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Sample records for reported median survival

  1. Predicting Mean Survival Time from Reported Median Survival Time for Cancer Patients

    DEFF Research Database (Denmark)

    Lousdal, Mette L; Kristiansen, Ivar S; Møller, Bjørn;

    2016-01-01

    BACKGROUND: Mean duration of survival following treatment is a prerequisite for cost-effectiveness analyses used for assessing new and costly life-extending therapies for cancer patients. Mean survival time is rarely reported due to censoring imposed by limited follow-up time, whereas the median...... survival time often is. The empirical relationship between mean and median survival time for cancer patients is not known. AIM: To derive the empirical associations between mean and median survival time across cancer types and to validate this empirical prediction approach and compare it with the standard...... approach of fitting a Weibull distribution. METHODS: We included all patients in Norway diagnosed from 1960 to 1999 with one of the 13 most common solid tumor cancers until emigration, death, or 31 December 2011, whichever came first. Observed median, restricted mean, and mean survival times were obtained...

  2. Intraneural hemangioma of the median nerve: A case report

    Directory of Open Access Journals (Sweden)

    Sevinç Teoman

    2008-02-01

    Full Text Available Abstract Hemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.

  3. Rhein lysinate increases the median survival time of SAMP10 mice: protective role in the kidney

    Institute of Scientific and Technical Information of China (English)

    Gang HU; Jiang LIU; Yong-zhan ZHEN; Rong XU; Yu QIAO; Jie WEI; Ping TU

    2013-01-01

    Aim:To investigate the protective effects of rhein lysinate (RHL),a major bioactive constituent of the rhizome of rhubarb (Rheum palmatum Linn or Rheum tanguticum Maxim),against kidney impairment in senescence-prone inbred strain 10 (SAMP10) mice.Methods:SAMP10 mice were orally administered RHL (25 or 50 mg/kg) daily until 50% of the mice died.Senescence-resistant inbred strain 1 (SAMR1) mice administered no drug were taken as control.The kidneys were harvested after animal death,and examined morphologically and with immunochemical assays.The levels of MAD,SOD and GSH-px in the kidneys were measured with a photometric method.The expression of inflammatory factors and related proteins in the kidneys was analyzed using Western blotting.Results:Treatment of SAMP10 mice with RHL had no effect on the body weight or phenotype.However,RHL significantly prolonged the median survival time of SAMP10 mice by approximately 25%,as compared to untreated SAMP10 mice.Compared SAMR1 mice,SAMP10 mice had a significantly lower level of SOD in the kidneys,but had no significant difference in the MDA or GSH-px levels.Treatment of SAMP10 mice with RHL significantly reduced the MAD level,and increased the SOD and GSH-px levels in the kidneys.Glomerulonephritis was observed in SAMP10 mice but not in SAMR1 mice.RHL decreased the incidence of glomerulonephritis,and significantly decreased the levels of TNF-α,IL-6,NF-κB,collagen types Ⅰ and Ⅲ in the kidneys.Conclusion:Accelerated senescence is associated with glomerulonephritis in SAMP10 mice,and RHL prolongs their median survival time by red ucing the severity of glomeruloneph ritis.

  4. Extended Pleurectomy-Decortication-Based Treatment for Advanced Stage Epithelial Mesothelioma Yielding a Median Survival of Nearly Three Years.

    Science.gov (United States)

    Friedberg, Joseph S; Simone, Charles B; Culligan, Melissa J; Barsky, Andrew R; Doucette, Abigail; McNulty, Sally; Hahn, Stephen M; Alley, Evan; Sterman, Daniel H; Glatstein, Eli; Cengel, Keith A

    2017-03-01

    The purpose of this study was to assess survival for patients with malignant pleural mesothelioma (MPM), epithelial subtype, utilizing extended pleurectomy-decortication combined with intraoperative photodynamic therapy (PDT) and adjuvant pemetrexed-based chemotherapy. From 2005 to 2013, 90 patients underwent lung-sparing surgery and PDT for MPM. All patients had a preoperative diagnosis of epithelial subtype, of which 17 proved to be of mixed histology. The remaining 73 patients with pure epithelial subtype were analyzed. All patients received lung-sparing surgery and PDT; 92% also received chemotherapy. The median follow-up was 5.3 years for living patients. Macroscopic complete resection was achieved in all 73 patients. Thirty-day mortality was 3% and 90-day mortality was 4%. For all 73 patients (89% American Joint Commission on Cancer stage III/IV, 69% N2 disease, median tumor volume 550 mL), the median overall and disease-free survivals were 3 years and 1.2 years, respectively. For the 19 patients without lymph node metastases (74% stage III/IV, median tumor volume 325 mL), the median overall and disease-free survivals were 7.3 years and 2.3 years, respectively. This is a mature dataset for MPM that demonstrates the ability to safely execute a complex treatment plan that included a surgical technique that consistently permitted achieving a macroscopic complete resection while preserving the lung. The role for lung-sparing surgery is unclear but this series demonstrates that it is an option, even for advanced cases. The overall survival of 7.3 years for the node negative subset of patients, still of advanced stage, is encouraging. Of particular interest is the overall survival being approximately triple the disease-free survival, perhaps PDT related. The impact of PDT is unclear, but it is hoped that it will be established by an ongoing randomized trial. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. The median hazard ratio: a useful measure of variance and general contextual effects in multilevel survival analysis.

    Science.gov (United States)

    Austin, Peter C; Wagner, Philippe; Merlo, Juan

    2017-03-15

    Multilevel data occurs frequently in many research areas like health services research and epidemiology. A suitable way to analyze such data is through the use of multilevel regression models (MLRM). MLRM incorporate cluster-specific random effects which allow one to partition the total individual variance into between-cluster variation and between-individual variation. Statistically, MLRM account for the dependency of the data within clusters and provide correct estimates of uncertainty around regression coefficients. Substantively, the magnitude of the effect of clustering provides a measure of the General Contextual Effect (GCE). When outcomes are binary, the GCE can also be quantified by measures of heterogeneity like the Median Odds Ratio (MOR) calculated from a multilevel logistic regression model. Time-to-event outcomes within a multilevel structure occur commonly in epidemiological and medical research. However, the Median Hazard Ratio (MHR) that corresponds to the MOR in multilevel (i.e., 'frailty') Cox proportional hazards regression is rarely used. Analogously to the MOR, the MHR is the median relative change in the hazard of the occurrence of the outcome when comparing identical subjects from two randomly selected different clusters that are ordered by risk. We illustrate the application and interpretation of the MHR in a case study analyzing the hazard of mortality in patients hospitalized for acute myocardial infarction at hospitals in Ontario, Canada. We provide R code for computing the MHR. The MHR is a useful and intuitive measure for expressing cluster heterogeneity in the outcome and, thereby, estimating general contextual effects in multilevel survival analysis. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

  6. Compression of the median nerve in the proximal forearm by a giant lipoma: A case report

    Directory of Open Access Journals (Sweden)

    O'Toole Greg A

    2008-06-01

    Full Text Available Abstract Background Compression of the median nerve by a tumour in the elbow and forearm region is rare. We present a case of neuropathy of the median nerve secondary to compression by giant lipoma in the proximal forearm. Case presentation A 46-year-old man presented with a six month history of gradually worsening numbness and paresthesia on the palmar aspect of the left thumb and thenar eminence. Clinical examination reveals a hypoaesthesia in the median nerve area of the left index and thumb compared to the contralateral side. Electromyography showed prolonged sensory latency in the distribution of the median nerve corresponding to compression in the region of the pronator teres (pronator syndrome. Radiological investigations were initially reported as normal. Conservative treatment for one month did not result in any improvement. Surgical exploration was performed and a large intermuscular lipoma enveloped the median nerve was found. A complete excision of the tumour was performed. Postoperative revaluation the X-ray of the elbow was seen to demonstrate a well-circumscribed mass in the anterior aspect of the proximal forearm. At follow-up, 14 months after surgery, the patient noted complete return of the sensation and resolution of the paresthesia. Conclusion In case of atypical findings or non frequent localization of nerve compression, clinically interpreted as an idiopathic compression, it is recommended to make a pre-operative complementary Ultrasound or MRI study.

  7. Recurrent Primary Synovial Sarcoma of Median Nerve: A Case Report and Literature Review.

    Science.gov (United States)

    Bhat, A K; Jayakrishnan, K N; Acharya, A M

    2016-10-01

    We report a case of intraneural synovial sarcoma of the median nerve in a 39 year old lady with multiple local recurrences over thirteen years with no distant metastasis. The diagnosis of biphasic type of synovial sarcoma was confirmed by histopathology and immunohistochemistry. At the time of the fourth recurrence below elbow amputation was performed. This case is being reported for its rarity and propensity for local recurrence without distant metastasis.

  8. Oral leiomyomatous hamartoma of the median maxillary gingiva: a case report and review of the literature.

    Science.gov (United States)

    ALQahtani, Dalal; Qannam, Ahmed

    2013-08-01

    Oral leiomyomatous hamartoma (OLH) is a rare lesion seen in the oral cavity. It mainly presents on the median maxilla and tongue. In the literature in English, there are only 10 reported cases of OLH of the median maxilla. Most of the cases were found in patients of Japanese and Latin American origin. We report a case of OLH in an 18-month-old boy of Middle Eastern ancestry. The lesion presented as a pedunculated, light pink, soft swelling that was located on the labial gingiva of tooth number 21. Microscopically, it showed proliferative smooth-muscle fascicles dispersed in loose fibrous stroma and multiple small vessels. The lesional cells looked mature and elongated and were deeply eosinophilic spindle cells with basophilic, central "cigar-shaped" nuclei. The diagnosis of OLH was supported by positive immunohistochemical reactivity of smooth-muscle actin and desmin. To our knowledge, this is the first reported case of OLH in a Middle Eastern patient.

  9. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Institute of Scientific and Technical Information of China (English)

    Rajesh Rohilla; Rohit Singla; Narender Kumar Magu; Roop Singh; Ashish Devgun; Reetadyuti Mukhopadhyay; Paritosh Gogna

    2013-01-01

    Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks' follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.

  10. Age-dependent improvement in median and long-term survival in unselected population-based Nordic registries of patients with synchronous metastatic colorectal cancer.

    Science.gov (United States)

    Sorbye, H; Cvancarova, M; Qvortrup, C; Pfeiffer, P; Glimelius, B

    2013-09-01

    In metastatic colorectal cancer (mCRC) trials, median survival has increased from 6 months to above 20 months during the previous decades. Uncertainty exists in how this survival improvement has translated to the general mCRC population. Survival data from patients with synchronous mCRC were collected from the Norwegian (1980-2008), Swedish (1996-2008) and Danish (2001-09) cancer registries. A total of 29 628 patients were identified. From 1980-1985 to 2006-2008, median survival increased from 5 to 10 months for Norwegian patients. Three-year survival increased from 7% to 21% and 5-year survival from 4% to 9%. For patients 75 years of age. An increase in median and long-term survival over time was found in unselected population-based registries of patients with synchronous mCRC. The improved outcome in survival was especially seen in younger patients, raising concerns over our ability to adapt available treatment options for elderly patients.

  11. Cannieu-Riche anastomosis of the ulnar to median nerve in the hand: case report.

    Science.gov (United States)

    Paraskevas, G; Ioannidis, O; Martoglou, S

    2010-01-01

    We observed in a male cadaver the presence of a new type of very long Cannieu-Riche anastomosis between the proximal portion of the deep branch of the ulnar nerve for the adductor pollicis and ramus of the recurrent branch of the median nerve to the superficial head of the flexor pollicis brevis. The clinical relevance of such a communication is the possible preservation of the function of all or part of thenar muscles from the ulnar nerve in case of median nerve lesion. The ignorance of that anomaly can induce obscure clinical, surgical and electroneuromyographical findings. We report on the incidence, the double innervation and the clinical significance of Cannieu-Riche anastomosis and provide a new classification of the various types of this nerval connection.

  12. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    Directory of Open Access Journals (Sweden)

    Ahmet Aslan

    2013-07-01

    Full Text Available Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms Keywords: Neuroma, wrist, median nerve, nerve ınjury.

  13. Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review

    Science.gov (United States)

    Teles, Alisson Roberto; Finger, Guilherme; Schuster, Marcelo N.; Gobbato, Pedro Luis

    2016-01-01

    Adipose lesions rarely affect the peripheral nerves. This can occur in two different ways: Direct compression by an extraneural lipoma, or by a lipoma originated from the adipose cells located inside the nerve. Since its first description, many terms have been used in the literature to mention intraneural lipomatous lesions. In this article, the authors report a case of a 62-year-old female who presented with an intraneural median nerve lipoma and review the literature concerning the classification of adipose lesions of the nerve, radiological diagnosis and treatment. PMID:27695575

  14. Surgical Repair of a Median Cleft of the Upper Lip via a Pfeifer Incision: A Case Report

    Science.gov (United States)

    Pandey, Rajeev; Gupta, Rajat; Bhagat, Nitin; Verma, Aviral

    2016-01-01

    Median cleft is the midline cleft of the lip. It develops due to incomplete or failed fusion of the median nasal prominence. It can present with minimal deformities such as involvement of the vermilion border, or complex clefting of the midline structures and brain. Median clefts are broadly classified as true and false clefts. This case report describes a rare case of median cleft of the upper lip involving the white roll, which was not associated with any other deformities. Treatment included reconstruction of the philtrum and the cupid's bow while maintaining vermilion fullness and continuity, and minimizing scar formation. Various techniques have been advocated for treatment of this type of median upper lip cleft. Here we describe a technique using Pfeifer incision to correct our patient's defect. Pfeifer incision consists of wavy lines and its use has been advocated for correction of various craniofacial abnormalities. PMID:27928243

  15. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  16. Range Medians

    OpenAIRE

    Har-Peled, Sariel; Muthukrishnan, S.

    2008-01-01

    We study a generalization of the classical median finding problem to batched query case: given an array of unsorted $n$ items and $k$ (not necessarily disjoint) intervals in the array, the goal is to determine the median in {\\em each} of the intervals in the array. We give an algorithm that uses $O(n\\log n + k\\log k \\log n)$ comparisons and show a lower bound of $\\Omega(n\\log k)$ comparisons for this problem. This is optimal for $k=O(n/\\log n)$.

  17. Median deficiency in the posterior arch of the atlas vertebra: a case report

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    Kaushal P

    2011-04-01

    Full Text Available Isolated cases of partial agenesis of atlas were initially considered benign variations, without any clinical or pathological significance. However, there is increasing evidence that neurological symptoms may occur even after minor cervical trauma in subjects with defects in the posterior arch of the atlas. The present case study describes a rare case of median deficiency in the posterior arch of atlas vertebra. The knowledge of this benign variation is crucial as it may aid clinicians in correct management of subjects presenting with resolution of symptoms and avoid excessive investigations.

  18. Ultrasound in the diagnosis of a median neuropathy in the forearm: case report

    Directory of Open Access Journals (Sweden)

    Yoon Joon-Shik

    2007-12-01

    Full Text Available Abstract Background Electrodiagnostic studies are traditionally used in the diagnosis of focal neuropathies, however they lack anatomical information regarding the nerve and its surrounding structures. The purpose of this case is to show that high-resolution ultrasound used as an adjunct to electrodiagnostic studies may complement this lack of information and give insight to the cause. Case presentation A 60-year-old male patient sustained a forearm traction injury resulting in progressive weakness and functional loss in the first three digits of the right hand. High-resolution ultrasound showed the presence of an enlarged nerve and a homogenous soft-tissue structure appearing to engulf the nerve. The contralateral side was normal. Surgery revealed fibrotic bands emanating from the flexor digitorum profundus muscle compressing the median nerve thus confirming the ultrasound findings. Conclusion A diagnostically challenging case of median neuropathy in the forearm is presented in which high-resolution ultrasound was valuable in establishing an anatomic etiology and directing appropriate management.

  19. Intrinsic hand muscle reinnervation by median-ulnar end-to-side bridge nerve graft: case report.

    Science.gov (United States)

    Magdi Sherif, M; Amr, Adel H

    2010-03-01

    Recovery of either the motor or sensory functions has not been consistently achieved in upper extremity end-to-side neurorrhaphy; this technique was only indicated when more conventional nerve repair was not possible. In most studies, the whole median or ulnar nerve was used for end-to-side neurotization. In this report, we present 4 cases of high-median or ulnar nerve laceration in which a nerve graft was placed end-to-side between the median and ulnar motor fascicles close to the wrist. At 4 months after surgery, 3 of 4 patients began to recover active movement of the affected small muscles of the hand. EMG and nerve conduction studies confirmed that nerve conduction was through the nerve grafts.

  20. Investigation of survival time and disability characteristics in 5 subjects with bilateral thalamus infarction near median line%双侧中线旁丘脑梗死5例致残特点及生存期调查

    Institute of Scientific and Technical Information of China (English)

    翟明; 刘江; 钟静玫; 林岚

    2002-01-01

    @@ Background:Bilateral thalamus infarction near median line is uncommon in clinic.Reports concerned with this conditions were more less.It is characterized by conscious disorder and Korsakoff syndrome.The main caused may be the injury of intralaminar nuclei,dorsomedial nuclei,and injury of cortical matter,mammalillary bodies,fasciculus thalamicus around cerebral chamer III.Comprehensing the disability characteristics in pateints with bilateral thalamus infarction near median line is important for direction of rehabilitation.While study of survival time will improve evaluation of prognosis. Design:Patients recruited from June 1997~ October 2000 were analyzed. Unit:Intraneural Department of First People's Hospital of Yunnan Province. Subjects:55 subjects with MRI proved bilateral thalamus infarction near median line entered study.These patients included 3 women,2 men(age ranging from 50 to 77 years old,mean age:68.6 years).The period from onset to admission ranged from 5 hours to 2 days.All subejcts experienced acute bilateral thalamus infarction near median line.All had hypertension previously,1 had diabetes,2 had auricular fibrillation. Intervention:All patients received management which was conducted according to protocol for treatment of ischemic cerebrovascular diseases. Patients clinical characteristics were summari-zed and analyzed.Follow up was conducted to determine the survival period. Main evaluation indexes:Survival time and conscious disorder were evaluated. Result:All patients showed different level of conscious disorder.3 cases developed thalamic dementia,2 developed vision numb,In 1 case,condition progressively deteriorated manifesting as moderate coma progressed to deep coma,and bilateral mydriasis.Finally,this patients died of central respiratory and circulatory failure after 8 days.4 cases with favorable prognosis discharged,3 out of them died within 1 year after discharge.Survival subject suffered from reduced memory was followed up till now

  1. Median Nerve Injury Due to High-Pressure Water Jet Injection: A Case Report and Review of Literature.

    Science.gov (United States)

    Emre, Ufuk; Unal, Aysun

    2009-08-01

    High-pressure injuries that occur accidentally are potentially destructive injuries that often affect the nondominant hands of young men. A variety of products such as paint, gasoline, grease, fuel oil, cement, thinner and solvents have been reported as destructive agents. High-pressure water jet injection injuries to soft tissues have rarely been reported. In this study, we present the first case of median nerve injury due to high-pressure water jet injection by a water spray gun.

  2. Hamartoma fibrolipomatoso de nervo mediano: relato de caso Fibrolipomatous hamartoma of the median nerve: case report

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2005-09-01

    Full Text Available O hamartoma fibrolipomatoso é neoplasia benigna rara que em alguns casos esta associada com macrodactilia. Descrevemos o caso de homem de 31 anos que apresentava desde o nascimento aumento de volume em região de punho, segundo e terceiro quirodáctilos da mão esquerda. Aos 23 anos iniciou dor contínua, de forte intensidade, predominante no período noturno e de evolução progressiva em mão esquerda. Associada à dor havia hipoestesia e parestesias de predomínio nos segundo e terceiro quirodáctilos esquerdos. A investigação complementar com radiografia, ultrassonografia, estudo eletrofisiológico e ressonância magnética de mão e punho esquerdos confirmaram a suspeita de síndrome do túnel do carpo secundária a macrodactilia com hamartoma fibrolipomatoso do nervo mediano. O paciente foi submetido à descompressão cirúrgica do túnel do carpo esquerdo devido a ausência de resposta ao tratamento clínico e evoluiu com melhora dos sintomas em avaliação após três meses do procedimento.Fibrolipomatous hamartoma is a rare benign neoplasm that in some cases is associated with macrodactylia. We describe a 31-years-old man who had a tissue enlargement in the wrist, second and third fingers of the left hand since infancy. At 23-years-old he began with continuous, progressive and high intensity pain that occurred more frequently at night, localized in the left hand. It was associated with paraesthesias and hypostesias predominantly at the fingers described above. Investigation with X-ray, ultrasonography, electrodiagnosis, magnetic resonance image of the left wrist and hand showed carpal tunnel syndrome with macrodactylia by fibrolipomatous hamartoma of the median nerve. The patient did not a have good response to clinical therapy, so he was submitted to a surgical decompression of the left carpal tunnel, and after three months of follow up is asymptomatic.

  3. Ciliated Median Raphe Cyst of Perineum Presenting as Perianal Polyp: A Case Report with Immunohistochemical Study, Review of Literature, and Pathogenesis

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    Jayesh Sagar

    2006-01-01

    Full Text Available Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus. We report a case of median raphe cyst in the perineum presenting as a perianal polyp in a 65-year-old, English white male with exceptionally rare ciliated epithelium. According to our knowledge, this is the third such case of ciliated median raphe cyst in the English literature. This case, also the first case of ciliated median raphe cyst in the perineum location, focuses on pathogenesis of median raphe cyst.

  4. A wakeboarding injury presented as acute carpal syndrome and median nerve contusion after wrist strangulation: a case report

    Science.gov (United States)

    2009-01-01

    Background We present a case of combined median nerve contusion with immediate loss of sensation after the strangulation with a wakeboarding rope and prolonged referral to our department 72 hours after the injury accompanied by an acute carpal tunnel syndrome with immediate relief of numbness of a significant proportion of the median nerve following surgical decompression. Case presentation The palmar branch of the median nerve was surrounded by a significant haematoma in addition to the strangulation damage caused by its more superficial location in contrast to the median nerve. Conclusion In case of acute median neuropathy, urgent surgical intervention with exploration, decompression of both, the median nerve and the superficial branch of the median nerve, accompanied by compartment measurements of the forearm should be performed to regain or re-establish neurological integrity. PMID:19178709

  5. MEDIAN NERVE AS A NERVE OF ANTERIOR COMPARTMENT OF ARM WITH ITS VARIANT FORMATION: A CASE REPORT

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    Charushila D. Shinde

    2015-06-01

    Full Text Available Absence of Musculocutaneous nerve and unusual formation and innervation of Median nerve were noted in left upper limb during anatomical dissection of 60 yr old female cadaver. Median nerve normally does not give any branch in arm but in this case it innervates all the muscles of anterior compartment of arm in place of Musculocutaneous nerve. Here we discussed its embryology. It is important to be aware of such possible anatomical variations in routine clinical practice.

  6. Red salmon survival studies in Karluk Lake, Kodiak Island, 1957: Salmon survival investigations field report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the findings of a study on red salmon survival in Karluk Lake on Kodiak Island. The objectives were to systematically isolate, study, and...

  7. 阴茎中线囊肿2例%Median raphe cyst of the penis:two cases report

    Institute of Scientific and Technical Information of China (English)

    秦明珠; 闵仲生; 谭城

    2015-01-01

    We present 2 patients ( age 18 and age 25) with median raphe cyst of the penis. Two patients presented with an asymptomatic mass on the ventral aspect of the foreskin of the penis, for one and two years respectively. Biopsy showed a normal epidermis, cyst in dermis, pseudostratified epithelium of cyst wall.%报道2例阴茎中线囊肿。2例患者(18岁,25岁)分别于1年前及2年前发现阴茎包皮系带旁囊样肿物,无特殊不适,渐增大。病理检查示:表皮正常,真皮内见囊肿,囊壁为假复层上皮。

  8. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Harun Kütahya

    2013-01-01

    Full Text Available Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%. They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography, MRI (magnetic resonance imagination, and USG (ultrasound are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.

  9. Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

    Directory of Open Access Journals (Sweden)

    Okada Kiyoshi

    2012-01-01

    Full Text Available Abstract Background Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm. Case presentation A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery. Conclusions A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

  10. Uncommon Dorsal Radiocarpal Fracture Dislocation Complicated With Median Nerve Palsy: Case Report, Review of the Literature, and a New Classification System Guiding the Management

    Directory of Open Access Journals (Sweden)

    Hing-Cheong Wong

    2012-06-01

    Full Text Available We report the case of a 36-year-old lorry driver who sustained left dorsal radiocarpal fracture dislocation and left median nerve injury in a traffic accident in 2010. Emergency operation of closed reduction, cross-wrist-bridging external fixation, percutaneous transradial styloid Kirschner wire fixation, decompression of left median nerve, and repair of the partially torn palmar radiocarpal ligament were performed under general anaesthesia. Because of the persistent depressed dorsal articular rim fracture of left distal radius, another operation of open reduction, corticocancellous bone grafting, and dorsal buttress plating was performed 5 days after the initial operation. Six months after the operation, the patient enjoyed good range of wrist motion but weak twisting power, especially in supination. There was no radiological feature of radiocarpal subluxation.

  11. Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

    2009-01-01

    We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking.

  12. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    and several natural special cases thereof. The rst special case is known as range median, which arises when k is xed to b(j 􀀀 i + 1)=2c. The second case, denoted prex selection, arises when i is xed to 0. Finally, we also consider the bounded rank prex selection problem and the xed rank range......Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...

  13. Towards optimal range medians

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Gfeller, Beat; Jørgensen, Allan Grønlund

    2011-01-01

    that in the cell-probe model, any data structure which supports updates in O(logO(1)n) time must have Ω(log n/loglog n) query time. Our approach naturally generalizes to higher-dimensional range median problems, where element positions and query ranges are multidimensional - it reduces a range median query...... to a logarithmic number of range counting queries....

  14. Functional Median Polish

    KAUST Repository

    Sun, Ying

    2012-08-03

    This article proposes functional median polish, an extension of univariate median polish, for one-way and two-way functional analysis of variance (ANOVA). The functional median polish estimates the functional grand effect and functional main factor effects based on functional medians in an additive functional ANOVA model assuming no interaction among factors. A functional rank test is used to assess whether the functional main factor effects are significant. The robustness of the functional median polish is demonstrated by comparing its performance with the traditional functional ANOVA fitted by means under different outlier models in simulation studies. The functional median polish is illustrated on various applications in climate science, including one-way and two-way ANOVA when functional data are either curves or images. Specifically, Canadian temperature data, U. S. precipitation observations and outputs of global and regional climate models are considered, which can facilitate the research on the close link between local climate and the occurrence or severity of some diseases and other threats to human health. © 2012 International Biometric Society.

  15. Identification of a Maleimide-Based Glycogen Synthase Kinase-3 (GSK-3) Inhibitor, BIP-135, that Prolongs the Median Survival Time of Δ7 SMA KO Mouse Model of Spinal Muscular Atrophy.

    Science.gov (United States)

    Chen, Po C; Gaisina, Irina N; El-Khodor, Bassem F; Ramboz, Sylvie; Makhortova, Nina R; Rubin, Lee L; Kozikowski, Alan P

    2012-01-18

    The discovery of upregulated glycogen synthase kinase-3 (GSK-3) in various pathological conditions has led to the development of a host of chemically diverse small molecule GSK-3 inhibitors, such as BIP-135. GSK-3 inhibition emerged as an alternative therapeutic target for treating spinal muscular atrophy (SMA) when a number of GSK-3 inhibitors were shown to elevate survival motor neuron (SMN) levels in vitro and to rescue motor neurons when their intrinsic SMN level was diminished by SMN-specific short hairpin RNA (shRNA). Despite their cellular potency, the in vivo efficacy of GSK-3 inhibitors has yet to be evaluated in an animal model of SMA. Herein, we disclose that a potent and reasonably selective GSK-3 inhibitor, namely BIP-135, was tested in a transgenic Δ7 SMA KO mouse model of SMA, and found to prolong the median survival of these animals. In addition, this compound was shown to elevate the SMN protein level in SMA patient-derived fibroblast cells as determined by western blot, and was neuroprotective in a cell-based, SMA-related model of oxidative stress-induced neurodegeneration.

  16. Robustifying Vector Median Filter

    Directory of Open Access Journals (Sweden)

    Valentín Gregori

    2011-08-01

    Full Text Available This paper describes two methods for impulse noise reduction in colour images that outperform the vector median filter from the noise reduction capability point of view. Both methods work by determining first the vector median in a given filtering window. Then, the use of complimentary information from componentwise analysis allows to build robust outputs from more reliable components. The correlation among the colour channels is taken into account in the processing and, as a result, a more robust filter able to process colour images without introducing colour artifacts is obtained. Experimental results show that the images filtered with the proposed method contain less noisy pixels than those obtained through the vector median filter. Objective measures demonstrate the goodness of the achieved improvement.

  17. Hyperbolicity in Median Graphs

    Indian Academy of Sciences (India)

    José M Sigarreta

    2013-11-01

    If is a geodesic metric space and $x_1,x_2,x_3\\in X$, a geodesic triangle $T=\\{x_1,x_2,x_3\\}$ is the union of the three geodesics $[x_1 x_2],[x_2 x_3]$ and $[x_3 x_1]$ in . The space is -hyperbolic (in the Gromov sense) if any side of is contained in a -neighborhood of the union of the two other sides, for every geodesic triangle in . If is hyperbolic, we denote by () the sharp hyperbolicity constant of , i.e.,$(X)=\\inf\\{≥ 0: X \\quad\\text{is}\\quad -\\text{hyperbolic}\\}$. In this paper we study the hyperbolicity of median graphs and we also obtain some results about general hyperbolic graphs. In particular, we prove that a median graph is hyperbolic if and only if its bigons are thin.

  18. Survival

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — These data provide information on the survival of California red-legged frogs in a unique ecosystem to better conserve this threatened species while restoring...

  19. Unusual course of the median nerve

    Directory of Open Access Journals (Sweden)

    Vashishtha K

    2010-12-01

    Full Text Available One extremely unusual observation has been reported in this case report. During dissection of left hand of an adult human cadaver we found median nerve passing through the substance of flexor retinaculum. Median nerve coursed through the entire extent of flexor retinaculum in a fascial canal. No other structure was found along with nerve in the fascial canal. After emerging from the flexor retinaculum median nerve took its usual course in the hand. To the best of our knowledge this kind of variant median nerve course has not been described in published literature.

  20. Emergent Median Sternotomy for Mediastinal Hematoma: A Rare Complication following Internal Jugular Vein Catheterization for Chemoport Insertion—A Case Report and Review of Relevant Literature

    Directory of Open Access Journals (Sweden)

    Saptarshi Biswas

    2014-01-01

    Full Text Available Mediastinal hematoma is a rare complication following insertion of a central venous catheter with only few cases reported in the English literature. We report a case of a 71-year-old female who was admitted for elective chemoport placement. USG guided right internal jugular access was attempted using the Seldinger technique. Resistance was met while threading the guidewire. USG showed a chronic clot burden in the RIJ. A microvascular access was established under fluoroscopic guidance. Rest of the procedure was completed without any further issues. Following extubation, the patient complained of right-sided chest pain radiating to the back. Chest X-ray revealed a contained white out in the right upper lung field. She became hemodynamically unstable. Repeated X-ray showed progression of the hematoma. Median Sternotomy showed posterior mediastinal hematoma tracking into right pleural cavity. Active bleeding from the puncture site at RIJ-SCL junction was repaired. Patient had an uneventful recovery. Injury to the central venous system is the result of either penetrating trauma or iatrogenic causes as in our case. A possible explanation of our complication may be attributed to the forced manipulation of the dilator or guidewire against resistance. Clavicle and sternum offer bony protection to the underlying vital venous structures and injuries often need sternotomy with or without neck extension. Division of the clavicle and disarticulation of the sternoclavicular joint may be required for optimum exposure. Meticulous surgical technique, knowledge of the possible complications, and close monitoring in the postprocedural period are of utmost importance. Chest X-ray showed to be routinely done to detect any complication early.

  1. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection and sev...

  2. Four communications between median and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Shukla L

    2010-11-01

    Full Text Available The present article is in reference to a case, encountered in routine dissection, displaying four sites of communication between the musculocutaneous and the median nerves, whereas in the literature not more than two communications have been reported.

  3. Patau syndrome with a long survival. A case report.

    Science.gov (United States)

    Duarte, A C; Menezes, A I C; Devens, E S; Roth, J M; Garcias, G L; Martino-Roth, M G

    2004-06-30

    Trisomy 13 is a clinically severe entity; 85% of the patients do not survive beyond one year, and most children die before completing six months of age. We report a female child, 28 months old, white, the fourth child of a non-consanguineous couple, who presented trisomy 13. The child was born at term, from a vaginal delivery, weighing 2600 g. At birth, she was cyanotic, icteric, spastic, and cried weakly. The initial clinical examination detected polydactyly in the left hand, congenital clubfoot and convex soles, ocular hypertelorism, a low nasal bridge, numerous hemangiomas distributed throughout the body, cardiomegaly, and perimembranous inter-ventricular communication. There was no cleft lip or palate. On physical examination at 18 months old, the child weighed 6,900 g, had a cephalic perimeter of 41 cm, a thoracic perimeter of 43 cm and was 76 cm tall. At 28 months, she weighed 10,760 g and was 88.5 cm tall. Neuropsychomotor development retardation was evident from birth and, according to the psychologist and the social assistant of APAE (Handicapped Parents and Friends Association) in Canguçu, Rio Grande do Sul, there was a noticeable improvement after physiotherapy and recreational sessions.

  4. Lipofibromatous hamartoma of the median nerve: report of a case and review of the literature; Hamartoma fibrolipomatoso del nervio mediano: descripcion de un caso y revision de la bibliografia

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, G.; Ruiz, F.; Rodriguez, C.; Carcia, E. [Hospital Universitario Virgen de las Nieves. Granada (Spain)

    2001-07-01

    Lipofibromatous hamartoma is a rare benign lesion that affects peripheral nerves. The predominant site is median nerve, although it has been reported in other locations. It usually presents prior to the third decade of life, and is associated with motor cycled in up to one third of cases. We describe a case involving median nerve in a 24-year-old man who underwent ultrasound and magnetic resonance, followed by surgical confirmation of the diagnosis. A brief review of the literature is also provided. The magnetic resonance findings are virtually pathognomonic of this disease and, thus, the diagnosis can be reached without the need to perform biopsy. (Author) 12 refs.

  5. The utility of abbreviated patient-reported outcomes for predicting survival in early stage colorectal cancer.

    Science.gov (United States)

    Hsu, Tina; Speers, Caroline H; Kennecke, Hagen F; Cheung, Winson Y

    2017-05-15

    Patient-reported outcomes (PROs) are increasingly used in clinical settings. Prior research suggests that PROs collected at baseline may be associated with cancer survival, but most of those studies were conducted in patients with breast or lung cancer. The objective of this study was to determine the correlation between prospectively collected PROs and cancer-specific outcomes in patients with early stage colorectal cancer. Patients who had newly diagnosed stage II or III colorectal cancer from 2009 to 2010 and had a consultation at the British Columbia Cancer Agency completed the brief Psychosocial Screen for Cancer (PSSCAN) questionnaire, which collects data on patients' perceived social supports, quality of life (QOL), anxiety and depression, and general health. PROs from the PSSCAN were linked with the Gastrointestinal Cancers Outcomes Database, which contains information on patient and tumor characteristics, treatment details, and cancer outcomes. Cox regression models were constructed for overall survival (OS), and Fine and Gray regression models were developed for disease-specific survival (DSS). In total, 692 patients were included. The median patient age was 67 years (range, 26-95 years), and the majority had colon cancer (61%), were diagnosed with stage III disease (54%), and received chemotherapy (58%). In general, patients felt well supported and reported good overall health and QOL. On multivariate analysis, increased fatigue was associated with worse OS (hazard ratio [HR], 1.99; P = .00007) and DSS (HR, 1.63; P = .03), as was lack of emotional support (OS: HR, 4.36; P = .0003; DSS: HR, 1.92; P = .02). Although most patients described good overall health and QOL and indicated that they were generally well supported, patients who experienced more pronounced fatigue or lacked emotional support had a higher likelihood of worse OS and DSS. These findings suggest that abbreviated PROs can inform and assist clinicians to identify patients who have a worse

  6. Joint Technical Coordinating Group on Aircraft Survivability (JTCG/AS). Bibliography of Joint Aircraft Survivability Reports

    Science.gov (United States)

    2000-07-01

    Repair (EBDR) Study 74 Final Report Volume HI Engine Battle Damage Repair (EBDR) Study 75 Final Report VOLUME II Ablative and Thermal Barriers for... Thermal Barriers for Aircraft Dry Bays Issued: September 1995 Progress - Oct 1992 - June 1995 Report Classification: UNCLASSIFIED Sponsor: JTCG...Shipman, Mr. David O’Brian. Mr. Chris Parmley, P&W; Mr. Les Throndson, NAWCWPNS China Lake (Govt Coordinator) Ablative and Thermal Barriers for Aircraft

  7. An IIR median hybrid filter

    Science.gov (United States)

    Bauer, Peter H.; Sartori, Michael A.; Bryden, Timothy M.

