We present a new set of type classes for mathematics and take full advantage of their unique features to make practical a particularly flexible approach formerly thought infeasible. Thus, we address both traditional proof engineering challenges as well as new ones resulting from our ambition to build upon this development a library...

  15. Exploring social class differences at work

    OpenAIRE

    Evans, Samantha

    2016-01-01

    This paper is part of a wider project that investigates how organisational and individual factors within the workplace contribute to social class differences and inequality by examining the relative impact of objective and subjective indicators of social class on explicit (e.g. salary, promotions) and implicit (e.g. career satisfaction, quality of working life, stress and well-being) career and work outcomes. \\ud There is increasing recognition that social class differences play a crucial rol...

  16. Middle Class Youth: Myth or Reality

    Directory of Open Access Journals (Sweden)

    U V Goliusova

    2008-09-01

    Full Text Available Many researches both in Russia and abroad are concerned with the question of whether middle class exists in Russia and, if so, what its distinctive features are. The problem of particular interest is the sources of recruiting to that social group. One of its source clusters is youth. The article considers main traits of middle class youth, their self-identification and their perception of Russian middle class.

  17. Gut-associated lymphoid tissue contains the molecular machinery to support T-cell-dependent and T-cell-independent class switch recombination.

    Science.gov (United States)

    Barone, F; Patel, P; Sanderson, J D; Spencer, J

    2009-11-01

    A PRoliferation-Inducing Ligand (APRIL) is a secreted cytokine member of the tumor necrosis factor family. It is a B-cell survival factor that also induces class switch recombination (CSR) toward immunoglobulin A (IgA), independent of T cells. It is therefore an important contributor to the maintenance of the mucosal immunological barrier, which has been linked to a putative extrafollicular inductive phase of the IgA response in lamina propria. By immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR) on microdissected tissue from normal human gut, we observed APRIL expression, together with TACI (transmembrane activator and CAML interactor) and BCMA (B-cell maturation antigen), in gut-associated lymphoid tissue (GALT), lamina propria, and in the epithelium of stomach, small and large intestine, and rectum. However, no activation-induced cytidine deaminase (AID) expression (an absolute requirement for class switching) was detected in lamina propria by IHC or qRT-PCR. APRIL and its receptors were only observed alongside AID in GALT, showing that GALT contains the apparatus to support both T-independent and T-dependent routes to IgA CSR.

  18. MHC class II expression in lung cancer.

    Science.gov (United States)

    He, Yayi; Rozeboom, Leslie; Rivard, Christopher J; Ellison, Kim; Dziadziuszko, Rafal; Yu, Hui; Zhou, Caicun; Hirsch, Fred R

    2017-10-01

    Immunotherapy is an exciting development in lung cancer research. In this study we described major histocompatibility complex (MHC) Class II protein expression in lung cancer cell lines and patient tissues. We studied MHC Class II (DP, DQ, DR) (CR3/43, Abcam) protein expression in 55 non-small cell lung cancer (NSCLC) cell lines, 42 small cell lung cancer (SCLC) cell lines and 278 lung cancer patient tissues by immunohistochemistry (IHC). Seven (12.7%) NSCLC cell lines were positive for MHC Class II. No SCLC cell lines were found to be MHC Class II positive. We assessed 139 lung cancer samples available in the Hirsch Lab for MHC Class II. There was no positive MHC Class II staining on SCLC tumor cells. MHC Class II expression on TILs in SCLC was significantly lower than that on TILs in NSCLC (P<0.001). MHC Class II was also assessed in an additional 139 NSCLC tumor tissues from Medical University of Gdansk, Poland. Patients with positive staining of MHC Class II on TILs had longer regression-free survival (RFS) and overall survival (OS) than those whose TILs were MHC Class II negative (2.980 years, 95% CI 1.628-4.332 vs. 1.050 years, 95% CI 0.556-1.554, P=0.028) (3.230 years, 95% CI 2.617-3.843 vs. 1.390 years, 95% CI 0.629-2.151, P=0.014). MHC Class II was expressed both in NSCLC cell lines and tissues. However, MHC Class II was not detected in SCLC cell lines or tissue tumor cells. MHC Class II expression was lower on SCLC TILs than on NSCLC TILs. Loss of expression of MHC Class II on SCLC tumor cells and reduced expression on SCLC TILs may be a means of escaping anti-cancer immunity. Higher MHC Class II expression on TILs was correlated with better prognosis in patients with NSCLC. Copyright © 2017. Published by Elsevier B.V.

  19. Operationalizing Max Weber's probability concept of class situation: the concept of social class.

    Science.gov (United States)

    Smith, Ken

    2007-03-01

    In this essay I take seriously Max Weber's astonishingly neglected claim that class situation may be defined, not in categorial terms, but probabilistically. I then apply this idea to another equally neglected claim made by Weber that the boundaries of social classes may be determined by the degree of social mobility within such classes. Taking these two ideas together I develop the idea of a non-categorial boundary 'surface' between classes and of a social class 'corridor' made up of all those people who are still to be found within the boundaries of the social class into which they were born. I call social mobility within a social class 'intra-class social mobility' and social mobility between classes 'inter-class social mobility'. I also claim that this distinction resolves the dispute between those sociologists who claim that late industrial societies are still highly class bound and those who think that this is no longer the case. Both schools are right I think, but one is referring to a high degree of intra-class social mobility and the other to an equally high degree of inter-class mobility. Finally I claim that this essay provides sociology with only one example among many other possible applications of how probability theory might usefully be used to overcome boundary problems generally in sociology.

  20. Class categories and the subjective dimension of class: the case of Denmark.

    Science.gov (United States)

    Harrits, Gitte Sommer; Pedersen, Helene Helboe

    2018-03-01

    Class relations have been proven to affect various aspects of social life, even in modern individualized societies. However, following claims on individualization and the so-called 'death of class' thesis, studying the subjective dimension of class - that is, the way individuals perceive of class relations and their own position within them - has gone out of style. We argue that even in equalized societies, subjective class perceptions may still influence attitudes and behaviour as they evolve to fit modern class relations. To explore the existence as well as structure and content of perceived social classes, this article investigates how people describe society and social groups in focus group discussions. We find that groups in different positions in terms of education and economy all tend to apply hierarchical class categories to describe Danish society, which is normally seen as one of the most equal societies and political systems in the world. In addition, we find that economic resources serve as a baseline for the hierarchical ordering, often supplemented with notions of education, lifestyle and/or occupational profile. Even though people are somewhat uncomfortable with the notion of class, their descriptions of Danish society and classes are surprisingly similar within and across groups. We conclude that not only do class relations matter; people are also highly aware of the existing classes and able to position themselves and others according to their notion of classes. © London School of Economics and Political Science 2017.

  1. Structural (Performance) class Potential for North America

    Science.gov (United States)

    Eric Jones; David E. Kretschmann; Kevin Cheung

    2014-01-01

    Structural class systems are species-independent product classification systems for structural timber. They are used throughout the world to reduce the number of species and grade choices that face the designer of wood construction projects. Structural class systems offer an opportunity to simplify timber specification in North America and to encourage more effective...

  2. Stress in Professional Classes: Causes, Manifestations, Coping.

    Science.gov (United States)

    Endres, Fred F.

    1992-01-01

    Investigates whether students in professional journalism and mass communication classes experience class-related stress, what factors contribute to the stress, and whether that stress changes over time. Finds that students perceive stress in their professional course work, and reveals general stress patterns over the 15-week semester. (SR)

  3. Using Mobile Phone Technology in EFL Classes

    Science.gov (United States)

    Sad, Süleyman Nihat

    2008-01-01

    Teachers of English as a foreign language (EFL) who want to develop successful lessons face numerous challenges, including large class sizes and inadequate instructional materials and technological support. Another problem is unmotivated students who refuse to participate in class activities. According to Harmer (2007), uncooperative and…

  4. New universality class in three dimensions

    DEFF Research Database (Denmark)

    Codello, A.; Safari, M.; Vacca, G. P.

    2017-01-01

    We study the Blume-Capel universality class in d=103-ϵ dimensions. The renormalization group flow is extracted by looking at poles in fractional dimension of three loop diagrams using MS. The theory is the only nontrivial universality class which admits an expansion to three dimensions with ϵ=13<...

  5. 29 CFR 1614.204 - Class complaints.

    Science.gov (United States)

    2010-07-01

    ... practice adversely affecting the class as well as the specific action or matter affecting the class agent.../Petition. (e) Notification. (1) Within 15 days of receiving notice that the administrative judge has... parties shall furnish to the administrative judge copies of all materials that they wish to be examined...

  6. The YouTube Makeup Class

    Science.gov (United States)

    Haase, David G.

    2009-01-01

    When a college instructor goes out of town and must miss a lecture, the standard options are to cancel the class meeting or to enlist a colleague to fill in. In the former case a teaching opportunity is lost; in the latter the substitute may not lead the class in the same way as the instructor. Some students routinely skip lectures by a guest…

  7. 76 FR 68058 - Classes of Poultry

    Science.gov (United States)

    2011-11-03

    ... for some poultry classes, while extensive cross breeding has produced poultry with higher meat yields... Committee on Meat and Poultry Inspection (NACMPI) for consultation to ensure that there is no inconsistency... classifications, proposed changes to the game hen classes, and other proposed editorial changes. Response: FSIS...

  8. Intercultural and Media Education on Art Classes

    Science.gov (United States)

    Borges, Maria José; Chaves, Anabela; Costa, Manuela; Pereira, Emília Sá

    2009-01-01

    Visual art, music and literature, are part of the culture. Thus Art shows the interactions between different cultures. The aim of the article is to present some activities to include intercultural issues in Art and Mother Language classes. Art classes also give the opportunity to do Media Education.