    1992-01-01

    A new class of nonlinear filters, the so-called class of multidirectional infinite impulse response median hybrid filters, is presented and analyzed. The input signal is processed twice using a linear shift-invariant infinite impulse response filtering module: once with normal causality and a second time with inverted causality. The final output of the MIMH filter is the median of the two-directional outputs and the original input signal. Thus, the MIMH filter is a concatenation of linear filtering and nonlinear filtering (a median filtering module). Because of this unique scheme, the MIMH filter possesses many desirable properties which are both proven and analyzed (including impulse removal, step preservation, and noise suppression). A comparison to other existing median type filters is also provided.

  8. Síndrome do incisivo central superior solitário: relato de caso Solitary median maxillary central incisor syndrome: case report

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2010-08-01

    Full Text Available INTRODUÇÃO: a presença de um incisivo central superior solitário é um evento bastante incomum na população. A prevalência da chamada Síndrome do Incisivo Central Superior Solitário (SICSS é verificada em 1:50.000 nascimentos, sendo registrado um maior acometimento no sexo feminino. Essa alteração no desenvolvimento da oclusão dentária é caracterizada por más formações estruturais, sobretudo na região de linha média do paciente. O diagnóstico precoce e o tratamento adequado dessa síndrome são de grande importância, pois essa condição talvez seja um indicativo de que o paciente pode apresentar outras más formações congênitas severas, não devendo ser a SICSS considerada uma simples anomalia dentária. Os procedimentos ortodônticos, nesses casos, variam dependendo do grau de comprometimento das estruturas ósseas da maxila, da oclusão em si, e principalmente da sutura palatina mediana. OBJETIVO: discutir, baseado em evidências científicas, aspectos importantes relacionados à SICSS, bem como apresentar um caso clínico de paciente do sexo feminino com SICSS, que foi submetida a tratamento ortodôntico na Clínica Odontológica Integrada Infantil da Universidade Federal de Santa Maria / RS. CONCLUSÃO: pela análise crítica da literatura, verifica-se ser muito importante o diagnóstico correto e precoce acerca dessa síndrome, visto que há possibilidade da mesma estar associada a outros problemas de desenvolvimento. Além disso, o paciente acometido pela SICSS deve ser assistido por uma equipe multidisciplinar de saúde, de forma a otimizar os resultados clínicos e devolver-lhe qualidade de vida.INTRODUCTION: The presence of a single median maxillary central incisor is an uncommon event in the population. The prevalence of the Solitary Median Maxillary Central Incisor (SMMCI syndrome is about 1:50,000 live births, occurring more in women. This alteration in the development of the dental occlusion is

  9. Topics in LIFE Target Survival: 11-SI-004 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Miles, Robin [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Benett, Bill [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bond, Tiziana [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Chang, Allan [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Dawson, David [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Fornasiero, Francesco [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hamilton, Julie [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Havstad, Mark [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kucheyev, Sergei [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); LeBlanc, Mary [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Rosso, Paul [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Schebler, Greg [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Van Cleve, Eli [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Worsley, Marcus [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-10-20

    The LIFE target design incorporates many considerations to generate the desired fusion gain including the physics design, the cost of manufacturing of the target, the injectability of the target, the aerodynamic flight characteristics of the target, the ability to track and engage the target and to maintain the structural and thermal integrity of the target. This document describes the effort that was made in support of issues of survivability of the target during injection which included issues massmanufactural materials and processes which could be used in the target.

  10. GPU Accelerated Vector Median Filter

    Science.gov (United States)

    Aras, Rifat; Shen, Yuzhong

    2011-01-01

    Noise reduction is an important step for most image processing tasks. For three channel color images, a widely used technique is vector median filter in which color values of pixels are treated as 3-component vectors. Vector median filters are computationally expensive; for a window size of n x n, each of the n(sup 2) vectors has to be compared with other n(sup 2) - 1 vectors in distances. General purpose computation on graphics processing units (GPUs) is the paradigm of utilizing high-performance many-core GPU architectures for computation tasks that are normally handled by CPUs. In this work. NVIDIA's Compute Unified Device Architecture (CUDA) paradigm is used to accelerate vector median filtering. which has to the best of our knowledge never been done before. The performance of GPU accelerated vector median filter is compared to that of the CPU and MPI-based versions for different image and window sizes, Initial findings of the study showed 100x improvement of performance of vector median filter implementation on GPUs over CPU implementations and further speed-up is expected after more extensive optimizations of the GPU algorithm .

  11. Non-Local Euclidean Medians.

    Science.gov (United States)

    Chaudhury, Kunal N; Singer, Amit

    2012-11-01

    In this letter, we note that the denoising performance of Non-Local Means (NLM) can be improved at large noise levels by replacing the mean by the Euclidean median. We call this new denoising algorithm the Non-Local Euclidean Medians (NLEM). At the heart of NLEM is the observation that the median is more robust to outliers than the mean. In particular, we provide a simple geometric insight that explains why NLEM performs better than NLM in the vicinity of edges, particularly at large noise levels. NLEM can be efficiently implemented using iteratively reweighted least squares, and its computational complexity is comparable to that of NLM. We provide some preliminary results to study the proposed algorithm and to compare it with NLM.

  12. Median statistics cosmological parameter values

    Energy Technology Data Exchange (ETDEWEB)

    Crandall, Sara, E-mail: sara1990@ksu.edu; Ratra, Bharat, E-mail: ratra@phys.ksu.edu

    2014-05-01

    We present median statistics central values and ranges for 12 cosmological parameters, using 582 measurements (published during 1990–2010) collected by [9]. On comparing to the recent Planck Collaboration [1] estimates of 11 of these parameters, we find good consistency in ten cases.

  13. Median nail dystrophy involving the thumb nail

    Directory of Open Access Journals (Sweden)

    Rahulkrishna Kota

    2016-01-01

    Full Text Available Median canaliform dystrophy of Heller is a rare entity characterized by a midline or a paramedian ridge or split and canal formation in nail plate of one or both the thumb nails. It is an acquired condition resulting from a temporary defect in the matrix that interferes with nail formation. Habitual picking of the nail base may be responsible for some cases. Histopathology classically shows parakeratosis, accumulation of melanin within and between the nail bed keratinocytes. Treatment of median nail dystrophy includes injectable triamcinalone acetonide, topical 0.1% tacrolimus, and tazarotene 0.05%, which is many a times challenging for a dermatologist. Psychiatric opinion should be taken when associated with the depressive, obsessive-compulsive, or impulse-control disorder. We report a case of 19-year-old male diagnosed as median nail dystrophy.

  14. Endocarditis lenta-patient survived septic shock: a case report

    Directory of Open Access Journals (Sweden)

    Amra Macić Džanković

    2012-09-01

    Full Text Available Infective endocarditis is defi ned as an infection of the endocardial surface of the heart. Its intracardiac effects include severe valvular insuffi ciency, which may lead to intractable congestive heart failure and myocardialabscesses. This disease still carries a poor prognosis and a high mortality.A severe case of infective endocarditis with its complications is presented. A man with aortic prosthetic valve due to earlier aortic stenosis and corrected aortal coarctation and implanted pacemaker presentedwith prolonged unexplained fever, malaise, sweating, weight loss (15 kg/4 months and lumbar pain. He was treated with broad-spectrum antibiotics prior IE diagnosis was considered. Echocardiogram showedaortic vegetations and possible periaortal abscess formation. Nonspecifi c infl ammation parameters were high positive. Cultures were constantly negative. His condition had deteriorated suddenly, and he had presentedwith worsening of cutaneous vasculitis, subacute glomerulonephritis and subsequent acute respiratory distress syndrome and septic shock. This patient survived with residual bilateral necrosis of the feet andtoxic peroneal paresis. At the end transthoracic echocardiogram showed enlarged heart chambers, LV mild dilated and concentric hypertrophy with ejection fraction about 40%, degenerative postinfl ammatory mitralvalve changes, mild mitral regurgitation and tricuspid regurgitation, postinfl ammatory aortic root fi brosis and moderate aortic valve stenosis (AVPG max 50,9 mmHg, AVPG mean 24 mmHg with no pericardial effusion. Initial suspicion of Q fever was defi nitely excluded by serological testing showing nonspecifi c IgM positivity,probably rheumatoid factor related.

  15. The reported effects of bullying on burn-surviving children.

    Science.gov (United States)

    Rimmer, Ruth B; Foster, Kevin N; Bay, Curtis R; Floros, Jim; Rutter, Cindy; Bosch, Jim; Wadsworth, Michelle M; Caruso, Daniel M

    2007-01-01

    There is a trend of increasing childhood aggression in America, which has been tied to bullying. Although there is growing research concerning bullying in the general pediatric population, there are limited data on bullying and its effects on children with disfigurements and physical limitations. This study was conducted to assess burned children's experience with bullying. A pretest was administered regarding experience with bullying and teasing. A curriculum regarding bullying, which incorporated the Harry Potter and the Sorcerer's Stone movie, was presented. After reviewing bullying depicted in the film and participating in a class regarding bullying, children were invited to complete a survey regarding their experience with bullying. A total of 61% of these children reported being bullied at school; 25% reported experiencing headaches or stomachaches due to bullying, and 12% reported staying home from school. Nearly 25% reported bullying as a big problem. Of those with visible scars (55%), a full 68% reported bullying as a problem, versus 54% with hidden scars (P < .05). However, those with visible scars were no more likely to tell an adult (54%) than those without (56%). Children were much more willing to disclose personal bullying experiences after participating in the class (57%) than before (45%) (P < .01). This study revealed that bullying impacts many burn-injured children and has negative effects on their physical and mental well-being. Many children (with visible or hidden scars) did not seek adult intervention for the problem. Participation in a bullying course appears to give children a forum that increases their willingness to disclose personal bullying experiences and can provide them with prevention information and a safe place to seek help.

  16. Surviving streptococcal toxic shock syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Madhusudhan Thayur R

    2007-10-01

    Full Text Available Abstract Streptococcal toxic shock syndrome and associated myositis caused by group A beta-hemolytic streptococcus pyogenes generally have a poor outcome despite aggressive operative treatment. Frequently the diagnosis is missed initially as the clinical features are non-specific. The progression to a toxic state is rapid and unless definitive treatment measures are initiated early, the end result can be catastrophic. We report a previously healthy patient who had features of toxic shock syndrome due to alpha haemolytic (viridans streptococcus mitis which was treated successfully with antibiotics, aggressive intensive care support including the use of a 'sepsis care bundle', monitoring and continuous multidisciplinary review. Life and limb threatening emergencies due to streptococcus mitis in an immune-competent person are rare and to our knowledge, have not previously been described in the English scientific literature. Successful outcome is possible provided a high degree of suspicion is maintained and the patient is intensively monitored.

  17. The clinical manifestations and survival of systemic lupus erythematosus patients in Turkey: report from two centers.

    Science.gov (United States)

    Pamuk, O N; Akbay, F G; Dönmez, S; Yilmaz, N; Calayir, G B; Yavuz, S

    2013-11-01

    Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Survival has become longer as a result of better treatment modalities and better supportive care. There is no information on survival of SLE patients in Turkey. We evaluated clinical features and survival in SLE patients in two rheumatology departments. All SLE patients being followed up by the Department of Rheumatology, Trakya University Medical Faculty, and the Department of Rheumatology, Marmara University Medical Faculty, over the 1996-2012 period were included. Patients were diagnosed with SLE if they fulfilled at least four American College of Rheumatology (ACR) criteria. The clinical and laboratory features, mortality data were obtained from medical charts. We had 428 SLE patients, and women (399 patients, 93.2%) far outnumbered men (29 patients, 6.8%). The mean age at the time of SLE diagnosis was 40.3 ± 12.4 years. The most frequent clinical manifestations were arthritis (76.9%) and photosensitivity (70.1%). Renal disease was present in 32.9% of patients and neurological involvement in 12.9% of patients. After a median follow-up of 60 months, 19 patients died. The most frequent causes of death were ischemic heart disease, chronic renal failure and sepsis. The rate of five-year survival was 96%; 10-year survival, 92%; and 15-year survival, 88.8%. Multivariate Cox analysis showed that serositis at the time of diagnosis, SLE disease activity index (SLEDAI) score 6, and autoimmune hemolytic anemia were independent prognostic factors. Data from two centers in Northwestern Turkey show that the mortality rate for SLE is similar to the rate in Western countries.

  18. Cyberknife Radiosurgery and Concurrent Intrathecal Chemotherapy for Leptomeningeal Metastases: Case Report of Prolonged Survival of a HER-2+ Breast Cancer Patient Status-Post Craniospinal Irradiation.

    Science.gov (United States)

    Lekovic, Gregory; Drazin, Doniel; Mak, Albert C; Schwartz, Marc S

    2016-01-07

    Leptomeningeal disease (LMD) from breast cancer is usually a rapidly fatal condition, with median overall survival reported to be 15 weeks. Conventional treatment for LMD includes craniospinal irradiation and intrathecal (IT) methotrexate. However, the role of stereotactic radiation for leptomeningeal disease remains poorly defined. This case report describes our experience using Cyberknife radiosurgery to treat a 49-year-old female with HER-2+ breast cancer and focal/nodular leptomeningeal metastases that were refractory to craniospinal irradiation and concurrent IT chemotherapy. This combined approach--i.e., craniospinal irradiation, IT chemotherapy, and Cyberknife Radiosurgery for local, recurrent metastases--resulted in survival of 46 months with controlled disease. Based on our experience with this patient, we believe further consideration of radiosurgery for LMD is warranted.

  19. Reporting quality of survival analyses in medical journals still needs improvement. A minimal requirements proposal.

    Science.gov (United States)

    Abraira, Víctor; Muriel, Alfonso; Emparanza, José I; Pijoan, José I; Royuela, Ana; Plana, María Nieves; Cano, Alejandra; Urreta, Iratxe; Zamora, Javier

    2013-12-01

    We reviewed publications with two main objectives: to describe how survival analyses are reported across medical journal specialties and to evaluate changes in reporting across periods and journal specialties. Systematic review of clinical research articles published in 1991 and 2007, in 13 high-impact medical journals. The number of articles performing survival analysis published in 1991 (104) and 2007 (240) doubled (17% vs. 33.5%; P = 0.000), although not uniformly across specialties. The percentage of studies using regression models and the number of patients included also increased. The presentation of results improved, although only the reporting of precision of effect estimates reached satisfactory levels (53.1% in 1991 vs. 94.2% in 2007; P = 0.000). Quality of reporting also varied across specialties; for example, cardiology articles were less likely than oncology ones to discuss sample size estimation (odds ratio = 0.12; 95% confidence interval: 0.05, 0.30). We also detected an interaction effect between period and specialty regarding the likelihood of reporting precision of curves and precision of effect estimates. The application of survival analysis to medical research data is increasing, whereas improvement in reporting quality is slow. We propose a list of minimum requirements for improved application and description of survival analysis. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Evaluation of Juvenile Salmonid Outmigration and Survival in the Lower Umatilla River Basin; 1996 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, Suzanne M.; Kern, J. Chris; Carmichael, Richard W. (Oregon Department of Fish and Wildlife, Portland, OR)

    1997-01-01

    This is the second year report of a multi-year project that monitors the outmigration and survival of hatchery and naturally-produced juvenile salmonids in the lower Umatilla River. This project supplements and complements ongoing or completed fisheries projects in the Umatilla River basin. Knowledge gained on outmigration and survival will assist researchers and managers in adapting hatchery practices, flow enhancement strategies, canal operations, and supplementation and enhancement efforts for natural and restored fish populations. The authors also report on tasks related to evaluating juvenile salmonid passage at Three Mile Falls Dam and West Extension Canal.

  1. Differences in case definitions as a cause of variation in reported in-hospital CPR survival.

    Science.gov (United States)

    Ballew, K A; Philbrick, J T; Caven, D E; Schorling, J B

    1994-05-01

    To determine the effect of different case definitions on reported survival following in-hospital cardiopulmonary arrest, the authors reviewed the charts of 411 patients for whom a nurse completed a cardiac arrest form at a university hospital during a two-year period. Survival to discharge was 16.0% for patients who required basic cardiopulmonary resuscitation (chest compression and pulmonary ventilation), 18.6% for patients who were pulseless and apneic, 23.0% for patients who were pulseless or apneic, and 28.2% for all 411 patients for whom a cardiac arrest form was completed. These results demonstrate that reported survival to discharge following in-hospital cardiac arrest varies widely depending on the case definition that is used.

  2. Long-term survival after sporadic and delayed metastases of conventional osteosarcoma: A case report.

    Science.gov (United States)

    Kubo, Tadahiko; Furuta, Taisuke; Johan, Muhammad P; Yoshizuka, Masaaki; Ochi, Mitsuo; Adachi, Nobuo

    2017-05-01

    Histologically conventional osteosarcoma, once metastasized to the lung, generally causes a rapid and fatal outcome. Osteosarcoma metastasis to the gastrointestinal tract is extremely rare.We report herein a case of osteoblastic osteosarcoma with exceptionally unique features: sporadic lung metastases and delayed metastases to the stomach and the jejunum with long-term survival. She received multiple operations and chemotherapies, but consequently died of peritoneal dissemination. A review of the literature on osteosarcoma metastasis to the gastrointestinal tract is presented.This patient was very unusual in terms of a long-term survival and metastatic sites, suggesting the importance of vigilance and thorough follow-up for patients with conventional osteosarcoma.

  3. 91-Year-Old Allograft: Oldest Surviving Donor Heart Still Going: A Case Report.

    Science.gov (United States)

    Doctorian, T; Narasimha, D; Stoletniy, L; Sakr, A

    2017-09-01

    For patients with end-stage heart failure, heart transplantation remains one of the most successful therapies with excellent long-term survival rates. However, over the past few decades, there has been a worsening supply/demand mismatch given the rising epidemic of heart failure and the relatively fixed availability of donor hearts. In this case report, we describe the case of a 30-year-old woman who underwent transplantation with a 68-year-old donor heart and who has survived for 23 years without any major cardiac problems. To our knowledge, this patient has one of the oldest surviving donor hearts (91-year-old heart). Review of the latest guidelines and recent studies have demonstrated a gradual expansion of donor criteria to meet this critical shortage of donor organs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Development of Rations for the Enhanced Survival of Salmon, 1981-1990 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ewing, Richard D.

    1990-12-01

    The nutritional quality of feed plays an important role in determining the health and ``fitness`` of smolts. Commercial fish meal, the major source of protein in salmon rations, may be reduced in quality from poor drying techniques during manufacture. Dietary stress in the hatchery may result. This investigation tests the hypothesis that protein quality of fish rations can influence the survival of smolts and the ultimate return of adults. The test involves a comparison between performances of coho (Oncorhynchus kisutch) and chinook salmon (O. tshawytscha) reared on rations containing very high quality protein derived from vacuum dried meals and those of fish reared on commercial rations, with commercial fish meal as a source of protein. Survival and return of several brood years of test and control fish are used to measure the influence of ration on survival. This report includes recovery data from these marked fish collected 1982 through September 1990.

  5. Review of the Reporting of Survival Analyses within Randomised Controlled Trials and the Implications for Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Sarah Batson

    Full Text Available Meta-analysis is a growing approach to evidence synthesis and network meta-analysis in particular represents an important and developing method within Health Technology Assessment (HTA. Meta-analysis of survival data is usually performed using the individual summary statistic-the hazard ratio (HR from each randomised controlled trial (RCT.The objectives of this study are to: (i review the methods and reporting of survival analyses in oncology RCTs; and (ii assess the suitability and relevance of survival data reported in RCTs for inclusion into meta-analysis.Five oncology journals were searched to identify Phase III RCTs published between April and July 2015. Eligible studies included those that analysed a survival outcome.Thirty-two RCTs reporting survival outcomes in cancer populations were identified. None of the publications reported details relating to a strategy for statistical model building, the goodness of fit of the final model, or final model validation for the analysis of survival outcomes. The majority of studies (88% reported the use of Cox proportional hazards (PH regression to analyse survival endpoints. However, most publications failed to report the validation of the statistical models in terms of the PH assumption.This review highlights deficiencies in terms of reporting the methods and validity of survival analyses within oncology RCTs. We support previous recommendations to encourage authors to improve the reporting of survival analyses in journal publications. We also recommend that the final choice of a statistical model for survival should be informed by goodness of model fit to a given dataset, and that model assumptions are validated. The failure of trial investigators and statisticians to investigate the PH for RCT survival data is likely to result in clinical decisions based on inappropriate methods. The development of alternative approaches for the meta-analysis of survival outcomes when the PH assumption is

  6. Review of the Reporting of Survival Analyses within Randomised Controlled Trials and the Implications for Meta-Analysis

    Science.gov (United States)

    Batson, Sarah; Greenall, Gemma; Hudson, Pollyanna

    2016-01-01

    Background Meta-analysis is a growing approach to evidence synthesis and network meta-analysis in particular represents an important and developing method within Health Technology Assessment (HTA). Meta-analysis of survival data is usually performed using the individual summary statistic—the hazard ratio (HR) from each randomised controlled trial (RCT). Objectives The objectives of this study are to: (i) review the methods and reporting of survival analyses in oncology RCTs; and (ii) assess the suitability and relevance of survival data reported in RCTs for inclusion into meta-analysis. Methods Five oncology journals were searched to identify Phase III RCTs published between April and July 2015. Eligible studies included those that analysed a survival outcome. Results Thirty-two RCTs reporting survival outcomes in cancer populations were identified. None of the publications reported details relating to a strategy for statistical model building, the goodness of fit of the final model, or final model validation for the analysis of survival outcomes. The majority of studies (88%) reported the use of Cox proportional hazards (PH) regression to analyse survival endpoints. However, most publications failed to report the validation of the statistical models in terms of the PH assumption. Conclusions This review highlights deficiencies in terms of reporting the methods and validity of survival analyses within oncology RCTs. We support previous recommendations to encourage authors to improve the reporting of survival analyses in journal publications. We also recommend that the final choice of a statistical model for survival should be informed by goodness of model fit to a given dataset, and that model assumptions are validated. The failure of trial investigators and statisticians to investigate the PH for RCT survival data is likely to result in clinical decisions based on inappropriate methods. The development of alternative approaches for the meta-analysis of survival

  7. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  8. A CASE REPORT OF LATE SURVIVAL IN ELLIS: VAN CREVELD SYNDROME

    Directory of Open Access Journals (Sweden)

    Hemant Narayan

    2014-10-01

    Full Text Available Ellis–van Creveld syndrome (EVC is an autosomal recessive disorder characterized by chondro-dystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Acromelic shortening of upper and lower limbs, genu valgum, multiple frenula, deformed teeth, short ribs and narrow thorax and congenital heart diseases complete the picture. The patients with the syndrome rarely survive into adulthood. Here, we report a lady with EVC presenting for the first time in middle age.

  9. Late survival in Ellis-van Creveld syndrome - a case report.

    Science.gov (United States)

    Mishra, Trinath; Routray, Satya N; Das, Biswajit

    2012-01-01

    Ellis-van Creveld syndrome (EVC) is an autosomal recessive disorder characterized by chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Acromelic shortening of upper and lower limbs, genu valgum, multiple frenula, deformed teeth, short ribs and narrow thorax and congenital heart diseases complete the picture. The patients with the syndrome rarely survive into adulthood. Here, we report a lady with EVC presenting for the first time in middle age.

  10. Long-term survival after intraluminal brachytherapy for inoperable hilar cholangiocarcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Siu-Yin Chan; Ronnie T. Poon; Kelvin K. Ng; Chi-Leung Liu; Raymond T. Chan; Sheung-Tat Fan

    2005-01-01

    Surgical resection with a tumor-free margin is the onlycurative treatment for hilar cholangiocarcinoma (Klatskin tumor). However, over half of the patients present late with unresectable tumors. Radiotherapy using external beamirradiation or intraluminal brachytherapy (ILBT) has been used to treat unresectable hilar cholangiocarcinoma with satisfactory outcome. We reported a patient with unresectable hilar cholangiocarcinoma surviving more than 6 years after combined external beam irradiation and ILBT.

  11. Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data

    Science.gov (United States)

    Wood, David Michael; Webster, Emma; Martinez, Daniel; Dargan, Paul Ivor; Jones, Alison Linda

    2002-01-01

    Introduction Strychnine poisoning is uncommon, and in most severe cases, the patient dies before reaching hospital. The management of strychnine poisoning is well documented, although there are few data on the kinetics of elimination of strychnine after overdose. Case report A 42-year-old man presented shortly after ingestion of an unknown quantity of strychnine powder. After a respiratory arrest, with intensive supportive management requiring admission to an intensive care unit, he survived. Eight serum samples were taken over the first 5 days and analysed subsequently for strychnine concentrations. Results The initial concentration at 1.5 hours after ingestion was 4.73 mg/l, falling to 0.38 mg/l at 74 hours postingestion. Serum concentrations followed a monoexponential elimination curve with a calculated elimination half-life of 12 hours. Discussion and conclusion Strychnine poisoning presents with classical features, and with early diagnosis and supportive management, the patient can survive. The initial serum concentration of 4.73 mg/l is the highest reported concentration in a patient who has survived. Previous reports of the elimination half-life have suggested it is between 10 and 16 hours, which conforms to the elimination data in our case. PMID:12398788

  12. Development of Rations for the Enhanced Survival of Salmon, 1986-1987 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Bradford, C. Samuel

    1987-12-01

    The nutritional quality of feed plays an important role in determining the health and fitness of smolts. Commercial fish meal, the major source of protein in salmon rations, is subject to heat damage during drying and chemical interaction of fat oxidation products with proteins. Protein bioavailability is reduced and dietary stress may be introduced into hatchery feeds. This investigation tests the hypothesis that ration protein quality can influence the survival of smolts and the ultimate return of adults. Improved survival production would be better able to reestablish natural runs of salmon in the Columbia River system and maintain and improve the genetic integrity of specific stocks. The general approach being used involves a comparison of coho and chinook salmon reared on rations containing very high quality protein derived from vacuum dried meals and commercial rations relying on commercial fish meal as a source of protein. Survival and return of replicate brood-years of coded wire tagged test and control fish are being used to determine the influence of ration on survival. Project rearing and release of tagged fish to date include 1982, 1983, 1984 and 1985-broods of coho salmon; the 1983 and 1984-broods of fall chinook (tule stock) salmon; and the 1985 and 1986-broods of fall chinook (up-river-bright stock) salmon. This report covers the rearing and release of the 1985-brood coho and the 1986-brood fall chinook (up-river-bright stock) salmon.

  13. Thirteen-Year Disease-Free Survival after Surgery for Cystic Duct Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Zine Abedine Benchellal

    2008-11-01

    Full Text Available Cystic duct carcinoma is known to have a better prognosis compared to its location in other biliary ducts. Only one case with a survival over ten years has been previously published. The authors report a case of survival over 13 years without recurrence or metastasis. Preoperative diagnosis of cystic duct tumor was carried in a 66-year-old male. Under the diagnosis of carcinoma of the cystic duct, the patient underwent en bloc resection of the gallbladder, cystic duct, hepaticocholedochus and lymph node dissection. A Roux-en-Y hepaticojejunostomy was performed. Histological examination revealed a moderately differentiated adenocarcinoma of the cystic duct. Five months later the patient underwent second look surgery for benign obstruction of the hepaticojejunal anastomosis. The patient is still doing well 13 years later without any local recurrence or metastasis. To our knowledge, this is the longest disease-free survival ever published in the literature. This case sustains that better and longer survival is possible with a real chance of potential cure if radical surgery is performed.

  14. Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Segadal Leidulf

    2010-11-01

    Full Text Available Abstract Background Patient-reported outcomes are increasingly seen as complementary to biomedical measures. However, their prognostic importance has yet to be established, particularly in female long-term myocardial infarction (MI survivors. We aimed to determine whether 10-year survival in older women after MI relates to patient-reported outcomes, and to compare their survival with that of the general female population. Methods We included all women aged 60-80 years suffering MI during 1992-1997, and treated at one university hospital in Norway. In 1998, 145 (60% of those alive completed a questionnaire package including socio-demographics, the Sense of Coherence Scale (SOC-29, the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF and an item on positive effects of illness. Clinical information was based on self-reports and hospital medical records data. We obtained complete data on vital status. Results The all-cause mortality rate during the 1998-2008 follow-up of all patients was 41%. In adjusted analysis, the conventional predictors s-creatinine (HR 1.26 per 10% increase and left ventricular ejection fraction below 30% (HR 27.38, as well as patient-reported outcomes like living alone (HR 6.24, dissatisfaction with self-rated health (HR 6.26, impaired psychological quality of life (HR 0.60 per 10 points difference, and experience of positive effects of illness (HR 6.30, predicted all-cause death. Major adverse cardiac and cerebral events were also significantly associated with both conventional predictors and patient-reported outcomes. Sense of coherence did not predict adverse events. Finally, 10-year survival was not significantly different from that of the general female population. Conclusion Patient-reported outcomes have long-term prognostic importance, and should be taken into account when planning aftercare of low-risk older female MI patients.

  15. Synthesis of Biological Reports on Juvenile Fish Passage and Survival at Bonneville Dam through 2005

    Energy Technology Data Exchange (ETDEWEB)

    Ploskey, Gene R.; Johnson, Gary E.; Giorgi, Albert E.; Johnson, Richard L.; Stevenson, John R.; Schilt, Carl R.; Johnson, Peter N.; Patterson, Deborah S.

    2005-06-01

    This report describes a review of available literature on juvenile salmonid passage at Bonneville Dam from 1939 through 2005. Studies of interest included project-wide fish-passage efficiency (FPE) studies by radio telemetry and fixed-aspect hydroacoustics, fish survival studies (direct and indirect), FGE studies, powerhouse and unit (by netting, hydroacoustics, and radio telemetry), predation studies in the forebay and tailrace, behavioral studies on forebay approach and egress, and surface-bypass studies. The FPE effort will include a review of available distribution data (horizontal, diel, and vertical) for juvenile salmon. This study does not repeat the results of previous review and synthesis studies but cites them. Where no previous review exists for a subject area, all reports were reviewed and synthesized. The report includes an annotated bibliography summarizing each of the documents reviewed and a DVD disk containing all of the original papers and reports along with an HTML index to the documents.

  16. Improving Survival in Patients Treated for a Lung Cancer Using Self-Evaluated Symptoms Reported Through a Web Application.

    Science.gov (United States)

    Denis, Fabrice; Yossi, Senna; Septans, Anne-Lise; Charron, Alexandre; Voog, Eric; Dupuis, Olivier; Ganem, Gérard; Pointreau, Yoann; Letellier, Christophe

    2015-03-24

    We retrospectively compared survivals in patients with a lung cancer history and followed by the so-called sentinel Web-application that allows early detection of relapse and early palliative care initiation versus a conventional follow-up in our center. The survival in 98 consecutive patients with lung cancer was assessed. The first part of them (the control arm) was retrospectively recruited between March 2011 and August 2012. The second half of them (the experimental arm) was prospectively recruited between August 2012 and December 2013 to weekly fill a form of 11 self-assessed symptoms, then processed by the "sentinel" Web-application. Data were sent to this sentinel application in real-time between planned visits. An email alert was sent to the oncologist when self-scored symptoms matched some predefined criteria. Follow-up visit and imaging were then organized after a phone call for confirming the suspect symptoms. In the control arm (49 patients), a common follow-up was applied (visit and imaging every 2 to 6 mo according to stage of tumor and kind of treatment). Median follow-up duration was 12.3 months in the experimental arm and 16.7 months in the control arm (P=0.27). Survival was significantly better in the sentinel arm than in the control arm (P=0.0014). Median survival was 16.7 months in the control arm and 22.4 months in the experimental arm. One-year survival was 86.6% in the experimental arm and 59.1% in the control arm. Survival may be improved by early detection of relapse and early palliative care initiation by using sentinel-like Web-application.

  17. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  18. Sosiaalisen median strategia : Case Yritys X

    OpenAIRE

    Tuomola, Miikka

    2015-01-01

    Tämän opinnäytetyön tarkoituksena oli luoda sosiaalisen median strategia Yritys X:n käyttöön. Tavoitteena oli löytää suomalaiselle telekommunikaatioalalla toimivalle yritykselle sopivat sosiaalisen median kanavat, jotka tarjoavat väylän markkinoinnin tehostamiseen ja yrityksen imagon vahvistamiseen. Toimeksiantaja keskittyy liiketoiminnassaan B2B-liiketoimintaan. Strategia oli ajankohtainen sosiaalisen median roolin jatkuvan kasvun vuoksi. Sosiaalisen median merkitys ja rooli on merkittäv...

  19. Advanced median method for timing jitter compensation

    Institute of Scientific and Technical Information of China (English)

    Wang Chen; Zhu Jiangmiao; Jan Verspecht; Liu Mingliang; Li Yang

    2008-01-01

    Timing jitter is one of the main factors that influence on the accuracy of time domain precision measurement. Timing jitter compensation is one of the problems people concern. Because of the flaws of median method, PDF deconvolution method and synthetic method, we put forward a new method for timing jitter compensation, which is called advanced median method. The theory of the advanced median method based on probability and statistics is analyzed, and the process of the advanced median method is summarized in this paper. Simulation and experiment show that compared with other methods, the new method could compensate timing jitter effectively.

  20. Development of Rations for the Enhanced Survival of Salmon, 1988-1989 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ewing, Richard D.

    1990-03-01

    The nutritional quality of feed plays an important role in determining the health and fitness'' of smolts. Commercial fish meal, the major source of protein in salmon rations, may be reduced in quality from poor drying techniques during manufacture. Dietary stress in the hatchery may result. This investigation test the hypothesis that protein quality of fish rations can influence the survival of smolts and the ultimate return of adults. The test involves a comparison between performances of coho (Oncorhynchus kisutch) and chinook salmon (O. tshawytscha) reared on rations containing very high quality protein derived from vacuum dried meals and those of fish reared on commercial rations, with commercial fish meal as a source of protein. Survival and return of several brood years of test and control fish are used to measure the influence of ration on survival. Rearing and release of tagged fish to date include 1982, 1983, 1984 and 1985 broods of coho salmon (Sandy stock); the 1983 and 1984 broods of fall chinook (tule stock) salmon; and the 1985 and 1986 broods of fall chinook (upriver bright stock) salmon. This report includes recovery data from these marked fish collected through September 1989. 2 tabs.

  1. Development of Rations for the Enhanced Survival of Salmon, 1987-1988 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ewing, Richard D.

    1988-12-01

    The nutritional quality of feed plays an important role in determining the health and fitness of smolts. Commercial fish meal, the major source of protein in salmon rations, may be reduced in quality from poor drying techniques during manufacture. Dietary stress in the hatchery may result. This investigation tests the hypothesis that protein quality of fish rations can influence the survival of smolts and the ultimate return of adults. The test involves a comparison between performances of coho and chinook salmon reared on rations containing very high quality protein derived from vacuum dried meals and those of fish reared on commercial rations, with commercial fish meal as a source of protein. Survival and return of several brood years of test and control fish are used to measure the influence of ration on survival. Rearing and release of tagged fish to date include 1982, 1983, 1984 and 1985 broods of coho salmon; the 1983 and 1984 broods of fall chinook (tule stock) salmon; and the 1985 and 1986 broods of fall chinook (upriver bright stock) salmon. This report includes recovery data from these marked fish collected through September 1988.

  2. Concurrent Variations of Lateral Pectoral, Median, and Musculocutaneous Nerves

    Directory of Open Access Journals (Sweden)

    Satheesha B Nayak

    2017-01-01

    Full Text Available Brachial plexus frequently presents variations of its cords and branches. We saw concurrent variations of lateral pectoral, median and musculocutaneous nerves. There were two lateral pectoral nerves. Median nerve was formed by the union of 3 roots; two lateral roots and one medial root. Medial root arose from the ulnar nerve. Musculocutaneous nerve did not pierce the coracobrachialis muscle. There was a thick communicating branch between the musculocutaneous and median nerves. Though there are reports on individual variations mentioned above, it is very rare to see all of them in the same individual. Knowledge of these variations may be handy in axillary lymph node clearance and performing nerve blocks

  3. Parotid small cell carcinoma presenting with long-term survival after surgery alone: a case report

    Directory of Open Access Journals (Sweden)

    Kanazawa Takeharu

    2012-12-01

    Full Text Available Abstract Introduction Primary involvement of the salivary glands in small cell carcinoma is rare, and has one of the worst prognoses of salivary gland neoplasms. However, it has been reported that some cases have a favorable outcome, although the prognostic factors are still under consideration. Multidisciplinary therapy was usually required to achieve long-term survival. Recently, a resemblance of some small cell carcinomas of the salivary gland to cutaneous Merkel cell carcinoma was suggested; the latter have the potential for spontaneous regression, which is related to a favorable clinical outcome. Case presentation We present a locoregional advanced parotid small cell carcinoma with multiple lymph node metastases in an 87-year-old Asian woman. The tumor was controlled by surgery alone, and nine-year disease-free survival was achieved without any adjunctive therapy. To the best of our knowledge, this is the longest reported follow-up of head and neck small cell carcinoma. Conclusion We believe this to be the first case of small cell carcinoma with involvement of the salivary glands reported in the literature with a good outcome after surgery alone without any adjunctive therapy.

  4. Development of Rations for the Enhanced Survival of Salmon, 1985-1986 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Bradford, C. Samuel

    1987-04-01

    This investigation tests the hypothesis that ration protein quality can influence the survival of smolts and the ultimate return of adults. The general approach being used involves a comparison of coho and chinook salmon reared on rations containing very high quality protein derived from vacuum dried meals and commercial rations relying on commercial fish meal as a source of protein. Survival and return of replicate brood-years of coded wire tagged test and control fish are being used to determine the influence of ration on survival. Project rearing and release of tagged fish to date include 1982, 1983, and 1984-brood replicates of coho salmon; the 1983 and 1984-brood replicates of fall chinook (tule stock salmon; and the 1985-brood of fall chinook (up-river-bright stock) salmon. The 1985-brood year replicate of coho salmon is presently being reared and has been tagged for release in April 1987. The rearing of the 1986-brood replicate of fall chinook (up-river-bright stock) salmon has been initiated. This report covers the rearing and release of the 1984-brood coho and the 1985-brood fall chinook (up-river-bright stock) salmon. Plasma cortisol and thyroxine (T/sub 4/) level, gill Na/sup +//K/sup +/-ATPase, osmoregulatory performance, immunocompetency and total hepatic/gill microsomal lipid content were monitored from early June to mid-October 1986 to assess the physiological condition of fall chinook salmon. Results indicated that on several sampling dates early in the 1986 rearing period fish supplied the control ration were physiologically different than fish receiving the salmon meal ration. Incomplete recovery of coded wire tags from 1982 and 1983-broods of coho salmon (Sandy stock) revealed an improved (P greater than or equal to .05) survival for fish supplied test rations.

  5. Stratified analysis of 800 Asian patients after robot-assisted radical prostatectomy with a median 64 months of follow up.

    Science.gov (United States)

    Abdel Raheem, Ali; Kim, Dae Keun; Santok, Glen Denmer; Alabdulaali, Ibrahim; Chung, Byung Ha; Choi, Young Deuk; Rha, Koon Ho

    2016-09-01

    To report the 5-year oncological outcomes of robot-assisted radical prostatectomy from the largest series ever reported from Asia. A retrospective analysis of 800 Asian patients who were treated with robot-assisted radical prostatectomy from July 2005 to May 2010 in the Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea was carried out. The primary end-point was to evaluate the biochemical recurrence. The secondary end-point was to show the biochemical recurrence-free survival, metastasis-free survival and cancer-specific survival. A total of 197 (24.65%), 218 (27.3%), and 385 (48.1%) patients were classified as low-, intermediate- and high-risk patients according to the D'Amico risk stratification risk criteria, respectively. The median follow-up period was 64 months (interquartile range 28-71 months). The overall incidence of positive surgical margin was 36.6%. There was biochemical recurrence in 183 patients (22.9%), 38 patients (4.8%) developed distant metastasis and 24 patients (3%) died from prostate cancer. Actuarial biochemical recurrence-free survival, metastasis-free survival, and cancer-specific survival rates at 5 years were 76.4%, 94.6% and 96.7%, respectively. Positive lymph node was associated with lower 5-year biochemical recurrence-free survival (9.1%), cancer-specific survival (75.7%) and metastasis-free survival (61.9%) rates (P < 0.001). On multivariable analysis, among all the predictors, positive lymph node was the strongest predictor of biochemical recurrence, cancer-specific survival and metastasis-free survival (P < 0.001). Herein we report the largest robot-assisted radical prostatectomy series from Asia. Robot-assisted radical prostatectomy is confirmed to be an oncologically safe procedure that is able to provide effective 5-year cancer control, even in patients with high-risk disease. © 2016 The Japanese Urological Association.

  6. The Ultrasonographic Findings of Bifid Median Nerve

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Jin; Park, Noh Hyuck; Joh, Joon Hee [Myoungji Hospital, Gwandong University College of Medicine, Gangneung (Korea, Republic of); Lee, Sung Moon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    We wanted to evaluate the ultrasonographic findings of bifid median nerve and its clinical significance. We retrospectively reviewed five cases (three men and two women, mean age: 54 years) of incidentally found bifid median nerve from 264 cases of clinically suspected carpal-tunnel syndrome that were seen at our hospital during last 6 years. Doppler sonography was performed in all five cases and MR angiography was done in one case for detecting a persistent median artery. The difference ({Delta}CSA) between the sum of the cross-sectional areas of the bifid median nerve at the pisiform level (CSA2) and the cross-sectional area proximal to the bifurcation(CSA1) was calculated. The incidence of a bifid median nerve was 1.9%. All the patients presented with a tingling sensation on a hand and two patients had nocturnal pain. All the cases showed bifurcation of the nerve bundle proximal to the carpal tunnel. The margins appeared relatively smooth and each bundle showed a characteristic fascicular pattern. A persistent median artery was noted between the bundles in four cases. {Delta}CSA was more than 2 mm 2 in four cases. Bifid median nerve with a persistent median artery is a relatively rare normal variance and these are very important findings before performing surgical intervention to avoid potential nerve injury and massive bleeding. We highly suggest that radiologists should understand the anatomical characteristics of this anomaly and make efforts to detect it

  7. Longevity and Patau syndrome: what determines survival?

    Science.gov (United States)

    Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

    2012-12-06

    The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7-10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity.

  8. Adaptive Marginal Median Filter for Colour Images

    Directory of Open Access Journals (Sweden)

    Almanzor Sapena

    2011-03-01

    Full Text Available This paper describes a new filter for impulse noise reduction in colour images which is aimed at improving the noise reduction capability of the classical vector median filter. The filter is inspired by the application of a vector marginal median filtering process over a selected group of pixels in each filtering window. This selection, which is based on the vector median, along with the application of the marginal median operation constitutes an adaptive process that leads to a more robust filter design. Also, the proposed method is able to process colour images without introducing colour artifacts. Experimental results show that the images filtered with the proposed method contain less noisy pixels than those obtained through the vector median filter.

  9. Allegheny County Median Age at Death

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The median age at death is calculated for each municipality in Allegheny County. Data is based on the decedent's residence at the time of death, not the location...

  10. Long survival of primary diffuse leptomeningeal gliomatosis following radiotherapy and temozolomide: case report and literature review

    Directory of Open Access Journals (Sweden)

    Hansen N

    2011-09-01

    Full Text Available Abstract Objective Primary diffuse leptomeningeal gliomatosis (PDLG is a rare neoplasm with a short survival time of a few months. there is currently no standardized therapeutic approach for PDLG. Materials and methods We report on a 53-year-old male patient who presented with epileptic seizures, gait disturbance, paraparesis and sensory deficits in the dermatomes T8-10. Results Magnetic resonance imaging (MRI revealing numerous spinal and cranial gadolinium-enhancing nodules in the meninges and histopathology led us to diagnose primary diffuse leptomeningeal gliomatosis with WHO grade III astrocytic cells. Consecutively, the patient underwent craniospinal radiotherapy (30 Gy and 11 sequential cycles of temozolomide. This regimen led to partial tumor regression. Thirteen months later, spinal MRI revealed tumor progression. Second-line chemotherapy with 5 cycles of irinotecan and bevacizumab did not prevent further clinical deterioration. The patient died twenty-two months after diagnosis, being the longest survival time described thus far with respect to PDLG consisting of astrocytic tumor cells. Conclusions Radiochemotherapy including temozolomide, as established standard therapy for brain malignant astrocytomas, might be valid as a basic therapeutic strategy for this PDLG subtype.

  11. Everolimus and exemestane in long survival hormone receptor positive male breast cancer: case report.

    Science.gov (United States)

    Ballatore, Z; Pistelli, M; Battelli, N; Pagliacci, A; De Lisa, M; Berardi, R; Cascinu, S

    2016-11-28

    Male breast cancer is a rare event, accounting for approximately 1% of all breast carcinomas. Although men with breast cancer had poorer survival when compared with women, data on prognosis principally derive from retrospective studies and from extrapolation of female breast cancer series. We reported the case of a very long survival patient. A caucasian 42-year-old man underwent radical mastectomy with axillary dissection for breast cancer in 1993. Pathologic stage was pT4pN0M0 infiltrating ductal carcinoma of right breast without lymph nodes metastases. Biological characterization was not available. He received adjuvant treatment with chemotherapy, six cycles of cyclophosphamide, methotrexate and fluorouracil, then endocrine therapy with tamoxifen for 5 years and complementary radiotherapy. Then he began clinical-instrumental follow up. In May 1996, a computed tomography scan showed multiple lung metastases. Hereafter he received several oncologic treatment including seven chemotherapy and five endocrine therapy lines with two re-challenge of endocrine therapy. In October 2007 further lung progression was showed and a biopsy was performed to characterize the disease. Histological examination confirmed breast cancer metastases, immunohistochemistry showed positive staining for estrogen receptor, negative for progesterone receptor and human epithelial growth factor receptor 2, proliferative index was 21%. In April 2013, bone disease progression was evident and he received radiant treatment to sacral spine. In May 2014 an off-label treatment with exemestane and everolimus combination was approved by Ethics Committee of the Marche Region. The patient received treatment for 3 months with evident clinical benefit to subcutaneous lesions of the chest wall that were not visible nor palpable on physical examination after 1 month of treatment. That is the case of long survival male breast cancer patient with luminal B subtype and no BRCA mutations. He achieved higher

  12. Evaluation of newspaper articles for coverage of public reporting data: a case study of unadjusted cancer survival data.

    Science.gov (United States)

    Higashi, Takahiro; Nakamura, Fumiaki; Saruki, Nobuhiro; Takegami, Misa; Hosokawa, Takayo; Fukuhara, Shunichi; Nakayama, Takeo; Sobue, Tomotaka

    2013-01-01

    The Japanese Association of Clinical Cancer Centers recently published the unadjusted 5-year survival rates of patients receiving care at each facility. A primary concern is that the media may cover this topic differently than originally intended. We examined all 13 newspaper articles that addressed the topic to assess their coverage of the public reporting program's key points, which were identified through interviews with the leader of the program. On average, 4.5 of the 10 key points identified were at least superficially covered. Although most articles mentioned the incomparability of the unadjusted data, eight created comparative tables that listed the survival data across facilities and seven sorted the facilities in descending order of survival. Four articles provided potentially misleading descriptions about the use of the relative survival. We concluded that caution is required because newspaper reports may convey potentially contradicting messages and technical details may be described inaccurately.

  13. Thriving or just surviving? Exploring student strategies for a smoother transition to university. A Practice Report

    Directory of Open Access Journals (Sweden)

    Amanda Richardson

    2012-08-01

    Full Text Available The first year of university study is one of the greatest transition periods in a student’s life. It is a time where they have to learn new academic skills as well as new social and independent living skills.  For many students, the struggle to balance the competing demands of study, work and personal commitments feels overwhelming and they report significant declines in their overall health and well-being.  However, some students appear to thrive in this new learning environment.  This presentation reports on the findings of a research project investigating the health and well-being of first year students in Australia.  It compares the experiences and coping strategies of “thriving” students with those who describe themselves as “just surviving.”  Forming close social relationships with peers, having good time management and organisational skills, together with effective coping strategies enable students to transition more successfully into university life.

  14. Sosiaalisen median toimintasuunnitelma, case Guild Travel Ltd

    OpenAIRE

    Vanhanen, Anni

    2014-01-01

    Tämän työn tarkoituksena on luoda käyttökelpoinen sosiaalisen median markkinointi-suunnitelma lontoolaiselle matkatoimistolle, joka myy matkoja Suomeen. Työn toimek-siantaja on Guild Travel Ltd. Työ toteutettiin vuoden 2014 keväällä. Työssä esitellään toimeksiantaja matkailualan toimijana ja perehdytään markkinoinnin teoriaan. Käsittelyssä ovat useat eri markkinoinnin teoriat, kuten SOSTAC, SMART ja marketing mix. Näitä malleja hyödyntäen luodaan yrityksen sosiaalisen median toimin-tasuun...

  15. Sosiaalisen median merkitys asiakkaan ravintolan valinnalle

    OpenAIRE

    Virtanen, Tessa

    2014-01-01

    Tässä opinnäytetyössä tutkittiin sosiaalisen median merkitystä asiakkaan ravintolan valintaan. Opinnäytetyön toimeksiantajana oli HOK-Elanto. Opinnäytetyön tarkoituksena oli tuottaa tietoa ja ymmärrystä HOK-Elannolle sosiaalisen median vaikutuksesta asiakkaan ravintolapäätöksen tekoon HOK-Elannon ravintoloissa Opinnäytetyön tavoitteena oli selvittää, millainen ja kuinka suuri merkitys on sosiaalisella medialla ja sen erilaisilla yhteisöillä asiakkaan ostopäätökseen eli käyntiin HOK-Elanno...

  16. Smolt Monitoring Program, Part I, Estimation of Survival, 1985 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Fish Passage Center

    1986-02-01

    The annual Smolt Monitoring Program is the result of implementation of Section 304(d)(2) of the Northwest Power Planning Council Fish and Wildlife Program. Survival was monitored for specific marked groups of steelhead and spring chinook. Survival through the mid-Columbia from Winthrop Hatchery and the Methow River to below Priest Rapids Dam was estimated. Estimation of survival of marked groups of steelhead from Little Goose Dam to below Ice Harbor Dam was attempted. Serious problems were evident in the Snake River survival data. A release strategy which avoids holding of control groups was tested with satisfactory results.

  17. The Surviving Crying study: progress report for the first stage of research.

    Science.gov (United States)

    St James-Roberts, Ian

    2016-03-01

    The term 'infant colic' has been used to refer both to 'prolonged' infant crying (a measure of crying) and to parents'concern thatexcessive'crying is a sign that something is wrong with their baby. There is growing evidence that the terms need to be distinguished, so that the traditional focus on the crying is balanced by an equal focus on the impact of the crying on parents. The Surviving Crying study is a first step towards developing and evaluating routine NHS services to support parents who are worried about their baby's excessive crying. This report summarises the study's overall aims and methods and describes the first stage, designed to develop this parental support package. The package comprises a website, printed materials for parents who do not use the internet and a CBT-based programme manual for delivering direct one-to-one or small-group support sessions to parents. Stage two of the study, designed to provide an initial evaluation of the package and its suitability for use in the NHS, is underway. An email address exists for practitioners and researchers who wish to be kept informed.

  18. Avalanche Survival After Rescue With the RECCO Rescue System: A Case Report.

    Science.gov (United States)

    Grasegger, Katharina; Strapazzon, Giacomo; Procter, Emily; Brugger, Hermann; Soteras, Inigo

    2016-06-01

    We report a case of survival of a completely buried avalanche victim after being located with the radar-based RECCO Rescue System. In the winter of 2015, 2 off-piste skiers were completely buried in an avalanche near the secured ski area in Baqueira Beret, Spain. The first victim was located with the RECCO Rescue System in less than 35 minutes and was alive and conscious at extrication. This system emits radio waves and requires a specific reflector. It is a portable device that is used by more than 600 rescue organizations worldwide, especially in secured ski areas. The device should be brought to the avalanche site together with electronic avalanche transceivers, a probing team, and avalanche dogs. In the hands of experienced professionals, the device may allow rapid location of victims not carrying an electronic avalanche transceiver. Although it is not the first successful extrication of a victim with the RECCO Rescue System, it is the first case published in the medical literature and is intended to encourage data collection and to increase our understanding of the effectiveness of this device in avalanche rescue.

  19. Survival Estimates for the Passage of Juvenile Salmonids through Snake River Dams and Reservoirs, 1997 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Hockersmith, Eric E.

    1999-03-01

    This report consists of two parts describing research activities completed during 1997 under Bonneville Power Administration Project Number 93-29. Part 1 provides reach survival and travel time estimates for 1997 for PIT-tagged hatchery steelhead and yearling chinook salmon in the Snake and Columbia Rivers. The results are reported primarily in the form of tables and figures with a minimum of text. More detailed information on methodology and the statistical models used in the analysis are provided in previous annual reports cited in the text. Analysis of the relationships among travel time, survival, and environmental factors for 1997 and previous years of the study will be reported elsewhere. Part 2 of this report describes research to determine areas of loss and delay for juvenile hatchery salmonids above Lower Granite Reservoir.

  20. Differences in characteristics between people with lower limb amputations who died before 12 weeks and those who survived: Short Report

    Directory of Open Access Journals (Sweden)

    L. Godlwana

    2011-02-01

    Full Text Available The baseline determinants of survival following a non-traumatic lower limb amputation (LLA in participants in the Johannesburg metropolitan area are unknown.The aim of the study was to establish the characteristics of participants who had died by three months after LLAA longitudinal pre- test- post test study utilized participant interviews (n=73.  Consecutive  sampling  was  used  to  select  participants  who  met  the  inclusion criteria. Ethical clearance was obtained. Permission was obtained from the hospitals. Participants gave consent before taking part in the study. A demographic questionnaire, the EQ-5D, the Modified Household Economic and Social Status Index (HESSI and the Barthel Index (BI were used, to collect data. Participants  were  interviewed  preoperatively  and  then  followed  up  three  months  post-operatively  to  establish survival/ existence. Twenty-four  participants  (33%  had  died.  The  preoperative  median  Visual  Analogue  Scale  (VAS  of  the  EQ-5D was 60 and 70 showing no significant difference in quality of life (QOL between those who survived and those who  died  respectively.  The  preoperative  median  total  BI  score  was  20  and  19  showing  significantly  inferior  function for the deceased (p=0.01. The deceased were significantly older (p=0.009 used alcohol (p=0.02 and smoked tobacco (p=0.03.Being older, having poorer function, being a smoker and drinking alcohol preoperatively seem to decrease the chance of survival following LLA in Johannesburg.

  1. Median Citation Index vs Journal Impact Factor

    Science.gov (United States)

    Antonoyiannakis, Manolis

    2015-03-01

    The Journal Impact Factor is an arithmetic mean: It is the average number of citations, in a year, to a journal's articles that were published the previous two years. But for the vast majority of scholarly journals, the distribution of these citations is skewed (non-symmetric). We argue that a more representative member of the skewed distribution of citations is its median, not the mean. We thus introduce the Median Citation Index (MCI) and compare it to the journal Impact Factor (JIF) as a potentially more suitable choice of the ``center'' of the distribution, or its typical value. Unlike the JIF, the MCI is far less sensitive to outlier (very highly cited) papers or to gaming, and does not lend itself to the hype of calculating it to three decimal digits.

  2. Median sternotomy closure: review and update research

    Institute of Scientific and Technical Information of China (English)

    Hua Kun; Yang Xiubin

    2009-01-01

    Cardiac surgery is a very common operation nowadays all over the world. Median stemotomy is a routine procedure required for cardiac access during open heart surgery. The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases, and bear a high mortality rate if they occur. Every individual surgeon must pay great attention on every detail during the sternal closure. This article shows the details as to conventional information and updated progress on median sternotomy closure. The update contents involve in biomechanics, number of wires twists, biomaterial and so on.According to our experience, we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.

  3. Association between time to disease progression end points and overall survival in patients with neuroendocrine tumors

    Directory of Open Access Journals (Sweden)

    Singh S

    2014-08-01

    Full Text Available Simron Singh,1 Xufang Wang,2 Calvin HL Law1 1Sunnybrook Odette Cancer Center, University of Toronto, Toronto, ON, Canada; 2Novartis Oncology, Florham Park, NJ, USA Abstract: Overall survival can be difficult to determine for slowly progressing malignancies, such as neuroendocrine tumors. We investigated whether time to disease progression is positively associated with overall survival in patients with such tumors. A literature review identified 22 clinical trials in patients with neuroendocrine tumors that reported survival probabilities for both time to disease progression (progression-free survival and time to progression and overall survival. Associations between median time to disease progression and median overall survival and between treatment effects on time to disease progression and treatment effects on overall survival were analyzed using weighted least-squares regression. Median time to disease progression was significantly associated with median overall survival (coefficient 0.595; P=0.022. In the seven randomized studies identified, the risk reduction for time to disease progression was positively associated with the risk reduction for overall survival (coefficient on −ln[HR] 0.151; 95% confidence interval −0.843, 1.145; P=0.713. The significant association between median time to disease progression and median overall survival supports the assertion that time to disease progression is an alternative end point to overall survival in patients with neuroendocrine tumors. An apparent albeit not significant trend correlates treatment effects on time to disease progression and treatment effects on overall survival. Informal surveys of physicians’ perceptions are consistent with these concepts, although additional randomized trials are needed. Keywords: neuroendocrine tumors, progression-free survival, disease progression, mortality

  4. COLOUR IMAGE STEGANOGRAPHY USING MEDIAN MAINTENANCE

    Directory of Open Access Journals (Sweden)

    S. Arivazhagan

    2011-08-01

    Full Text Available Steganographic algorithms in the recent past have been producing stego images with perceptual invisibility, better secrecy and certain robustness against attacks like cropping, filtering etc. Recovering a good quality secret from a good quality stego image may not always be possible. The method proposed in this paper works in transform domain and attempts to extract the secret almost as same as the embedded one maintaining minimal changes to the cover image by using techniques like median maintenance, offset and quantization.

  5. Shoulder posture and median nerve sliding

    Directory of Open Access Journals (Sweden)

    Dilley Andrew

    2004-07-01

    Full Text Available Abstract Background Patients with upper limb pain often have a slumped sitting position and poor shoulder posture. Pain could be due to poor posture causing mechanical changes (stretch; local pressure that in turn affect the function of major limb nerves (e.g. median nerve. This study examines (1 whether the individual components of slumped sitting (forward head position, trunk flexion and shoulder protraction cause median nerve stretch and (2 whether shoulder protraction restricts normal nerve movements. Methods Longitudinal nerve movement was measured using frame-by-frame cross-correlation analysis from high frequency ultrasound images during individual components of slumped sitting. The effects of protraction on nerve movement through the shoulder region were investigated by examining nerve movement in the arm in response to contralateral neck side flexion. Results Neither moving the head forward or trunk flexion caused significant movement of the median nerve. In contrast, 4.3 mm of movement, adding 0.7% strain, occurred in the forearm during shoulder protraction. A delay in movement at the start of protraction and straightening of the nerve trunk provided evidence of unloading with the shoulder flexed and elbow extended and the scapulothoracic joint in neutral. There was a 60% reduction in nerve movement in the arm during contralateral neck side flexion when the shoulder was protracted compared to scapulothoracic neutral. Conclusion Slumped sitting is unlikely to increase nerve strain sufficient to cause changes to nerve function. However, shoulder protraction may place the median nerve at risk of injury, since nerve movement is reduced through the shoulder region when the shoulder is protracted and other joints are moved. Both altered nerve dynamics in response to moving other joints and local changes to blood supply may adversely affect nerve function and increase the risk of developing upper quadrant pain.

  6. Iatrogenic selective lesion of the median nerve at the elbow.

    Science.gov (United States)

    Di Fabio, Roberto; Casali, Carlo; Pierelli, Francesco

    2010-03-01

    A lesion of the median nerve may occur as a consequence of a compression by a haematoma or for a direct damage of the axons caused by a needle insertion. To date, no investigation reported a very selective lesion of the median nerve at the elbow, with the suffering limited only to the fibres for the first digit. A 53 year-old left-handed violinist underwent an arterial blood gas drawing. The patient complained immediately of an electrical shock impression going down the arm, followed by pin sensation into the first finger. A tingling sensation associated with numbness in the first fingertip and difficulty in the index-thumb pinch became progressively evident. The ENG-EMG findings showed an impairment mainly of the sensory fibres innervating the first digit and a drop of the motor action potential amplitude when the nerve was stimulated at the elbow. We reported a very partial lesion of the left median nerve at the elbow in a violinist who had a selective involvement of the fibres for his first digit. Even minimal lesions of the median nerve may impair severely the quality of life of patients.

  7. Portfolio optimization using median-variance approach

    Science.gov (United States)

    Wan Mohd, Wan Rosanisah; Mohamad, Daud; Mohamed, Zulkifli

    2013-04-01

    Optimization models have been applied in many decision-making problems particularly in portfolio selection. Since the introduction of Markowitz's theory of portfolio selection, various approaches based on mathematical programming have been introduced such as mean-variance, mean-absolute deviation, mean-variance-skewness and conditional value-at-risk (CVaR) mainly to maximize return and minimize risk. However most of the approaches assume that the distribution of data is normal and this is not generally true. As an alternative, in this paper, we employ the median-variance approach to improve the portfolio optimization. This approach has successfully catered both types of normal and non-normal distribution of data. With this actual representation, we analyze and compare the rate of return and risk between the mean-variance and the median-variance based portfolio which consist of 30 stocks from Bursa Malaysia. The results in this study show that the median-variance approach is capable to produce a lower risk for each return earning as compared to the mean-variance approach.

  8. Wildlife Inquiry through Zoo Education (WIZE) Module II: Survival Strategies. Dissemination Project Evaluation Report 1995-96.

    Science.gov (United States)

    Mei, Dolores M.

    This report is a dissemination project evaluation of the Wildlife Inquiry through Zoo Education (WIZE) program, a well-known life science program for grades seven through ten that takes a non-traditional, multi-disciplinary approach to learning. The program content focuses on population ecology, wildlife conservation, and species survival. Chapter…

  9. Long-term survival after resection of a primary leiomyosarcoma of the innominate vein Report of a case.

    Science.gov (United States)

    Illuminati, Giulio; Miraldi, Fabio; A Pacilè, Maria; Palumbo, Piero; Vietri, Francesco

    2012-10-29

    Leiomyosarcoma of the innominate vein is a rare but usually lethal disease. We report the case of a 50-year-old woman, undergoing a curative resection of the tumor. She is alive and free of disease at 88-month follow-up. Surgical excision remains the current optimal treatment able to provide a chance of cure. KEY WORDS: Late survival, Venous leiomyosarcoma.

  10. Progress report -- February 1983 : Migration and survival of MVP Canada geese

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The objectives of this study were (1) to document the variation in numbers, movements, harvest, and survival of MVP Canada geese and (2) to relate variation in these...

  11. Survival and migration ecology of emperor geese along the Alaska Peninsula, progress report, March 1990

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Survival and migratory patterns of emperor geese (Chen canagica) were investigated during 1988-89 by marking flightless geese with neck collars and reobserving them...

  12. Correlation of Biological Characteristics of Smolts with Survival and Travel Time, 1987 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Rondorf, Dennis W.; Beeman, John W.; Free, Mary E. (Seattle National Fishery Research Center, Columbia River Field Station, Cook, WA)

    1988-06-01

    The biological characteristics of smolts were examined to determine their effect on estimates of survival in the Columbia and Snake rivers. Freeze branded groups of steelhead trout (Salmo gairdneri) from Lyons Ferry State Fish Hatchery (SFH) and Wells SFH and spring chinook salmon (Oncorhynchus tshawytscha) from Winthrop National Fish Hatchery (NFH) were used to estimate survival. Past estimates of survival, using a ratio of test and control fish recaptured at McNary Dam, have resulted in estimates > 100%, presumably due to some unknown bias. Study objectives were to determine if stress and descaling, degree of smoltification, and prevalence of bacterial kidney disease (BKD) differed among test and control groups of fish, thereby biasing survival estimates. 19 refs., 20 figs., 10 tabs.

  13. Evaluation of Juvenile Salmonid Outmigration and Survival in the Lower Umatilla River Basin, Annual Report 1999-2000.

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, Suzanne M.; Carmichael, Richard W.; Ehlers, Danette L.

    2002-04-01

    This is the sixth annual report of a multi-year project that monitors the outmigration and survival of hatchery and natural juvenile salmonids in the lower Umatilla River. This project supplements and complements ongoing or completed fisheries projects in the Umatilla River basin. Knowledge gained on outmigration and survival assists researchers and managers in adapting hatchery practices, flow enhancement strategies, canal and fish ladder operations, and supplementation and enhancement efforts for natural and restored fish populations. Findings from this study also measure the success of upriver habitat improvement projects and provide an overall evaluation of the Umatilla River fisheries restoration program.

  14. Medians and means in Finsler geometry

    CERN Document Server

    Arnaudon, Marc

    2010-01-01

    We investigate existence and uniqueness of p-means and the median of a probability measure on a Finsler manifold, in relation with the convexity of the support of the measure. We prove that the p-mean is the limit point of a continuous time gradient flow. Under some additional condition which is always satisfied for larger than or equal to 2, a discretization of this path converges to the p-mean. This provides an algorithm for determining those Finsler center points.

  15. Evaluation of Juvenile Salmonid Outmigration and Survival in the Lower Umatilla River Basin, Annual Report 2003-2006.

    Energy Technology Data Exchange (ETDEWEB)

    White, Tara

    2007-02-01

    This report summarizes activities conducted by the Oregon Department of Fish and Wildlife's Juvenile Outmigration and Survival M&E project in the Umatilla River subbasin between 2004-2006. Information is used to make informed decisions on hatchery effectiveness, natural production success, passage improvement and flow enhancement strategies. Data collected includes annual estimates of smolt abundance, migration timing, and survival, life history characteristics and productivity status and trends for spring and fall Chinook salmon, coho salmon and summer steelhead. Productivity data provided is the key subbasin scale measure of the effectiveness of salmon and steelhead restoration actions in the Umatilla River. Information is also used for regional planning and recovery efforts of Mid-Columbia River (MCR) ESA-listed summer steelhead. Monitoring is conducted via smolt trapping and PIT-tag interrogation at Three Mile Falls Dam. The Umatilla Juvenile Outmigration and Survival Project was established in 1994 to evaluate the success of management actions and fisheries restoration efforts in the Umatilla River Basin. Project objectives for the 2004-2006 period were to: (1) operate the PIT tag detection system at Three Mile Falls Dam (TMFD), (2) enhance provisional PIT-tag interrogation equipment at the east bank adult fish ladder, (3) monitor the migration timing, abundance and survival of naturally-produced juvenile salmonids and trends in natural production, (4) determine migration parameters and survival of hatchery-produced fish representing various rearing, acclimation and release strategies, (5) evaluate the relative survival between transported and non-transported fish, (6) monitor juvenile life history characteristics and evaluate trends over time, (7) investigate the effects of river, canal, fishway operations and environmental conditions on smolt migration and survival, (8) document the temporal distribution and diversity of resident fish species, and (9

  16. Robust non-local median filter

    Science.gov (United States)

    Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

    2017-04-01

    This paper describes a novel image filter with superior performance on detail-preserving removal of random-valued impulse noise superimposed on natural gray-scale images. The non-local means filter is in the limelight as a way of Gaussian noise removal with superior performance on detail preservation. By referring the fundamental concept of the non-local means, we had proposed a non-local median filter as a specialized way for random-valued impulse noise removal so far. In the non-local processing, the output of a filter is calculated from pixels in blocks which are similar to the block centered at a pixel of interest. As a result, aggressive noise removal is conducted without destroying the detailed structures in an original image. However, the performance of non-local processing decreases enormously in the case of high noise occurrence probability. A cause of this problem is that the superimposed noise disturbs accurate calculation of the similarity between the blocks. To cope with this problem, we propose an improved non-local median filter which is robust to the high level of corruption by introducing a new similarity measure considering possibility of being the original signal. The effectiveness and validity of the proposed method are verified in a series of experiments using natural gray-scale images.

  17. Inference with the Median of a Prior

    Directory of Open Access Journals (Sweden)

    Ali Mohammad-Djafari

    2006-06-01

    Full Text Available We consider the problem of inference on one of the two parameters of a probability distribution when we have some prior information on a nuisance parameter. When a prior probability distribution on this nuisance parameter is given, the marginal distribution is the classical tool to account for it. If the prior distribution is not given, but we have partial knowledge such as a fixed number of moments, we can use the maximum entropy principle to assign a prior law and thus go back to the previous case. In this work, we consider the case where we only know the median of the prior and propose a new tool for this case. This new inference tool looks like a marginal distribution. It is obtained by first remarking that the marginal distribution can be considered as the mean value of the original distribution with respect to the prior probability law of the nuisance parameter, and then, by using the median in place of the mean.

  18. Sequential Metastatic Breast Cancer Chemotherapy:Should the Median be the Message?

    Directory of Open Access Journals (Sweden)

    Su Yon eJung

    2013-11-01

    Full Text Available Background: Counseling and anticipatory guidance of the expected course of treatment for women newly diagnosed with metastatic breast cancer (MBC are difficult due to multiple factors influencing survival following metastatic breast cancer therapy. In order to better tailor counseling at the onset and through the duration of metastatic breast cancer we used non-clinical trial data to better characterize real life experience of sequential metastatic breast cancer treatment. We examined the following aims:1. What demographic and tumor characteristics are predictive of survival in metastatic breast cancer?2. What is the median duration of each sequential chemotherapy regimen and subsequent survival of women following each sequence of chemotherapy regimen in metastatic breast cancer?Methods: Retrospective study included 792 women diagnosed from January 1999 through December 2009 at the University of Pittsburgh Cancer Institute Breast Cancer Program.Results: Median duration of sequential chemotherapy regimen and median survival from completion of sequence of chemotherapy regimens were relatively short with a wide range of treatment duration and survival. Characteristics for poor survival included hormone status, human epidermal growth factor receptor-2 (HER 2/neu status, and increased number and type of metastatic sites. Women who took more than the second sequential chemotherapy regimens had no more than median 3 months of treatment duration and 6 months survival from treatment termination.Discussion: Median clinical response and survival shorten with sequential chemotherapy regimen but with wide ranges. The rare clinical response of the minority should not set the standard for treatment expectations. All cancer clinicians, including oncology nurses, must ensure that patients are receiving tailored counseling regarding their specific risks and benefits for sequential metastatic breast cancer chemotherapy.

  19. The impact of under-reporting of cases on the estimates of childhood cancer incidence and survival in Estonia.

    Science.gov (United States)

    Paapsi, Keiu; Mägi, Margit; Mikkel, Sirje; Saks, Kadri; Aareleid, Tiiu; Innos, Kaire

    2017-06-09

    About 35 new childhood cancer cases are diagnosed in Estonia (population 1.3 million in 2011) every year. Despite continuous improvements in the healthcare system and available cancer treatment options, the survival rates for childhood cancers have appeared to remain lower than the European average. These observations and the accompanying decrease in incidence led us to hypothesize that some nonfatal cases might be missing from the Estonian Cancer Registry (ECR). The aim of this study was to evaluate the completeness of reporting of childhood cancer cases to the ECR and its impact on the estimates of cancer incidence and survival. All cases of benign and malignant tumours, diagnosed in 2000-2011 among children aged 0-17 years and eligible for registration in the ECR, were included in the study. Completeness of reporting was evaluated for cases aged 0-17 years, and incidence and survival were analysed for cases aged 0-14 for international comparisons. The total number of new cancer cases increased from 459 to 515. Overall completeness of case ascertainment was estimated to be 89.5%. After adding the missing cases, the overall incidence rate increased from 12.9 to 14.9/100 000 (from 3.4 to 4.7 for leukaemias). The 2010-2014 period estimate of the 5-year survival increased from 70 to 76% for all sites combined and from 71 to 82% for leukaemias. In conclusion, the under-reporting of nonfatal childhood cancer cases to the ECR had an important impact on incidence and survival rates, causing a considerable underestimation of both.

  20. Improved Survival from Ovarian Cancer in Patients Treated in Phase III Trial Active Cancer Centres in the UK.

    Science.gov (United States)

    Khoja, L; Nolan, K; Mekki, R; Milani, A; Mescallado, N; Ashcroft, L; Hasan, J; Edmondson, R; Winter-Roach, B; Kitchener, H C; Mould, T; Hutson, R; Hall, G; Clamp, A R; Perren, T; Ledermann, J; Jayson, G C

    2016-12-01

    Ovarian cancer is the principal cause of gynaecological cancer death in developed countries, yet overall survival in the UK has been reported as being inferior to that in some Western countries. As there is a range of survival across the UK we hypothesised that in major regional centres, outcomes are equivalent to the best internationally. Data from patients treated in multicentre international and UK-based trials were obtained from three regional cancer centres in the UK; Manchester, University College London and Leeds (MUL). The median progression-free survival (PFS) and overall survival were calculated for each trial and compared with the published trial data. Normalised median survival values and the respective 95% confidence intervals (ratio of pooled MUL data to trial median survival) were calculated to allow inter-trial survival comparisons. This strategy then allowed a comparison of median survival across the UK, in three regional UK centres and in international centres. The analysis showed that the trial-reported PFS was the same in the UK, in the MUL centres and in international centres for each of the trials included in the study. Overall survival was, however, 45% better in major regional centre-treated patients (95% confidence interval 9-73%) than the median overall survival reported in UK trials, whereas the median overall survival in MUL centres equated with that achieved in international centres. The data suggest that international survival statistics are achieved in UK regional cancer centres. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Robust Mediation Analysis Based on Median Regression

    Science.gov (United States)

    Yuan, Ying; MacKinnon, David P.