  9. Higher Education and Class: Production or Reproduction?

    Science.gov (United States)

    Sotiris, Panagiotis

    2013-01-01

    This article deals with questions relating to the role of education and especially Higher Education in the reproduction of class division in society. Social classes and how they are formed and reproduced has always been one of the greatest challenges for Marxism and social theory in general. The questions regarding the role of education, and…

  10. Software Training Classes Now Open | Poster

    Science.gov (United States)

    By Nancy Parrish, Staff Writer                                            Data Management Services, Inc. (DMS), has announced the opening of its spring session of software training classes, available to all employees at NCI at Frederick. Classes begin on March 31 and run through June 30.

  11. Teaching Multilevel Adult ESL Classes. ERIC Digest.

    Science.gov (United States)

    Shank, Cathy C.; Terrill, Lynda R.

    Teachers in multilevel adult English-as-a-Second-Language classes are challenged to use a variety of materials, activities, and techniques to engage the interest of the learners and assist them in their educational goals. This digest recommends ways to choose and organize content for multilevel classes, explains grouping strategies, discusses a…

  12. Gender, Class and Rurality: Australian Case Studies

    Science.gov (United States)

    Bryant, Lia; Pini, Barbara

    2009-01-01

    The interrelationship between gender and class in rural spaces has received little attention. While rural scholars have focused on the implications for class from processes of gentrification and agricultural and rural restructuring, these analyses have remained largely ungendered. Similarly, feminist rural studies have rarely explored subjectivity…

  13. Social Class and Education: Global Perspectives

    Science.gov (United States)

    Weis, Lois, Ed.; Dolby, Nadine, Ed.

    2012-01-01

    "Social Class and Education: Global Perspectives" is the first empirically grounded volume to explore the intersections of class, social structure, opportunity, and education on a truly global scale. Fifteen essays from contributors representing the US, Europe, China, Latin America and other regions offer an unparralleled examination of…

  14. Social class, dementia and the fourth age.

    Science.gov (United States)

    Jones, Ian Rees

    2017-02-01

    Research addressing social class and dementia has largely focused on measures of socioeconomic status as causal risk factors for dementia and in observed differences in diagnosis, treatment and care. This large body of work has produced important insights but also contains numerous problems and weaknesses. Research needs to take account of the ways in which ageing and social class have been transformed in tandem with the economic, social and cultural coordinates of late modernity. These changes have particular consequences for individual identities and social relations. With this in mind this article adopts a critical gaze on research that considers interactions between dementia and social class in three key areas: (i) epidemiological approaches to inequalities in risk (ii) the role of social class in diagnosis and treatment and (iii) class in the framing of care and access to care. Following this, the article considers studies of dementia and social class that focus on lay understandings and biographical accounts. Sociological insights in this field come from the view that dementia and social class are embedded in social relations. Thus, forms of distinction based on class relations may still play an important role in the lived experience of dementia. © 2017 Foundation for the Sociology of Health & Illness.

  15. Social Class on Campus: Theories and Manifestations

    Science.gov (United States)

    Barratt, Will

    2011-01-01

    This is at once a playful text with a serious purpose: to provide the reader with the theoretical lenses to analyze the dynamics of social class. It will appeal to students, and indeed anyone interested in how class mediates relationships in higher education, both because of its engaging tone, and because it uses the college campus as a microcosm…

  16. The Power of In-Class Debates

    Science.gov (United States)

    Kennedy, Ruth R.

    2009-01-01

    The students in three sections of a class rated their knowledge and identified their view before and after each of five in-class debates. The degree of self-reported knowledge was significantly different after four of the five debates. Between 31% and 58% of participants changed their views after participating in or observing each debate. Some…

  17. Meat Cutting Classes--Popular with Adults

    Science.gov (United States)

    Mostad, James; Carpentier, Dale

    1976-01-01

    Presents a session by session description of a "meats" class, which is offered to high school students (9-week period) and adults (8-week period). The classes cover identification of cuts (beef, sheep, hogs, and veal; grades and grading of live animals and carcasses; economics of butchering and cutting your own meat; actual slaughtering; and the…

  18. Morphological caracteristics of malocclusion class II

    Directory of Open Access Journals (Sweden)

    Pavlović J.

    2015-01-01

    Full Text Available Class II malocclusion are complex anomalies of the skeletal and dental systems. The aim of this study is that the rengenkefalometrics analysis closer determine the morphological characteristics of this malocclusion. For this study were used 30 patients aged 18-30, previously clinically diagnosed class II, before the planned orthodontic treatment. The results analisis lateral cephalometric radiographs were compared with the 30 patients with class I malocclusion. Analyzed three linear and two angular cranial base dimensions and nine angular and four linear measures from the facial skeleton. The Results show: No statistically significant differensis in cranial base angle (SNBa and anterior cranial base length (S-N between class II and control Class I. Angle maxillar prognathism ( SNA is no signifikant different between class I and Class II but SNB angle were signifikant smaller. The length of maxillary base (A'-SnP is longer and the length of mandibule (Pg'-MT1/MT is signifficantly smaller. The gonial angle (ArGo-Me was smaller with open articular angle (GoArSN. Morphological characteristics of class II malocclusion are , retrognathic and smaller mandibular ligth, normognathic and longer maxilla, open articular angle with vertical tendency of the craniofacial growth pattern.

  19. 40 CFR 2.207 - Class determinations.

    Science.gov (United States)

    2010-07-01

    ... Confidentiality of Business Information § 2.207 Class determinations. (a) The General Counsel may make and issue a... items of business information; (2) One or more characteristics common to all such items of information... § 2.204(b)(1), § 2.204(d), § 2.205(d), or § 2.206. However, the existence of a class determination...

  20. Flipping a Calculus Class: One Instructor's Experience

    Science.gov (United States)

    Palmer, Katrina

    2015-01-01

    This paper describes one instructor's experiences during a year of flipping four calculus classes. The first exploration attempts to understand student expectations of a math class and their preference towards a flipped classroom. The second examines success of students from a flipped classroom, and the last investigates relationships with student…

  1. Race, class, gender, and American environmentalism.

    Science.gov (United States)

    Dorceta E. Taylor

    2002-01-01

    This paper examines the environmental experiences of middle and working class whites and people of color in the United States during the 19th and 20th centuries. It examines their activism and how their environmental experiences influenced the kinds of discourses they developed. The paper posits that race, class, and gender had profound effects on people's...

  2. Introducing Newspapers in Developmental Reading Classes

    Science.gov (United States)

    Karstadt, Roberta; Rey, Victoria M.

    2009-01-01

    Newspapers are an effective educational and motivational tool in developmental reading classes. However, many students are unfamiliar with newspapers and read them infrequently. In order to foster newspaper reading and familiarize the college freshmen enrolled in their developmental reading classes with newspapers, the writers of this article…

  3. Various chapter styles for the memoir class

    DEFF Research Database (Denmark)

    Madsen, Lars

    2008-01-01

    Document showcasing various chapter title page designs either included in the LaTeX memoir class or is easily manually coded.......Document showcasing various chapter title page designs either included in the LaTeX memoir class or is easily manually coded....

  4. The Communication Audit as a Class Project.

    Science.gov (United States)

    Conaway, Roger N.

    1994-01-01

    Describes a class project in which students conduct a "communication audit" or assessment of an off-campus organization, providing students with opportunities to explore, examine, monitor, and evaluate communication in a practical way. Discusses grading, beginning the class, contacting clients, instrumentation and procedures, costs, and…

  5. Special Classes for Gifted Students? Absolutely!

    Science.gov (United States)

    Burton-Szabo, Sally

    1996-01-01

    This article makes a case for special classes for gifted students and answers objections to special classes raised by the middle school movement and the cooperative learning movement. A sample "Celebration of Me" unit taught to gifted seventh graders which involved poetry, literature, personal development, art, music, and physical fitness is…

  6. Gait and Function in Class III Obesity

    Directory of Open Access Journals (Sweden)

    Catherine Ling

    2012-01-01

    Full Text Available Walking, more specifically gait, is an essential component of daily living. Walking is a very different activity for individuals with a Body Mass Index (BMI of 40 or more (Class III obesity compared with those who are overweight or obese with a BMI between 26–35. Yet all obesity weight classes receive the same physical activity guidelines and recommendations. This observational study examined the components of function and disability in a group with Class III obesity and a group that is overweight or has Class I obesity. Significant differences were found between the groups in the areas of gait, body size, health condition, and activity capacity and participation. The Timed Up and Go test, gait velocity, hip circumference, and stance width appear to be most predictive of activity capacity as observed during gait assessment. The findings indicate that Class III-related gait is pathologic and not a normal adaptation.

  7. The structural dynamics of social class.

    Science.gov (United States)

    Kraus, Michael W; Park, Jun Won

    2017-12-01

    Individual agency accounts of social class persist in society and even in psychological science despite clear evidence for the role of social structures. This article argues that social class is defined by the structural dynamics of society. Specifically, access to powerful networks, groups, and institutions, and inequalities in wealth and other economic resources shape proximal social environments that influence how individuals express their internal states and motivations. An account of social class that highlights the means by which structures shape and are shaped by individuals guides our understanding of how people move up or down in the social class hierarchy, and provides a framework for interpreting neuroscience studies, experimental paradigms, and approaches that attempt to intervene on social class disparities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Social class & risk preferences and behavior.