    2014-01-01

    Mediation analysis has many applications in psychology and the social sciences. The most prevalent methods typically assume that the error distribution is normal and homoscedastic. However, this assumption may rarely be met in practice, which can affect the validity of the mediation analysis. To address this problem, we propose robust mediation analysis based on median regression. Our approach is robust to various departures from the assumption of homoscedasticity and normality, including heavy-tailed, skewed, contaminated, and heteroscedastic distributions. Simulation studies show that under these circumstances, the proposed method is more efficient and powerful than standard mediation analysis. We further extend the proposed robust method to multilevel mediation analysis, and demonstrate through simulation studies that the new approach outperforms the standard multilevel mediation analysis. We illustrate the proposed method using data from a program designed to increase reemployment and enhance mental health of job seekers. PMID:24079925

  2. Ultra Low-Power Analog Median Filters

    Directory of Open Access Journals (Sweden)

    A. Diaz-Sanchez

    2013-09-01

    Full Text Available The design and implementation of three analog median filter topologies, whose transistors operate in the deep weak-inversion region, is described. The first topology is a differential pairs array, in which drain currents are driven into two nodes in a differential fashion, while the second topology is based on a wide range OTA, which is used to maximize the dynamic range. Finally, the third topology uses three range-extended OTAs. The proposed weak-inversion filters were designed and fabricated in ON Semiconductor 0.5 micrometer technology through MOSIS. Experimental results of three-input fabricated prototypes for all three topologies are show, where power consumptions of 90nW in the first case, and 270nW in the other two cases can be noticed. A dual power supply +/-1.5 Volts were used.

  3. Longevity and Patau syndrome: what determines survival?

    OpenAIRE

    Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

    2012-01-01

    The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7–10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity.

  4. Longevity and Patau syndrome: what determines survival?

    Science.gov (United States)

    Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

    2012-01-01

    The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7–10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity. PMID:23220825

  5. Longevity and Patau syndrome: what determines survival?

    OpenAIRE

    Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

    2012-01-01

    The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7–10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity.

  6. Social Security: a financial appraisal for the median voter.

    Science.gov (United States)

    Galasso, V

    Several explanations have been proposed for why voters continue to support unfunded social security systems. Browning (1975) suggests that the extremely large unfunded pension systems of most democracies depend on the existence of a voting majority composed of middle-aged and older people who fail to fully internalize the cost of financing the system. In fact, when voting, economically rational workers consider only their current and future contributions to the system and their expected pension benefits--not their past contributions, which they regard as sunk costs. If, for a majority of voters, the expected continuation return from social security exceeds the return from alternative assets, an unfunded social security system is politically sustainable. This article explores the validity of Browning's proposition by quantifying the returns that U.S. voters in presidential elections from 1964 to 1996 have obtained, or expect to obtain, from Social Security. Did "investments" in Social Security outperform alternative forms of investment, such as mutual funds or pension funds, for a majority of the voters? What can be expected for the future? The U.S. Social Security system redistributes income within age cohorts on the basis of sex, income, and marital status. To account for some of these features, the median voter is represented by a family unit whose members--a husband who accounts for 70 percent of household earnings and a wife who accounts for 30 percent--make joint economic and voting decisions. Thus, retirement and survival benefits paid out to the spouse of an insured worker can be included in the calculation of Social Security returns. Interval estimates of voters' family incomes from the U.S. Census Bureau were used to obtain the median voter's household earnings. The median voter's age is derived from the ages of those who voted in presidential elections, not from the ages of the entire electorate. The median voter's contributions to Social Security are the

  7. Survival and Passage of Yearling Chinook Salmon and Steelhead at The Dalles Dam, Spring 2011 - FINAL REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Gary E.; Hennen, Matthew J.; Zimmerman, Shon A.; Batten, G.; Carpenter, Scott M.; Deng, Zhiqun; Fu, Tao; Hughes, James S.; Martinez, Jayson J.; Ploskey, Gene R.; Royer, Ida M.; Townsend, Richard L.; Woodley, Christa M.; Kim, Jeongkwon; Etherington, D. J.; Skalski, J. R.; Carlson, Thomas J.; Cushing, Aaron W.; Fisher, Erik J.; Greiner, Michael J.; Khan, Fenton; Mitchell, T. D.; Rayamajhi, Bishes; Seaburg, Adam; Weiland, Mark A.

    2012-10-01

    The study reported herein was conducted by the Pacific Northwest National Laboratory (PNNL) and the University of Washington (UW) for the U.S. Army Corps of Engineers, Portland District (USACE). The PNNL and UW project managers were Drs. Thomas J. Carlson and John R. Skalski, respectively. The USACE technical lead was Mr. Brad Eppard. The study was designed to estimate dam passage survival and other performance measures at The Dalles Dam as stipulated by the 2008 Federal Columbia River Power System Biological Opinion (BiOp) and the 2008 Columbia Basin Fish Accords. The study is being documented in two types of reports: compliance and technical. A compliance report is delivered within 6 months of the completion of the field season and focuses on results of the performance metrics outlined in the 2008 BiOp and Fish Accords. A technical report is produced within the 18 months after field work, providing comprehensive documentation of a given study and results on route-specific survival estimates and fish passage distributions, which are not included in compliance reports. This technical report concerns the 2011 acoustic telemetry study at The Dalles Dam.

  8. Development of Rations for the Enhanced Survival of Salmon, 1983-1984 Progress (Annual) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Crawford, David L.

    1985-04-01

    Hydroelectric development coupled with numerous other encroachments on the supply and quality of water has reduced the natural habitat for the spawning and rearing of salmon in the Columbia river system. Artificial production in hatcheries has become a critical link in the restoration of natural stocks of salmon. Released hatchery salmon must survive predation, be able to acquire sustainable nutrients under natural conditions, possess the vitality to surmount man-made impediments to seaward migration and adapt to a sea water environment. Survival of hatchery salmonids is dependent upon a number of factors. Time of release, natural food abundance, fish size and the health and/or quality of smolts all play synergistic roles. The nutritional and physical characteristics of ration regimes for hatchery fish plays a major role in determining the effectiveness of hatchery production and the health and/or quality of smolts.Ration regimes containing high quality components in uniform and fine-free pellet forms produce efficient growth response and minimize loss of nutrients maintaining the quality of hatchery water supply. Under such feed regimes, fish are less susceptible to disease and more uniform and desirable fish sizes can be achieved at release time. High quality smolts would help to optimize out-migration survival and successful adaptation to salt water.

  9. IgD multiple myeloma a descriptive report of 17 cases: survival and response to therapy

    Directory of Open Access Journals (Sweden)

    Pisani Francesco

    2012-03-01

    Full Text Available Abstract Background Immunoglobulin D multiple myeloma (MM is rare and has a poorer prognosis than other MM isotypes. Design and methods Seventeen patients (pts diagnosed from 1993 to 2009 with IgD MM were selected from six institutions of Multiple Myeloma Latium-Region GIMEMA Working Group. Results Median age was 55 years, 14 patients had bone lesions, eight had renal impairment with estimated glomerular filtration rate (eGFR Conclusions Despite the retrospective analysis and the small number of pts our study showed that the use of HDT/ASCT seems to improve also the prognosis of IgD MM patients. Treatment options including new drugs, before and after stem cell transplantation, may further improve the outcomes of these patients.

  10. Solitary median maxillary central incisor (SMMCI syndrome

    Directory of Open Access Journals (Sweden)

    Hall Roger K

    2006-04-01

    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  11. Long-term survival of full trisomy 13 in a 14 year old male: a case report.

    Science.gov (United States)

    Imataka, G; Hagisawa, S; Nitta, A; Hirabayashi, H; Suzumura, H; Arisaka, O

    2016-03-01

    Long term survival for the cases of trisomy 13 into over a first decade is very rare. We reported here the case of a 14-year-old male karyotype with full type of trisomy 13. In this clinical phenomenon, the case had typical facial, finger and limb anomalies for trisomy 13. Arterial septal defect and patent ductus arteriosus were recognized using ultrasonography after birth. Major cerebral malformation such as holoprosencephaly or cerebellar hypoplasia were also not revealed. After 5 months of his age, artificial ventilation therapy for dyspnea associated with laryngomalacia was required. A tracheotomy was performed at 6 months of his age. After 12 years old, intractable partial epilepsy was recognized. For his partial seizures, a treatment with a combination of two anti-epileptic drugs, valproic acid and levetiracetam, were advised. Now he is alive for 14-years-old and he is the 4th longest surviving patient with full karyotype of trisomy 13.

  12. Canada-USA Salmon Shelf Survival Study, 2007-2008 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Trudel, Marc; Tucker, Strahan; Morris, John

    2009-03-09

    Historically, salmon stocks from the Columbia River and Snake River formed one of the most valuable fisheries on the west coast of North America. However, salmon and steelhead returns sharply declined during the 1980s and 1990s to reach nearly 1 million fish. Although several factors may be responsible for the decline of Columbia River salmon and steelhead, there is increasing evidence that these drastic declines were primarily attributable to persistently unfavorable ocean conditions. Hence, an understanding of the effects of ocean conditions on salmon production is required to forecast the return of salmon to the Columbia River basin and to assess the efficacy of mitigation measures such as flow regulation on salmon resources in this system. The Canadian Program on High Seas Salmon has been collecting juvenile salmon and oceanographic data off the west coast of British Columbia and Southeast Alaska since 1998 to assess the effects of ocean conditions on the distribution, migration, growth, and survival of Pacific salmon. Here, we present a summary of the work conducted as part of the Canada-USA Salmon Shelf Survival Study during the 2008 fiscal year and compare these results with those obtained from previous years. The working hypothesis of this research is that fast growth enhances the marine survival of salmon, either because fast growing fish quickly reach a size that is sufficient to successfully avoid predators, or because they accumulate enough energy reserves to better survive their first winter at sea, a period generally considered critical in the life cycle of salmon. Sea surface temperature decreased from FY05 to FY08, whereas, the summer biomass of phytoplankton increased steadily off the west coast of Vancouver Island from FY05 to FY08. As in FY07, zooplankton biomass was generally above average off the west coast of Vancouver Island in FY08. Interestingly, phytoplankton and zooplankton biomass were higher in FY08 than was expected from the observed

  13. Ovarian germ cell tumors in children. Management, survival and ovarian prognosis. A report of 75 cases.

    Science.gov (United States)

    Vaysse, Charlotte; Delsol, Martine; Carfagna, Luana; Bouali, Ourdia; Combelles, Sophie; Lemasson, Frederique; Le Mandat, Aurélie; Castex, Marie-Pierre; Pasquet, Marlène; Moscovici, Jacques; Guitard, Jacques; Pienkowski, Catherine; Rubie, Hervé; Galinier, Philippe; Vaysse, Philippe

    2010-07-01

    The aims of this study were to evaluate survival and ovarian prognosis in patients treated for ovarian germ cell tumor (OGCT) and to propose a decision-making protocol. Charts of girls operated on for OGCT from 1976 up to 2009 were reviewed retrospectively. Tumor characteristics were assessed by tumor markers, imaging, and pathology. Charts were available in 71 children presenting 75 OGCT. Tumors were benign in 58 cases and malignant in 17 cases. The average of the largest diameter of benign OGCT was significantly lower than that of malignant OGCT (76.5 +/- 49 mm versus 169 +/- 54 mm, P < .0001). Ovarian-sparing tumorectomy was carried out in 27 benign OGCT; 23 (85%) preserved ovaries were follicular. Malignant OGCTs were managed according to the protocols of the French Society for Pediatric Oncology. Bilateral oophorectomy had to be performed in 2 children. One patient presented a recurrence and 1 died. In our series, both benign and malignant OGCTs have a good prognosis. A 75-mm cutoff size is proposed as an important criterion to preoperatively differentiate between benign and malignant tumors. In benign OGCT, ovarian-sparing tumorectomy leads to preserve ovaries in approximately 85% of cases, and in malignant OGCT, high survival rate has been obtained. Copyright 2010 Elsevier Inc. All rights reserved.

  14. Use of the Novel Therapeutic Agent Miltefosine for the Treatment of Primary Amebic Meningoencephalitis: Report of 1 Fatal and 1 Surviving Case.

    Science.gov (United States)

    Cope, Jennifer R; Conrad, Dennis A; Cohen, Naiomi; Cotilla, Manuel; DaSilva, Alexandre; Jackson, Jonathan; Visvesvara, Govinda S

    2016-03-15

    Primary amebic meningoencephalitis (PAM) is a fulminant central nervous system infection caused by the thermophilic free-living ameba Naegleria fowleri. Few survivals have been documented and adequate treatment is lacking. We report 2 PAM cases, 1 fatal and 1 surviving, treated with the novel antiparasitic agent miltefosine.

  15. Fall Chinook Salmon Survival and Supplementation Studies in the Snake River Reservoirs, 1996 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Williams, John G.; Bjornn (Bjomn), Theodore C.

    1998-05-01

    In 1996, the National Marine Fisheries Service, the Nez Perce Tribe, and the U.S. Fish and Wildlife Service completed the second year of cooperative research to investigate migrational characteristics of subyearling fall chinook salmon in the Snake River Basin. In spring and early summer, we captured natural subyearling fall chinook salmon by beach seine, PIT tagged them, and released them in two reaches of the Snake River. Also, subyearling fall chinook salmon reared at Lyons Ferry Hatchery were PIT tagged at the hatchery, transported, and released weekly at Pittsburg Landing on the Snake River and Big Canyon Creek on the Clearwater River to collect data on survival detection probabilities, and travel time.

  16. Canada-USA Salmon Shelf Survival Study, 2007-2008 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Trudel, Marc; Tucker, Strahan; Morris, John

    2009-03-09

    Historically, salmon stocks from the Columbia River and Snake River formed one of the most valuable fisheries on the west coast of North America. However, salmon and steelhead returns sharply declined during the 1980s and 1990s to reach nearly 1 million fish. Although several factors may be responsible for the decline of Columbia River salmon and steelhead, there is increasing evidence that these drastic declines were primarily attributable to persistently unfavorable ocean conditions. Hence, an understanding of the effects of ocean conditions on salmon production is required to forecast the return of salmon to the Columbia River basin and to assess the efficacy of mitigation measures such as flow regulation on salmon resources in this system. The Canadian Program on High Seas Salmon has been collecting juvenile salmon and oceanographic data off the west coast of British Columbia and Southeast Alaska since 1998 to assess the effects of ocean conditions on the distribution, migration, growth, and survival of Pacific salmon. Here, we present a summary of the work conducted as part of the Canada-USA Salmon Shelf Survival Study during the 2008 fiscal year and compare these results with those obtained from previous years. The working hypothesis of this research is that fast growth enhances the marine survival of salmon, either because fast growing fish quickly reach a size that is sufficient to successfully avoid predators, or because they accumulate enough energy reserves to better survive their first winter at sea, a period generally considered critical in the life cycle of salmon. Sea surface temperature decreased from FY05 to FY08, whereas, the summer biomass of phytoplankton increased steadily off the west coast of Vancouver Island from FY05 to FY08. As in FY07, zooplankton biomass was generally above average off the west coast of Vancouver Island in FY08. Interestingly, phytoplankton and zooplankton biomass were higher in FY08 than was expected from the observed

  17. Long-Term Survival after Gamma Knife Radiosurgery in a Case of Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sudheer R. Thumma

    2012-01-01

    Full Text Available The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8–12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide. The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8–12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity.

  18. Long-Term Survival after Gamma Knife Radiosurgery in a Case of Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

    Science.gov (United States)

    Thumma, Sudheer R.; Elaimy, Ameer L.; Daines, Nathan; Mackay, Alexander R.; Lamoreaux, Wayne T.; Fairbanks, Robert K.; Demakas, John J.; Cooke, Barton S.; Lee, Christopher M.

    2012-01-01

    The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8–12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8–12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity. PMID:22548078

  19. Survival, Smoking, Physical Activity, and Obesity - Life After Cancer Summary Table | Cancer Trends Progress Report

    Science.gov (United States)

    The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

  20. Electrodiagnostic Studies of Median and Ulnar Nerves in Cyclists.

    Science.gov (United States)

    Jackson, D L

    1989-09-01

    In brief: Twenty long-distance cyclists (13 men, 7 women) completed a questionnaire and underwent a neurologic examination and electrodiagnostic studies of the median and ulnar nerves. The purpose was to determine the frequency, severity, and clinical significance of numbness or pain in the hand or wrist and to assess the correlation of electrodiagnostic findings with these complaints. Results of the studies were normal for all 20 cyclists, nine of whom reported symptoms. These cyclists attributed their discomfort to prolonged riding without changing hand position, especially on rough road surfaces. They also reported that their symptoms diminished after they modified their cycling technique and adjusted their bicycle to better fit their body dimensions.

  1. Long-Time Survival of a Patient with Metastatic Pancreatic Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Željko Soldić

    2011-08-01

    Full Text Available Pancreatic cancer is a malignant neoplasm of the pancreas. It does not cause any symptoms in the early stage, and later symptoms are nonspecific, thus the disease is usually diagnosed when already advanced. In 2008, pancreatic cancer ranked eighth on the list of the 10 most common cancers among men in Croatia and tenth on the list of the most common cancers among Croatian women. Pancreatic cancer has a poor prognosis, with a survival time of only 6–8 months for metastatic disease. Gemcitabine is the standard chemotherapeutic option. Other chemotherapeutic agents include5-fluorouracil and leucovorin. In this paper, we present a case of a patient diagnosed with locally advanced and metastatic pancreatic cancer, who is still alive and currently receives his fourth line of chemotherapy 5 years after the diagnosis. Following disease progression on gemcitabine chemotherapy, he was treated with chemoradiotherapy which, however, had no effect. We then applied cisplatin monochemotherapy which offered excellent disease control, was well tolerated by the patient and, although somewhat obsolete in this form, showed to be a valuable chemotherapeutic option.

  2. Comparative Survival Study (CSS) of PIT-Tagged Spring/Summer Chinook and Summer Steelhead : 2008 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Comparative Survival Study Oversight Committee and Fish Passage Center

    2008-12-02

    The Comparative Survival Study (CSS; BPA Project 199602000) began in 1996 with the objective of establishing a long term dataset of the survival rate of annual generations of salmon from their outmigration as smolts to their return to freshwater as adults to spawn (smolt-to-adult return rate; SAR). The study was implemented with the express need to address the question whether collecting juvenile fish at dams and transporting them downstream in barges and trucks and releasing them downstream of Bonneville Dam was compensating for the effect of the Federal Columbia River Power System (FCRPS) on survival of Snake Basin spring/summer Chinook salmon migrating through the hydrosystem. The Completion of this annual report for the CSS signifies the 12th outmigration year of hatchery spring/summer Chinook salmon marked with Passive Integrated Transponder (PIT) tags as part of the CSS and the 9th complete brood year return as adults of those PIT-tagged fish (report covers adult returns from 1997-2006 hatchery Chinook juvenile migrations). In addition, the CSS has provided PIT-tags to on-going tagging operations for wild Chinook since 2002 (report covers adult returns from 1994-2006 wild Chinook juvenile migrations). The CSS tags wild steelhead on the lower Clearwater River and utilized wild and hatchery steelhead from other tagging operations in evaluations of transportation (report covers adult returns from 1997-2005 wild and hatchery steelhead migrations). The primary purpose of this report is to update the time series of smolt-to-adult survival rate data and related parameters with additional years of data since the completion of the CSS 10-yr retrospective analysis report (Schaller et al 2007). The 10-yr report provided a synthesis of the results from this ongoing study, the analytical approaches employed, and the evolving improvements incorporated into the study as reported in CSS annual progress reports. This current report specifically addresses the constructive

  3. Comparative Survival Study (CSS) of PIT-Tagged Spring/Summer Chinook and Summer Steelhead : 2008 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Comparative Survival Study Oversight Committee and Fish Passage Center

    2008-12-02

    The Comparative Survival Study (CSS; BPA Project 199602000) began in 1996 with the objective of establishing a long term dataset of the survival rate of annual generations of salmon from their outmigration as smolts to their return to freshwater as adults to spawn (smolt-to-adult return rate; SAR). The study was implemented with the express need to address the question whether collecting juvenile fish at dams and transporting them downstream in barges and trucks and releasing them downstream of Bonneville Dam was compensating for the effect of the Federal Columbia River Power System (FCRPS) on survival of Snake Basin spring/summer Chinook salmon migrating through the hydrosystem. The Completion of this annual report for the CSS signifies the 12th outmigration year of hatchery spring/summer Chinook salmon marked with Passive Integrated Transponder (PIT) tags as part of the CSS and the 9th complete brood year return as adults of those PIT-tagged fish (report covers adult returns from 1997-2006 hatchery Chinook juvenile migrations). In addition, the CSS has provided PIT-tags to on-going tagging operations for wild Chinook since 2002 (report covers adult returns from 1994-2006 wild Chinook juvenile migrations). The CSS tags wild steelhead on the lower Clearwater River and utilized wild and hatchery steelhead from other tagging operations in evaluations of transportation (report covers adult returns from 1997-2005 wild and hatchery steelhead migrations). The primary purpose of this report is to update the time series of smolt-to-adult survival rate data and related parameters with additional years of data since the completion of the CSS 10-yr retrospective analysis report (Schaller et al 2007). The 10-yr report provided a synthesis of the results from this ongoing study, the analytical approaches employed, and the evolving improvements incorporated into the study as reported in CSS annual progress reports. This current report specifically addresses the constructive

  4. Electrodiagnostic evaluation of median nerve conduction in Type II ...

    African Journals Online (AJOL)

    MJP

    2015-12-29

    Dec 29, 2015 ... them at high risk of developingdevastating hand and foot .... range in the case of parametric and non- parametric data ... The median value of median nerve velocities. (motor) with ... clinical approaches are, to a large extent,.

  5. Intraneural fibroma of the median nerve at the wrist.

    Science.gov (United States)

    Burrows, Anthony M; Folpe, Andrew L; Wenger, Doris E; Spinner, Robert J

    2014-06-01

    Distal median neuropathy from carpal tunnel syndrome is the most well known lesion affecting the median nerve. Mass lesions may affect the nerve at the wrist. We present to our knowledge the first histologically confirmed case of an intraneural fibroma.

  6. Survival Following Rectal Impalement through the Pelvic, Abdominal, and Thoracic Cavities: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Moncure

    2009-01-01

    Full Text Available Impalement injuries are a unique form of penetrating trauma and are typically associated with a fall onto the object (Steele, 2006. We present the case of a 45-year-old man who reportedly slipped in his bathtub and fell onto a broomstick. Radiographic examination revealed a slender mass extending from his rectum to the right side of his neck. A review of English literature suggests that this is the second reported case in the last 100 years describing the successful management of an impalement injury traversing the pelvic, abdominal, and thoracic cavities. The management of this case is described.

  7. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

    AMENT, W; BONGA, GJJ; HOF, AL; VERKERKE, GJ

    1993-01-01

    EMG median power frequency of the calf muscles was investigated during an exhausting treadmill exercise. This exercise was an uphill run, the average endurance time was 1.5 min. Median power frequency of the calf muscles declined by more than 10% during this exercise. In addition EMG median power fr

  8. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

    AMENT, W; BONGA, GJJ; HOF, AL; VERKERKE, GJ

    1993-01-01

    EMG median power frequency of the calf muscles was investigated during an exhausting treadmill exercise. This exercise was an uphill run, the average endurance time was 1.5 min. Median power frequency of the calf muscles declined by more than 10% during this exercise. In addition EMG median power fr

  9. An observational study: associations between nurse-reported hospital characteristics and estimated 30-day survival probabilities

    OpenAIRE

    Tvedt, Christine Raaen; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

    2014-01-01

    Background There is a growing body of evidence for associations between the work environment and patient outcomes. A good work environment may maximise healthcare workers’ efforts to avoid failures and to facilitate quality care that is focused on patient safety. Several studies use nurse-reported quality measures, but it is uncertain whether these outcomes are correlated with clinical outcomes. The aim of this study was to determine the correlations between hospital-aggregated, nurse-assesse...

  10. Survival Estimates for the Passage of Spring-Migrating Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2000 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Zabel, Richard; Smith, Steven G.; Muir, William D. (Northwest and Alaska Fisheries Science Center, Fish Ecology Division, Seattle, WA)

    2001-02-01

    In 2000, the National Marine Fisheries Service and the University of Washington completed the eight year of a study to estimate survival of juvenile salmonids (Oncorhynchus spp.) passing through dams and reservoirs on the Snake and Columbia Rivers. A total of 20,313 hatchery steelhead were tagged with passive integrated transpoder (PIT) tags and released at Lower Granite Dam for reach survival estimation. They did not PIT tag any yearlying chinook salmon (O. tshawytscha) for reach survival estimates in 2000 because sufficient numbers for these estimates were available from other studies. Primary research objectives in 2000 were (1) to estimate reach and project survival in the Snake and Columbia Rivers throughout the yearling chinook salmon and steelhead migrations, and (2) to evaluate the survival-estimation models under prevailing conditions. In addition, they estimated survival from point of release to Lower Granite Dam and below for chinook salmon, steelhead, and sockeye salmon (O.nerka) PIT tagged and released at Snake River basin hatcheries and chinook salmon and steelhead PIT tagged and released at Snake River basin hatcheries and chinook salmon and steelhead PIT tagged and released at Snake River basin smolt traps. This report provides reach survival and travel time estimates for 2000 for PIT-tagged yearling chinook salmon and steelhead (hatchery and wild) in the Snake and Columbia Rivers. Results are reported primarily in the form of tables and figures. Further details on methodology and statistical models used are provided in previous reports cited in the text.

  11. Translating Science into Survival: Report on the Inaugural International Cancer Immunotherapy Conference.

    Science.gov (United States)

    Hubbard-Lucey, Vanessa M; Tontonoz, Matthew J

    2016-01-01

    The inaugural International Cancer Immunotherapy Conference, cohosted by the Cancer Research Institute (CRI), the American Association for Cancer Research (AACR), the Association for Cancer Immunotherapy (CIMT), and the European Academy of Tumor Immunology (EATI), was held in New York City on September 16–19, 2015. The conference brought together nearly 1,400 scientists, clinicians, regulators, patient advocates, and other stakeholders to discuss the latest scientific developments in cancer immunology and immunotherapy, as well as the regulatory hurdles facing new drug development. This conference report summarizes the main themes that emerged during the 4-day meeting.

  12. Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: a rare case report.

    Science.gov (United States)

    Sood, A; Chauhan, S; Chandel, L; Jaryal, S C

    2014-01-01

    Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

  13. Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: A rare case report

    Directory of Open Access Journals (Sweden)

    A Sood

    2014-01-01

    Full Text Available Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water. Wet mount of cerebrospinal fluid (CSF revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

  14. Incidence and overall survival of malignant ameloblastoma.

    Directory of Open Access Journals (Sweden)

    Alexandra Rizzitelli

    Full Text Available Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma.Using the International Classification of Diseases for Oncology (ICD-O codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma.The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival.To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  15. Incidence and overall survival of malignant ameloblastoma.

    Science.gov (United States)

    Rizzitelli, Alexandra; Smoll, Nicolas R; Chae, Michael P; Rozen, Warren M; Hunter-Smith, David J

    2015-01-01

    Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER) database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma. Using the International Classification of Diseases for Oncology (ICD-O) codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma. The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival. To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  16. Pediatric spinal glioblastoma ofthe conus medullaris:a case report oflong survival

    Institute of Scientific and Technical Information of China (English)

    AntonellaCacchione; AngelaMastronuzzi; MariaGiuseppinaCefalo; GiovannaStefaniaColafati; FrancescaDiomediCamassei; MicheleRizzi; AlessandroDeBenedictis; AndreaCarai

    2016-01-01

    High‑grade gliomas of the spinal cord represent a rare entity in children. Their biology, behavior, and controversial treatment options have been discussed in a few pediatric cases. These tumors are associated with severe disability and poor prognosis. We report a case of a 4‑year‑old child diagnosed with an isolated glioblastoma multiforme of the conus medullaris. The patient underwent subtotal surgical excision, followed by adjuvant radiotherapy and oral chem‑otherapy. He is alive with mild neurologic deifcits at 52months after diagnosis. We describe the peculiar characteris‑tics of this rare condition in pediatric oncology. We also provide an overview of current multidisciplinary therapeutic approaches and prognostic factors for this disease.

  17. Annual Report to the Bonneville Power Administration, Reporting Period: April 2008 - February 2009 [re: "Survival and Growth in the Columbia River Plume and north California Current"].

    Energy Technology Data Exchange (ETDEWEB)

    Northwest Fisheries Science Center, NOAA Fisheries; Cooperative Institute for Marine Resources Studies, Oregon State University; OGI School of Science & Engineering, Oregon Health Sciences University.

    2009-07-17

    We have made substantial progress toward our objectives outlined in our BPA supported proposal entitled 'Columbia River Basin Juvenile Salmonids: Survival and Growth in the Columbia River Plume and northern California Current' which we report on herein. During 2008, we were able to successfully conduct 3 mesoscale cruises. We also were able to conduct 7 biweekly predator cruises, along with substantial shore-based visual observations of seabirds. Detailed results of the mesoscale cruises are available in the Cruise Reports and summarized in the next section. We have taken a proactive approach to getting the results of our research to fisheries managers and the general public. We have begun to make annual predictions based on ocean conditions of the relative survival of juvenile coho and Chinook salmon well before they return as adults. This is based on both biological and physical indicators that we measure during our surveys or collect from outside data sources. Examples of our predictions for 2009 and 2010 are available on the following web site: http://www.nwfsc.noaa.gov/research/divisions/fed/oeip/a-ecinhome.cfm.

  18. Atypical clinical presentation and long-term survival in a patient with optic nerve medulloepithelioma: a case report

    Directory of Open Access Journals (Sweden)

    Pastora-Salvador Natalia

    2012-05-01

    Full Text Available Abstract Introduction Medulloepithelioma is a rare congenital tumor of the primitive medullary neuroepithelium. A significant proportion of patients with medulloepithelioma arising from the optic nerve die from intracranial spread or cerebral metastasis. Because it has no known distinct clinical features and because of its low frequency, this tumor presents within the first two to six years of life and is usually misdiagnosed clinically as a different type of optic nerve tumor. Here, we describe a new and atypical case of medulloepithelioma of the optic nerve in a 12-year-old boy. To the best of our knowledge, he is the oldest reported patient to present with this disease and, now as an adult, has the longest documented period of disease-free survival. Case presentation A 12-year-old Caucasian boy with headache and unilateral amaurosis was referred for a presumed optic nerve glioma to our hospital. A computed tomography scan showed optic nerve enlargement, and fundoscopy showed a whitish mass at the optic disc. Our patient had been followed at his local hospital for four years for an 'optic disc cyst' with no change or progression. He experienced mild progressive visual impairment during that period. He was admitted for resection, and a histopathological analysis revealed a medulloepithelioma of the optic nerve. Supplemental orbital radiotherapy was performed. He remained disease-free for 25 years. Conclusions Medulloepithelioma of the optic nerve can clinically mimic more common pediatric tumors, such as optic glioma, meningioma, or retinoblastoma. Thus, medulloepithelioma should be included in the differential diagnoses of pediatric optic nerve lesions. Fundoscopy in these patients may provide relevant information for diagnosis. Anterior optic nerve medulloepitheliomas may behave differently from and have a better prognosis than medulloepitheliomas that have a more posterior location. Our case report illustrates that long-term survival can be

  19. Endocervical metastasis of pancreatic cancer: A rare case report of long-term survival

    Directory of Open Access Journals (Sweden)

    Yuichi Kinoshita

    2016-09-01

    Full Text Available Most uterine cervix adenocarcinomas are primary tumors. Here, we report a case of pancreatic cancer that metastasized to the uterine cervix. The patient was a 77-year-old Jehovah's Witness whose pancreatic cancer had been diagnosed 10 years previously. As she had refused blood transfusion on religious grounds, the tumor only underwent segmental excision, followed by radiofrequency wave therapy and chemotherapy. During a routine health examination 6 years after her pancreatic tumor resection, a tumor in the left lower lobe of her lung was found, and then removed. Three years after the lung surgery, her serum CA19-9 increased. A detailed examination found tumors in the ascending colon and uterine cervix. She underwent chemotherapy and radiotherapy after a right hemicolectomy, endocervical biopsy, and endocervical cytology. At present, about 10 years after her initial diagnosis, she is alive with no recurrence or metastatic findings. Morphologically, well-differentiated pancreatic adenocarcinoma is similar to endocervical type adenocarcinoma and adenocarcinoma in situ of the uterine cervix. Therefore, careful immunohistochemical examination and clear understanding of the patient's clinical information are needed in diagnosing adenocarcinoma in the uterine cervix.

  20. The Effects of Public Access Defibrillation on Survival After Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Bækgaard, Josefine; Viereck, Søren; Møller, Thea

    2017-01-01

    into three groups according to who applied the defibrillator: non-dispatched lay first responders, professional first responders (firefighters/police) dispatched by the Emergency Medical Dispatch Center (EMDC) or lay first responders dispatched by the EMDC. Results -A total of 41 studies were included; 18...... reported PAD by non-dispatched lay first responders, 20 reported PAD by EMDC-dispatched professional first responders (firefighters/police) and three reported both. We identified no qualified studies reporting survival after PAD by EMDC-dispatched lay first responders. The overall survival to hospital...... discharge after OHCA treated with PAD showed a median of 40.0% (range 9.1-83.3). Defibrillation by non-dispatched lay first responders was associated with the highest survival with a median of 53.0% (range 26.0-72.0) while defibrillation by EMDC-dispatched professional first responders (firefighters...

  1. Medians and means in Riemannian geometry: existence, uniqueness and computation

    CERN Document Server

    Arnaudon, Marc; Yang, Le

    2011-01-01

    This paper is a short summary of our recent work on the medians and means of probability measures in Riemannian manifolds. Firstly, the existence and uniqueness results of local medians are given. In order to compute medians in practical cases, we propose a subgradient algorithm and prove its convergence. After that, Fr\\'echet medians are considered. We prove their statistical consistency and give some quantitative estimations of their robustness with the aid of upper curvature bounds. We also show that, in compact Riemannian manifolds, the Fr\\'echet medians of generic data points are always unique. Stochastic and deterministic algorithms are proposed for computing Riemannian p-means. The rate of convergence and error estimates of these algorithms are also obtained. Finally, we apply the medians and the Riemannian geometry of Toeplitz covariance matrices to radar target detection.

  2. Some properties of Fr\\'echet medians in Riemannian manifolds

    CERN Document Server

    Yang, Le

    2011-01-01

    The consistency of Fr\\'echet medians is proved for probability measures in proper metric spaces. In the context of Riemannian manifolds, assuming that the probability measure has more than a half mass lying in a convex ball and verifies some concentration conditions, the positions of its Fr\\'echet medians are estimated. It is also shown that, in compact Riemannian manifolds, the Fr\\'echet sample medians of generic data points are always unique.

  3. A rare case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus

    Directory of Open Access Journals (Sweden)

    Chawla R

    2007-01-01

    Full Text Available We describe a case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus . The patient, a known diabetic and a case of coronary artery disease underwent coronary artery bypass surgery. In the postoperative period, patient developed infection of the median sternotomy wound, from which R. arrhizus was isolated on culture. Patient succumbed in spite of being treated with surgical debridement and amphotericin B. To the best of our knowledge, this is the first reported case of mucormycosis of median sternotomy wound from India.

  4. Adaptive Threshold Median Filter for Multiple-Impulse Noise

    Institute of Scientific and Technical Information of China (English)

    JIANG Bo; HUANG Wei

    2007-01-01

    Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter(ATMF) has been developed by combining the adaptive median filter (AMF) and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed Filter.

  5. Head rotation and sound image localization in the median plane

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2005-01-01

    The effect of head rotation on median plane sound source (or image) localization is studied. It is suggested that, at low frequency, the change of interaural time difference (ITD) caused by head rotation supplies information for determining sound source direction in the median plane. Based on the suggestion, the summed sound image localization equations for multiple loudspeakers arranged in the median plane are derived. Especially, for a pair of loudspeakers arranged front-back symmetrically in the median plane, the localization equations are similar to that of stereophonic sound in horizontal plane. A sound image localization experiment was carried out to prove the theoretical analysis. The results of this paper are not only available to virtual spatial auditory, but also supply a quantitative validation of the hypothesis that head rotation is a cue for sound source localization in the median plane at low frequency.

  6. Osteosarcoma: the addition of muramyl tripeptide to chemotherapy improves overall survival--a report from the Children's Oncology Group.

    Science.gov (United States)

    Meyers, Paul A; Schwartz, Cindy L; Krailo, Mark D; Healey, John H; Bernstein, Mark L; Betcher, Donna; Ferguson, William S; Gebhardt, Mark C; Goorin, Allen M; Harris, Michael; Kleinerman, Eugenie; Link, Michael P; Nadel, Helen; Nieder, Michael; Siegal, Gene P; Weiner, Michael A; Wells, Robert J; Womer, Richard B; Grier, Holcombe E

    2008-02-01

    To compare three-drug chemotherapy with cisplatin, doxorubicin, and methotrexate with four-drug chemotherapy with cisplatin, doxorubicin, methotrexate, and ifosfamide for the treatment of osteosarcoma. To determine whether the addition of muramyl tripeptide (MTP) to chemotherapy enhances event-free survival (EFS) and overall survival in newly diagnosed patients with osteosarcoma. Six hundred sixty-two patients with osteosarcoma without clinically detectable metastatic disease and whose disease was considered resectable received one of four prospectively randomized treatments. All patients received identical cumulative doses of cisplatin, doxorubicin, and methotrexate and underwent definitive surgical resection of primary tumor. Patients were randomly assigned to receive or not to receive ifosfamide and/or MTP in a 2 x 2 factorial design. The primary end points for analysis were EFS and overall survival. In the current analysis, there was no evidence of interaction, and we were able to examine each intervention separately. The chemotherapy regimens resulted in similar EFS and overall survival. There was a trend toward better EFS with the addition of MTP (P = .08). The addition of MTP to chemotherapy improved 6-year overall survival from 70% to 78% (P = .03). The hazard ratio for overall survival with the addition of MTP was 0.71 (95% CI, 0.52 to 0.96). The addition of ifosfamide to cisplatin, doxorubicin, and methotrexate did not enhance EFS or overall survival for patients with osteosarcoma. The addition of MTP to chemotherapy resulted in a statistically significant improvement in overall survival and a trend toward better EFS.

  7. [Long-term survival after surgical resection of a cancer of unknown primary site-a case report].

    Science.gov (United States)

    Tsukao, Yukiko; Moon, Jeong Ho; Kobayashi, Kenji; Hyuga, Satoshi; Chono, Teruhiro; Watanabe, Risa; Matsumoto, Takashi; Takemoto, Hiroyoshi; Takachi, Ko; Nishioka, Kiyonori; Aoki, Taro; Uemura, Yoshio

    2013-11-01

    We report a case of long-term survival after combination chemotherapy and surgical resection of a cancer of unknown primary site[ CUPs]. A septuagenarian female was identified as having high blood levels of carcinoembryonic antigen (CEA) during follow-up monitoring of asthma. Endoscopy and imaging studies including computed tomography (CT) and positron emission tomography (PET)-CT revealed a malignant lymph node adjacent to the abdominal aorta; however, no other lesion was detected. Therefore, we performed CT-guided biopsy and diagnosed the lesion to be a lymph node metastasis of poorly differentiated adenocarcinoma. As we considered this as a systemic disease, the patient received 2 courses of combination chemotherapy with 5-fluorouracil( 5-FU)/cisplatin( CDDP) and achieved a partial response (PR). Later, the patient received S-1 therapy as second-line chemotherapy and S-1/irinotecan( CPT-11) as third-line chemotherapy in an outpatient clinic. However, the tumor continued to grow, and therefore, we decided to perform surgical resection. Histopathological examination of the resected specimen yielded a diagnosis of metastatic adenocarcinoma of the lymph node. The patient has been well without any signs of recurrence for more than 9 years since surgery. As CUPs is generally associated with poor prognosis, this case raises the possibility that combination therapy might improve convalescence.

  8. Trends in differences between births and surviving infants reported for immunization program planning and external data sources in Eastern and Southern Africa 2000-2013.

    Science.gov (United States)

    Kaiser, Reinhard; Chakauya, Jethro M; Shibeshi, Messeret E

    2016-02-24

    To inform our WHO team's support for immunization programs in Member States in Eastern and Southern Africa, we compared annual trends from 2000 to 2013 in target populations reported by Member States through the WHO-UNICEF joint reporting form with United Nations (UN) population projections and modeled infant mortality estimates from the UN Inter-agency Group for Child Mortality Estimation. Our findings indicated a tendency of underestimating births and surviving infants used by Member States as denominators for administrative immunization coverage rates, resulting in or contributing to overestimation of coverage. The difference with UN estimates appeared to be more pronounced for surviving infants than births. Measures of central tendency for individual country differences indicated that those differences decreased over time. Comparing trends of births and surviving infants with external sources can help monitoring progress in efforts to provide accurate and reliable target population estimates and sampling frames.

  9. Differences in excitability between median and superficial radial sensory axons.

    Science.gov (United States)

    Fujimaki, Yumi; Kanai, Kazuaki; Misawa, Sonoko; Shibuya, Kazumoto; Isose, Sagiri; Nasu, Saiko; Sekiguchi, Yukari; Ohmori, Shigeki; Noto, Yu-ichi; Kugio, Yumiko; Shimizu, Toshio; Matsubara, Shiro; Lin, Cindy S Y; Kuwabara, Satoshi

    2012-07-01

    The aim of this study was to investigate differences in excitability properties of human median and superficial radial sensory axons (e.g., axons innervating the glabrous and hairy skin in the hand). Previous studies have shown that excitability properties differ between motor and sensory axons, and even among sensory axons between median and sural sensory axons. In 21 healthy subjects, threshold tracking was used to examine excitability indices such as strength-duration time constant, threshold electrotonus, supernormality, and threshold change at the 0.2 ms inter-stimulus interval in latent addition. In addition, threshold changes induced by ischemia for 10 min were compared between median and superficial radial sensory axons. Compared with radial sensory axons, median axons showed shorter strength-duration time constant, greater threshold changes in threshold electrotonus (fanning-out), greater supernormality, and smaller threshold changes in latent addition. Threshold changes in both during and after ischemia were greater for median axons. These findings suggest that membrane potential in human median sensory axons is more negative than in superficial radial axons, possibly due to greater activity of electrogenic Na(+)/K(+) pump. These results may reflect adaptation to impulses load carried by median axons that would be far greater with a higher frequency. Biophysical properties are not identical in different human sensory axons, and therefore their responses to disease may differ. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Stratification of ALS patients' survival: a population-based study.

    Science.gov (United States)

    Marin, Benoît; Couratier, Philippe; Arcuti, Simona; Copetti, Massimiliano; Fontana, Andrea; Nicol, Marie; Raymondeau, Marie; Logroscino, Giancarlo; Preux, Pierre Marie

    2016-01-01

    The natural history of amyotrophic lateral sclerosis (ALS) and patient risk stratification are areas of considerable research interest. We aimed (1) to describe the survival of a representative cohort of French ALS patients, and (2) to identify covariates associated with various patterns of survival using a risk classification analysis. ALS patients recruited in the FRALim register (2000-2013) were included. Time-to-death analyses were performed using Kaplan-Meier method and Cox model. A recursive partitioning and amalgamation (RECPAM) algorithm analysis identified subgroups of patients with different patterns of survival. Among 322 patients, median survival times were 26.2 and 15.6 months from time of onset and of diagnosis, respectively. Four groups of patients were identified, depending on their baseline characteristics and survival (1) ALSFRS-R slope >0.46/month and definite or probable ALS (median survival time (MST) 10.6 months); (2) ALSFRS-R slope >0.46/month and possible or probable laboratory-supported ALS (MST: 18.1 months); (3) ALSFRS-R slope ≤0.46/month and definite or probable ALS (MST: 22.5 months), and (4) ALSFRS-R slope ≤0.46/month and possible or probable laboratory-supported ALS (MST: 37.6 months). Median survival time is among the shortest ever reported by a worldwide population-based study. This is probably related to the age structure of the patients (the oldest identified to date), driven by the underlying population (30 % of subjects older than 60 years). Further research in the field of risk stratification could help physicians better anticipate prognosis of ALS patients, and help improve the design of randomized controlled trials.

  11. THE USE OF gusA REPORTER GENE TO MONITOR THE SURVIVAL OF INTRODUCED BACTERIA IN THE SOIL

    Directory of Open Access Journals (Sweden)

    Edi Husen

    2013-07-01

    Full Text Available An effective marker to monitor the survival of introduced bacteria in the soil is required for further evaluation of their beneficial effects on plant growth. This study tested the use of gusA gene as a marker to trace the fate of three Gram negative bacteria in the root, rhizosphere, and soil. The study was conducted at the laboratory and greenhouse of the National Institute of Molecular Biology and Biotechnology, Philippines from January to December 2001. Isolates TCaR 61 and TCeRe 60, and Azotobacter vinelandii Mac 259 were selected as test bacteria based on their ability to produce indole-3acetic acid and solubilize precipitated phosphate, which may promote plant growth in the field. These bacteria were marked with gusA reporter gene from Escherichia coli strain S17-1(λ-pir containing mTn5SSgusA21. The gusA (β-glucuronidase gene from the donor (E. coli was transferred to each bacterium (recipient through bacterial conjugation in mating procedures using tryptone-yeast agar followed by the selection of the transconjugants (bacteria receiving gusA in tryptone-yeast agar supplemented with double antibiotics and X-GlcA (5bromo-4chloro- 3indoxyl-β-D-glucuronic acid. The antibiotics used were rifampicin and either streptomycin or spectinomycin based on antibiotic profiles of the donor and recipients. The results showed that the insertion of gusA gene into bacterial genomes of the recipient did not impair its phenotypic traits; the growth rates of the transconjugants as well as their ability to produce indole-3acetic acid and solubilize precipitated phosphate in pure culture were similar to their wild types. All transconjugants colonized the roots of hot pepper (Capsicum annuum L. and survived in the rhizosphere and soil until the late of vegetative growth stage. The distinct blue staining of transconjugants as the expression of gusA gene in media containing X-GlcA coupled with their resistance to rifampicin and streptomycin or spectinomycin

  12. Prolonged survival after sequential multimodal treatment in metastatic renal cell carcinoma: two case reports and a review of the literature

    Directory of Open Access Journals (Sweden)

    Syrios John

    2012-09-01

    Full Text Available Abstract Introduction In this case series and short review of the literature, we underline the impact of nephrectomy combined with sequential therapy based on cytokines, antiangiogenic factors, and mammalian target of rapamycin inhibitors along with metastasectomy on overall survival and quality of life in patients with metastatic clear cell renal carcinoma. Case presentation In the first of two cases reported here, a 53-year-old Caucasian man underwent a radical left nephrectomy for renal cell cancer and relapsed with a bone metastasis in his right humerus. He was treated with closed nailing and cytokine-based chemotherapy. For 5 years, the disease was stable and he had great improvement in quality of life. Subsequently, the disease relapsed in his lymph nodes, lung, and thorax soft tissue. He was then treated with antiangiogenic factors and mammalian target of rapamycin inhibitors. The disease progressed until September 2009, when he died of allergic shock during a blood transfusion, 9 years after the initial diagnosis of renal cell cancer. In the second case, a 54-year-old Caucasian man underwent a radical left nephrectomy for renal cell cancer. A year later, the disease progressed to his neck lymph nodes, and cytokine-based chemotherapy was initiated. While he was on cytokines, a solitary pulmonary nodule appeared and he underwent a metastasectomy. Nine months later, magnetic resonance imaging of his brain revealed a focal right occipitoparietal lesion, which was resected. After two years of active surveillance, the disease relapsed as a pulmonary metastasis and he was treated with an antiangiogenic factor. Further progressions presenting as enlarged axillary lymph nodes, chest soft tissue lesions, and thoracic spine bone metastases were sequentially observed. He then received a first-generation mammalian target of rapamycin inhibitor, an antiangiogenic factor, and later a second-generation mammalian target of rapamycin inhibitor and

  13. Survival Estimates for the Passage of Spring-Migrating Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2001-2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Zabel, Richard; Williams, John G.; Smith, Steven G. (Northwest and Alaska Fisheries Science Center, Fish Ecology Division, Seattle, WA)

    2002-06-01

    In 2001, the National Marine Fisheries Service and the University of Washington completed the ninth year of a study to estimate survival and travel time of juvenile salmonids (Oncorhynchus spp.) passing through dams and reservoirs on the Snake and Columbia Rivers. All estimates were derived from passive integrated transponder (PIT)-tagged fish. We PIT tagged and released at Lower Granite Dam a total of 17,028 hatchery and 3,550 wild steelhead. In addition, we utilized fish PIT tagged by other agencies at traps and hatcheries upstream of the hydropower system and sites within the hydropower system. PIT-tagged smolts were detected at interrogation facilities at Lower Granite, Little Goose, Lower Monumental, McNary, John Day, and Bonneville Dams and in the PIT-tag detector trawl operated in the Columbia River estuary. Survival estimates were calculated using the Single-Release Model. Primary research objectives in 2001 were to: (1) estimate reach and project survival and travel time in the Snake and Columbia Rivers throughout the yearling chinook salmon and steelhead migrations; (2) evaluate relationships between survival estimates and migration conditions; and (3) evaluate the survival-estimation models under prevailing conditions. This report provides reach survival and travel time estimates for 2001 for PIT-tagged yearling chinook salmon and steelhead (hatchery and wild) in the Snake and Columbia Rivers. Results are reported primarily in the form of tables and figures with a minimum of text. More details on methodology and statistical models used are provided in previous reports cited in the text. Results for summer-migrating chinook salmon will be reported separately.

  14. Survival Estimates for the Passage of Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Muir, William D.; Smith, Steven G.; Zabel, Richard W. (NOAA Fisheries, Northwest Fisheries Center, Seattle, WA)

    2003-07-01

    In 2002, the National Marine Fisheries Service and the University of Washington completed the tenth year of a study to estimate survival and travel time of juvenile salmonids (Oncorhynchus spp.) passing through dams and reservoirs on the Snake and Columbia Rivers. All estimates were derived from detections of fish tagged with passive integrated transponder tags (PIT tags). We PIT tagged and released a total of 19,891 hatchery steelhead at Lower Granite Dam. In addition, we utilized fish PIT tagged by other agencies at traps and hatcheries upstream from the hydropower system and sites within the hydropower system. PIT-tagged smolts were detected at interrogation facilities at Lower Granite, Little Goose, Lower Monumental, McNary, John Day, and Bonneville Dams and in the PIT-tag detector trawl operated in the Columbia River estuary. Survival estimates were calculated using a statistical model for tag-recapture data from single release groups (the ''Single-Release Model''). Primary research objectives in 2002 were to (1) estimate reach and project survival and travel time in the Snake and Columbia Rivers throughout the migration period of yearling chinook salmon O. tshawytscha and steelhead O. mykiss; (2) evaluate relationships between survival estimates and migration conditions; and (3) evaluate the survival-estimation models under prevailing conditions. This report provides reach survival and travel time estimates for 2002 for PIT-tagged yearling chinook salmon (hatchery and wild), hatchery sockeye salmon O. nerka, hatchery coho salmon O. kisutch, and steelhead (hatchery and wild) in the Snake and Columbia Rivers. Results are reported primarily in the form of tables and figures; details on methodology and statistical models used are provided in previous reports cited here. Results for summer-migrating chinook salmon will be reported separately.

  15. Factors Affecting the Survival of Upstream Migrant Adult Salmonids in the Columbia River Basin : Recovery Issues for Threatened and Endangered Snake River Salmon : Technical Report 9 of 11.

    Energy Technology Data Exchange (ETDEWEB)

    Dauble, Dennis D.; Mueller, Robert P.

    1993-06-01

    The Bonneville Power Administration (BPA) is developing conservation planning documentation to support the National Marine Fisheries Service`s (NMFS) recovery plan for Columbia Basin salmonid stocks that are currently listed under the Endangered Species Act (ESA). Information from the conservation planning documentation will be used as a partial scientific basis for identifying alternative conservation strategies and to make recommendations toward conserving, rebuilding, and ultimately removing these salmon stocks from the list of endangered species. This report describes the adult upstream survival study, a synthesis of biological analyses related to conditions affecting the survival of adult upstream migrant salmonids in the Columbia River system. The objective of the adult upstream survival study was to analyze existing data related to increasing the survival of adult migrant salmonids returning to the Snake River system. The fate and accountability of each stock during its upstream migration period and the uncertainties associated with measurements of escapement and survival were evaluated. Operational measures that affected the survival of adult salmon were evaluated including existing conditions, augmented flows from upstream storage release, and drawdown of mainstem reservoirs. The potential impacts and benefits of these measures to each ESA stock were, also described based on considerations of species behavior and run timing.

  16. Median age at death as an indicator of premature mortality

    OpenAIRE

    Jannerfeldt, Eric; Hörte, Lars-Gunnar

    1988-01-01

    The median age at death from certain diseases was calculated for each year for 1969-85 and compared with that at death from all causes. The results indicated the impact of these diseases in terms of premature mortality and changes over time. Cancer was a more important cause of premature mortality among women than among men. For cancer of the cervix the median age at death increased appreciably whereas for cancer of the lung in women it slightly decreased. The median age at death is easy to c...

  17. A theoretical analysis of the median LMF adaptive algorithm

    DEFF Research Database (Denmark)

    Bysted, Tommy Kristensen; Rusu, C.

    1999-01-01

    Higher order adaptive algorithms are sensitive to impulse interference. In the case of the LMF (Least Mean Fourth), an easy and effective way to reduce this is to median filter the instantaneous gradient of the LMF algorithm. Although previous published simulations have indicated that this reduces...... the speed of convergence, no analytical studies have yet been made to prove this. In order to enhance the usability, this paper presents a convergence and steady-state analysis of the median LMF adaptive algorithm. As expected this proves that the median LMF has a slower convergence and a lower steady...

  18. Survival and Cause of Death among a Cohort of Confirmed Amyotrophic Lateral Sclerosis Cases.

    Directory of Open Access Journals (Sweden)

    Susan T Paulukonis

    Full Text Available Amyotrophic lateral sclerosis (ALS is a progressive neurodegenerative disorder. Estimates of survival from disease onset range from 20 to 48 months and have been generated using clinical populations or death records alone.Data on a cohort of ALS cases diagnosed between 2009-2011 were collected as part of the Los Angeles and San Francisco Bay Area Metropolitan ALS Surveillance projects; death records 2009-2013 were linked to these confirmed cases to determine survival post diagnosis and factors associated with survival time.There were 618 cases identified and 283 of these died during the follow up time period. Median age at death was 64.3 years, and median survival time post-diagnosis was 2.6 years. Age at diagnosis and year of diagnosis were predictors of survival time in adjusted models; those diagnosed at age 80 or older had shorter survival than those diagnosed at age 50 or younger. Most (92% had ALS noted as a cause of death.Survival post-diagnosis may be improved compared with previous reports. Age at diagnosis continues to be the strongest predictor of prognosis; recall case reporting bias may play a role in estimates of survival time.

  19. An exact solver for the DCJ median problem.

    Science.gov (United States)

    Zhang, Meng; Arndt, William; Tang, Jijun

    2009-01-01

    The "double-cut-and-join" (DCJ) model of genome rearrangement proposed by Yancopoulos et al. uses the single DCJ operation to account for all genome rearrangement events. Given three signed permutations, the DCJ median problem is to find a fourth permutation that minimizes the sum of the pairwise DCJ distances between it and the three others. In this paper, we present a branch-and-bound method that provides accurate solution to the multichromosomal DCJ median problems. We conduct extensive simulations and the results show that the DCJ median solver performs better than other median solvers for most of the test cases. These experiments also suggest that DCJ model is more suitable for real datasets where both reversals and transpositions occur.

  20. Estimates of Median Flows for Streams on the 1999 Kansas Surface Water Register

    Science.gov (United States)

    Perry, Charles A.; Wolock, David M.; Artman, Joshua C.

    2004-01-01

    regression-estimated and gaged flow information. On controlled segments of Kansas streams, the median flow information was interpolated between gaging stations using only gaged data weighted by drainage area. Of the 2,232 total stream segments on the Kansas Surface Water Register, 34.5 percent of the segments had an estimated median streamflow of less than 1 cubic foot per second when the KSA analysis was used. When the AAH analysis was used, 36.2 percent of the segments had an estimated median streamflow of less than 1 cubic foot per second. This report supercedes U.S. Geological Survey Water-Resources Investigations Report 02?4292.

  1. REGRESI KUANTIL MEDIAN UNTUK MENGATASI HETEROSKEDASTISITAS PADA ANALISIS REGRESI

    Directory of Open Access Journals (Sweden)

    IDA AYU PRASETYA UTHAMI

    2013-01-01

    Full Text Available In regression analysis, the method used to estimate the parameters is Ordinary Least Squares (OLS. The principle of OLS is to minimize the sum of squares error. If any of the assumptions were not met, the results of the OLS estimates are no longer best, linear, and unbiased estimator (BLUE. One of the assumptions that must be met is the assumption about homoscedasticity, a condition in which the variance of the error is constant (same. Violation of the assumptions about homoscedasticity is referred to heteroscedasticity. When there exists heteroscedas­ticity, other regression techniques are needed, such as median quantile regression which is done by defining the median as a solution to minimize sum of absolute error. This study intended to estimate the regression parameters of the data were known to have heteroscedasticity. The secondary data were taken from the book Basic Econometrics (Gujarati, 2004 and analyzing method were performed by EViews 6. Parameter estimation of the median quantile regression were done by estimating the regression parameters at each quantile ?th, then an estimator was chosen on the median quantile as regression coefficients estimator. The result showed heteroscedasticity problem has been solved with median quantile regression although error still does not follow normal distribution properties with a value of R2 about 71 percent. Therefore it can be concluded that median quantile regression can overcome heteroscedasticity but the data still abnormalities.

  2. REGRESI KUANTIL MEDIAN UNTUK MENGATASI HETEROSKEDASTISITAS PADA ANALISIS REGRESI

    Directory of Open Access Journals (Sweden)

    IDA AYU PRASETYA UTHAMI

    2013-03-01

    Full Text Available In regression analysis, the method used to estimate the parameters is Ordinary Least Squares (OLS. The principle of OLS is to minimize the sum of squares error. If any of the assumptions were not met, the results of the OLS estimates are no longer best, linear, and unbiased estimator (BLUE. One of the assumptions that must be met is the assumption about homoscedasticity, a condition in which the variance of the error is constant (same. Violation of the assumptions about homoscedasticity is referred to heteroscedasticity. When there exists heteroscedas­ticity, other regression techniques are needed, such as median quantile regression which is done by defining the median as a solution to minimize sum of absolute error. This study intended to estimate the regression parameters of the data were known to have heteroscedasticity. The secondary data were taken from the book Basic Econometrics (Gujarati, 2004 and analyzing method were performed by EViews 6. Parameter estimation of the median quantile regression were done by estimating the regression parameters at each quantile ?th, then an estimator was chosen on the median quantile as regression coefficients estimator. The result showed heteroscedasticity problem has been solved with median quantile regression although error still does not follow normal distribution properties with a value of R2 about 71 percent. Therefore it can be concluded that median quantile regression can overcome heteroscedasticity but the data still abnormalities.

  3. Testing the gravity p-median model empirically

    Directory of Open Access Journals (Sweden)

    Kenneth Carling

    2015-12-01

    Full Text Available Regarding the location of a facility, the presumption in the widely used p-median model is that the customer opts for the shortest route to the nearest facility. However, this assumption is problematic on free markets since the customer is presumed to gravitate to a facility by the distance to and the attractiveness of it. The recently introduced gravity p-median model offers an extension to the p-median model that account for this. The model is therefore potentially interesting, although it has not yet been implemented and tested empirically. In this paper, we have implemented the model in an empirical problem of locating vehicle inspections, locksmiths, and retail stores of vehicle spare-parts for the purpose of investigating its superiority to the p-median model. We found, however, the gravity p-median model to be of limited use for the problem of locating facilities as it either gives solutions similar to the p-median model, or it gives unstable solutions due to a non-concave objective function.

  4. Prolonged survival in a patient with isolated skull recurrence of cervical carcinoma — Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ariel Zilberlicht

    2015-01-01

    Bone metastases from cervical carcinoma are usually part of widespread metastatic disease. Skull metastases are extremely rare. Selected cases of solitary bone metastases can be treated radically and achieve long term disease free survival.

  5. Role of Cell Cycle Regulation and MLH1, A Key DNA Mismatch Repair Protein, In Adaptive Survival Responses. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    David A. Boothman

    1999-08-11

    Due to several interesting findings on both adaptive survival responses (ASRs) and DNA mismatch repair (MMR), this grant was separated into two discrete Specific Aim sets (each with their own discrete hypotheses). The described experiments were simultaneously performed.

  6. Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli [Dept. of Radiology, Sakarya University Medical Faculty, Sakarya (Turkmenistan)

    2014-08-15

    Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

  7. Evaluation of Juvenile Salmonid Outmigration and Survival in the Lower Umatilla River Basin, Annual Report 2000-2001.

    Energy Technology Data Exchange (ETDEWEB)

    White, Tara C.; Jewett, Shannon M.; Hanson, Josh T.

    2003-04-11

    This is the seventh year of a multi-year project, monitoring the outmigration and survival of juvenile salmonids in the lower Umatilla River. This project both supplements and complements ongoing and completed work within the Umatilla River basin. Knowledge gained on juvenile outmigration and survival assists researchers and managers in adapting hatchery practices, flow enhancement strategies, canal and fish ladder operations, and supplementation and enhancement efforts of natural and restored fish populations. Findings from this study also measure the success of upriver habitat improvement projects and provide an overall evaluation of the Umatilla River fisheries restoration program. The general objectives for 2001 were to: (1) Estimate migrant abundance and survival and determine migration parameters of PIT-tagged hatchery and natural juvenile salmonids; (2) Monitor natural production and estimate overall abundance of pacific lamprey, chinook and coho salmon and summer steelhead; (3) Assess the condition and health of migrants and determine length-frequency distributions through time; (4) Investigate the effects of canal and fishway operations and environmental conditions on fish migration and survival; (5) Investigate and implement improved tag monitoring capabilities; and (6) Participate in planning and coordination activities within the basin and disseminate results. More specifically, 2001 objectives included the ongoing evaluation of migrant abundance and survival of tagged hatchery fish groups from various species-specific hatchery, rearing, acclimation and release strategies; fourth year reach survival results; continuation of transport evaluation studies; outmigrant monitoring and estimation of natural abundance, and further investigation of the effects of canal operations, environmental factors, fish condition and health on migration, abundance and survival. Some of the key findings for 2001 are: (1) A significant decline in outmigrant abundance of

  8. Survival Estimates for the Passage of Juvenile Chinook Salmon through Snake River Dams and Reservoirs, 1993 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Robert N.; Sandford, Benjamin P.; McIntyre, Kenneth W.

    1994-04-01

    A pilot study was conducted to estimate survival of hatchery-reared yearling chinook salmon through dams and reservoirs on the Snake River. The goals of the study were to: (1) field test and evaluate the Single-Release, Modified-Single-Release, and Paired-Release Models for the estimation of survival probabilities through sections of a river and hydroelectric projects; (2) identify operational and logistical constraints to the execution of these models; and (3) determine the usefulness of the models in providing estimates of survival probabilities. Field testing indicated that the numbers of hatchery-reared yearling chinook salmon needed for accurate survival estimates could be collected at different areas with available gear and methods. For the primary evaluation, seven replicates of 830 to 1,442 hatchery-reared yearling chinook salmon were purse-seined from Lower Granite Reservoir, PIT tagged, and released near Nisqually John boat landing (River Kilometer 726). Secondary releases of PIT-tagged smolts were made at Lower Granite Dam to estimate survival of fish passing through turbines and after detection in the bypass system. Similar secondary releases were made at Little Goose Dam, but with additional releases through the spillway. Based on the success of the 1993 pilot study, the authors believe that the Single-Release and Paired-Release Models will provide accurate estimates of juvenile salmonid passage survival for individual river sections, reservoirs, and hydroelectric projects in the Columbia and Snake Rivers.

  9. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Lawrence; Gai, Neville [Clinical Center, Radiology and Imaging Sciences, Bethesda, MD (United States)

    2009-04-15

    Enlargement of the median nerve is an objective potential imaging sign of carpal tunnel syndrome. Diffusion tensor MRI (DTI) may provide additional structural information that may prove useful in characterizing median neuropathy. This study further examines normal values for median nerve cross-sectional area (CSA), apparent diffusion coefficient (ADC), and fractional anisotropy (FA). Twenty-three wrists in 17 healthy volunteers underwent MRI of the wrist at 3 T. In 13 subjects, DTI was performed at a B value of 600 mm{sup 2}/s. Median nerve CSA, ADC, and FA were analyzed at standardized anatomic levels. Mean (SD) median nerve CSA within the proximal carpal tunnel was 10.0 (3.4) mm{sup 2}. The mean (SD) FA of the median nerve was 0.71 (0.06) and 0.70 (0.13) proximal to and within the carpal tunnel, respectively. There was a significant difference between nerve CSA and ADC, but not FA, at the distal forearm and proximal carpal tunnel. Nerve CSA, ADC, and FA did not differ between men and women or between dominant and non-dominant wrists. Nerve CSA at the proximal carpal tunnel was positively correlated with subject age and body mass index. Our results suggest a 90% upper confidence limit for normal median nerve CSA of 14.4 mm{sup 2} at the proximal carpal tunnel, higher than normal limits reported by many ultrasound studies. We observed a difference between the CSA and ADC, but not the FA, of the median nerve at the distal forearm and proximal carpal tunnel levels. (orig.)

  10. Patient-reported health status prior to cardiac resynchronisation therapy identifies patients at risk for poor survival and prolonged hospital stays

    DEFF Research Database (Denmark)

    Versteeg, H.; Denollet, J.; Meine, M.;

    2016-01-01

    BACKGROUND: Patient-reported factors have largely been neglected in search of predictors of response to cardiac resynchronisation therapy (CRT). The current study aimed to examine the independent value of pre-implantation patient-reported health status in predicting four-year survival and cardiac......-related hospitalisation of CRT patients. METHODS: Consecutive patients (N = 139) indicated to receive a first-time CRT-defibrillator at the University Medical Center Utrecht were asked to complete a set of questionnaires prior to implantation. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess heart...... % CI 1.88-5.44). CONCLUSIONS: Patient-reported health status assessed prior to CRT identifies patients at risk for poor survival and prolonged hospital stays, independent of traditional risk factors. These results emphasise the importance of incorporating health status measures in cardiovascular...

  11. Long-term comparative outcomes of open versus laparoscopic nephroureterectomy for upper urinary tract urothelial-cell carcinoma after a median follow-up of 13 years*.

    Science.gov (United States)

    Stewart, Grant D; Humphries, Katie J; Cutress, Mark L; Riddick, Antony C P; McNeill, S Alan; Tolley, David A

    2011-08-01

    Open nephroureterectomy (ONU) rather than laparoscopic nephroureterectomy (LNU) is still regarded as the standard of care for extirpative surgical management of upper urinary tract urothelial-cell carcinoma (UUT-UCC). The longest published follow-up of LNU is 7 years. We report outcomes for patients having surgery ≥10 years ago. Consecutive patients with UUT-UCC who were treated with ONU (n=39) or LNU (n=23) between April 1992 to September 2000 were included. Preoperative, tumor, operative and postoperative characteristics, recurrence, and outcomes were collated. Survival was estimated using the Kaplan-Meier method. Median follow-up of censored patients was 163 months (13.6 y). Estimated mean overall survival (OS) was 111 months for ONU and 103 months for LNU. Mean progression free survival (PFS) was 175 months for ONU and 143 months for LNU. Probability of PFS at 10 years was 79% for ONU and 76% for LNU and was unchanged at 15 years. There was no significant difference between ONU and LNU in terms of OS (P=0.51, log-rank test), PFS (P=0.70) or cancer-specific survival (CSS; P=0.43). There were no prognostic differences between ONU and LNU after correcting for confounding variables. There was no increase in the probability of a bladder cancer recurrence from 10 to 15 years postoperation. Long-term follow-up of patients who were operated on more than 10 years ago suggests that LNU has oncologic equivalence to ONU because there were no significant differences in OS, PFS, or CSS between ONU and LNU patients followed for a median of 13 years.

  12. Survival Estimates for the Passage of Spring-Migrating Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2005-2006 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.; Muir, William D.; Marsh, Douglas M. (National Marine Fisheries Service, Northwest Fisheries Science Center, Fish Ecology Division, Seattle, WA)

    2006-05-01

    In 2005, the National Marine Fisheries Service and the University of Washington completed the thirteenth year of a study to estimate survival and travel time of juvenile salmonids Oncorhynchus spp. passing through dams and reservoirs on the Snake and Columbia Rivers. All estimates were derived from detections of fish tagged with passive integrated transponder tags (PIT tags). We PIT tagged and released a total of 18,439 hatchery steelhead, 5,315 wild steelhead, and 6,964 wild yearling Chinook salmon at Lower Granite Dam in the Snake River. In addition, we utilized fish PIT tagged by other agencies at traps and hatcheries upstream from the hydropower system and at sites within the hydropower system in both the Snake and Columbia Rivers. PIT-tagged smolts were detected at interrogation facilities at Lower Granite, Little Goose, Lower Monumental, Ice Harbor, McNary, John Day, and Bonneville Dams and in the PIT-tag detector trawl operated in the Columbia River estuary. Survival estimates were calculated using a statistical model for tag-recapture data from single release groups (the ''single-release model''). Primary research objectives in 2005 were: (1) Estimate reach survival and travel time in the Snake and Columbia Rivers throughout the migration period of yearling Chinook salmon O. tshawytscha and steelhead O. mykiss. (2) Evaluate relationships between survival estimates and migration conditions. (3) Evaluate the survival estimation models under prevailing conditions. This report provides reach survival and travel time estimates for 2005 for PIT-tagged yearling Chinook salmon (hatchery and wild), hatchery sockeye salmon O. nerka, hatchery coho salmon O. kisutch, and steelhead (hatchery and wild) in the Snake and Columbia Rivers. Additional details on the methodology and statistical models used are provided in previous reports cited here.

  13. Surviving Math, Surviving College

    Science.gov (United States)

    Schaffhauser, Dian

    2009-01-01

    According to a 2000 community college study by Miami Dade College (FL) President Emeritus Robert McCabe, 41 percent of students entering community colleges are underprepared in at least one basic skill area. A three-year study of community college students, published in 2009 by the National Center for Education Statistics, reported that 41 percent…

  14. Adaptive weighted median filter utilizing impulsive noise detection

    Science.gov (United States)

    Ishihara, Jun; Meguro, Mitsuhiko; Hamada, Nozomu

    1999-10-01

    The removal of noise in image is one of the current important issues. It is also useful as a preprocessing for edge detection, motion estimation and so on. In this paper, an adaptive weighted median filter utilizing impulsive noise detection is proposed for the removal of impulsive noise in digital images. The aim of our proposed method is to eliminate impulsive noise effectively preserving original fine detail in images. This aim is same for another median-type nonlinear filters try to realized. In our method, we use weighted median filter whose weights should be determined by balancing between the signal preserving ability and noise reduction performance. The trade off between these two inconsistent properties is realized using the noise detection mechanism and optimized adaptation process. In the previous work, threshold value between the signal and the output of the median filter have to be decided for the noise detection. Adaptive algorithm for optimizing WM filters uses the teacher image for training process. In our method, following two new approaches are introduced in the filtering. (1) The noise detection process uses the discriminant method to the histogram distribution of the derivation from median filter output. (2) Filter weights which have been learned by uncorrupted pixels and their neighborhood without the original image are used for the restoration filtering for noise corrupted pixels. The validity of the proposed method is shown through some experimental results.

  15. Survival Estimates for the Passage of Juvenile Salmonids through Snake River Dams and Reservoirs, 1996 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.

    1998-02-01

    In 1996, the National Marine Fisheries Service and the University of Washington completed the fourth year of a multi-year study to estimate survival of juvenile salmonids (Oncorhynchus spp.) passing through dams and reservoirs on the Snake River. Actively migrating smolts were collected near the head of Lower Granite Reservoir and at Lower Granite Dam, tagged with passive integrated transponder (PIT) tags, and released to continue their downstream migration. Individual smolts were subsequently detected at PIT-tag detection facilities at Lower Granite, Little Goose, Lower Monumental, McNary, John Day and Bonneville Dams. Survival estimates were calculated using the Single-Release (SR) and Paired-Release (PR) Models. Timing of releases of tagged hatchery steelhead (O. mykiss) from the head of Lower Granite Reservoir and yearling chinook salmon (O. tshawytscha) from Lower Granite Dam in 1996 spanned the major portion of their juvenile migrations. Specific research objectives in 1996 were to (1) estimate reach and project survival in the Snake River using the Single-Release and Paired-Release Models throughout the yearling chinook salmon and steelhead migrations, (2) evaluate the performance of the survival-estimation models under prevailing operational and environmental conditions in the Snake River, and (3) synthesize results from the 4 years of the study to investigate relationships between survival probabilities, travel times, and environmental factors such as flow levels and water temperature.