    Science.gov (United States)

    Kish-Gephart, Jennifer J

    2017-12-01

    This paper reviews recent work regarding the link between one's societal ranking (or social class), and risk preferences and behavior. While the topic of social class and its relationship to risk has been studied only tentatively in psychology, preliminary evidence suggests that experiences with rank, access to resources, and movement between classes have a meaningful impact on people's risk preferences and behaviors. Yet, a clear pattern of results remains elusive. Some studies suggest that lower social class standing is related to risk aversion, while others suggest it is related to risk taking. These mixed results highlight the need for future research that examines when and why lower social class standing is related to more or less risky decisions. By shedding light on this important phenomenon, the hope is to offer intervention opportunities that influence policies and mitigate inequality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. MATLAB tensor classes for fast algorithm prototyping.

    Energy Technology Data Exchange (ETDEWEB)

    Bader, Brett William; Kolda, Tamara Gibson (Sandia National Laboratories, Livermore, CA)

    2004-10-01

    Tensors (also known as mutidimensional arrays or N-way arrays) are used in a variety of applications ranging from chemometrics to psychometrics. We describe four MATLAB classes for tensor manipulations that can be used for fast algorithm prototyping. The tensor class extends the functionality of MATLAB's multidimensional arrays by supporting additional operations such as tensor multiplication. The tensor as matrix class supports the 'matricization' of a tensor, i.e., the conversion of a tensor to a matrix (and vice versa), a commonly used operation in many algorithms. Two additional classes represent tensors stored in decomposed formats: cp tensor and tucker tensor. We descibe all of these classes and then demonstrate their use by showing how to implement several tensor algorithms that have appeared in the literature.

  10. Social class, power, and selfishness: when and why upper and lower class individuals behave unethically.

    Science.gov (United States)

    Dubois, David; Rucker, Derek D; Galinsky, Adam D

    2015-03-01

    Are the rich more unethical than the poor? To answer this question, the current research introduces a key conceptual distinction between selfish and unethical behavior. Based on this distinction, the current article offers 2 novel findings that illuminate the relationship between social class and unethical behavior. First, the effects of social class on unethical behavior are not invariant; rather, the effects of social class are moderated by whether unethical behavior benefits the self or others. Replicating past work, social class positively predicted unethical behavior; however, this relationship was only observed when that behavior was self-beneficial. When unethical behavior was performed to benefit others, social class negatively predicted unethical behavior; lower class individuals were more likely than upper class individuals to engage in unethical behavior. Overall, social class predicts people's tendency to behave selfishly, rather than predicting unethical behavior per se. Second, individuals' sense of power drove the effects of social class on unethical behavior. Evidence for this relationship was provided in three forms. First, income, but not education level, predicted unethical behavior. Second, feelings of power mediated the effect of social class on unethical behavior, but feelings of status did not. Third, two distinct manipulations of power produced the same moderation by self-versus-other beneficiary as was found with social class. The current theoretical framework and data both synthesize and help to explain a range of findings in the social class and power literatures. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  11. Self-Education, Class and Gender in Edwardian Britain: Women in Lower Middle Class Families

    Science.gov (United States)

    Sutherland, Gillian

    2015-01-01

    Once societies embarked on programmes of mass education home schooling became essentially a middle-class project and remains so. This paper looks at the educational experiences of some lower middle class women at the turn of the nineteenth and twentieth centuries for whom the resources of the middle-class home were simply not available. It…

  12. A Tale of Two Classes: The Black Poor and the Black Middle Class.

    Science.gov (United States)

    Lewin, Arthur

    1991-01-01

    To understand the African-American family, the African-American poor and middle class must be investigated. Extra costs mean that it is much harder for African Americans to reach the middle class. Ways to improve the economic status of African-American families and to increase the middle class are discussed. (SLD)

  13. Social Class (In)Visibility and the Professional Experiences of Middle-Class Novice Teachers

    Science.gov (United States)

    Hall, David; Jones, Lisa

    2013-01-01

    This article focuses upon the classed and early professional experiences of middle-class novice teachers in England experiencing and contemplating working in schools serving socio-economically disadvantaged communities. Through an examination of the visibility and invisibility of social class in education set within an increasingly unequal and…

  14. 78 FR 72056 - Proposed Amendment of Class D and Class E Airspace; Christiansted, St. Croix, VI

    Science.gov (United States)

    2013-12-02

    ... Class D and Class E Airspace; Christiansted, St. Croix, VI AGENCY: Federal Aviation Administration (FAA... Class E Airspace at Christiansted, St. Croix, VI, to adjust the geographic coordinates of Henry E..., Christiansted, St. Croix, VI, to bring it in concert with the FAAs aeronautical database. The coordinates would...

  15. Evolution of major histocompatibility complex class I and class II genes in the brown bear

    Science.gov (United States)

    2012-01-01

    Background Major histocompatibility complex (MHC) proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. Results We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN) exceeded the rate of synonymous substitutions (dS) at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Conclusions Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South–north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia. PMID:23031405

  16. Evolution of major histocompatibility complex class I and class II genes in the brown bear

    Directory of Open Access Journals (Sweden)

    Kuduk Katarzyna

    2012-10-01

    Full Text Available Abstract Background Major histocompatibility complex (MHC proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. Results We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN exceeded the rate of synonymous substitutions (dS at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Conclusions Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South–north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia.

  17. Evolution of major histocompatibility complex class I and class II genes in the brown bear.

    Science.gov (United States)

    Kuduk, Katarzyna; Babik, Wiesław; Bojarska, Katarzyna; Sliwińska, Ewa B; Kindberg, Jonas; Taberlet, Pierre; Swenson, Jon E; Radwan, Jacek

    2012-10-02

    Major histocompatibility complex (MHC) proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN) exceeded the rate of synonymous substitutions (dS) at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South-north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia.

  18. Maxillary molar distalization with first class appliance.

    Science.gov (United States)

    Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

    2014-02-27

    Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation.

  19. Do Convolutional Neural Networks Learn Class Hierarchy?

    Science.gov (United States)

    Bilal, Alsallakh; Jourabloo, Amin; Ye, Mao; Liu, Xiaoming; Ren, Liu

    2018-01-01

    Convolutional Neural Networks (CNNs) currently achieve state-of-the-art accuracy in image classification. With a growing number of classes, the accuracy usually drops as the possibilities of confusion increase. Interestingly, the class confusion patterns follow a hierarchical structure over the classes. We present visual-analytics methods to reveal and analyze this hierarchy of similar classes in relation with CNN-internal data. We found that this hierarchy not only dictates the confusion patterns between the classes, it furthermore dictates the learning behavior of CNNs. In particular, the early layers in these networks develop feature detectors that can separate high-level groups of classes quite well, even after a few training epochs. In contrast, the latter layers require substantially more epochs to develop specialized feature detectors that can separate individual classes. We demonstrate how these insights are key to significant improvement in accuracy by designing hierarchy-aware CNNs that accelerate model convergence and alleviate overfitting. We further demonstrate how our methods help in identifying various quality issues in the training data.

  20. Timely management of developing class III malocclusion

    Directory of Open Access Journals (Sweden)

    M R Yelampalli

    2012-01-01

    Full Text Available Timing of orthodontic treatment, especially for children with developing class III malocclusions, has always been somewhat controversial, and definitive treatment tends to be delayed for severe class III cases. Developing class III patients with moderate to severe anterior crossbite and deep bite may need early intervention in some selected cases. Class III malocclusion may develop in children as a result of an inherent growth abnormality, i.e. true class III malocclusion, or as a result of premature occlusal contacts causing forward functional shift of the mandible, which is known as pseudo class III malocclusion. These cases, if not treated at the initial stage of development, interfere with normal growth of the jaw bases and may result in severe facial deformities. The treatment should be carried out as early as possible for permitting normal growth of the skeletal bases. This paper deals with the selection of an appropriate appliance from the various current options available for early intervention in developing class III malocclusion through two case reports.

  1. How social-class stereotypes maintain inequality.

    Science.gov (United States)

    Durante, Federica; Fiske, Susan T

    2017-12-01

    Social class stereotypes support inequality through various routes: ambivalent content, early appearance in children, achievement consequences, institutionalization in education, appearance in cross-class social encounters, and prevalence in the most unequal societies. Class-stereotype content is ambivalent, describing lower-SES people both negatively (less competent, less human, more objectified), and sometimes positively, perhaps warmer than upper-SES people. Children acquire the wealth aspects of class stereotypes early, which become more nuanced with development. In school, class stereotypes advantage higher-SES students, and educational contexts institutionalize social-class distinctions. Beyond school, well-intentioned face-to-face encounters ironically draw on stereotypes to reinforce the alleged competence of higher-status people and sometimes the alleged warmth of lower-status people. Countries with more inequality show more of these ambivalent stereotypes of both lower-SES and higher-SES people. At a variety of levels and life stages, social-class stereotypes reinforce inequality, but constructive contact can undermine them; future efforts need to address high-status privilege and to query more heterogeneous samples. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. The Cosmology Large Angular Scale Surveyor (CLASS)

    Science.gov (United States)

    Cleary, Joseph

    2018-01-01

    The Cosmology Large Angular Scale Surveyor (CLASS) is an array of four telescopes designed to measure the polarization of the Cosmic Microwave Background. CLASS aims to detect the B-mode polarization from primordial gravitational waves predicted by cosmic inflation theory, as well as the imprint left by reionization upon the CMB E-mode polarization. This will be achieved through a combination of observing strategy and state-of-the-art instrumentation. CLASS is observing 70% of the sky to characterize the CMB at large angular scales, which will measure the entire CMB power spectrum from the reionization peak to the recombination peak. The four telescopes operate at frequencies of 38, 93, 145, and 217 GHz, in order to estimate Galactic synchrotron and dust foregrounds while avoiding atmospheric absorption. CLASS employs rapid polarization modulation to overcome atmospheric and instrumental noise. Polarization sensitive cryogenic detectors with low noise levels provide CLASS the sensitivity required to constrain the tensor-to-scalar ratio down to levels of r ~ 0.01 while also measuring the optical depth the reionization to sample-variance levels. These improved constraints on the optical depth to reionization are required to pin down the mass of neutrinos from complementary cosmological data. CLASS has completed a year of observations at 38 GHz and is in the process of deploying the rest of the telescope array. This poster provides an overview and update on the CLASS science, hardware and survey operations.