  16. Evaluation of Juvenile Salmonid Outmigration and Survival in the Lower Umatilla River Basin, Annual Report 2001-2002.

    Energy Technology Data Exchange (ETDEWEB)

    White, Tara C.; Hanson, Josh T.; Jewett, Shannon M.

    2004-01-01

    The year of 2002 represented the eighth year of a multi-year project, monitoring the outmigration and survival of juvenile salmonids in the lower Umatilla River. This project both supplements and complements various ongoing and completed work within the Umatilla River basin. Knowledge gained on juvenile outmigration and survival assists researchers and managers in adapting hatchery practices, flow enhancement strategies, canal and fish ladder operations, and supplementation and enhancement efforts of natural and restored fish populations. Findings from this study also assist in assessment of the success of upriver habitat improvement projects and provide an overall evaluation of the Umatilla River fisheries restoration program. General project objectives include: Evaluation of the outmigration and survival of natural and hatchery juvenile salmonids in the lower Umatilla River, in an effort to enhance the understanding of migration characteristics, survival bottlenecks, species interactions and effects of management strategies. Specific objectives for 2002 included: (1) Operation of the remote interrogation system at Three Mile Falls Dam, West Extension Canal; (2) Design of improved PIT tag detection capabilities at Three Mile Falls Dam east bank adult fish ladder; (3) Estimates of migrant abundance, migration timing and in-basin survival of tagged juvenile salmonids representing various hatchery, rearing, acclimation and release strategies; (4) Monitoring of abundance and trends in natural production of salmon, steelhead and pacific lamprey; (5) Continuation of transport evaluation studies to evaluate the relative survival between transported and nontransported fish; (6) Assessment of the condition, health, size, growth and smolt status of hatchery and natural migrants; (7) Investigation of the effects of canal and fishway operations and environmental conditions on fish migration and survival; (8) Documentation of temporal distribution and diversity of resident

  17. Survival Estimates for the Passage of Juvenile Salmonids through Snake River Dams and Reservoirs, 1994 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Muir, William D.

    1995-02-01

    In 1994, the National Marine Fisheries Service and the University of Washington completed the second year of a multi-year study to estimate survival of juvenile salmonids (Oncorhynchus spp.) passing through the dams and reservoirs of the Snake River. Actively migrating smolts were collected at selected locations above, at, and below Lower Granite Dam, tagged with passive integrated transponder (PIT) tags, and released to continue their downstream migration. Survival estimates were calculated using the Single-Release, Modified Single-Release, and Paired-Release Models.

  18. Landscaping of highway medians and roadway safety at unsignalized intersections.

    Science.gov (United States)

    Chen, Hongyun; Fabregas, Aldo; Lin, Pei-Sung

    2016-05-01

    Well-planted and maintained landscaping can help reduce driving stress, provide better visual quality, and decrease over speeding, thus improving roadway safety. Florida Department of Transportation (FDOT) Standard Index (SI-546) is one of the more demanding standards in the U.S. for landscaping design criteria at highway medians near intersections. The purposes of this study were to (1) empirically evaluate the safety results of SI-546 at unsignalized intersections and (2) quantify the impacts of geometrics, traffic, and landscaping design features on total crashes and injury plus fatal crashes. The studied unsignalized intersections were divided into (1) those without median trees near intersections, (2) those with median trees near intersections that were compliant with SI-546, and (3) those with median trees near intersections that were non-compliant with SI-546. A total of 72 intersections were selected, for which five-year crash data from 2006-2010 were collected. The sites that were compliant with SI-546 showed the best safety performance in terms of the lowest crash counts and crash rates. Four crash predictive models-two for total crashes and two for injury crashes-were developed. The results indicated that improperly planted and maintained median trees near highway intersections can increase the total number of crashes and injury plus fatal crashes at a 90% confidence level; no significant difference could be found in crash rates between sites that were compliant with SI-546 and sites without trees. All other conditions remaining the same, an intersection with trees that was not compliant with SI-546 had 63% more crashes and almost doubled injury plus fatal crashes than those at intersections without trees. The study indicates that appropriate landscaping in highway medians near intersections can be an engineering technology that not only improves roadway environmental quality but also maintains intersection safety.

  19. Somesoppa : sosiaalisen median kehittämissuunnitelma ravintola Rustikille

    OpenAIRE

    Hartikainen, Lotta

    2016-01-01

    Tämän opinnäytetyön tarkoituksena oli tehdä Ravintola Rustikille sosiaalisen median kehittämissuunnitelma. Kehittämissuunnitelmaa varten ideoita ja kehittämiskohtia kerättiin kolmen eri keinon avulla. Ensimmäiseksi tehtiin vertaileva kirjoituspöytätutkimus neljän muun ravintolan toiminnasta sosiaalisessa mediassa ja etsittiin muiden toiminnasta vinkkejä Rustikia varten. Seuraavaksi tehtiin kartoitus Rustikin toiminnasta sosiaalisessa mediassa. Rustikin käyttämät sosiaalisen median alustat ova...

  20. FASCICULAR NEURORRHAPHY FOR NEUROMA IN CONTINUITY OF MEDIAN NERVE

    Directory of Open Access Journals (Sweden)

    Manikumar

    2015-10-01

    Full Text Available It is not common for an orthopaedic surgeon to anastomose or repair a peripheral nerve lesion. Fascicular neurorrhaphy has variable out come with median nerve repairs. The recovery by neuropathy as evidenced by NCVS does not correlate with the clinical out come. We treated a post traumatic median nerve neuroma in continuity of right hand proximal to wrist with sensory hyperaesthesisa. It was treated with excision of neuroma internal neurolysis and fascicular neurorrhaphy along with, carpal tunnel release whi ch gave him good relief from pain in the immediate post - operative period.

  1. The Median Solution of the Newsvendor Problem and Some Observations

    Directory of Open Access Journals (Sweden)

    Sinha Pritibhushan

    2015-09-01

    Full Text Available We consider the median solution of the Newsvendor Problem. Some properties of such a solution are shown through a theoretical analysis and a numerical experiment. Sometimes, though not often, median solution may be better than solutions maximizing expected profit, or maximizing minimum possible, over distribution with the same average and standard deviation, expected profit, according to some criteria. We discuss the practical suitability of the objective function set and the solution derived, for the Newsvendor Problem, and other such random optimization problems.

  2. BREAST IMPLANT RUPTURE AS A COMPLICATION OF HEART SURGERY IN MEDIAN STERNOTOMY

    OpenAIRE

    G. Nisi; CAMPANA, M.; GRIMALDI, L; C. Brandi; R. Cuomo; C. D'Aniello

    2014-01-01

    The authors report a case of a woman who underwent heart surgery in median sternotomy after breast reconstruction using prosthesis in 1984. After this open heart surgery in 2008, she developed an injury at right breast implant with intra and extra capsular silicone gel spread out the prosthesis.

  3. Survival probability in ataxia telangiectasia

    Science.gov (United States)

    Crawford, T O; Skolasky, R L; Fernandez, R; Rosquist, K J; Lederman, H M

    2006-01-01

    Ataxia telangiectasia is a rare, multiorgan neurodegenerative disorder with enhanced vulnerability to cancer and infection. Median survival in two large cohorts of patients with this disease, one prospective and one retrospective, is 25 and 19 years, with a wide range. Life expectancy does not correlate well with severity of neurological impairment. PMID:16790721

  4. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  5. Mean, Median and Mode from a Decision Perspective

    Science.gov (United States)

    Holt, Melinda Miller; Scariano, Stephen M.

    2009-01-01

    The classroom activity described here allows mathematically mature students to explore the role of mean, median and mode in a decision-making environment. While students discover the importance of choosing a measure of central tendency, their understanding of probability distributions, maximization, and prediction is reinforced through active…

  6. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    Rajkumar L Biradar; Vinayadatt V Kohir

    2013-08-01

    Image inpainting is the technique of filling-in the missing regions and removing unwanted objects from an image by diffusing the pixel information from the neighbourhood pixels. Image inpainting techniques are in use over a long time for various applications like removal of scratches, restoring damaged/missing portions or removal of objects from the images, etc. In this study, we present a simple, yet unexplored (digital) image inpainting technique using median filter, one of the most popular nonlinear (order statistics) filters. The median is maximum likelihood estimate of location for the Laplacian distribution. Hence, the proposed algorithm diffuses median value of pixels from the exterior area into the inner area to be inpainted. The median filter preserves the edge which is an important property needed to inpaint edges. This technique is stable. Experimental results show remarkable improvements and works for homogeneous as well as heterogeneous background. PSNR (quantitative assessment) is used to compare inpainting results.

  7. Elementary School Teachers' Understanding of the Mean and Median

    Science.gov (United States)

    Jacobbe, Tim

    2012-01-01

    This study provides a snapshot of elementary school teachers' understanding of the mean and median. The research is presented in light of recent work regarding preservice teachers' understanding of the mean. Common misconceptions are identified which lead to potential implications for teacher preparation programs. One of the primary concerns…

  8. Median cleft of the upper lip associated with a mass: a rare case.

    Science.gov (United States)

    Jian, Xin-Chun; Zheng, Lian; Xu, Pu; Liu, De-Yu

    2014-12-01

    Median cleft lip is a midline vertical cleft through the upper lip. This is a very rare anomaly described in the literature. Median cleft lip is caused by the failure of fusion of the medial nasal prominences. In this case report, a 4-month-old boy with a median cleft associated with a mass of the upper lip is presented. The patient has no other anomalies of the nose or alveolus. The patient has normotelorism. A Z-plasty technique was used on the skin of the base of the columella. A vertical excision of the cleft with muscle approximation was performed on the white roll and the wet-dry border of either side of the defect of the upper lip. Postoperatively, the patient had a satisfactory result. The incisive scars were not visible. Cupid's bow was appropriately aligned, and the height of the upper lip was equal on both sides.

  9. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse

    Science.gov (United States)

    Zeichner, Simon B; Ambros, Tadeu; Zaravinos, John; Montero, Alberto J; Mahtani, Reshma L; Ahn, Eugene R; Mani, Aruna; Markward, Nathan J; Vogel, Charles L

    2015-01-01

    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment. There were 189 patients diagnosed with metastatic disease within 2 months of being seen by our therapeutic team and 101 patients diagnosed with metastatic disease greater than 2 months. The patients were divided in order to account for lead-time bias than could potentially confound the analysis of the latter 101 patients. RESULTS Median survival for our primary study population of 189 patients was 33 months. As expected, the median survival from first systemic relapse (MSFSR) for the 101 patients excluded because of the potential for lead-time bias was better at 46 months. Factors influencing prognosis included estrogen receptor (ER) status, disease-free interval (DFI), and dominant site of metastasis. Compared with our original series, even with elimination of local-regional recurrences in our present series, the median survival from first relapse has improved by 7 months over the past two decades. CONCLUSION The new benchmark for MSFSR approaches 3 years. PMID:25922577

  10. Prolonged survival of a patient with metastatic leptomeningeal melanoma treated with BRAF inhibition-based therapy: a case report

    OpenAIRE

    Kim, Dae Won; Barcena, Edelyn; Mehta, Urvi N.; Rohlfs, Michelle L; Kumar, Ashok J.; Penas-Prado, Marta; Kim, Kevin B

    2015-01-01

    Background Leptomeningeal metastasis of melanoma is a devastating complication with a grave prognosis, and there are no known effective standard treatments. Although selective BRAF inhibitors have demonstrated a significant clinical activity in patients with metastatic melanoma harboring a BRAF mutation, the clinical benefit of BRAF inhibitor-based therapy in leptomeningeal disease is not clear. Case presentation We present a case of prolonged survival of a patient with BRAF V600E-mutant lept...

  11. Survival rates and causes of revision in cemented primary total knee replacement: a report from the Norwegian Arthroplasty Register 1994-2009.

    Science.gov (United States)

    Gøthesen, O; Espehaug, B; Havelin, L; Petursson, G; Lygre, S; Ellison, P; Hallan, G; Furnes, O

    2013-05-01

    We evaluated the rates of survival and cause of revision of seven different brands of cemented primary total knee replacement (TKR) in the Norwegian Arthroplasty Register during the years 1994 to 2009. Revision for any cause, including resurfacing of the patella, was the primary endpoint. Specific causes of revision were secondary outcomes. Three posterior cruciate-retaining (PCR) fixed modular-bearing TKRs, two fixed non-modular bearing PCR TKRs and two mobile-bearing posterior cruciate-sacrificing TKRs were investigated in a total of 17 782 primary TKRs. The median follow-up for the implants ranged from 1.8 to 6.9 years. Kaplan-Meier 10-year survival ranged from 89.5% to 95.3%. Cox's relative risk (RR) was calculated relative to the fixed modular-bearing Profix knee (the most frequently used TKR in Norway), and ranged from 1.1 to 2.6. The risk of revision for aseptic tibial loosening was higher in the mobile-bearing LCS Classic (RR 6.8 (95% confidence interval (CI) 3.8 to 12.1)), the LCS Complete (RR 7.7 (95% CI 4.1 to 14.4)), the fixed modular-bearing Duracon (RR 4.5 (95% CI 1.8 to 11.1)) and the fixed non-modular bearing AGC Universal TKR (RR 2.5 (95% CI 1.3 to 5.1)), compared with the Profix. These implants (except AGC Universal) also had an increased risk of revision for femoral loosening (RR 2.3 (95% CI 1.1 to 4.8), RR 3.7 (95% CI 1.6 to 8.9), and RR 3.4 (95% CI 1.1 to 11.0), respectively). These results suggest that aseptic loosening is related to design in TKR.

  12. Comparative Survival Study (CSS) of Hatchery PIT-tagged Spring/Summer Chinook; Migration Years 1997-2000 Mark/Recapture Activities, 2001 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Bouwes, Nick (EcoLogical Research, Providence, UT); Petrosky, Charlie (Idaho Department of Fish and Game, Boise ID); Schaller, Howard (US Fish and Wildlife Service, Columbia River Fisheries Program Office, Vancouver, WA)

    2002-02-01

    below Bonneville Dam to adults returning to Lower Granite Dam. A ''D'' equal to one indicates that there is no difference in survival rate after hydrosystem passage, while a ''D'' less than one indicates that transported smolts die at a greater rate after release, than smolts that have migrated through the hydrosystem. While the relative survival rates of transported and in-river migrants are important, the SARs must be also be sufficient to allow the salmon to persist and recover (Mundy et al. 1994). Decreased SARs could result from delayed hydrosystem mortality for either transported or in-river migrants, or both. Major objectives of CSS include: (1) development of a long-term index of transport SAR to in-river SAR for Snake River hatchery spring and summer chinook smolts measured at Lower Granite Dam; (2) develop a long-term index of survival rates from release of smolts at Snake River hatcheries to return of adults to the hatcheries; (3) compute and compare the overall SARs for selected upriver and downriver spring and summer chinook hatcheries; (4) begin a time series of SARs for use in hypothesis testing and in the regional long-term monitoring and evaluation program; (5) evaluate growth patterns of transported and in-river migrating smolts, and of upriver and downriver stocks. Primary CSS focus in this report for the 1997-1999 migration years included hatchery chinook tasks for objectives 1, 4 and 5.

  13. Median Statistics and the Mass Density of the Universe

    CERN Document Server

    Chen, G; Chen, Gang; Ratra, Bharat

    2003-01-01

    We use weighted mean and median statistics techniques to combine individual estimates of Omega_m0, the present mean mass density in non-relativistic matter, and determine the observed values and ranges of Omega_m0 from different combinations of data. The derived weighted mean Omega_m0 values are not good representatives of the individual measurements, under the assumptions of Gaussianity and negligible correlation between the individual measurements. This could mean that some observational error bars are under-estimated. Discarding the most discrepant about 5% of the measurements generally alleviates but does not completely resolve this problem. While the results derived from the different combinations of data are not identical, they are mostly consistent, and a reasonable summary of the median statistics analyses is 0.2 <= Omega_m0 <= 0.35 at two standard deviations.

  14. A Rank Test on Equality of Population Medians

    Directory of Open Access Journals (Sweden)

    Pooi Ah Hin

    2013-02-01

    Full Text Available The Kruskal-Wallis test is a non-parametric test for the equality of K population medians. The test statistic involved is a measure of the overall closeness of the K average ranks in the individual samples to the average rank in the combined sample. The resulting acceptance region of the test however may not be the smallest region with the required acceptance probability under the null hypothesis. Presently an alternative acceptance region is constructed such that it has the smallest size, apart from having the required acceptance probability. Compared to the Kruskal-Wallis test, the alternative test is found to have larger average power computed from the powers along the evenly chosen directions of deviation of the medians.

  15. The median recoil direction as a WIMP directional detection signal

    CERN Document Server

    Green, Anne M

    2010-01-01

    Direct detection experiments have reached the sensitivity required to detect dark matter WIMPs. Demonstrating that a putative signal is due to WIMPs, and not backgrounds, is a major challenge however. The direction dependence of the WIMP scattering rate provides a potential WIMP `smoking gun'. If the WIMP distribution is predominantly smooth, the Galactic recoil distribution is peaked in the direction opposite to the direction of Solar motion. Previous studies have found that, for an ideal detector, of order 10 WIMP events would be sufficient to reject isotropy, and rule out an isotropic background. We examine how the median recoil direction could be used to confirm the WIMP origin of an anisotropic recoil signal. Specifically we determine the number of events required to reject the null hypothesis that the median direction is random (corresponding to an isotropic Galactic recoil distribution) at 95% confidence. We find that for zero background 31 events are required, a factor of roughly 2 more than are requi...

  16. Long-Term Survival and Improved Quality of Life following Multiple Repeat Gamma Knife Radiosurgeries for Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Erik W. Larson

    2013-01-01

    Full Text Available The management of glioblastoma multiforme (GBM is in most cases complex and must be specifically tailored to the needs of the patient with the goals of extended survival and improved quality of life. Despite advancements in therapy, treatment outcomes remain almost universally poor. Salvage treatment options for the recurrence of the disease is an area of intense study. The following case highlights the utility of Gamma Knife Radiosurgery (GKRS as a salvage treatment. In this clinical situation, three sequential GKRS treatments led to prolonged survival (beyond four years after diagnosis and improved quality of life in a patient who was unable to receive further chemotherapy regimens and was unwilling to undergo further aggressive resection. To date, there have been few reports of three or more sequential GKRS treatment sessions utilized as salvage therapy for recurrent GBM in patients who can no longer tolerate chemotherapy. This report provides evidence that aggressive local treatment with GKRS at the time of recurrence may be appropriate, depending on a patient’s individual clinical situation, and can lead to prolonged survival and improved quality of life.

  17. Cortical plasticity in response to median nerve trauma

    OpenAIRE

    2016-01-01

    Median nerve injuries in adults, repaired with nerve suture, lead to incomplete functional recovery despite improved surgical technique. This results in a reduction in quality of life, poorer working ability and a considerable expense for society. Misrouting of axons at the suture site connects regenerating axons to the wrong distal end organs. When distorted signals are conveyed to the dorsal root ganglia, spinal cord, thalamus and the somatosensory cortex, somatotopic maps at...

  18. Educational system, income inequality and growth: the median voter's decision

    Directory of Open Access Journals (Sweden)

    Joilson Dias

    2005-03-01

    Full Text Available I analyze a long run educational policy as a mechanism to close the income gap among low, median and high-income families. If the choice is made endogenous by the use of the median voter theorem, the results are as follow: i public education system guarantees income convergence, however the income growth rate of the median voter is smaller; ii the combination public and private (hybrid educational system allows faster income growth rate, but income inequality is almost the natural outcome. The ending result is that the combination public and private system will prevail, since the income growth rate of the median voter is higher in this system. This might explain the persistence and differences of income inequality among the economies.O objetivo deste artigo é analisar a utilização da política educacional no longo prazo como mecanismo para a redução da desigualdade de renda entre famílias de renda baixa, mediana e alta. Se a decisão sobre a política for endogeneizada, de acordo com o teorema do eleitor mediano, os resultados são os seguintes: i o sistema educacional público para todos, apesar de garantir convergência de renda, produz uma menor taxa de crescimento da renda do eleitor mediano; ii a combinação público-privado (sistema educacional híbrido permite uma maior taxa de crescimento da renda do eleitor mediano, no entanto a desigualdade de renda é inerente a este sistema. Como resultado final, o eleitor mediano irá escolher o sistema público-privado, pois o crescimento da sua renda é maior, o que pode explicar a persistência e as diferenças na desigualdade de renda das economias.

  19. Male median raphe cysts: serial retrospective analysis and histopathological classification

    Directory of Open Access Journals (Sweden)

    Shao I-Hung

    2012-09-01

    Full Text Available Abstract Background To review the clinical and pathological characteristics of median raphe cysts and to classify the lesions according to pathogenesis and histopathological findings. Methods The medical records of patients who were diagnosed with median raphe cysts between 2001 and 2010 were reviewed to document the clinical presentation and pathological findings of the cysts. Results Most patients were asymptomatic; however, 9 patients had inflammatory or infectious cysts that were tender or painful. Four patients who had cysts on the parameatus and distal prepuce had difficulty voiding. Hematuria and hematospermia were noted in 2 cases. Thirty-one cysts were lined with an urothelium-like epithelium, and a squamous epithelium lining was found in 3 cases. In 2 cases, a well-formed mucinous glandular structure was observed. The other 20 cysts consisted of mixed epithelia. After excision of the cysts under local or general anesthesia, an urethral fistula developed as a complication in only 1 case. Conclusions Median raphe cysts are benign lesions formed due to tissue trapping during the development of urethral folds. The cysts can be defined into 4 types based on pathological findings: urethral, epidermoid, glandular, and mixed. The associated symptoms and signs should be taken into consideration when determining the treatment for the cysts. Virtual slides The virtual slide(s for this article can be found here: http//http://www.diagnosticpathology.diagnomx.eu/vs/7727074877500751

  20. Microseismic event denoising via adaptive directional vector median filters

    Science.gov (United States)

    Zheng, Jing; Lu, Ji-Ren; Jiang, Tian-Qi; Liang, Zhe

    2017-03-01

    We present a novel denoising scheme via Radon transform-based adaptive vector directional median filters named adaptive directional vector median filter (AD-VMF) to suppress noise for microseismic downhole dataset. AD-VMF contains three major steps for microseismic downhole data processing: (i) applying Radon transform on the microseismic data to obtain the parameters of the waves, (ii) performing S-transform to determine the parameters for filters, and (iii) applying the parameters for vector median filter (VMF) to denoise the data. The steps (i) and (ii) can realize the automatic direction detection. The proposed algorithm is tested with synthetic and field datasets that were recorded with a vertical array of receivers. The P-wave and S-wave direct arrivals are properly denoised for poor signal-to-noise ratio (SNR) records. In the simulation case, we also evaluate the performance with mean square error (MSE) in terms of signal-to-noise ratio (SNR). The result shows that the distortion of the proposed method is very low; the SNR is even less than 0 dB.

  1. Survival Estimates for the Passage of Spring-Migrating Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.; Muir, William D.; Marsh, Douglas M. (National Marine Fisheries Service, Northwest Fisheries Science Center, Fish Ecology Division, Seattle, WA)

    2005-10-01

    In 2004, the National Marine Fisheries Service and the University of Washington completed the twelfth year of a study to estimate survival and travel time of juvenile salmonids (Oncorhynchus spp.) passing through dams and reservoirs on the Snake and Columbia Rivers. All estimates were derived from detections of fish tagged with passive integrated transponder tags (PIT tags). We PIT tagged and released a total of 19,621 hatchery steelhead, 8,128 wild steelhead, and 9,227 wild yearling Chinook salmon at Lower Granite Dam. In addition, we utilized fish PIT tagged by other agencies at traps and hatcheries upstream from the hydropower system and sites within the hydropower system. PIT-tagged smolts were detected at interrogation facilities at Lower Granite, Little Goose, Lower Monumental, McNary, John Day, and Bonneville Dams and in the PIT-tag detector trawl operated in the Columbia River estuary. Survival estimates were calculated using a statistical model for tag-recapture data from single release groups (the single-release model). Primary research objectives in 2004 were to (1) estimate reach survival and travel time in the Snake and Columbia Rivers throughout the migration period of yearling Chinook salmon O. tshawytscha and steelhead O. mykiss; (2) evaluate relationships between survival estimates and migration conditions; and (3) evaluate the survival-estimation models under prevailing conditions. This report provides reach survival and travel time estimates for 2004 for PIT-tagged yearling Chinook salmon (hatchery and wild), hatchery sockeye salmon O. nerka, hatchery coho salmon O. kisutch, and steelhead (hatchery and wild) in the Snake and Columbia Rivers. Results are reported primarily in the form of tables and figures; details on methodology and statistical models used are provided in previous reports cited here. Survival and detection probabilities were estimated precisely for most of the 2004 yearling Chinook salmon and steelhead migrations. Hatchery and

  2. Long-term Survival of A Patient with Advanced Non-small Cell Lung Cancer 
on Bevacizumab Therapy: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Wei WU

    2013-06-01

    Full Text Available We report an advanced stage Chinese female lung adenocarcinoma patient who was negative for epidermal growth factor receptor (EGFR, V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS gene mutations, also negative for chinodem microtubule-associated protein-like 4/anaplastic lymphoma kinase (EML4-ALK gene rearrangement and treated with bevacizumab (15 mg/kg in combination with 6 cycles of conventional doses of paclitaxel and carboplatin chemotherapy. She was then treated with maintenance bevacizumab for a total of 42 cycles, the total dose of bevacizumab is 44,730 mg. The progression-free survival was 39 months. Our findings suggest that maintenance bevacizumab for the treatment of non-small cell lung cancer (NSCLC is safe and its benefit for long-term survival overwhelms its side effects.

  3. Survival of Korean Huntington’s Disease Patients

    Science.gov (United States)

    Kim, Han-Joon; Shin, Chae-Won; Jeon, Beomseok; Park, Hyeyoung

    2016-01-01

    Objective The survival of Huntington’s disease (HD) patients is reported to be 15–20 years. However, most studies on the survival of HD have been conducted in patients without genetic confirmation with the possible inclusion of non-HD patients, and all studies have been conducted in Western countries. The survival of patients with HD in East Asia, where its prevalence is 10–50-fold lower compared with Western populations, has not yet been reported. Methods Forty-seven genetically confirmed Korean HD patients from independent families were included in this retrospective medical record review study. Results The mean age at onset among the 47 patients was 46.1 ± 14.0 years. At the time of data collection, 25 patients had died, and these patients had a mean age at death of 57.8 ± 13.7 years. The Kaplan-Meier estimate of the median survival from onset in the 47 patients was 14.5 years (95% confidence interval: 12.3–16.6). None of the following factors were associated with the survival time in the univariate Cox regression analysis: gender, age at onset, normal CAG repeat size, mutant CAG repeat size, and the absence or presence of non-motor symptoms at onset. Conclusion This is the first Asian study on survival in HD patients. Survival in Korean HD patients may be shorter than that reported for Western populations, or at least is in the lower range of expected survival. A larger longitudinal observation study is needed to confirm the results found in this study. PMID:27667189

  4. A Unique Case of Hepatocellular Carcinoma Treated with Radiofrequency Ablation with More than 12 Years Overall Survival: A Case Report

    Directory of Open Access Journals (Sweden)

    Loukas Thanos

    2010-01-01

    Full Text Available The case of a 72-year-old male patient with HCC is presented in whom percutaneous RFA was used as the sole first-line anticancer treatment, since he denied having partial hepatectomy. The patient underwent RFA two more times, at 1.5 years for treating a local tumor progression at the initial ablation site and at 11 years after the first session for treating a new remote intrahepatic recurrence. He revealed a long-term survival of more than 12 years so far and still remains in excellent clinical status.

  5. Comparative Survival [Rate] Study (CSS) of Hatchery PIT-tagged Chinook; Migration Years 1996-1998 Mark/Recapture Activities, 2000 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Berggren, Thomas J.; Basham, Larry R. (Columbia Basin Fish and Wildlife Authority, Fish Passage Center, Portland, OR)

    2000-10-01

    The Comparative Survival Rate Study (CSS) is a multi-year program of the fishery agencies and tribes to measure the smolt-to-adult survival rates of hatchery spring and summer chinook at major production hatcheries in the Snake River basin and at selected hatcheries in the lower Columbia River. The CSS also compares the smolt-to-adult survival rates for Snake River basin chinook that were transported versus those that migrated in-river to below Bonneville Dam. Estimates of smolt-to-adult survival rates will be made both from Lower Granite Dam back to Lower Granite Dam (upriver stocks) and from the hatchery back to the hatchery (upriver and downriver stocks). This status report covers the first three migration years, 1996 to 1998, of the study. Study fish were implanted with a PIT (Passive Integrated Transponder) tag which allows unique identification of individual fish. Beginning in 1997, a predetermined proportion of the PIT tagged study fish in the collection/bypass channel at the transportation sites, such as Lower Granite and Little Goose dams, was purposely routed to the raceways for transportation and the rest was routed back to the river. Two categories of in-river migrating fish are used in this study. The in-river group most representative of the non-tagged fish are fish that migrate past Lower Granite, Little Goose, and Lower Monumental dams undetected in the bypass systems. This is because all non-tagged fish collected at these three dams are currently being transported. The other in-river group contains those fish remaining in-river below Lower Monumental Dam that had previously been detected at one or more dams. The number of fish starting at Lower Granite dam that are destined to one of these two in-river groups must be estimated. The Jolly-Seber capture-recapture methodology was used for that purpose. Adult (including jacks) study fish returning to the hatcheries in the Snake River basin were sampled at the Lower Granite Dam adult trap. There the PIT

  6. Post-Release Attributes and Survival of Hatchery and Natural Fall Chinook Salmon in the Snake River, Annual Report 1998.

    Energy Technology Data Exchange (ETDEWEB)

    Tiffan, Kenneth F.; Rondorf, Dennis W.; Connor, William P.; Burge, Howard L.

    1999-12-01

    This report summarizes results of research activities conducted primarily in 1997 and 1998. This report communicates significant findings that will aid in the management and recovery of fall chinook salmon in the Columbia River Basin.

  7. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    The General Unified Threshold model for Survival (GUTS) integrates previously published toxicokinetic-toxicodynamic models and estimates survival with explicitly defined assumptions. Importantly, GUTS accounts for time-variable exposure to the stressor. We performed three studies to test...... the ability of GUTS to predict survival of aquatic organisms across different pesticide exposure patterns, time scales and species. Firstly, using synthetic data, we identified experimental data requirements which allow for the estimation of all parameters of the GUTS proper model. Secondly, we assessed how...

  8. Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry.

    Science.gov (United States)

    Ling, Qi; Dai, Haojiang; Zhuang, Runzhou; Shen, Tian; Wang, Weilin; Xu, Xiao; Zheng, Shusen

    2017-02-13

    To compare the performance of eight score systems (MELD, uMELD, MELD-Na. iMELD, UKELD, MELD-AS, CTP, and mCTP) in predicting the post-transplant mortality, we analyzed the data of 6,014 adult cirrhotic patients who underwent liver transplantation between January 2003 and December 2010 from the China Liver Transplant Registry database. In hepatitis B virus (HBV) group, MELD, uMELD and MELD-AS showed good predictive accuracies at 3-month mortality after liver transplantation; by comparison with other five models, MELD presented the best ability in predicting 3-month, 6-month and 1-year mortality, showing a significantly better predictive ability than UKELD and iMELD. In hepatitis C virus and Alcohol groups, the predictive ability did not differ significantly between MELD and other models. Patient survivals in different MELD categories were of statistically significant difference. Among patients with MELD score >35, a new prognostic model based on serum creatinine, need for hemodialysis and moderate ascites could identify the sickest one. In conclusion, MELD is superior to other score systems in predicting short-term post-transplant survival in patients with HBV-related liver disease. Among patients with MELD score >35, a new prognostic model can identify the sickest patients who should be excluded from waiting list to prevent wasteful transplantation.

  9. Outcome of contralateral C7 nerve transferring to median nerve

    Institute of Scientific and Technical Information of China (English)

    GAO Kai-ming; LAO Jie; ZHAO Xin; GU Yu-dong

    2013-01-01

    Background Contralateral C7 (cC7) transfer had been widely used in many organizations in the world,but the outcomes were significantly different.So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.Methods A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted.All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve.The cC7 nerve was used in three different ways.The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients.The mean follow-up period was 6.9 years.Results The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function.The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer.The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.Conclusions cC7 transfer is an effective procedure in repairing median nerve.But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor.The optimal interval between two surgery stages is 4-8 months.

  10. Quadratic Assignment of Hubs in p-Hub Median Problem

    DEFF Research Database (Denmark)

    Gelareh, Shahin

    We introduce Generalized p-Hub Median Problem (GpHMP) that seeks to locate p hub nodes and install p distinct hub facilities/operators on the hubs while discount factor resulted by consolidation of flow on the hub links depends on the facilities/operators that are installed/operating on both hub...... nodes end-point. In contrast, in traditional hub location problems it is commonly assumed that all the hub facilities share a similar characteristic and economy of scale resulted by consolidation of flow over hub edges is not directly relevant to the hub facilities being installed at both end...

  11. The p-median Facility Location Problem and Solution Approaches

    Directory of Open Access Journals (Sweden)

    Mehmet BASTI

    2012-05-01

    Full Text Available In today’s globalized and increasingly competitive environment, organizations’ need to implement successful strategies for supply chain management has become indispensable. Transportation costs within the supply chain comprise an important part of the organizations’ expenses. For this reason, the strategic selection of location is an issue that directly affects supply chain performance and costs. At this stage, it becomes very important to apply the latest and the best methods to the facility location problem. The focus of this study is the p-median problem and its solution techniques, one of the location allocation problems aimed at minimizing the costs arising from shipments between facilities and demand points.

  12. Median and ulnar nerve compression at the wrist caused by anomalous muscles.

    Science.gov (United States)

    De Smet, L

    2002-12-01

    Compression of the median and ulnar nerves at the wrist is frequently encountered. Carpal tunnel syndrome usually occurs without any obvious extrinsic cause; several cases have however been reported caused by anomalous or hypertrophic muscles. A survey of the literature shows that compression neuropathy of the median nerve has been reported in relation with anomalies affecting three muscles: the first (or second) lumbrical, the palmaris longus and its anatomic variants and the superficial flexor of the index finger. In the ulnar tunnel the situation is thoroughly different: so-called idiopathic ulnar tunnel syndrome is rare and an extrinsic compressing structure can usually be disclosed. Anomalous muscles belong to the palmaris longus/abductor digiti minimi group; the flexor carpi ulnaris is sometimes involved. One can suspect the presence of such an anomalous muscle when the compression syndrome concerns a patient who is not within the "usual" age group with symptoms initiated or aggravated by physical exercise.

  13. Evaluation of Life History Diversity, Habitat Connectivity, and Survival Benefits Associated with Habitat Restoration Actions in the Lower Columbia River and Estuary, Annual Report 2010

    Energy Technology Data Exchange (ETDEWEB)

    Diefenderfer, Heida L.; Johnson, Gary E.; Sather, Nichole K.; Skalski, J. R.; Dawley, Earl M.; Coleman, Andre M.; Ostrand, Kenneth G.; Hanson, Kyle C.; Woodruff, Dana L.; Donley, Erin E.; Ke, Yinghai; Buenau, Kate E.; Bryson, Amanda J.; Townsend, Richard L.

    2011-10-01

    This report describes the 2010 research conducted under the U.S. Army Corps of Engineers (USACE) project EST-P-09-1, titled Evaluation of Life History Diversity, Habitat Connectivity, and Survival Benefits Associated with Habitat Restoration Actions in the Lower Columbia River and Estuary, and known as the 'Salmon Benefits' study. The primary goal of the study is to establish scientific methods to quantify habitat restoration benefits to listed salmon and trout in the lower Columbia River and estuary (LCRE) in three required areas: habitat connectivity, early life history diversity, and survival (Figure ES.1). The general study approach was to first evaluate the state of the science regarding the ability to quantify benefits to listed salmon and trout from habitat restoration actions in the LCRE in the 2009 project year, and then, if feasible, in subsequent project years to develop quantitative indices of habitat connectivity, early life history diversity, and survival. Based on the 2009 literature review, the following definitions are used in this study. Habitat connectivity is defined as a landscape descriptor concerning the ability of organisms to move among habitat patches, including the spatial arrangement of habitats (structural connectivity) and how the perception and behavior of salmon affect the potential for movement among habitats (functional connectivity). Life history is defined as the combination of traits exhibited by an organism throughout its life cycle, and for the purposes of this investigation, a life history strategy refers to the body size and temporal patterns of estuarine usage exhibited by migrating juvenile salmon. Survival is defined as the probability of fish remaining alive over a defined amount of space and/or time. The objectives of the 4-year study are as follows: (1) develop and test a quantitative index of juvenile salmon habitat connectivity in the LCRE incorporating structural, functional, and hydrologic components; (2

  14. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review.

    Science.gov (United States)

    Moraschini, V; Poubel, L A da C; Ferreira, V F; Barboza, E dos S P

    2015-03-01

    The aim of this systematic review was to evaluate the survival and success rates of osseointegrated implants determined in longitudinal studies that conducted a follow-up of at least 10 years. A broad electronic search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications in indexed journals, evaluating the clinical performance of dental implants. Using inclusion and exclusion criteria, two reviewers analyzed titles, abstracts, and complete articles, prioritizing studies of the randomized clinical trial type. A total of 23 articles were included in this review. Ten prospective studies, nine retrospective studies, and four randomized clinical trials, which evaluated 7711 implants, were selected. The mean follow-up time of the studies included was 13.4 years. All of the studies reported survival rates and mean marginal bone resorption values, with cumulative mean values of 94.6% and 1.3mm, respectively. Fourteen studies related success rates. Taking into consideration the disparate outcome measures employed to assess dental implant performance and within the limitations of this systematic review, we may affirm that osseointegrated implants are safe and present high survival rates and minimal marginal bone resorption in the long term.

  15. Effects of Summer Flow Augmentation on the Migratory Behavior and Survival of Juvenile Snake River Fall Chinook Salmon; 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Tiffan, Kenneth F.; Haskell, Craig A. (US Geological Survey, Western Fisheries Research Center, Columbia River Research Laboratory, Cook, WA); Connor, William P. (US Fish and Wildlife Service, Idaho Fishery Resource Office, Ahsahka, ID)

    2003-10-01

    This report summarizes results of research activities conducted in 2002 and years previous to aid in the management and recovery of fall chinook salmon Oncorhynchus tshawytscha in the Columbia River basin. The report is divided into self-standing chapters. For detailed summaries, we refer the reader to the abstracts given on the second page of each chapter. The Annual Reporting section includes information provided to fishery managers in-season and post-season, and it contains a detailed summary of life history and survival statistics on wild Snake River fall chinook salmon juveniles for the years 1992-2002. Peer-review publication remains a high priority of this research project, and it insures that our work meets high scientific standards. The Bibliography of Published Journal Articles section provides citations for peer-reviewed papers coauthored by personnel of project 199102900 that were written or published from 1998 to 2003.

  16. More than 10 years survival with sequential therapy in a patient with advanced renal cell carcinoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, J.L.; Wang, F.L.; Yi, X.M.; Qin, W.J.; Wu, G.J. [Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China); Huan, Y. [Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China); Yang, L.J.; Zhang, G.; Yu, L.; Zhang, Y.T.; Qin, R.L.; Tian, C.J. [Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China)

    2014-10-31

    Although radical nephrectomy alone is widely accepted as the standard of care in localized treatment for renal cell carcinoma (RCC), it is not sufficient for the treatment of metastatic RCC (mRCC), which invariably leads to an unfavorable outcome despite the use of multiple therapies. Currently, sequential targeted agents are recommended for the management of mRCC, but the optimal drug sequence is still debated. This case was a 57-year-old man with clear-cell mRCC who received multiple therapies following his first operation in 2003 and has survived for over 10 years with a satisfactory quality of life. The treatments given included several surgeries, immunotherapy, and sequentially administered sorafenib, sunitinib, and everolimus regimens. In the course of mRCC treatment, well-planned surgeries, effective sequential targeted therapies and close follow-up are all of great importance for optimal management and a satisfactory outcome.

  17. Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Hiromasa Fujii

    2009-01-01

    Full Text Available We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8×4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP→FDS; ECRL→FDP; BrR→FPL; EDM→opponens with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment.

  18. Reporting errors in siblings' survival histories and their impact on adult mortality estimates: results from a record linkage study in Senegal.

    Science.gov (United States)

    Helleringer, Stéphane; Pison, Gilles; Kanté, Almamy M; Duthé, Géraldine; Andro, Armelle

    2014-04-01

    Estimates of adult mortality in countries with limited vital registration (e.g., sub-Saharan Africa) are often derived from information about the survival of a respondent's siblings. We evaluated the completeness and accuracy of such data through a record linkage study conducted in Bandafassi, located in southeastern Senegal. We linked at the individual level retrospective siblings' survival histories (SSH) reported by female respondents (n = 268) to prospective mortality data and genealogies collected through a health and demographic surveillance system (HDSS). Respondents often reported inaccurate lists of siblings. Additions to these lists were uncommon, but omissions were frequent: respondents omitted 3.8 % of their live sisters, 9.1 % of their deceased sisters, and 16.6 % of their sisters who had migrated out of the DSS area. Respondents underestimated the age at death of the siblings they reported during the interview, particularly among siblings who had died at older ages (≥45 years). Restricting SSH data to person-years and events having occurred during a recent reference period reduced list errors but not age and date errors. Overall, SSH data led to a 20 % underestimate of 45 q 15 relative to HDSS data. Our study suggests new quality improvement strategies for SSH data and demonstrates the potential use of HDSS data for the validation of "unconventional" demographic techniques.

  19. Traumatic posterior atlantooccipital dislocation with Jefferson fracture and fracture-dislocation of C6-C7: a case report with survival

    OpenAIRE

    Park, Jong-Beom; Ha, Kee-Yong; Chang, Han

    2001-01-01

    Atlantooccipital dislocation (AOD) is a rare and usually fatal injury. In the current study, the authors reported an extremely rare case of posterior AOD with Jefferson fracture and fracture-dislocation of C6-C7. The patient survived the injury and had only incomplete quadriplegia below the C7 segment with anterior cord syndrome. He was successfully managed with in situ occipitocervical fusion using the Cotrel-Dubousset rod system, corpectomy of C6, and anterior interbody fusion of C5–C7 with...

  20. Allergies, obesity, other risk factors and survival from pancreatic cancer.

    Science.gov (United States)

    Olson, Sara H; Chou, Joanne F; Ludwig, Emmy; O'Reilly, Eileen; Allen, Peter J; Jarnagin, William R; Bayuga, Sharon; Simon, Jennifer; Gonen, Mithat; Reisacher, William R; Kurtz, Robert C

    2010-11-15

    Survival from pancreatic adenocarcinoma remains extremely poor, approximately 5% at 5 years. Risk factors include smoking, high body mass index (BMI), family history of pancreatic cancer, and long-standing diabetes; in contrast, allergies are associated with reduced risk. Little is known about associations between these factors and survival. We analyzed overall survival in relation to risk factors for 475 incident cases who took part in a hospital based case-control study. Analyses were conducted separately for those who did (160) and did not (315) undergo tumor resection. Kaplan-Meier methods were used to describe survival according to smoking, BMI, family history, diabetes, and presence of allergies. Cox proportional hazards models were used to adjust for covariates. There was no association with survival based on smoking, family history, or history of diabetes in either group. Among patients with resection, those with allergies showed nonstatistically significant longer survival, a median of 33.1 months (95% CI: 19.0-52.5) vs. 21.8 months (95% CI: 18.0-33.1), p = 0.25. The adjusted hazard ratio (HR) was 0.72 (95% CI: 0.43-1.23), p = 0.23. Among patients without resection, those with self-reported allergies survived significantly longer than those without allergies: 13.3 months (95% CI: 10.6-16.9) compared to 10.4 months (95% CI: 8.8-11.0), p = 0.04, with an adjusted HR of 0.68 (95% CI: 0.49-0.95), p = 0.02. Obesity was nonsignificantly associated with poorer survival, particularly in the resected group (HR = 1.62, 95% CI: 0.76-3.44). The mechanisms underlying the association between history of allergies and improved survival are unknown. These novel results need to be confirmed in other studies.

  1. Radiographic signs of open median sternotomy in neonates and infants

    Energy Technology Data Exchange (ETDEWEB)

    Wu, George [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Geisinger Medical Center, Danville, PA (United States); Jaimes, Camilo; Markowitz, Richard I. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Gaynor, J.W. [The Children' s Hospital of Philadelphia, Department of Surgery, Philadelphia, PA (United States)

    2012-06-15

    Leaving the median sternotomy wound open following cardiac surgery is employed to avoid cardiovascular compression. Horizontal struts can be used. Radiologists interpreting portable radiographs might be unaware of the open median sternotomy (OMS). To describe the frequency of radiographic signs of OMS and to increase awareness among radiologists to prevent misdiagnosis of pneumothorax and pneumomediastinum. Radiographs of 41 infants (17 girls/24 boys) with OMS were studied (age range 2 days to 8 months, mean 33 days). Central lucency and sternal edges were noted. Interclavicular distances before and after sternotomy were compared. Central lucency was seen in 25/41 (61%) children. Sternal struts were apparent in 27 (66%). In 14 without struts, central lucency was present in 8 (57%). In 27 children with struts, central lucency was present in 17 (63%) and absent in 10 (37%). Split sternal centers were identified in 6/41 (15%). The mean interclavicular distance was 23.5 mm (SD = 4.39) before sternotomy and 38.2 mm (SD = 7.0 mm) after sternotomy (P < 0.001). OMS has characteristic signs in the majority of cases. Recognition of these findings is useful and can prevent misinterpretation. (orig.)

  2. Neural Organization of the Median Ocellus of the Dragonfly

    Science.gov (United States)

    Dowling, John E.; Chappell, Richard L.

    1972-01-01

    Two types of presumed synaptic contacts have been recognized by electron microscopy in the synaptic plexus of the median ocellus of the dragonfly. The first type is characterized by an electron-opaque, button-like organelle in the presynaptic cytoplasm, surrounded by a cluster of synaptic vesicles. Two postsynaptic elements are associated with these junctions, which we have termed button synapses. The second synaptic type is characterized by a dense cluster of synaptic vesicles adjacent to the presumed presynaptic membrane. One postsynaptic element is observed at these junctions. The overwhelming majority of synapses seen in the plexus are button synapses. They are found most commonly in the receptor cell axons where they synaptically contact ocellar nerve dendrites and adjacent receptor cell axons. Button synapses are also seen in the ocellar nerve dendrites where they appear to make synapses back onto receptor axon terminals as well as onto adjacent ocellar nerve dendrites. Reciprocal and serial synaptic arrangements between receptor cell axon terminals, and between receptor cell axon terminals and ocellar nerve dendrites are occasionally seen. It is suggested that the lateral and feedback synapses in the median ocellus of the dragonfly play a role in enhancing transients in the postsynaptic responses. PMID:5049076

  3. Docetaxel- and 5-FU-concurrent radiotherapy in patients presenting unresectable locally advanced pancreatic cancer: a FNCLCC-ACCORD/0201 randomized phase II trial's pre-planned analysis and case report of a 5.5-year disease-free survival

    Directory of Open Access Journals (Sweden)

    Peiffert Didier

    2011-09-01

    Full Text Available Abstract Background To explore possible improvement in the treatment of locally advanced pancreatic carcinoma (LAPC we performed a randomized, non-comparative phase II study evaluating docetaxel - plus either daily continuous 5 FU or weekly cisplatin concurrent to radiotherapy. We report here the results of the docetaxel plus 5 FU regimen stopped according to the interim analysis. The docetaxel plus cisplatin arm was continued. Methods Forty (40 chemotherapy-naive patients with unresectable LAPC were randomly assigned (1:1 to either continuous fluorouracil (5-FU 200 mg/m2/day (protracted IV and docetaxel (DCT 20 mg/m2/week or DCT 20 mg/m2 and cisplatin (CDDP 20 mg/m2, plus concurrent radiotherapy for a period of 6 weeks. The radiation dose to the primary tumor was 54 Gy in 30 fractions. The trial's primary endpoint was the 6-month crude non-progression rate (NPR. Secondary endpoints were tolerance, objective response rate, and overall survival. Accrual was to be stopped if at 6 months more than 13 disease progressions were observed in 20 patients. Results Eighteen (18 progressions occurred at 6 months in the 5-FU-DCT arm. Six-month NPR was 10% (95%CI: 0-23. Six and 12-month survivals were 85% (95%CI: 64-95 and 40% (95%CI: 22-61; median overall survival was 10.1 months. Median progression-free survival was 4.3 months. We report the case of one patient who was amenable to surgery and has been in complete response (CR for 5.5 years. Toxicities grade ≥ 3 were reported in 75% of patients; no treatment-related death occurred. Severe toxicities were mainly vomiting (35%, abdominal pain (10% and fatigue (10%. Conclusions Combination of 5-FU, docetaxel and radiotherapy has inadequate efficacy in the treatment of LAPC despite good tolerance for the 5-FU-DCT regimen. Trial Registration ClinicalTrials.gov: NCT00112697

  4. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-06-02

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures.

  5. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse

    OpenAIRE

    Zeichner, Simon B.; Tadeu Ambros; John Zaravinos; Montero, Alberto J.; Mahtani, Reshma L; Ahn, Eugene R; Aruna Mani; Markward, Nathan J; Vogel, Charles L.

    2015-01-01

    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between ...

  6. Survival of Hatchery Subyearling Fall Chinook Salmon in the Free-Flowing Snake River and Lower Snake River Reservoirs, 1998-2001 Summary Report.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.; Muir, William D. (National Marine Fisheries Service, Seattle, WA)

    2002-09-01

    We report results from four years (1998-2001) of an ongoing study of survival and travel time of subyearling fall chinook salmon in the Snake River. We report analyses of associations among river conditions and survival and travel time estimates, which include data from 1995 through 1997. At weekly intervals from early June to early July each year (mid-May to late June in 2001), hatchery-reared subyearling fall chinook salmon were PIT tagged at Lyons Ferry Hatchery, trucked upstream, acclimated, and released above Lower Granite Dam at Pittsburgh Landing and Billy Creek on the Snake River and at Big Canyon Creek on the Clearwater River. Each year, a small proportion of fish released were not detected until the following spring. However, the number that overwintered in the river and migrated seaward as yearlings the following spring was small and had minimal effect on survival estimates. Concurrent with our studies, a number of subyearling fall chinook salmon that reared naturally in the Snake River were caught by beach seine, PIT tagged, and released. We compared a number of characteristics of hatchery and wild fish. Hatchery and wild fish were similar in 2001, and from 1995 through 1997. Results for 1998 through 2000 showed some relatively large differences between hatchery and wild fish. However, recent information suggests that a considerable proportion of wild subyearling chinook salmon migrating in a given year may actually be stream-type (spring/summer), rather than ocean-type (fall) fish, which may account for some of the differences we have observed.

  7. Long-term survival following two recurrences and re-irradiation courses for a nasopharyngeal carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Haddad P

    2010-10-01

    Full Text Available "nBackground: Local recurrence in Nasopharyngeal Carcinoma (NPC presents is a major challenge. Patients experience substantial morbidity as well as poor survival if no further treatment is offered. Residual or recurrent nasopharyngeal carcinoma is usually managed by chemotherapy, stereotactic radiosurgery, external beam radiation therapy (EBRT, interstitial, and intracavitary brachytherapy or salvage surgery. This case presents the treatment of two consecutive localized recurrences of NPC."n "nCase presentation: The patient was a 59-year-old man who underwent a course of radical external-beam radiotherapy for a primary NPC in 1999, then another course of external radiation in 2004 for his first recurrence, and finally a course of brachytherapy for the second recurrence in 2005. The patient is well now in 2010, with no signs of disease five years after the third radiotherapy."n "nConclusion: Our experience of re-irradiation for this twice recurrent nasopharyngeal carcinoma has been promising with encouraging tumor control and acceptable treatment-related toxicity profile. This case indicates the efficacy of definitive re-irradiation for regional recurrence and the necessity for long-term observation for the salvageable early-stage local failure.

  8. Breast Cancer in Young Women: Research Priorities. A Report of the Young Survival Coalition Research Think Tank Meeting.

    Science.gov (United States)

    Korde, Larissa A; Partridge, Ann H; Esser, Michelle; Lewis, Stacy; Simha, Joy; Johnson, Rebecca H

    2015-03-01

    Breast cancer in young women is a significant issue-7% of all female breast cancer is diagnosed in women under 40 years of age. Young women with breast cancer (YWBC) face significant and unique challenges, including a higher likelihood of biologically aggressive disease and metastatic disease at diagnosis, leading to poorer prognosis, more aggressive treatment and long-term treatment-related toxicities, and unique psychosocial concerns. This article summarizes the Young Survival Coalition (YSC) Research Think Tank Meeting, held in Arlington, Virginia, in February 2013, and presents the process that led to YSC's priorities for YWBC research. The meeting's participants focused on six broad categories of investigation in which additional advancements in research on YWBC are crucial: risk factors; treatment; fertility; pregnancy-associated breast cancer; quality of life and survivorship; and metastasis. Several key themes emerged from this meeting. Researchers and advocates felt that a large-scale data registry focused on YWBC is necessary to collect quality information to guide future research for YWBC. This database should include clinical data, genomic profiling of primary tumor and metastatic sites, and an increased focus on fertility and pregnancy following breast cancer treatment. The participants also felt that more must be done to elucidate how and why YWBC develop more aggressive tumors, and to what degree treatment should be modified for young women. The discussions summarized here led to the formulation of YSC's Research Agenda, published in May 2014.

  9. Recursive estimation of the conditional geometric median in Hilbert spaces

    CERN Document Server

    Cardot, Hervé; Zitt, Pierre-André

    2012-01-01

    A recursive estimator of the conditional geometric median in Hilbert spaces is studied. It is based on a stochastic gradient algorithm whose aim is to minimize a weighted L1 criterion and is consequently well adapted for robust online estimation. The weights are controlled by a kernel function and an associated bandwidth. Almost sure convergence and L2 rates of convergence are proved under general conditions on the conditional distribution as well as the sequence of descent steps of the algorithm and the sequence of bandwidths. Asymptotic normality is also proved for the averaged version of the algorithm with an optimal rate of convergence. A simulation study confirms the interest of this new and fast algorithm when the sample sizes are large. Finally, the ability of these recursive algorithms to deal with very high-dimensional data is illustrated on the robust estimation of television audience profiles conditional on the total time spent watching television over a period of 24 hours.

  10. Effects of summer flow augmentation on the migratory behavior and survival of juvenile Snake River fall Chinook salmon. Annual report 2005

    Science.gov (United States)

    Tiffan, Kenneth F.; Connor, William P.

    2006-01-01

    This report summarizes results of research activities conducted in 2004 and years previous to aid in the management and recovery of fall Chinook salmon Oncorhynchus tshawytscha in the Columbia River basin. For detailed summaries, we refer the reader to the abstracts given on the second page of each chapter. The Annual Reporting section includes information provided to fishery managers in-season and post-season, and it contains a detailed summary of life history and survival statistics on wild Snake River fall Chinook salmon juveniles for the years 1992-2004. Publication is a high priority of our staff. Publication provides our results to a wide audience, and it insures that our work meets high scientific standards. The Bibliography of Published Journal Articles section provides citations for peer-reviewed papers co-authored by personnel of project 1991-02900 that were written or published from 1998 to 2005.

  11. Effects of Summer Flow Augmentation on the Migratory Behavior and Survival of Juvenile Snake River Fall Chinook Salmon; 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Tiffan, Kenneth F. (US Geological Survey, Western Fisheries Research Center, Columbia River Research Laboratory, Cook, WA); Connor, William P. (US Fish and Wildlife Service, Idaho Fishery Resource Office, Ahsahka, ID)

    2006-03-01

    This report summarizes results of research activities conducted in 2004 and years previous to aid in the management and recovery of fall Chinook salmon Oncorhynchus tshawytscha in the Columbia River basin. For detailed summaries, we refer the reader to the abstracts given on the second page of each chapter. The Annual Reporting section includes information provided to fishery managers in-season and post-season, and it contains a detailed summary of life history and survival statistics on wild Snake River fall Chinook salmon juveniles for the years 1992-2004. Publication is a high priority of our staff. Publication provides our results to a wide audience, and it insures that our work meets high scientific standards. The Bibliography of Published Journal Articles section provides citations for peer-reviewed papers co-authored by personnel of project 1991-02900 that were written or published from 1998 to 2005.

  12. Prolonged survival of a woman with lung cancer diagnosed and treated with chemotherapy during pregnancy. Review of cases reported.

    Science.gov (United States)

    Garrido, M; Clavero, J; Huete, A; Sánchez, C; Solar, A; Alvarez, M; Orellana, E

    2008-05-01

    Lung cancer is the most common cause of cancer death in women in the US, diagnosis during pregnancy is rare and has been reported 34 times. We report a case of a 34-year-old woman with stage III locally advanced lung cancer diagnosed during the 27th week of pregnancy. Chest X-ray and thorax MRI revealed a 9cmx7cm mass in the upper right lung lobe. CT guided FNA biopsy indicated adenocarcinoma. Neoadjuvant chemotherapy was administered with vinorelvine (Navelbine) and cisplatin for three cycles with partial response. At 39 weeks, she delivered a healthy baby. Right upper lobectomy with complete lymphadenectomy was performed 3 weeks later. Final pathology was reported as an adenocarcinoma of 7.5cmx6.2cm with involvement of 16/30 lymph nodes. She received three additional cycles of chemotherapy and radiotherapy. Follow-up with CT scan after 11 months did not show recurrence.

  13. Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit?

    Science.gov (United States)

    Ly, Bevan H; Nguyen, Nam P; Vinh-Hung, Vincent; Rapiti, Elisabetta; Vlastos, Georges

    2010-02-01

    A number of studies have recently demonstrated a survival benefit in stage IV breast cancer patients following surgical resection of the primary tumor. Here, we investigate the relationship between loco-regional treatment and survival in patients with metastatic breast cancer and evaluate the impact of different loco-regional treatments. We conducted a systematic review of the literature using PubMed to analyze studies with the following criteria: Type of loco-regional treatment (surgery alone or combined with radiation, radiotherapy), overall survival, progression-free survival, selection factors for local treatment, and complication rates. Thirteen studies evaluated the effect of loco-regional treatment on overall survival with overall median survival increasing from a range of 12.6-28.3 months among patients without surgery to a range of 25-42 months among patients with surgery. In addition, six studies reported a 3-year survival benefit of 28-95% and 17-79% in women with and without locoregional therapy respectively. Two studies did not find any improvement in overall survival. One study found an improvement in 5-year breast cancer-specific survival of 27% with negative surgical margins versus 12% with no surgery. Three studies reported an advantage in progression-free survival in the treatment group compared with the non-treatment group. Loco-regional treatment for breast cancer patients with distant metastases at diagnosis is an important issue because of possible improvement of survival or disease-free survival. The possibility of surgery and/or radiotherapy following induction chemotherapy should be weighed and left to individual practice. Participation in randomized controlled trials should be encouraged.

  14. Long-Term Survival of a Patient with Giant Cell Glioblastoma: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    E. Naydenov

    2009-07-01

    Full Text Available Glioblastoma multiforme (GBM is the most common glial tumor of the central nervous system. Overall survival is less than a year in most of the cases in spite of multimodal treatment approaches. A 45-year-old female with histologically confirmed giant cell GBM was treated at our institution. Subtotal excision of the lesion situated in the right precentral area was performed during the initial stay in August 2005. The patient improved after the procedure with no hypertension and additional neurological deficit. Radiotherapy plus concomitant and adjuvant temozolomide was performed. The patient was symptom-free for 35 months after initial surgery. From July 2008 the patient developed partial motor seizures in the left side of the body and progressive hemiparesis. Local tumor progression was demonstrated on the neuroimaging studies. In December 2008, a second operative intervention was performed with subtotal excision of the tumor. Forty-five months after the initial diagnosis the patient is still alive with moderate neurological deficit. Microarray analysis of the tumor found the following numeric chromosomal aberrations: monosomy 8, 10, 13, 22, and trisomy 21, as well as amplifications in 4q34.1, 4q28.2, 6q16.3, 7q36.1, 7p21.3, and deletions in 1q42.12, 1q32.2, 1q25.2, 1p33, 2q37.2, 18q22.3, 19p13.2, Xq28, and Xq27.3. GBMs seem to be a heterogeneous group of glial tumors with different clinical course and therapeutic response. Microarray analysis is a useful method to establish a number of possible molecular predictors.

  15. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  16. Beyond Child Survival: Towards a New Future. Report of the Bernard van Leer Foundation, 1986-1987.

    Science.gov (United States)

    Bernard Van Leer Foundation, The Hague (Netherlands).

    This report on the Bernard van Leer Foundation's early childhood grant program of 1986-1987 is organized by geographic region. Regional sections cover Africa, Asia and the Pacific, Europe, and the Western Hemisphere. Each regional section contains an introduction, a table of major projects being supported in the region, and feature articles on…

  17. Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors

    Directory of Open Access Journals (Sweden)

    Kanas GP

    2012-11-01

    Full Text Available Gena P Kanas,1 Aliki Taylor,2 John N Primrose,3 Wendy J Langeberg,4 Michael A Kelsh,4 Fionna S Mowat,1 Dominik D Alexander,5 Michael A Choti,6 Graeme Poston71Health Sciences, Exponent, Menlo Park, CA, USA; 2Centre for Observational Research, Amgen, Uxbridge, UK; 3Department of Surgery, Southampton General Hospital, Southampton, UK; 4Center for Observational Research, Amgen, Thousand Oaks, CA, USA; 5Health Sciences, Exponent, Chicago, IL, USA; 6Johns Hopkins Hospital, Baltimore, MD, USA; 7Department of Surgery, Aintree University Hospitals NHS, Liverpool, UKBackground: Hepatic metastases develop in approximately 50% of colorectal cancer (CRC cases. We performed a review and meta-analysis to evaluate survival after resection of CRC liver metastases (CLMs and estimated the summary effect for seven prognostic factors.Methods: Studies published between 1999 and 2010, indexed on Medline, that reported survival after resection of CLMs, were reviewed. Meta-relative risks for survival by prognostic factor were calculated, stratified by study size and annual clinic volume. Cumulative meta-analysis results by annual clinic volume were plotted.Results: Five- and 10-year survival ranged from 16% to 74% (median 38% and 9% to 69% (median 26%, respectively, based on 60 studies. The overall summary median survival time was 3.6 (range: 1.7–7.3 years. Meta-relative risks (95% confidence intervals by prognostic factor were: node positive primary, 1.6 (1.5–1.7; carcinoembryonic antigen level, 1.9 (1.1–3.2; extrahepatic disease, 1.9 (1.5–2.4; poor tumor grade, 1.9 (1.3–2.7; positive margin, 2.0 (1.7–2.5; >1 liver metastases, 1.6 (1.4–1.8; and >3 cm tumor diameter, 1.5 (1.3–1.8. Cumulative meta-analyses by annual clinic volume suggested improved survival with increasing volume.Conclusion: The overall median survival following CLM liver resection was 3.6 years. All seven investigated prognostic factors showed a modest but significant predictive

  18. Fatigue testing of three peristernal median sternotomy closure techniques

    Directory of Open Access Journals (Sweden)

    Griffin Lanny V

    2008-09-01

    Full Text Available Abstract Background Failure of a sternotomy closure because of closure system fatigue is a complication that may result in dehiscence and put the individual at risk for serious complications. The purpose of this study was to assess the fatigue performance of three peristernal median sternotomy closure techniques (figure-of-eight stainless-steel wires, figure-of-eight stainless-steel cables, or Pectofix Dynamic Sternal Fixation [DSF] stainless-steel plates in order to quantify the potential risk of fatigue failure of these devices when subject to cyclic loads in physiologically relevant loading directions. Study Design All tests were conducted on polyurethane foam sternal models. A cardiothoracic surgeon divided each sternal model longitudinally and repaired it with a closure device. Tests were performed using a materials testing system that applied cyclic loading in a uniaxial direction until the test model catastrophically broke or data run-out occurred. For each loading direction (lateral distraction and longitudinal shear, five trials of each closure technique were tested. Life data and location of device failure (if present were evaluated. Statistical analysis was performed using regression with life data allowed for correlation between life data and the various closure techniques to develop risk assessment curves for each device. Results The data show that the figure-of-eight stainless-steel cable and the DSF plate systems are considerably less likely to fail under both lateral distraction and longitudinal shear cyclic loading conditions as compared to the figure-of-eight stainless-steel wire system. Moreover, the figure-of-eight stainless-steel cable system is the most resistant to failure, particularly for high cycle counts. Conclusion This study in addition to Cohen and Griffin's earlier published biomechanical comparison of the ultimate strength of these same three closure techniques provide extensive experimental evidence regarding the

  19. Comparative Survival Study (CSS) of Hatchery PIT-tagged Spring/Summer Chinook; Migration Years 1997-2000 Mark/Recapture Activities and Bootstrap Analysis, 2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Berggren Thomas J.; Franzoni, Henry; Basham, Larry R. (Columbia Basin Fish and Wildlife Authority, Fish Passage Center, Portland, OR)

    2005-04-01

    Granite Dam. When D = 1, there is no difference in survival rate after hydrosystem passage. When D < 1, then transported smolts die at a greater rate after release below Bonneville Dam than smolts that have migrated in-river to below Bonneville Dam. While the relative survival rates of transported and in-river migrants are important, the SARs must be also be sufficient to allow the salmon to persist and recover (Mundy et al. 1994). Decreased SARs could result from delayed hydrosystem mortality for either transported or in-river migrants, or both. Major objectives of the CSS include: (1) development of a long-term index of transport SAR to in-river SAR for Snake River hatchery and wild spring and summer chinook smolts measured at Lower Granite Dam; (2) develop a long-term index of survival rates from release of smolts at Snake River hatcheries to return of adults to the hatcheries; (3) compute and compare the overall SARs for selected upriver and downriver spring and summer chinook hatchery and wild stocks; and (4) begin a time series of SARs for use in hypothesis testing and in the regional long-term monitoring and evaluation program. Primary CSS focus in this report is for wild and hatchery spring/summer chinook that outmigrated in 1997 to 2000 and returned in 2003. Another goal of CSS was to help resolve uncertainty concerning marking, handling and bypass effects associated with control fish used in National Marine Fisheries Service's (NMFS) transportation research and evaluation. Significant concern had been raised that the designated control groups, which were collected, marked and released at dams, did not experience the same conditions as the in-river migrants which were not collected and bypassed under existing management, and that the estimated ratios of SARs of transported fish to SARs of control fish may be biased (Mundy et al. 1994). Instead of marking at the dams, as traditionally done for NMFS transportation evaluations, CSS began marking sufficient

  20. Comparative Survival Study (CSS) of Hatchery PIT-tagged Spring/Summer Chinook; Migration Years 1997-2000 Mark/Recapture Activities and Bootstrap Analysis, 2002 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Berggren Thomas J.; Franzoni, Henry; Basham, Larry R. (Columbia Basin Fish and Wildlife Authority, Fish Passage Center, Portland, OR)

    2005-04-01

    Granite Dam. When D = 1, there is no difference in survival rate after hydrosystem passage. When D < 1, then transported smolts die at a greater rate after release below Bonneville Dam than smolts that have migrated in-river to below Bonneville Dam. While the relative survival rates of transported and in-river migrants are important, the SARs must be also be sufficient to allow the salmon to persist and recover (Mundy et al. 1994). Decreased SARs could result from delayed hydrosystem mortality for either transported or in-river migrants, or both. Major objectives of the CSS include: (1) development of a long-term index of transport SAR to in-river SAR for Snake River hatchery and wild spring and summer chinook smolts measured at Lower Granite Dam; (2) develop a long-term index of survival rates from release of smolts at Snake River hatcheries to return of adults to the hatcheries; (3) compute and compare the overall SARs for selected upriver and downriver spring and summer chinook hatchery and wild stocks; and (4) begin a time series of SARs for use in hypothesis testing and in the regional long-term monitoring and evaluation program. Primary CSS focus in this report is for wild and hatchery spring/summer chinook that outmigrated in 1997 to 2000 and returned in 2003. Another goal of CSS was to help resolve uncertainty concerning marking, handling and bypass effects associated with control fish used in National Marine Fisheries Service's (NMFS) transportation research and evaluation. Significant concern had been raised that the designated control groups, which were collected, marked and released at dams, did not experience the same conditions as the in-river migrants which were not collected and bypassed under existing management, and that the estimated ratios of SARs of transported fish to SARs of control fish may be biased (Mundy et al. 1994). Instead of marking at the dams, as traditionally done for NMFS transportation evaluations, CSS began marking sufficient

  1. Adaptation of median partial sternotomy in head and neck surgery.

    Science.gov (United States)

    Shpitzer, Thomas; Saute, Milton; Gilat, Hanna; Raveh, Eyal; Koren, Ilan; Shvero, Jacob; Bahar, Gideon; Feinmesser, Raphael

    2007-12-01

    Upper mediastinum involvement in diseases of the head and neck may require a sternal split. This study describes our adaptation of the upper median or "minimal" sternotomy technique for the treatment of head and neck pathologies. Between April 2002 and October 2005, 17 patients aged 4 to 82 years underwent minimal sternotomy in our institution for a variety of head and neck pathologies. The 17 patients included 11 adults with metastatic thyroid disease (six metastatic papillary thyroid carcinoma, two medullary carcinoma, and one Hiirthle cell carcinoma) and huge retrosternal goiter (n = 2), four adults with parathyroid disease (two primary parathyroid adenoma, one secondary hyperplasia, and one parathyroid carcinoma), and two children with lymphangioma and huge thymic cyst (one each). Average hospitalization was 8 days. Four patients needed a thoracic drain for 2 days, one had recurrent laryngeal nerve palsy, and one had phrenic nerve paresis. There were no postoperative deaths. Minimal sternotomy appears to be an excellent alternative for surgical exploration of the mediastinum and may be used in head and neck surgery for a range of indications.

  2. Interdisciplinary treatment of the patient with adenoid cystic carcinoma of the Bartholin’s gland resulting in 15 years’ survival: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Marek Nowak

    2014-11-01

    Full Text Available Carcinoma of the Bartholin’s gland is very rare, comprises below 2% of Bartholin’s gland lesions and adenoid cystic carcinoma (ADC is one of the most uncommon variants and accounts for 10-15% of Bartholin’s gland malignancies. There is no consensus on treatment of ADC of the Bartholin’s gland: reported cases were treated with local excision or vulvectomy with or without lymphadenectomy followed or not by radiotherapy. The survival of patients varies significantly, so we present a case of interdisciplinary treatment of ADC resulting in 15 years’ survival. The patient was initially treated with local excision, but the margins were not clear. Then vulvectomy, inguinal lymphadenectomy and adjuvant brachytherapy were performed resulting in 7 years free of the disease. Relapses were excised by abdominoperineal amputation of the rectum and distal part of the vagina with sigmoideostomy, excisions of local recurrences in vagina and metastasectomy of isolated lung metastases. The patient died manifesting multiple lung metastases 15 years after the initial diagnosis. Based on our experience and world literature, in cases of adenoid cystic carcinoma of the Bartholin’s gland, vulvectomy with or without lymphadenectomy should be considered as a treatment of choice and in patients with positive margin, surgery should be extended by adjuvant radiotherapy.

  3. Interdisciplinary treatment of the patient with adenoid cystic carcinoma of the Bartholin's gland resulting in 15 years' survival: a case report and review of literature.

    Science.gov (United States)

    Nowak, Marek; Rycel, Magdalena; Szpakowski, Marian; Kulig, Andrzej; Sobotkowski, Janusz; Dziki, Adam

    2014-10-01

    Carcinoma of the Bartholin's gland is very rare, comprises below 2% of Bartholin's gland lesions and adenoid cystic carcinoma (ADC) is one of the most uncommon variants and accounts for 10-15% of Bartholin's gland malignancies. There is no consensus on treatment of ADC of the Bartholin's gland: reported cases were treated with local excision or vulvectomy with or without lymphadenectomy followed or not by radiotherapy. The survival of patients varies significantly, so we present a case of interdisciplinary treatment of ADC resulting in 15 years' survival. The patient was initially treated with local excision, but the margins were not clear. Then vulvectomy, inguinal lymphadenectomy and adjuvant brachytherapy were performed resulting in 7 years free of the disease. Relapses were excised by abdominoperineal amputation of the rectum and distal part of the vagina with sigmoideostomy, excisions of local recurrences in vagina and metastasectomy of isolated lung metastases. The patient died manifesting multiple lung metastases 15 years after the initial diagnosis. Based on our experience and world literature, in cases of adenoid cystic carcinoma of the Bartholin's gland, vulvectomy with or without lymphadenectomy should be considered as a treatment of choice and in patients with positive margin, surgery should be extended by adjuvant radiotherapy.