  3. 77 FR 9839 - Amendment of Class D and Class E Airspace, and Establishment of Class E Airspace; Bozeman, MT

    Science.gov (United States)

    2012-02-21

    ..., to accommodate aircraft using Instrument Landing System (ILS) Localizer (LOC) standard instrument... 6005 Class E airspace areas extending upward from 700 feet or more above the surface of the earth...

  4. SFRO booklets - The radiotherapy of cancers: of anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder for a better understanding of radiotherapy, sarcoma radiotherapy - To better understand your treatment

    International Nuclear Information System (INIS)

    Leroy, Thomas; Mornex, Francoise; Peiffert, Didier; Thariat, Juliette; Faivre, Jean-Christophe; Huguet, Florence; Vendrely, Veronique; Barillot, Isabelle; Janoray, Guillaume; Bibault, Jean-Emmanuel; Antoni, Delphine; Crehange, Gilles; Meillan, Nicolas; Pichon, Baptiste; Biau, Julian; Pointreau, Yoann; Mirabel, Xavier; Leysalle, Axel; Claren, Audrey; Cartier, Lysian; Chand, Mari-Eve; Jacob, Julian; Renard-Oldrini, Sophie; Le Pechoux, Cecile; Ducassou, Anne; Moureau-Zabotto, Laurence; Lagrange, Jean Leon; Molina, Sarah

    2016-07-01

    This document gathers several booklets which, for different types of cancers, propose information regarding the anatomy and location of the cancer, its diagnosis, possible treatments, secondary effects during treatment, some practical advices, issues related to the post-treatment period, associations and other resources which can be useful for patient information, and a glossary of the main terms used for this cancer and its treatment. Cancer types are anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder cancers

  5. Sartorial symbols of social class elicit class-consistent behavioral and physiological responses: a dyadic approach.

    Science.gov (United States)

    Kraus, Michael W; Mendes, Wendy Berry

    2014-12-01

    Social rank in human and nonhuman animals is signaled by a variety of behaviors and phenotypes. In this research, we examined whether a sartorial manipulation of social class would engender class-consistent behavior and physiology during dyadic interactions. Male participants donned clothing that signaled either upper-class (business-suit) or lower-class (sweatpants) rank prior to engaging in a modified negotiation task with another participant unaware of the clothing manipulation. Wearing upper-class, compared to lower-class, clothing induced dominance--measured in terms of negotiation profits and concessions, and testosterone levels--in participants. Upper-class clothing also elicited increased vigilance in perceivers of these symbols: Relative to perceiving lower-class symbols, perceiving upper-class symbols increased vagal withdrawal, reduced perceptions of social power, and catalyzed physiological contagion such that perceivers' sympathetic nervous system activation followed that of the upper-class target. Discussion focuses on the dyadic process of social class signaling within social interactions. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  6. Social affiliation in same-class and cross-class interactions.

    Science.gov (United States)

    Côté, Stéphane; Kraus, Michael W; Carpenter, Nichelle C; Piff, Paul K; Beermann, Ursula; Keltner, Dacher

    2017-02-01

    Historically high levels of economic inequality likely have important consequences for relationships between people of the same and different social class backgrounds. Here, we test the prediction that social affiliation among same-class partners is stronger at the extremes of the class spectrum, given that these groups are highly distinctive and most separated from others by institutional and economic forces. An internal meta-analysis of 4 studies (N = 723) provided support for this hypothesis. Participant and partner social class were interactively, rather than additively, associated with social affiliation, indexed by affiliative behaviors and emotions during structured laboratory interactions and in daily life. Further, response surface analyses revealed that paired upper or lower class partners generally affiliated more than average-class pairs. Analyses with separate class indices suggested that these patterns are driven more by parental income and subjective social class than by parental education. The findings illuminate the dynamics of same- and cross-class interactions, revealing that not all same-class interactions feature the same degree of affiliation. They also reveal the importance of studying social class from an intergroup perspective. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. The State of the Australian Middle Class

    Directory of Open Access Journals (Sweden)

    Clive Hamilton

    2008-09-01

    Full Text Available There is a widespread view that the middle class in Australia is doing it tough, that they arefinding it increasingly difficult to maintain a decent standard of living and are suffering frommortgage stress. Indeed, some media reports have announced the end of the middle classdream.This paper tests a number of these popular views against the statistical data. It asks whetherthe typical Australian family can be said to be struggling? Are mortgages creating severeproblems for middle-class families? Is the middle class shrinking? Are families copingfinancially only because wives are going out to work?

  8. Characteristic classes, singular embeddings, and intersection homology.

    Science.gov (United States)

    Cappell, S E; Shaneson, J L

    1987-06-01

    This note announces some results on the relationship between global invariants and local topological structure. The first section gives a local-global formula for Pontrjagin classes or L-classes. The second section describes a corresponding decomposition theorem on the level of complexes of sheaves. A final section mentions some related aspects of "singular knot theory" and the study of nonisolated singularities. Analogous equivariant analogues, with local-global formulas for Atiyah-Singer classes and their relations to G-signatures, will be presented in a future paper.

  9. Class, Mothering and the Values of Food

    DEFF Research Database (Denmark)

    Aamann, Iben Charlotte

    2015-01-01

    The data analysed in this empirical paper stems from ethnographic fieldwork among new school parents at three Danish primary schools. I draw on empirically grounded theories on the cultural and subjective dimensions of class, inspired by the “English School” of poststructuralist informed, feminist...... scholars, to explore how class matters. Using the values ascribed to food at social arrangements as a lens, I explore different ways of doing class and mothering: through the exchange value of the food, through its use value and through its healthiness. I conclude by arguing that food studies hold a huge...

  10. Class and ideological orientations revisited: an exploration of class-based mechanisms.

    Science.gov (United States)

    Bengtsson, Mattias; Berglund, Tomas; Oskarson, Maria

    2013-12-01

    Studies of the relationship between class position and political outlooks still only have a limited understanding of the class-related mechanisms that matter for ideological orientations. This article presents a comprehensive analysis of the mechanisms that link class position and left/right and authoritarian/libertarian orientations. Besides main factors such as income, career prospects, job security, education, class origin and class identification, the significance of work-related factors such as work autonomy, working in a team, a physically demanding job and a mentally demanding job is studied. The findings are based on a survey specifically designed for this purpose and collected in Sweden in 2008/2009. A great deal of the association between class position and left/right orientations is explained by socio-economic conditions; different classes sympathize with policies that will benefit them economically. Another important factor is class identification. Work-related factors also have relevance, but the effect of class position on left/right orientations works mainly through the remuneration system. Class position is also related to authoritarian/libertarian orientations. However, this relationship is less explained by socio-economic position per se, but is rather an effect of the educational system and its allocation of the workforce into different class positions. It also turns out that work-related factors do not explain the class effects; however, a physically demanding job shows a unique effect. Overall, our findings suggest that besides factors such as class position, income, education and class identification, we need to consider work-related aspects to derive a more complete understanding of the distribution of ideological orientations in Western societies. © London School of Economics and Political Science 2013.

  11. Introducing Emergency Preparedness in Childbirth Education Classes

    OpenAIRE

    DeWald, Lauren; Fountain, Lily

    2006-01-01

    In the wake of recent natural and man-made disasters and emergency situations, pregnant women are especially vulnerable. The authors of this column encourage childbirth educators to include disaster preparedness instruction and emergency childbirth techniques in their class content.

  12. Student Attitudes: A Study of Social Class

    Science.gov (United States)

    Hardy, Clifford A.

    1976-01-01

    Student attitudes toward current controversial problems (bussing for racial integration, legalization of abortion, and legalization of marijuana) were studied with regard to social class. The 1960 revision of the Purdue Master Attitude Scale was used. (LBH)

  13. Acquired Class D β-Lactamases

    Directory of Open Access Journals (Sweden)

    Nuno T. Antunes

    2014-08-01

    Full Text Available The Class D β-lactamases have emerged as a prominent resistance mechanism against β-lactam antibiotics that previously had efficacy against infections caused by pathogenic bacteria, especially by Acinetobacter baumannii and the Enterobacteriaceae. The phenotypic and structural characteristics of these enzymes correlate to activities that are classified either as a narrow spectrum, an extended spectrum, or a carbapenemase spectrum. We focus on Class D β-lactamases that are carried on plasmids and, thus, present particular clinical concern. Following a historical perspective, the susceptibility and kinetics patterns of the important plasmid-encoded Class D β-lactamases and the mechanisms for mobilization of the chromosomal Class D β-lactamases are discussed.

  14. National Cyber Expert Addresses ELP Class

    OpenAIRE

    Center for Homeland Defense and Security

    2012-01-01

    Center for Homeland Defense and Security, PRESS RELEASES Governments, businesses and educational institutions should be making cybersecurity a top priority, a leading expert told a class of the Center for Homeland Defense and Security’s Executive Leaders Program. Brian...

  15. Distributed optimization of multi-class SVMs.

    Directory of Open Access Journals (Sweden)

    Maximilian Alber

    Full Text Available Training of one-vs.-rest SVMs can be parallelized over the number of classes in a straight forward way. Given enough computational resources, one-vs.-rest SVMs can thus be trained on data involving a large number of classes. The same cannot be stated, however, for the so-called all-in-one SVMs, which require solving a quadratic program of size quadratically in the number of classes. We develop distributed algorithms for two all-in-one SVM formulations (Lee et al. and Weston and Watkins that parallelize the computation evenly over the number of classes. This allows us to compare these models to one-vs.-rest SVMs on unprecedented scale. The results indicate superior accuracy on text classification data.

  16. On characteristic classes and continuous cohomology

    International Nuclear Information System (INIS)

    Bott, R.

    1986-01-01

    The paper was presented at the workshop on 'Supersymmetry and its applications', Cambridge, United Kingdom, 1985. Six theorems on characteristic classes and continuous cohomology are described, in connection with the theory of anomalies. (UK)

  17. Diagrammatic Reasoning with Classes and Relationships

    DEFF Research Database (Denmark)

    Nilsson, Jørgen Fischer

    2013-01-01

    We present and discuss a diagrammatic visualization and reasoning language coming about by augmenting Euler diagrams with higraphs. The diagrams serve (hierarchical as well as trans-hierarchical) classification and specification of various logical relationships between classes. The diagrams rely...

  18. Class, Social Suffering, and Health Consumerism.

    Science.gov (United States)

    Merrild, Camilla Hoffmann; Risør, Mette Bech; Vedsted, Peter; Andersen, Rikke Sand

    2016-01-01

    In recent years an extensive social gradient in cancer outcome has attracted much attention, with late diagnosis proposed as one important reason for this. Whereas earlier research has investigated health care seeking among cancer patients, these social differences may be better understood by looking at health care seeking practices among people who are not diagnosed with cancer. Drawing on long-term ethnographic fieldwork among two different social classes in Denmark, our aim in this article is to explore the relevance of class to health care seeking practices and illness concerns. In the higher middle class, we predominantly encountered health care seeking resembling notions of health consumerism, practices sanctioned and encouraged by the health care system. However, among people in the lower working class, health care seeking was often shaped by the inseparability of physical, political, and social dimensions of discomfort, making these practices difficult for the health care system to accommodate.

  19. MANAGING LARGE CLASSES IN DEVELOPING COUNTRIES

    African Journals Online (AJOL)

    PROF. BARTH EKWUEME

    GLOBAL JOURNAL OF EDUCATIONAL RESEARCH VOL 15, 2016: 31-39. COPYRIGHT© ... classes or overcrowded classrooms affect the quality of education delivered in the school system. ... central to their national development strategy.

  20. Local formulae for combinatorial Pontryagin classes

    International Nuclear Information System (INIS)

    Gaifullin, Alexander A

    2004-01-01

    Let p(|K|) be the characteristic class of a combinatorial manifold K given by a polynomial p in the rational Pontryagin classes of K. We prove that for any polynomial p there is a function taking each combinatorial manifold K to a cycle z p (K) in its rational simplicial chains such that: 1) the Poincare dual of z p (K) represents the cohomology class p(|K|); 2) the coefficient of each simplex Δ in the cycle z p (K) is determined solely by the combinatorial type of linkΔ. We explicitly describe all such functions for the first Pontryagin class. We obtain estimates for the denominators of the coefficients of the simplices in the cycles z p (K)

  1. Communication in the Special Needs Class

    Science.gov (United States)

    Freeman, David

    1975-01-01

    This article stressed the importance of constant constructive communication between parents, teachers and students as a means towards building a relationship of trust, understanding and fulfillment in the special class. (Editor/RK)

  2. Combination Classes and "Hora de comunicacion."

    Science.gov (United States)

    Eldredge, Dee L.

    1989-01-01

    Ways to combine small classes of higher education students studying Spanish at various levels are described, including judicious use of language laboratories, staggering of the different level groups, and rotation of activities geared toward students' individual proficiency levels. (CB)

  3. CLASS: Core Library for Advanced Scenario Simulations

    International Nuclear Information System (INIS)

    Mouginot, B.; Thiolliere, N.

    2015-01-01

    The nuclear reactor simulation community has to perform complex electronuclear scenario simulations. To avoid constraints coming from the existing powerful scenario software such as COSI, VISION or FAMILY, the open source Core Library for Advanced Scenario Simulation (CLASS) has been developed. The main asset of CLASS is its ability to include any type of reactor, whether the system is innovative or standard. A reactor is fully described by its evolution database which should contain a set of different validated fuel compositions in order to simulate transitional scenarios. CLASS aims to be a useful tool to study scenarios involving Generation-IV reactors as well as innovative fuel cycles, like the thorium cycle. In addition to all standard key objects required by an electronuclear scenario simulation (the isotopic vector, the reactor, the fuel storage and the fabrication units), CLASS also integrates two new specific modules: fresh fuel evolution and recycled fuel fabrication. The first module, dealing with fresh fuel evolution, is implemented in CLASS by solving Bateman equations built from a database induced cross-sections. The second module, which incorporates the fabrication of recycled fuel to CLASS, can be defined by user priorities and/or algorithms. By default, it uses a linear Pu equivalent-method, which allows predicting, from the isotopic composition, the maximum burn-up accessible for a set type of fuel. This paper presents the basis of the CLASS scenario, the fuel method applied to a MOX fuel and an evolution module benchmark based on the French electronuclear fleet from 1977 to 2012. Results of the CLASS calculation were compared with the inventory made and published by the ANDRA organisation in 2012. For UOX used fuels, the ANDRA reported 12006 tonnes of heavy metal in stock, including cooling, versus 18500 tonnes of heavy metal predicted by CLASS. The large difference is easily explained by the presence of 56 tonnes of plutonium already separated

  4. A class of minimally modified gravity theories

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Chunshan; Mukohyama, Shinji, E-mail: chunshan.lin@yukawa.kyoto-u.ac.jp, E-mail: shinji.mukohyama@yukawa.kyoto-u.ac.jp [Center for Gravitational Physics, Yukawa Institute for Theoretical Physics, Kyoto University, Kyoto 606-8502 (Japan)

    2017-10-01

    We investigate the Hamiltonian structure of a class of gravitational theories whose actions are linear in the lapse function. We derive the necessary and sufficient condition for a theory in this class to have two or less local physical degrees of freedom. As an application we then find several concrete examples of modified gravity theories in which the total number of local physical degrees of freedom in the gravity sector is two.

  5. On skein relations in class S theories

    International Nuclear Information System (INIS)

    Tachikawa, Yuji; Watanabe, Noriaki

    2015-01-01

    Loop operators of a class S theory arise from networks on the corresponding Riemann surface, and their operator product expansions are given in terms of the skein relations, that we describe in detail in the case of class S theories of type A. As two applications, we explicitly determine networks corresponding to dyonic loops of N=4SU(3) super Yang-Mills, and compute the superconformal index of a nontrivial network operator of the T 3 theory.

  6. Are segregated sports classes scientifically justified?

    OpenAIRE

    Lawson, Sian; Hall, Edward

    2014-01-01

    School sports classes are a key part of physical and mental development, yet in many countries these classes are gender segregated. Before institutionalised segregation can be condoned it is important to tackle assumptions and check for an evidence-based rationale. This presentation aims to analyse the key arguments for segregation given in comment-form response to a recent media article discussing mixed school sports (Lawson, 2013).\\ud \\ud The primary argument given was division for strength...

  7. CLASS: The Cosmology Large Angular Scale Surveyor

    Science.gov (United States)

    Essinger-Hileman, Thomas; Ali, Aamir; Amiri, Mandana; Appel, John W.; Araujo, Derek; Bennett, Charles L.; Boone, Fletcher; Chan, Manwei; Cho, Hsiao-Mei; Chuss, David T.; hide

    2014-01-01

    The Cosmology Large Angular Scale Surveyor (CLASS) is an experiment to measure the signature of a gravitational wave background from inflation in the polarization of the cosmic microwave background (CMB). CLASS is a multi-frequency array of four telescopes operating from a high-altitude site in the Atacama Desert in Chile. CLASS will survey 70% of the sky in four frequency bands centered at 38, 93, 148, and 217 GHz, which are chosen to straddle the Galactic-foreground minimum while avoiding strong atmospheric emission lines. This broad frequency coverage ensures that CLASS can distinguish Galactic emission from the CMB. The sky fraction of the CLASS survey will allow the full shape of the primordial B-mode power spectrum to be characterized, including the signal from reionization at low-length. Its unique combination of large sky coverage, control of systematic errors, and high sensitivity will allow CLASS to measure or place upper limits on the tensor-to-scalar ratio at a level of r = 0:01 and make a cosmic-variance-limited measurement of the optical depth to the surface of last scattering, tau. (c) (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

  8. Hidden Advantages and Disadvantages of Social Class.

    Science.gov (United States)

    Goudeau, Sébastien; Croizet, Jean-Claude

    2017-02-01

    Three studies conducted among fifth and sixth graders examined how school contexts disrupt the achievement of working-class students by staging unfair comparison with their advantaged middle-class peers. In regular classrooms, differences in performance among students are usually showcased in a way that does not acknowledge the advantage (i.e., higher cultural capital) experienced by middle-class students, whose upbringing affords them more familiarity with the academic culture than their working-class peers have. Results of Study 1 revealed that rendering differences in performance visible in the classroom by having students raise their hands was enough to undermine the achievement of working-class students. In Studies 2 and 3, we manipulated students' familiarity with an arbitrary standard as a proxy for social class. Our results suggest that classroom settings that make differences in performance visible undermine the achievement of the students who are less familiar with academic culture. In Study 3, we showed that being aware of the advantage in familiarity with a task restores the performance of the students who have less familiarity with the task.

  9. Gender differences in Class III malocclusion.

    Science.gov (United States)

    Baccetti, Tiziano; Reyes, Brian C; McNamara, James A

    2005-07-01

    This study evaluated gender differences in the cephalometric records of a large-scale cross-sectional sample of Caucasian subjects with Class III malocclusion at different developmental ages. The purpose also was to provide average age-related and sex-related data for craniofacial measures in untreated Class III subjects that are used as reference in the diagnostic appraisal of the patient with Class III disharmony. The sample examined consisted of 1094 pretreatment lateral cephalometric records (557 female subjects and 537 male subjects) of Caucasian Class III individuals. The age range for female subjects was between three years six months and 57 years seven months. The male subject group ranged from three years three months to 48 years five months. Twelve age groups were identified. Skeletal maturity at different age periods also was determined using the stage of cervical vertebral maturation. Gender differences for all cephalometric variables were analyzed using parametric statistics. The findings of the study indicated that Class III malocclusion is associated with a significant degree of sexual dimorphism in craniofacial parameters, especially from the age of 13 onward. Male subjects with Class III malocclusion present with significantly larger linear dimensions of the maxilla, mandible, and anterior facial heights when compared with female subjects during the circumpubertal and postpubertal periods.

  10. Mandibular condyle dimensions in Peruvian patients with Class II and Class III skeletal patterns.

    Directory of Open Access Journals (Sweden)

    Hugo Zegarra-Baquerizo

    2017-10-01

    Full Text Available Objective: To compare condylar dimensions of young adults with Class II and Class III skeletal patterns using cone-beam computed tomography (CBCT. Materials and methods: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III were evaluated. Skeletal patterns were classified by measuring the ANB angle of each patient. The anteroposterior diameter (A and P of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior to P (posterior. The coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium to L (lateral; all distances were measured in mm. Results: In Class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in Class III these values were 8.71±1.2 and 8.84±1.42. In Class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in Class III these values were 19.16±2.75 and 19.16±2.54. Conclusion: Class III M-L dimensions showed higher values than Class II, whereas these differences were minimal in A-P.

  11. Duration of the pubertal peak in skeletal Class I and Class III subjects.

    Science.gov (United States)

    Kuc-Michalska, Małgorzata; Baccetti, Tiziano

    2010-01-01

    To estimate and compare the duration of the pubertal growth peak in Class I and Class III subjects. The data examined consisted of pretreatment lateral cephalometric records of 218 skeletal Class I or Class III subjects (93 female and 125 male subjects) of white ancestry. The duration of the pubertal peak was calculated from the average chronological age intervals between stages CS3 and CS4 of the cervical vertebral maturation in Class I vs Class III groups (t-test). In skeletal Class I subjects, the pubertal peak had a mean duration of 11 months, whereas in Class III subjects it lasted 16 months. The average difference (5 months) was statistically significant (P < .001). The growth interval corresponding to the pubertal growth spurt (CS3-CS4) was longer in Class III subjects than in subjects with normal skeletal relationships; the larger increases in mandibular length during the pubertal peak reported in the literature for Class III subjects may be related to the longer duration of the pubertal peak.

  12. 25 CFR 502.4 - Class III gaming.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Class III gaming. 502.4 Section 502.4 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GENERAL PROVISIONS DEFINITIONS OF THIS CHAPTER § 502.4 Class III gaming. Class III gaming means all forms of gaming that are not class I gaming or class...

  13. Classes and Theories of Trees Associated with a Class Of Linear Orders

    DEFF Research Database (Denmark)

    Goranko, Valentin; Kellerman, Ruaan

    2011-01-01

    Given a class of linear order types C, we identify and study several different classes of trees, naturally associated with C in terms of how the paths in those trees are related to the order types belonging to C. We investigate and completely determine the set-theoretic relationships between...... these classes of trees and between their corresponding first-order theories. We then obtain some general results about the axiomatization of the first-order theories of some of these classes of trees in terms of the first-order theory of the generating class C, and indicate the problems obstructing such general...... results for the other classes. These problems arise from the possible existence of nondefinable paths in trees, that need not satisfy the first-order theory of C, so we have started analysing first order definable and undefinable paths in trees....

  14. Identifying classes of persons with mild intellectual disability or borderline intellectual functioning: a latent class analysis.

    Science.gov (United States)

    Nouwens, Peter J G; Lucas, Rosanne; Smulders, Nienke B M; Embregts, Petri J C M; van Nieuwenhuizen, Chijs

    2017-07-17

    Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of persons with mild intellectual disability or borderline intellectual functioning and to examine whether these classes are related to individual and/or environmental characteristics. Latent class analysis was performed using file data of 250 eligible participants with a mean age of 26.1 (SD 13.8, range 3-70) years. Five distinct classes of persons with mild intellectual disability or borderline intellectual functioning were found. These classes significantly differed in individual and environmental characteristics. For example, persons with a mild intellectual disability experienced fewer problems than those with borderline intellectual disability. The identification of five classes implies that a differentiated approach is required towards persons with mild intellectual disability or borderline intellectual functioning.

  15. Mapping the social class structure: From occupational mobility to social class categories using network analysis

    DEFF Research Database (Denmark)

    Toubøl, Jonas; Larsen, Anton Grau

    2017-01-01

    This article develops a new explorative method for deriving social class categories from patterns of occupational mobility. In line with Max Weber, our research is based on the notion that, if class boundaries do not inhibit social mobility then the class categories are of little value. Thus......, unlike dominant, theoretically defined class schemes, this article derives social class categories from observed patterns in a mobility network covering intra-generational mobility. The network is based on a mobility table of 109 occupational categories tied together by 1,590,834 job shifts on the Danish...... labour market 2001–2007. The number of categories are reduced from 109 to 34 by applying a new clustering algorithm specifically designed for the study of mobility tables (MONECA). These intra-generational social class categories are related to the central discussions of gender, income, education...

  16. Debye classes in A15 compounds

    International Nuclear Information System (INIS)

    Staudenmann, J.; DeFacio, B.; Testardi, L.R.; Werner, S.A.; Fluekiger, R.; Muller, J.

    1981-01-01

    The comparison between electron charge-density distribution of V 3 Si, Cr 3 Si, and V 3 Ge at room temperature leads us to study the Debye temperatures at 0 0 K THETA 0 from specific-heat measurements for over 100 A15 compounds. A phenomenological THETA 0 (M), M the molecular mass, is obtained from the static scaling relation THETA 0 (M) = aM/sup b/ and this organizes all of the data into five Debye classes: V(V 3 Si), V-G, G(V 3 Ge), G-C, and C(Cr 3 Si). In contrast, the Debye temperature THETA 0 (V), with V as the unit-cell volume does not relate alloys as THETA 0 (M) does, with the exception of the C class. This latter case leads to the surprising result MproportionalV/sup approximately1/3/ and to a Grueneisen constant of 1.6 +- 0.1 for all compounds of this class. In the V class where V 3 Si and Nb 3 Sn are found, THETA 0 (V) labels these two alloys differently, as does their martensitic c/a ratios. With T-bar/sub c/ denoting the average superconducting transition temperature within a Debye class, interesting correlations are shown. One is the maximum of T-bar/sub c/ which exists in the V class where the strongest anharmonicity occurs. Another is the case of compounds formed only by transition elements up to and including Au. This interesting case shows that approx.3.2< T-bar/sub c/< approx.5.0 K in all of the five classes and that there is no correlation between T/sub c/ and the thermal properties. The implications of these observations for creating better models for the A15 compounds are briefly discussed

  17. Evaluation depth of the curve of Spee in class I, class II, and class III malocclusion: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Sanjna Nayar

    2015-01-01

    Full Text Available Occlusal plane is an essential consideration when multiple long-span posterior restorations are designed. When restorations are added to an existing tooth arrangement characterized by rotated, tipped, or extruded teeth, excursive interferences may be incorporated, resulting in detrimental squeal. The curve of Spee, which exists in the ideal natural dentition, allows harmony to exist between the anterior tooth and condylar guidance. This curve exists in the sagittal plane and is the best viewed from a lateral aspect. It permits total posterior disclusion on mandibular protrusion, given proper anterior tooth guidance. It is unclear that whether the curve of Spee is a description of the occlusal surface of each arch separately or in maximal intercuspation. The purpose of this study was to examine the differences in the depth of curve of Spee between the class I, class II, class III and to investigate the relationship of depth of curve of Spee with over jet, over-bite.

  18. The relationship between Class I and Class II methanol masers at high angular resolution

    Science.gov (United States)

    McCarthy, T. P.; Ellingsen, S. P.; Voronkov, M. A.; Cimò, G.

    2018-06-01

    We have used the Australia Telescope Compact Array (ATCA) to make the first high-resolution observations of a large sample of class I methanol masers in the 95-GHz (80-71A+) transition. The target sources consist of a statistically complete sample of 6.7-GHz class II methanol masers with an associated 95-GHz class I methanol maser, enabling a detailed study of the relationship between the two methanol maser classes at arcsecond angular resolution. These sources have been previously observed at high resolution in the 36- and 44-GHz transitions, allowing comparison between all three class I maser transitions. In total, 172 95-GHz maser components were detected across the 32 target sources. We find that at high resolution, when considering matched maser components, a 3:1 flux density ratio is observed between the 95- and 44-GHz components, consistent with a number of previous lower angular resolution studies. The 95-GHz maser components appear to be preferentially located closer to the driving sources and this may indicate that this transition is more strongly inverted nearby to background continuum sources. We do not observe an elevated association rate between 95-GHz maser emission and more evolved sources, as indicated by the presence of 12.2-GHz class II masers. We find that in the majority of cases where both class I and class II methanol emission is observed, some component of the class I emission is associated with a likely outflow candidate.

  19. On CSM classes via Chern-Fulton classes of f-schemes

    OpenAIRE

    Fullwood, James; Wang, Dongxu

    2015-01-01

    The Chern-Fulton class is a generalization of Chern class to the realm of arbitrary embeddable schemes. While Chern-Fulton classes are sensitive to non-reduced scheme structure, they are not sensitive to possible singularities of the underlying support, thus at first glance are not interesting from a singularity theory viewpoint. However, we introduce a class of formal objects which we think of as `fractional schemes', or f-schemes for short, and then show that when one broadens the domain of...

  20. Classes, cultura e ação coletiva Classes, culture and collective action

    Directory of Open Access Journals (Sweden)

    Brasílio Sallum Jr.

    2005-08-01

    Full Text Available O artigo faz uma revisão da literatura sobre classes e conflito social, analisando seus impasses. Em seguida, faz uma incursão aos legados de Pierre Bordieu e Marx sobre a matéria, indicando como poderiam ser integrados numa teoria renovada das classes sociais.The article surveys the literature on class and social conflict, focusing its theoretical dilemmas. Then it discusses Pierre Bordieu's and Marx's legacies on the subject, pointing out how they could be integrated in a renewed theory of social classes.

  1. Software engineering processes for Class D missions

    Science.gov (United States)

    Killough, Ronnie; Rose, Debi

    2013-09-01

    Software engineering processes are often seen as anathemas; thoughts of CMMI key process areas and NPR 7150.2A compliance matrices can motivate a software developer to consider other career fields. However, with adequate definition, common-sense application, and an appropriate level of built-in flexibility, software engineering processes provide a critical framework in which to conduct a successful software development project. One problem is that current models seem to be built around an underlying assumption of "bigness," and assume that all elements of the process are applicable to all software projects regardless of size and tolerance for risk. This is best illustrated in NASA's NPR 7150.2A in which, aside from some special provisions for manned missions, the software processes are to be applied based solely on the criticality of the software to the mission, completely agnostic of the mission class itself. That is, the processes applicable to a Class A mission (high priority, very low risk tolerance, very high national significance) are precisely the same as those applicable to a Class D mission (low priority, high risk tolerance, low national significance). This paper will propose changes to NPR 7150.2A, taking mission class into consideration, and discuss how some of these changes are being piloted for a current Class D mission—the Cyclone Global Navigation Satellite System (CYGNSS).

  2. The Cosmology Large Angular Scale Surveyor (CLASS)

    Science.gov (United States)

    Harrington, Kathleen; Marriange, Tobias; Aamir, Ali; Appel, John W.; Bennett, Charles L.; Boone, Fletcher; Brewer, Michael; Chan, Manwei; Chuss, David T.; Colazo, Felipe; hide

    2016-01-01

    The Cosmology Large Angular Scale Surveyor (CLASS) is a four telescope array designed to characterize relic primordial gravitational waves from in ation and the optical depth to reionization through a measurement of the polarized cosmic microwave background (CMB) on the largest angular scales. The frequencies of the four CLASS telescopes, one at 38 GHz, two at 93 GHz, and one dichroic system at 145/217 GHz, are chosen to avoid spectral regions of high atmospheric emission and span the minimum of the polarized Galactic foregrounds: synchrotron emission at lower frequencies and dust emission at higher frequencies. Low-noise transition edge sensor detectors and a rapid front-end polarization modulator provide a unique combination of high sensitivity, stability, and control of systematics. The CLASS site, at 5200 m in the Chilean Atacama desert, allows for daily mapping of up to 70% of the sky and enables the characterization of CMB polarization at the largest angular scales. Using this combination of a broad frequency range, large sky coverage, control over systematics, and high sensitivity, CLASS will observe the reionization and recombination peaks of the CMB E- and B-mode power spectra. CLASS will make a cosmic variance limited measurement of the optical depth to reionization and will measure or place upper limits on the tensor-to-scalar ratio, r, down to a level of 0.01 (95% C.L.).

  3. Effects of emotion on different phoneme classes

    Science.gov (United States)

    Lee, Chul Min; Yildirim, Serdar; Bulut, Murtaza; Busso, Carlos; Kazemzadeh, Abe; Lee, Sungbok; Narayanan, Shrikanth

    2004-10-01

    This study investigates the effects of emotion on different phoneme classes using short-term spectral features. In the research on emotion in speech, most studies have focused on prosodic features of speech. In this study, based on the hypothesis that different emotions have varying effects on the properties of the different speech sounds, we investigate the usefulness of phoneme-class level acoustic modeling for automatic emotion classification. Hidden Markov models (HMM) based on short-term spectral features for five broad phonetic classes are used for this purpose using data obtained from recordings of two actresses. Each speaker produces 211 sentences with four different emotions (neutral, sad, angry, happy). Using the speech material we trained and compared the performances of two sets of HMM classifiers: a generic set of ``emotional speech'' HMMs (one for each emotion) and a set of broad phonetic-class based HMMs (vowel, glide, nasal, stop, fricative) for each emotion type considered. Comparison of classification results indicates that different phoneme classes were affected differently by emotional change and that the vowel sounds are the most important indicator of emotions in speech. Detailed results and their implications on the underlying speech articulation will be discussed.

  4. COMMUNICATION AND INTERACTION IN ART CLASSES

    Directory of Open Access Journals (Sweden)

    Maja Hrvanović

    2014-04-01

    Full Text Available Numerous indicators affect communication and interaction in art classes. For every teacher, as pedagogue, his successful educational activity is very important as some indicators influence the two-way exchange of information in art classes. Teaching art is very specific way of teaching process, because it is mostly based on exchange of visual information of artistic type which represents a special form of communication. The specificity of artistic information, way of acting on the viewer and intense emotional charge in the process of communication should be used as visual stimulus. The richness of imagery, stimulation of reality, abstraction and other cognitive processes in art classes experientially and visually improve students’ awareness and should be represented and diversified by origin and multiplied by quantity. The research paper aims to demonstrate the importance of connectivity between judgment of taste and ability to evaluate the quality of the work of art in art and non-art schools. Teaching and education in art classes is being realized precisely inside communicative relations and appropriate socio-emotional climate. In this research, visual communication in art classes is defined over the structure of the inventory that will examine the differences between abilities to evaluate the quality of artistic information and the judgment of taste.

  5. Static Members of Classes in C#

    Directory of Open Access Journals (Sweden)

    Adrian LUPASC

    2017-12-01

    Full Text Available The C# language is object-oriented, which is why the declared member data must be part of a class. Thus, there is no possibility to declare certain variables that can be accessed from anywhere within the application, as it happens, for example, with global variables at the C language level. Making this work in C# is possible through static members of the class. Declaring a class implies defining some of its member data that later receive values when creating each object. A static member of the class can be interpreted as belonging only to the class, not to the objects subsequently created, which means that for the non-static data, there are as many children as there were objects created, while for the static ones there is only one copy, regardless of the number of created objects. In this regard, this paper presents the main aspects that characterize these abstract concepts of object oriented programming in general and C# language in particular, detailing how to develop an application that includes both static and non-static members. At the same time, particularities in the mirror for the two types of data, restrictions on use and potential limitations are presented.

  6. Class solution to decrease rectal dose in prostate radiotherapy treatments 3D-CRT

    International Nuclear Information System (INIS)

    Andres Rodriguez, C.; Tortosa Oliver, R.; Alonso Hernandez, D.; Mari Palacios, A.; Castillo Belmonte, A. del

    2011-01-01

    This paper contains a method developed in our center with conventional 3D radiotherapy techniques to increase the dose conformation around the target volume in prostate cancer treatments significantly reduced the doses to the rectum. To evaluate the goodness of the method, the results are compared with two classical techniques of treatment.

  7. Middle Class and Democracy in Latin America

    Directory of Open Access Journals (Sweden)

    Jaime Fierro

    2015-06-01

    Full Text Available The consolidation of the middle class has been interpreted by modernization and postmodernization theories as a key factor for the functioning and stability of the democratic system. However, in Latin America the middle class has tended to be associated with two contradictory positions. On the one hand, it is emphasized that it plays a stabilizing and democratic role while, on the other hand, it is linked to supporting military coups. With the purpose of elucidate such a dilemma, the relationship that can be established between the socioeconomic status and the degree of support for democracy will be examined. In order to do this, an empirical analysis from Latinbarometer surveys databases will be conducted, covering seventeen countries in the region for the period from 1996 to 2011. It will be concluded that the middle class in Latin America does not have particularly more favorable attitudes toward democracy than other social segments.

  8. Young people, drinking and social class

    DEFF Research Database (Denmark)

    Kolind, Torsten

    2011-01-01

    Analytical concepts such as 'bounded consumption' or 'controlled loss of control' have been applied to characterise contemporary youth intoxication. This article argues that this kind of cultural diagnosis benefits from being related to a focus on differences in social class. It is shown that in ......Analytical concepts such as 'bounded consumption' or 'controlled loss of control' have been applied to characterise contemporary youth intoxication. This article argues that this kind of cultural diagnosis benefits from being related to a focus on differences in social class. It is shown...... people to construct social class-related identities: mainstream youngsters continually confirm their taken-for-granted normality, and mainstream breakers resist the mainstream hegemonic (school) culture which usually defies them. In conclusion, bounded consumption, corresponding with contemporary ideals...

  9. Novamene: A new class of carbon allotropes

    Directory of Open Access Journals (Sweden)

    Larry A Burchfield

    2017-02-01

    Full Text Available We announce a new class of carbon allotropes. The basis of this new classification resides on the concept of combining hexagonal diamond (sp3 bonded carbon − lonsdaleite and ring carbon (sp2 bonded carbon − graphene. Since hexagonal diamond acts as an insulator and sp2 bonded rings act as conductors, these predicted materials have potential applications for transistors and other electronic components. We describe the structure of a proposed series of carbon allotropes, novamene, and carry out a detailed computational analysis of the structural and electronic properties of the simplest compound in this class: the single-ring novamene. In addition, we suggest how hundreds of different allotropes of carbon could be constructed within this class.

  10. THE LYGEO-STIPETEA CLASS IN SICILY

    Directory of Open Access Journals (Sweden)

    C. BRULLO

    2010-04-01

    Full Text Available Basing on literature data and unpublished relevés from Sicily, a survey of the syntaxa belonging to the class Lygeo-Stipetea Rivas-Martínez 1978 is presented. This perennial vegetation is characterized by the dominance of big caespitose hemicryptophytes, and it is widely distributed in Sicily from the sea level up to 1500 m a.s.l. The class is represented in Sicily by two orders, floristically and ecologically well differentiated: Lygeo-Stipetalia, including the sole alliance Moricandio-Lygeion exclusively of clayey substrates, and Hyparrhenietalia hirtae, including five alliances (Hyparrhenion hirtae, Avenulo cincinnatae-Ampelodesmion mauritanici, Thero-Brachypodion ramosi, Bromo-Oryzopsion miliaceae, and Arundion collinae occurring on various substrates. Within the class, 50 associations have been recognized. To support the syntaxonomic proposal, a multivariate numerical analysis, considering literature and personal data, has been performed. Nomenclature, floristic settlement, ecology, syndynamism and chorology are examined for each syntaxon.

  11. Class Generation for Numerical Wind Atlases

    DEFF Research Database (Denmark)

    Cutler, N.J.; Jørgensen, B.H.; Ersbøll, Bjarne Kjær

    2006-01-01

    A new optimised clustering method is presented for generating wind classes for mesoscale modelling to produce numerical wind atlases. It is compared with the existing method of dividing the data in 12 to 16 sectors, 3 to 7 wind-speed bins and dividing again according to the stability...... of the atmosphere. Wind atlases are typically produced using many years of on-site wind observations at many locations. Numerical wind atlases are the result of mesoscale model integrations based on synoptic scale wind climates and can be produced in a number of hours of computation. 40 years of twice daily NCEP...... adapting to the local topography. The purpose of forming classes is to minimise the computational time for the mesoscale model while still representing the synoptic climate features. Only tried briefly in the past, clustering has traits that can be used to improve the existing class generation method...

  12. TEACHER’S POLITENESS IN EFL CLASS

    Directory of Open Access Journals (Sweden)

    Ayfer Sülü

    2015-10-01

    Full Text Available Politeness is considered to promote effective interaction between people. In the context of language teaching, it is believed to enhance learning by providing a lively and friendly atmosphere in classroom (Jiang, 2010. This study investigates an EFL classroom in terms of interaction between English learners and a native English speaking teacher. The aim of the study is to see whether the effects of politeness strategies differ when students and teacher do not share the same culture and native language. Two hours of classes were observed and taperecorded by the researcher. The recordings were transcribed and analyzed by making use of related politeness strategies and functions of speech. Also, three randomly chosen students were interviewed after the class. The findings showed that politeness existed in that EFL classroom and it helped students to have positive feelings towards the lesson and motivated them to participate more in classes.

  13. Communicative Language Teaching in Second Language Class

    Institute of Scientific and Technical Information of China (English)

    Xiao Juan

    2010-01-01

    IntroductionReturn the class to the students and let the students be the masters of the class.This is what I have changed during the last three years in my class.I have been using Communicative Language Teaching method instead of Grammar Translation method.In the Grammar Translation method, students only study grammar and learn lists of words and then translate what they have learned into Chinese.In the classroom,the teacher uses the students' first language to explain the grammar and vocabulary in the text and then helps the students to translate it.This method is based on the idea that language is made up of words and that language changes according to the grammar rules.

  14. Education, class and vernacular awareness on Tyneside

    DEFF Research Database (Denmark)

    Jensen, Marie Møller

    2017-01-01

    . This group consisted of mainly older female speakers and results are interpreted in light of first wave studies on the patterning of language use by class, age and gender. Finally, the issue of vernacular awareness is linked to social indexicality and it is suggested that an interpretation of participants...... identification. The results indicate that participants’ self-identification is at odds with the classification based on education and, furthermore, that the group of participants who identify as middle class but have low educational attainment behave significantly different from the other participants......This chapter reports on a questionnaire study investigating Tyneside residents’ vernacular awareness and attested language use. Participant performance is interpreted on the basis of a cross-tabulation of participants’ social class as determined by their level of education and participants’ own...

  15. A class of convergent neural network dynamics

    Science.gov (United States)

    Fiedler, Bernold; Gedeon, Tomáš

    1998-01-01

    We consider a class of systems of differential equations in Rn which exhibits convergent dynamics. We find a Lyapunov function and show that every bounded trajectory converges to the set of equilibria. Our result generalizes the results of Cohen and Grossberg (1983) for convergent neural networks. It replaces the symmetry assumption on the matrix of weights by the assumption on the structure of the connections in the neural network. We prove the convergence result also for a large class of Lotka-Volterra systems. These are naturally defined on the closed positive orthant. We show that there are no heteroclinic cycles on the boundary of the positive orthant for the systems in this class.

  16. The power of language used in class

    Directory of Open Access Journals (Sweden)

    Mitrović Milica

    2015-01-01

    Full Text Available This article deals with the analysis of the language used in class by: (1 indicating the relevance of this type of analysis in the context of current research questions about the relations between language and education, (2 the analysis of the selected school classes and (3 by presenting methodological characteristics and possible research achievements of this form of analysis. Class language is here seen as one of school languages, and an item for the analysis of teaching and authentic evaluative information about education. Our research comprised the analyses of six classes in Belgrade elementary schools. The aim of the research was to identify and describe the language of the selected classes and to analyse the obtained information in the view of furthering language learning and learning by the use of language. Selected were three lessons in the first and three in the final classes, and planned so that pupils could be the main speakers (lesson repetition and elaboration. The analyses of the teaching contents were done, and the results showed that, compared to pupils, teachers do a major part of talking, that pupils usually give one word or short answers, that they communicate within uniform speech models and have no opportunity to develop a sense of ownership of the language of the lesson which is a precondition for further language learning and using language for school learning. The results also indicate certain contradictions in the identified language practice, which we deem important for further systematic research of language use and learning in our schools.

  17. The YouTube Makeup Class

    Science.gov (United States)

    Haase, David G.

    2009-05-01

    When a college instructor goes out of town and must miss a lecture, the standard options are to cancel the class meeting or to enlist a colleague to fill in. In the former case a teaching opportunity is lost; in the latter the substitute may not lead the class in the same way as the instructor. Some students routinely skip lectures by a guest instructor, in the belief that the material in the substitute lecture will not be covered on the exam. There are other makeup options such as a directed study assignment. For instance, a missed class is sometimes a good opportunity to require students to investigate web-based simulations such as Physlets® that illustrate the class topics. These are most effective if the students are given a clear structure and if there are questions that the students must answer from their investigations with the Physlets. But many students are more comfortable with the audio and visual communication that occurs in the classroom. Web 2.0 technology, e.g., YouTube (http://www.youtube.com), makes it convenient for faculty to upload videos of lectures and demonstrations that can be used for makeup classes. College students already use YouTube for entertainment, and the YouTube format is simple to view on any web-connected computer. Although some universities have highly developed media delivery systems, YouTube is extremely convenient and accessible by anyone. This paper discusses how a YouTube makeup class can be efficiently produced and structured to be an effective learning experience.

  18. Class I Underground Injection Control Program: Study of the Risks Associated with Class I Underground Injection Wells

    Science.gov (United States)

    The document provides describes the current Class I UIC program, the history of Class I injection, and studies of human health risks associated with Class I injection wells, which were conducted for past regulatory efforts and policy documentation.

  19. 78 FR 34552 - Modification of Class D and Class E Airspace and Establishment of Class E Airspace; Pasco, WA

    Science.gov (United States)

    2013-06-10

    ... Compass Locator at ILS Outer Marker (LOM) has been decommissioned and needs to be removed from Class E... within 3.5 miles each side of the Tri-Cities Airport 045[deg] bearing extending from the 4.3-mile radius...] bearing of Richland Airport extending 20.9 miles northeast of Richland Airport; that airspace extending...

  20. SOME REFLECTIONS ABOUT LEADING LARGE CLASSES

    Directory of Open Access Journals (Sweden)

    GIOVANY SUÁREZ PINILLA

    2016-07-01

    Full Text Available This article provides some strategies for teachers to deal with large classes having into account that this is a very common situation in different educational levels. Some teaching methods that have been used to make significant progress in the learning and teaching process are presented here, with the aim of getting more efficient and effective educational environment. Under these circumstances, teachers need to assure that they provide an interactive learning environment to their students. Finally, a lesson plan example for a mathematics class considering all these aspects is presented at the end of this paper.