  4. Post-Release Attributes and Survival of Hatchery and Natural Fall Chinook Salmon in the Snake River; 2000-2001 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connor, William P. (US Fish and Wildlife Service, Idaho Fishery Resource Office, Ahsahka, ID)

    2003-02-01

    This report summarizes results of research activities conducted in 2000, 2001, and years previous to aid in the management and recovery of fall chinook salmon in the Columbia River basin. The report is divided into sections and self-standing chapters. For detailed summaries, we refer the reader to the abstracts given on the second page of each chapter. The Annual Reporting section includes information provided to fishery managers in-season and post-season, and it contains a detailed summary of life history and survival statistics on wild Snake River fall chinook salmon juveniles for the years 1992-2001. The Journal Manuscripts section includes complete copies of papers submitted or published during 2000 and 2001 that were not included in previous annual reports. Publication is a high priority for this project because it provides our results to a wide audience, it ensures that our work meets high scientific standards, and we believe that it is a necessary obligation of a research project. The Bibliography of Published Journal Articles section provides citations for peer-reviewed papers co-authored by personnel of project 199102900 that were published from 1998 to 2001.

  5. Post-Release Attributes and Survival of Hatchery and Natural Fall Chinook Salmon in the Snake River : Annual Report 1999.

    Energy Technology Data Exchange (ETDEWEB)

    Tiffan, Kenneth F.; Rondorf, Dennis W.

    2001-01-01

    This report summarizes results of research activities conducted in 1999 and years previous. In an effort to provide this information to a wider audience, the individual chapters in this report have been submitted as manuscripts to peer-reviewed journals. These chapters communicate significant findings that will aid in the management and recovery of fall chinook salmon in the Columbia River Basin. Abundance and timing of seaward migration of Snake River fall chinook salmon was indexed using passage data collected at Lower Granite Dam for five years. We used genetic analyses to determine the lineage of fish recaptured at Lower Granite Dam that had been previously PIT tagged. We then used discriminant analysis to determine run membership of PIT-tagged smolts that were not recaptured to enable us to calculate annual run composition and to compared early life history attributes of wild subyearling fall and spring chinook salmon. Because spring chinook salmon made up from 15.1 to 44.4% of the tagged subyearling smolts that were detected passing Lower Granite Dam, subyearling passage data at Lower Granite Dam can only be used to index fall chinook salmon smolt abundance and passage timing if genetic samples are taken to identify run membership of smolts. Otherwise, fall chinook salmon smolt abundance would be overestimated and timing of fall chinook salmon smolt passage would appear to be earlier and more protracted than is the case.

  6. TP53 gene status affects survival in advanced mycosis fungoides

    Directory of Open Access Journals (Sweden)

    Gitte Wooler

    2016-11-01

    Full Text Available TP53 is frequently mutated in different types of neoplasms including leukemia and lymphomas. Mutations of TP53 have also been reported in mycosis fungoides (MF, the most common type of cutaneous lymphoma. However, little is known about the frequency, spectrum of mutations and their prognostic significance in MF. In this study we have optimized the protocol for Sanger sequencing of TP53 using DNA extracted from archival paraffin-embedded biopsies. Of 19 samples from patients with stage IIB MF or higher, 31% harboured mutations in TP53. Overall survival of the patients with mutated TP53 was significantly shorter than median survival in the age- and stage-matched patients treated in our Institution. Distribution of mutations was heterogenous in TP53 exons, however C>T transitions were common suggesting the causal role of ultraviolet radiation. We propose that TP53 mutation status would be useful for risk stratification of patients with advanced MF.

  7. Evaluation of Life History Diversity, Habitat Connectivity, and Survival Benefits Associated with Habitat Restoration Actions in the Lower Columbia River and Estuary, Annual Report 2009

    Energy Technology Data Exchange (ETDEWEB)

    Diefenderfer, Heida L.; Johnson, Gary E.; Sather, Nichole K.; Skalski, John R.; Dawley, Earl M.; Coleman, Andre M.

    2010-08-01

    This report describes the 2009 research conducted under the U.S. Army Corps of Engineers (USACE or Corps) project EST-09-P-01, titled “Evaluation of Life History Diversity, Habitat Connectivity, and Survival Benefits Associated with Habitat Restoration Actions in the Lower Columbia River and Estuary.” The research was conducted by the Pacific Northwest National Laboratory, Marine Science Laboratory and Hydrology Group, in partnership with the University of Washington, School of Aquatic and Fishery Sciences, Columbia Basin Research, and Earl Dawley (NOAA Fisheries, retired). This Columbia River Fish Mitigation Program project, referred to as “Salmonid Benefits,” was started in FY 2009 to evaluate the state-of-the science regarding the ability to quantify the benefits to listed salmonids1 of habitat restoration actions in the lower Columbia River and estuary.

  8. Brain metastases in women with epithelial ovarian cancer: multimodal treatment including surgery or gamma-knife radiation is associated with prolonged survival.

    Science.gov (United States)

    Niu, Xiaoyu; Rajanbabu, Anupama; Delisle, Megan; Peng, Feng; Vijaykumar, Dehannathuparambil K; Pavithran, Keechilattu; Feng, Yukuan; Lau, Susie; Gotlieb, Walter H; Press, Joshua Z

    2013-09-01

    To explore the impact of treatment modality on survival in patients with brain metastases from epithelial ovarian cancer. We conducted a retrospective review of cases of ovarian cancer with brain metastases treated at institutions in three countries (Canada, China, and India) and conducted a search for studies regarding brain metastases in ovarian cancer reporting survival related to treatment modality. Survival was analyzed according to treatment regimens involving (1) some form of surgical excision or gamma-knife radiation with or without other modalities, (2) other modalities without surgery or gamma-knife radiation, or (3) palliation only. Twelve patients (mean age 56 years) with detailed treatment/outcome data were included; five were from China, four from Canada, and three from India. Median time from diagnosis of ovarian cancer to brain metastasis was 19 months (range 10 to 37 months), and overall median survival time from diagnosis of ovarian cancer was 38 months (13 to 82 months). Median survival time from diagnosis of brain metastasis was 17 months (1 to 45 months). Among patients who had multimodal treatment including gamma-knife radiotherapy or surgical excision, the median survival time after the identification of brain metastasis was 25.6 months, compared with 6.0 months in patients whose treatment did not include this type of focused localized modality (P = 0.006). Analysis of 20 studies also indicated that use of gamma-knife radiotherapy and excisional surgery in multi-modal treatment resulted in improved median survival interval (25 months vs. 6.0 months, P gamma-knife radiotherapy and surgical excision.

  9. Poor prosthesis survival and function after component exchange of total ankle prostheses

    Science.gov (United States)

    Henricsson, Anders; Karlsson, Magnus K; Magnusson, Håkan; Nilsson, Jan-Åke; Carlsson, Åke; Rosengren, Björn E

    2015-01-01

    Background and purpose In failed total ankle replacements (TARs), fusion is often the procedure of preference; the outcome after exchanging prosthetic components is debated. We analyzed prosthetic survival, self-reported function, and patient satisfaction after component exchange. Patients and methods We identified patients in the Swedish Ankle Registry who underwent exchange of a tibial and/or talar component between January 1, 1993 and July 1, 2013 and estimated prosthetic survival by Kaplan-Meier analysis. We evaluated the patient-reported outcome measures (PROMs) SEFAS, EQ-5D, EQ-VAS, SF-36, and patient satisfaction by direct questions. Results 69 patients underwent revision TAR median 22 (0–110) months after the primary procedure. 24 of these failed again after median 26 (1–110) months. Survival analysis of revision TAR showed a 5-year survival rate of 76% and a 10-year survival of 55%. 29 patients with first revision TAR in situ answered the PROMs at mean 8 (1–17) years after revision and had the following mean scores: SEFAS 22, SF-36 physical 37 and mental 49, EQ-5D index 0.6, and EQ-VAS 64. 15 of the patients were satisfied, 5 were neither satisfied nor dissatisfied, and 9 were dissatisfied. Interpretation Revision TAR had a 10-year survival of 55%, which is lower than the 10-year survival of 74% for primary TAR reported from the same registry. Only half of the patients were satisfied. Future studies should show which, if any, patients benefit from revision TAR and which patients should rather be fused directly. PMID:25673048

  10. The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK

    Directory of Open Access Journals (Sweden)

    Moore David

    2008-09-01

    Full Text Available Abstract Background Mucopolysaccharidosis type I (MPS I is a rare lysosomal storage disease subdivided into three phenotypes of increasing severity: Scheie, Hurler-Scheie and Hurler. To gauge the effectiveness of treatments and to determine the load likely to fall on health-care systems, it is necessary to understand the prevalence and natural progression of the disease especially with regard to life-expectancy. In general such data on the natural history of lysosomal storage diseases is sparse. Methods Analysis of prevalence and patient survival in MPS I disease using a unique longitudinal data set initiated and maintained over a period of more than 20 years by the Society for Mucopolysaccharide Diseases (UK. Results The birth prevalence of MPS I in England and Wales over the period 1981 to 2003 was 1.07/100,000 births and within ± 5% of estimates reported in several studies that examined reasonably large populations. The median survival for MPS I patients (including all phenotypes irrespective of various treatments was found by Kaplan-Meier analysis to be 11.6 years. This result was driven by the relatively poor survival of patients with the Hurler phenotype who, irrespective of any treatments received, had a median survival of 8.7 years; when censoring for receipt of bone marrow transplant (BMT was implemented median survival of Hurler patients was diminished to 6.8 years. The difference between these survival curves was statistically significant by log rank test and can be attributed to beneficial effects of BMT and or selection of patients with superior prognosis for intervention with BMT. Survival curves for Hurler patients who received and did not receive BMT were very different. Probability of survival at 2 year after BMT was ~68% and was similar to this after 5 years (66% and ten years (64%; the mean age of Hurler patients at receipt of BMT was 1.33 years (range 0.1 to 3 years. Follow up was insufficient to determine median survival of

  11. The usefulness of terminal latency index of median nerve and f-wave difference between median and ulnar nerves in assessing the severity of carpal tunnel syndrome.

    Science.gov (United States)

    Park, Kang Min; Shin, Kyong Jin; Park, Jinse; Ha, Sam Yeol; Kim, Sung Eun

    2014-04-01

    The calculated electrophysiological parameters, such as terminal latency index (TLI), residual latency, modified F ratio, and F-wave inversion, have been investigated as a diagnostic tool for detection of early stage of carpal tunnel syndrome (CTS) in the literature. However, the correlation of these calculated electrophysiological parameters with the clinical severity of CTS has not been reported. The aim of this study was to determine the correlation of the calculated electrophysiological parameters and clinical severity in patients with CTS. A retrospective study was performed with 212 hands of 106 CTS patients. The CTS hands were classified as asymptomatic, mild, moderate, and severe according to the clinical severity. The distal motor latency and distal motor conduction velocity of median nerve, minimal F-wave latency of median and ulnar nerves, and sensory nerve conduction velocity in the finger-wrist and palm-wrist segment of median nerve (SNCV f-w and SNCV p-w) were obtained in a conventional nerve conduction study. The TLI, residual latency, and modified F ratio of the median nerve and the difference of minimal F-wave latencies between the median and ulnar nerves (F-diff M-U) were calculated. The distal motor latency, residual latency, and F-diff M-U were significantly increased according to the clinical severity of CTS. The motor conduction velocity, SNCV p-w, SNCV f-w, TLI, and modified F ratio were significantly decreased according to the clinical severity of CTS. In analyses of variance and Kruskal-Wallis test, we used the Scheffe test as a post-hoc comparison analysis. The TLI, F-diff M-U, and SNCV f-w showed a significant difference among all groups of each CTS severity. The sensitivity, specificity, and cut-off value of TLI, F-diff M-U, and SNCV f-w between asymptomatic and mild, mild and moderate, and moderate and severe CTS groups were calculated by using receiver operating characteristic curve analysis. The cut-off values of TLI, F-diff M-U, and

  12. Congenital nasal pyriform aperture stenosis in association with solitary median maxillary central incisor: unique radiologic features.

    Science.gov (United States)

    Yang, Sara; Orta, Pedro; Renk, Elizabeth M; Inman, Jared C

    2016-09-01

    Solitary median maxillary central incisor (SMMCI) coexists in 34%-65% of patients initially diagnosed with congenital nasal pyriform aperture stenosis. SMMCI, a genetic syndrome, warrants consideration for further screening because of its high prevalence of other diagnostic possibilities-specifically central defects, like nasal obstruction and hypothalamo-pituitary axis abnormalities. We report on a presentation of SMMCI with congenital nasal pyriform aperture stenosis which highlights the unique radiologic features and notes the relationship between these two central associated findings in the literature.

  13. Speckled lentiginous nevus syndrome with median nerve paresis: A rare syndrome with a new association

    Directory of Open Access Journals (Sweden)

    Vibhu Mendiratta

    2013-01-01

    Full Text Available Speckled lentiginous nevus (SLN represents a mosaic phenotype which consists of café au lait macule superimposed by melanocytic nevi. Recently, SLN syndrome has been characterized where ipsilateral neurological abnormalities have been reported in association with SLN with papular type of melanocytic nevi only. This case describes the presence of ipsilateral thenar muscle atrophy with median nerve paresis in nevus spilus which had melanocytic nevi of the macular type alone, thus delineating a new association in SLN syndrome, hitherto unreported.

  14. Ant colony optimization techniques for the hamiltonian p-median problem

    Directory of Open Access Journals (Sweden)

    M. Zohrehbandian

    2010-12-01

    Full Text Available Location-Routing problems involve locating a number of facilitiesamong candidate sites and establishing delivery routes to a set of users in such a way that the total system cost is minimized. A special case of these problems is Hamiltonian p-Median problem (HpMP. This research applies the metaheuristic method of ant colony optimization (ACO to solve the HpMP. Modifications are made to the ACO algorithm used to solve the traditional vehicle routing problem (VRP in order to allow the search of the optimal solution of the HpMP. Regarding this metaheuristic algorithm a computational experiment is reported as well.

  15. Surviving Objects

    OpenAIRE

    Murjas, Teresa

    2012-01-01

    Surviving Objects (2012) is a devised multi-media practice-as-research performance based on extensive interviews conducted with my elderly mother and recorded on a hand-held device. Our conversations concern her experiences as a child refugee following violent deportation by the Soviet Army from Eastern Poland to Siberia (1941), and her subsequent route, via Persia, to a British-run refugee camp in Northern Rhodesia, where she remained for 6 years before arriving in the UK. In order to aid my...

  16. Asbestos Burden Predicts Survival in Pleural Mesothelioma

    OpenAIRE

    Christensen, Brock C; Roelofs, Cora R.; Longacker, Jennifer L.; Marsit, Carmen J; Nelson, Heather H.; Kelsey, Karl T.; Godleski, John Joseph; Bueno, Raphael; Sugarbaker, David John

    2008-01-01

    Background: Malignant pleural mesothelioma (MPM) is a rapidly fatal asbestos-associated malignancy with a median survival time of < 1 year following diagnosis. Treatment strategy is determined in part using known prognostic factors. Objective: The aim of this study was to examine the relationship between asbestos exposure and survival outcome in MPM in an effort to advance the understanding of the contribution of asbestos exposure to MPM prognosis. Methods: We studied incident cases of MPM...

  17. "The Success of Captive Broodstock Programs Depends on High In-Culture Survival, ..." [from the Abstract], 2006-2007 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Berejikian, Barry A. [National Marine Fisheries Service

    2009-04-08

    The success of captive broodstock programs depends on high in-culture survival, appropriate development of the reproductive system, and the behavior and survival of cultured salmon after release, either as adults or juveniles. Continuing captive broodstock research designed to improve technology is being conducted to cover all major life history stages of Pacific salmon. Accomplishments detailed in this report are listed below by major objective. Objective 1: This study documented that captively reared Chinook exhibited spawn timing similar to their founder anadromous population. An analysis of spawn timing data of captively reared Chinook salmon that had received different levels of antibiotic treatment did not suggest that antibiotic treatments during the freshwater or seawater phase of the life cycle affects final maturation timing. No effect of rearing density was found with respect to spawn timing or other reproductive behaviors. Objective 2: This study investigated the critical period(s) for imprinting for sockeye salmon by exposing juvenile salmon to known odorants at key developmental stages. Molecular assessments of imprinting-induced changes in odorant receptor gene expression indicated that regulation of odorant expression differs between coho and sockeye salmon. While temporal patterns differ between these species, exposure to arginine elicited increases in odorant receptor mRNA expression in sockeye salmon. Objective 3: This study: (i) identified the critical period when maturation is initiated in male spring Chinook salmon and when body growth affects onset of puberty, (ii) described changes in the reproductive endocrine system during onset of puberty and throughout spermatogenesis in male spring Chinook salmon, (iii) found that the rate of oocyte development prior to vitellogenesis is related to body growth in female spring Chinook, and (iv) demonstrated that growth regimes which reduce early (age 2) male maturation slow the rate of primary and early

  18. Survival of patients with stomach cancer in Changle city of China

    Institute of Scientific and Technical Information of China (English)

    Jun Tian; Xiao-Dong Wang; Zhen-Chun Chen

    2004-01-01

    AIM: The survival rate of patients with stomach cancer is used to evaluate the effects of treatments. The short- and mid-term survival of patients on the present level of treatments can be described by calculating 1- to 5-year survival rates.The aims of this study were to document patterns of survival after treatments for stomach cancer in Changle city and analyze whether the stage of cancer and the way of treatment impacted on survival of patients or not.METHODS: A total number of 745 patients with stomach cancer reported in the Changle Cancer Registry from 1993to 1998 were investigated with respect to the disease condition, the way of treatment and survival time. 1- to 5-year survival rates were estimated by using life-table method.RESULTS: The 1- to 5-year survival rates in the patients with stomach cancer in Changle city were 54.23%, 41.77%,37.95%, 33.98% and 30.47%, respectively. The 1- to 5-year survival rates in stageIor Ⅱ group were 3, 6.1, 7.4, 8.9and 9.8 times as high as those in stage Ⅲ or Ⅳ group,respectively. The 1- to 5-year survival rates in operation group were 3.5, 8.7, 11.2, 11.7 and 19 times as high as those in no operation group, respectively. For the patients with stage Ⅲ or Ⅳ stomach cancer the 1-year survival rate in operation group was 3 times as high as that in no operation group and 2-year survival rate in operation group was 11.9 times as high as that in no operation group. For the patients with stage Ⅲ or Ⅳstomach cancer, the differences of the survival rates average survival times between total gastrectomy and partial gastrectomy were not significant and the median survival times in these 2 groups were 8 mo and 9 mo, respectively.CONCLUSION: Mid-term survival rates of patients with stomach cancer in Changle city are low. Stage of cancer is an important factor influencing survival of patients with stomach cancer. Surgery is an effective treatment for the patients with stage Ⅳ cancer and can raise short- and mid

  19. Extracorporeal Cardiopulmonary Resuscitation (E-CPR) During Pediatric In-Hospital Cardiopulmonary Arrest Is Associated With Improved Survival to Discharge: A Report from the American Heart Association's Get With The Guidelines-Resuscitation (GWTG-R) Registry.

    Science.gov (United States)

    Lasa, Javier J; Rogers, Rachel S; Localio, Russell; Shults, Justine; Raymond, Tia; Gaies, Michael; Thiagarajan, Ravi; Laussen, Peter C; Kilbaugh, Todd; Berg, Robert A; Nadkarni, Vinay; Topjian, Alexis

    2016-01-12

    Although extracorporeal cardiopulmonary resuscitation (E-CPR) can result in survival after failed conventional CPR (C-CPR), no large, systematic comparison of pediatric E-CPR and continued C-CPR has been reported. Consecutive patients CPR events ≥10 minutes in duration reported to the Get With the Guidelines-Resuscitation registry between January 2000 and December 2011 were identified. Hospitals were grouped by teaching status and location. Primary outcome was survival to discharge. Regression modeling was performed, conditioning on hospital groups. A secondary analysis was performed with the use of propensity score matching. Of 3756 evaluable patients, 591 (16%) received E-CPR and 3165 (84%) received C-CPR only. Survival to hospital discharge and survival with favorable neurological outcome (Pediatric Cerebral Performance Category score of 1-3 or unchanged from admission) were greater for E-CPR (40% [237 of 591] and 27% [133 of 496]) versus C-CPR patients (27% [862 of 3165] and 18% [512 of 2840]). Odds ratios (ORs) for survival to hospital discharge and survival with favorable neurological outcome were greater for E-CPR versus C-CPR. After adjustment for covariates, patients receiving E-CPR had higher odds of survival to discharge (OR, 2.80; 95% confidence interval, 2.13-3.69; PCPR. This association persisted when analyzed by propensity score-matched cohorts (OR, 1.70; 95% confidence interval, 1.33-2.18; PCPR of ≥10 minutes duration, E-CPR was associated with improved survival to hospital discharge and survival with favorable neurological outcome compared with C-CPR. © 2015 American Heart Association, Inc.

  20. Confidence Bands for the Median Survival Time as a Function of the Covariates in the Cox Model

    Science.gov (United States)

    1991-06-25

    plementation of the "universal random number generator" of Marsaglia and Zaman (1987). This random number generator combines a lagged-Fibonacci...exponential variables are generated by the ziggurat method of Marsaglia and Tsang (19S4). Fortran programs to calculate all the bands are available from the...Computing, 5, 349 -359. Marsaglia , G. and Zaman. A. (1989), "Toward a Universal Random Number Generator," Statistics and Probabilty Letters. 8, 1 - 5

  1. Median effective dose of remifentanil for awake laryngoscopy and intudation

    Institute of Scientific and Technical Information of China (English)

    XU Ya-chao; XUE Fu-shan; LUO Mad-ping; YANG Quan-yong; LIAO Xu; LU Yi; ZHANG Yan-ming

    2009-01-01

    Background Awake intubation requires an anesthetic management that provides sufficient patient safety and comfort, adequate intubating conditions, and stable hemodynamics. In this prospective clinical study, our aim was to determine the median effective dose (ED50) of remifentanil in combination with midazolam and airway topical anesthesia for awake laryngoscopy and intubation.Methods Thirty-six female adult patients, scheduled for elective plastic surgery under general anesthesia requiring orotracheal intubation were included in this study. Ten minutes after intravenous administration of midazolam 0.1 mg/kg, patients were assigned to receive remifentanil in bolus, followed by a continuous infusion. The bolus dose and infusion rate of remifentanil were adjusted by a modified Dixon's up-and-down method. Patient's reaction score at laryngoscopy and an Observer's Assessment of Alertness/Sedation Scale (OAA/S) were used to determine whether the remifentanil dosage regimen was accepted. During laryngoscopy, 2% lidocaine was sprayed into the airway to provide the topical anesthesia. EDso of remifentanil was calculated by the modified Dixon up-and-clown method, and the probit analysis was then used to confirm the results obtained from the modified Dixon's up-and-down method. In the patients who were scored as "accept", patient's OAA/S and reaction scores at different observed points, intubating condition score and patient's tolerance to the endotracheal tube after intubation were evaluated and recorded. Blood pressure and heart rate at different measuring points were also noted.Results ED50 of remifentanil for awake laryngoscopy and intubation obtained by the modified Dixon's up-and-down method was (0.62±0.02) pg/kg. Using probit analysis, ED50 and ED95 of remifentanil were 0.63 μg/kg (95% Cl, 0.54-0.70) and 0.83 μg/kg (95% Cl, 0.73-2.59), respectively. Nineteen patients who were scored as =accept" had an OAA/S of 15 and tolerated well laryngoscopy without significant

  2. Influence of body mass index on median nerve function, carpal canal pressure, and cross-sectional area of the median nerve.

    Science.gov (United States)

    Werner, Robert A; Jacobson, Jon A; Jamadar, David A

    2004-10-01

    Obese individuals have slowed conduction in the median nerve across the wrist, but the mechanism for this is not established. This case-control study of 27 obese subjects and 16 thin subjects was designed to test the hypothesis that obese individuals have higher carpal canal pressures and more median nerve swelling than thin individuals. All subjects were asymptomatic for hand symptoms, and had measurements of median and ulnar sensory nerve conduction in the nondominant hand, ultrasound measurement of the median nerve cross-sectional area proximal to the carpal canal, and carpal canal pressure measurement. There was no difference in age or gender ratio between the obese and thin groups. The median nerve cross-sectional area was equal in the obese and thin groups (9.3 mm2 vs. 9.4 mm2), as was the carpal canal pressure (16.2 mmHg vs. 15.5 mmHg, respectively). There was a strong correlation between median nerve conduction slowing across the wrist and median nerve cross-sectional area at the wrist (r = 0.55, P = 0.002). Obesity does not influence carpal canal pressure or the size of the median nerve at the wrist. However, there is a strong association between slowed median nerve conduction and increased nerve size which suggests endoneurial edema as a metabolic mechanism; the conduction slowing does not appear to be related to mechanical stress.

  3. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial.

    NARCIS (Netherlands)

    Stupp, R.; Hegi, M.E.; Mason, W.P.; Bent, M.J. van den; Taphoorn, M.J.B.; Janzer, R.C.; Ludwin, S.K.; Allgeier, A.; Fisher, B.; Belanger, K.; Hau, P.; Brandes, A.A.; Gijtenbeek, J.M.M.; Marosi, C.; Vecht, C.J.; Mokhtari, K.; Wesseling, P.; Villa, S.; Eisenhauer, E.; Gorlia, T.; Weller, M.; Lacombe, D.; Cairncross, J.G.; Mirimanoff, R.O.

    2009-01-01

    BACKGROUND: In 2004, a randomised phase III trial by the European Organisation for Research and Treatment of Cancer (EORTC) and National Cancer Institute of Canada Clinical Trials Group (NCIC) reported improved median and 2-year survival for patients with glioblastoma treated with concomitant and ad

  4. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study : 5-year analysis of the EORTC-NCIC trial

    NARCIS (Netherlands)

    Stupp, Roger; Hegi, Monika E.; Mason, Warren P.; van den Bent, Martin J.; Taphoorn, Martin J. B.; Janzer, Robert C.; Ludwin, Samuel K.; Allgeier, Anouk; Fisher, Barbara; Belanger, Karl; Hau, Peter; Brandes, Alba A.; Gijtenbeek, Johanna; Marosi, Christine; Vecht, Charles J.; Mokhtari, Karima; Wesseling, Pieter; Villa, Salvador; Eisenhauer, Elizabeth; Gorlia, Thierry; Weller, Michael; Lacombe, Denis; Cairncross, J. Gregory; Mirimanoff, Rene-Olivier

    2009-01-01

    Background In 2004, a randomised phase III trial by the European Organisation for Research and Treatment of Cancer (EORTC) and National Cancer Institute of Canada Clinical Trials Group (NCIC) reported improved median and 2-year survival for patients with glioblastoma treated with concomitant and adj

  5. Dental Items of Interest: The Case of Delphic Sibyl by Michelangelo: Solitary Median Maxillary Central Incisor or Mesiodens.

    Science.gov (United States)

    Perciaccante, Antonio; Coralli, Alessia

    2015-01-01

    A case of an anomaly in the maxillary dental arch on "Delphic Sibyl," a fresco by Michelangelo is reported. An accurate analysis of this fresco shows a single incisor tooth is present precisely in the midline. We hypothesize that it may be a case of solitary median maxillary central incisor (SMMCI) and discuss the differential diagnosis with another similar anomaly--the mesiodens.

  6. A persisting median artery in a patient with symbrachydactyly and carpal tunnel syndrome.

    Science.gov (United States)

    Tollan, C J; Sivarajan, V

    2008-07-01

    A persisting median artery associated with carpal tunnel syndrome in a patient with symbrachydactyly has not been previously described in the literature. It is unclear whether there may be a developmental association between persistence of a median artery and Symbrachydactyly.

  7. Circulating plasma cells detected by flow cytometry as a predictor of survival in 302 patients with newly diagnosed multiple myeloma.

    Science.gov (United States)

    Nowakowski, Grzegorz S; Witzig, Thomas E; Dingli, David; Tracz, Michal J; Gertz, Morie A; Lacy, Martha Q; Lust, John A; Dispenzieri, Angela; Greipp, Philip R; Kyle, Robert A; Rajkumar, S Vincent

    2005-10-01

    We detected circulating plasma cells (PCs) by flow cytometry in 302 patients with newly diagnosed multiple myeloma (MM) by gating on CD38+CD45- cells. The number of circulating PCs per 50 000 mononuclear cells was reported. In 80 (27%) patients, no circulating PC were seen; 106 (35%) patients had 1 to 10 and 115 (38%) patients had more than 10 circulating PCs. Median overall survival for the 302 patients was 47 months. Patients with 10 or fewer circulating PCs had a median survival of 58.7 months, whereas patients with more than 10 circulating PCs had a median survival of 37.3 months (P = .001). On multivariate analysis, the prognostic value of circulating PCs was independent of beta2-microglobulin, albumin, and C-reactive protein. There was only a weak correlation between tumor mass and circulating PCs, suggesting that the appearance of circulating PCs may be a reflection of tumor biology. We conclude that the number of circulating PCs measured by flow cytometry in patients with newly diagnosed MM is an independent predictor of survival.

  8. Unusual nerve supply of biceps from ulnar nerve and median nerve and a third head of biceps

    Directory of Open Access Journals (Sweden)

    Arora L

    2006-01-01

    Full Text Available Variations in branching pattern of the brachial plexus are common and have been reported by several investigators. Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of the arm. Ulnar nerve after taking origin from medial cord of brachial plexus runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters the posterior compartment of arm. Ulnar nerve enters forearm between two heads of flexor carpi ulnaris from where it continues further. It supplies flexor carpi ulnaris , flexor digitorum profundus and several intrinsic muscles of hand . We recently observed dual supply of biceps muscle from ulnar and median nerves in arm. Musculocutaneous nerve was absent. Although communications between nerves in arm is rare, the communication between median nerve and musculocutaneous nerve were described from the 19th century which could explain innervation of biceps from median nerve. But no accurate description of ulnar nerve supplying biceps could be found in literature. Knowledge of anatomical variation of these nerves at level of upper arm is essential in light of the frequency with which surgery is performed to transfer nerve fascicles from ulnar nerve to biceps in case of brachial plexus injuries. We also observed third head of biceps, our aim is to describe the exact topography of this variation and to discuss its morphological.

  9. Breast Cancer. Patients' Survival. Report to the Chairman, Subcommittee on Health and Environment, Committee on Energy and Commerce. House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This monograph examines the effectiveness of adjuvant chemotherapy in premenopausal women with breast cancer that has spread to the lymph nodes under the arm. The review focuses on the issue of how the survival of node-positive breast cancer patients has changed over time. It concludes that the survivability benefits from this treatment need…

  10. Atypical teratoid/rhabdoid tumor of the velum interpositum presenting as a spontaneous intraventricular hemorrhage in an infant: case report with long-term survival.

    Science.gov (United States)

    Donovan, Daniel J; Smith, Alice B; Petermann, Gregory W

    2006-01-01

    Atypical teratoid/rhabdoid tumors (ATRT) of infancy are highly malignant neoplasms that are most common in the first 2 years of life. We present the case of a 3-month-old girl who presented with the acute onset of generalized seizures and was found to have a large spontaneous intraventricular hemorrhage. The blood masked an underlying ATRT of the velum interpositum in the midline of the lateral ventricles and roof of the third ventricle, the first reported case in this location. Serial imaging studies and two ventriculoscopic biopsies were required to establish the diagnosis of the tumor in this unique location and in the midst of an evolving hematoma. After surgical resection, the patient received adjuvant chemotherapy. At 4-year follow-up, the child is neurologically intact, meeting normal developmental milestones, and imaging studies show no evidence of tumor. ATRT were previously associated with an extremely poor prognosis, but more recent evidence with complete surgical resection and adjuvant chemotherapy shows extended survival in some cases, supporting an aggressive and comprehensive approach to give these patients the best chance for a good outcome. Spontaneous brain hemorrhage in a full-term infant requires a diligent and persistent search to rule out an underlying neoplasm.

  11. Improvement of quality of life and survival using self-expandable metal stent placement for severe malignant stenosis of the gastric body: a case report

    Directory of Open Access Journals (Sweden)

    Kumagai Hozumi

    2012-09-01

    Full Text Available Abstract Introduction Advanced gastric carcinoma often decreases quality of life because of upper gastrointestinal tract stenosis. Self-expandable metal stents have been thought to be an effective, minimally invasive treatment for stenosis. However, the effectiveness of self-expandable metal stent placement for carcinomatous stenosis of the gastric body and antrum has not been clarified, and there have been few reports of such cases. Case presentation A 74-year-old Japanese woman developed stenosis of the gastric body and antrum caused by advanced gastric cancer during first-line chemotherapy. She developed weight loss and poor nutrition due to inadequate intake. Self-expandable metal stent placement for stenosis of the gastric body and antrum ameliorated her symptoms rapidly and improved her general condition and quality of life. Eight days after self-expandable metal stent placement, second-line chemotherapy could be administered safely. Oral intake and nutritional status were maintained for 117 days after self-expandable metal stent placement, and she died of gastric cancer 176 days after self-expandable metal stent placement and initiation of second-line chemotherapy. Conclusions Self-expandable metal stent placement for carcinomatous stenosis in the gastric body and antrum could be an effective therapeutic strategy for patients with inadequate oral uptake. It may provide rapid improvement of the patient’s general condition and oral intake with minimal complications, comparatively long-term symptom relief, and a survival benefit by allowing second-line chemotherapy.

  12. Brain metastases free survival differs between breast cancer subtypes

    Science.gov (United States)

    Berghoff, A; Bago-Horvath, Z; De Vries, C; Dubsky, P; Pluschnig, U; Rudas, M; Rottenfusser, A; Knauer, M; Eiter, H; Fitzal, F; Dieckmann, K; Mader, R M; Gnant, M; Zielinski, C C; Steger, G G; Preusser, M; Bartsch, R

    2012-01-01

    Background: Brain metastases (BM) are frequently diagnosed in patients with HER-2-positive metastatic breast cancer; in addition, an increasing incidence was reported for triple-negative tumours. We aimed to compare brain metastases free survival (BMFS) of breast cancer subtypes in patients treated between 1996 until 2010. Methods: Brain metastases free survival was measured as the interval from diagnosis of extracranial breast cancer metastases until diagnosis of BM. HER-2 status was analysed by immunohistochemistry and reanalysed by fluorescent in situ hybridisation if a score of 2+ was gained. Oestrogen-receptor (ER) and progesterone-receptor (PgR) status was analysed by immunohistochemistry. Brain metastases free survival curves were estimated with the Kaplan–Meier method and compared with the log-rank test. Results: Data of 213 patients (46 luminal/124 HER-2/43 triple-negative subtype) with BM from breast cancer were available for the analysis. Brain metastases free survival differed significantly between breast cancer subtypes. Median BMFS in triple-negative tumours was 14 months (95% CI: 11.34–16.66) compared with 18 months (95% CI: 14.46–21.54) in HER-2-positive tumours (P=0.001) and 34 months (95% CI: 23.71–44.29) in luminal tumours (P=0.001), respectively. In HER-2-positive patients, co-positivity for ER and HER-2 prolonged BMFS (26 vs 15 m; P=0.033); in luminal tumours, co-expression of ER and PgR was not significantly associated with BMFS. Brain metastases free survival in patients with lung metastases was significantly shorter (17 vs 21 months; P=0.014). Conclusion: Brain metastases free survival in triple-negative breast cancer, as well as in HER-2-positive/ER-negative, is significantly shorter compared with HER-2/ER co-positive or luminal tumours, mirroring the aggressiveness of these breast cancer subtypes. PMID:22233926

  13. Ginseng and Ganoderma lucidum use after breast cancer diagnosis and quality of life: a report from the Shanghai Breast Cancer Survival Study.

    Directory of Open Access Journals (Sweden)

    Ping-Ping Bao

    Full Text Available OBJECTIVE: To evaluate associations between quality of life (QOL and use of ginseng and Ganoderma lucidum (G. lucidum among breast cancer survivors. METHODS: Included in this study were 4,149 women with breast cancer who participated in the Shanghai Breast Cancer Survival Study. Ginseng use was assessed at 6-, 18-, and 36-month post-diagnosis surveys; G. lucidum use was assessed at the 6- and 36-month surveys. QOL was evaluated at the 6- and 36-month surveys. Multiple linear regression models were used to examine associations between ginseng and G.lucidum use and QOL assessed at the 36-month survey, with adjustment for potential confounders and baseline QOL. RESULTS: At 6 months post-diagnosis, 14.2% of participants reported regular use of ginseng and 58.8% reported use of G. lucidum. We found no significant associations between ginseng use at 6, 18, and 36 months post-diagnosis and participants' total QOL score or individual scores for psychological, physical, or social well-being. Post-diagnosis G. lucidum use was positively associated with social well-being (adjusted mean difference: 1.26; 95% CI: 0.66, 1.86, but was inversely associated with physical well-being (adjusted mean difference: -1.16; 95% CI: -1.86, -0.47 with a dose-response pattern observed for cumulative number of times of use (P for trend <0.001 for both. CONCLUSION: We found no evidence that post-diagnosis ginseng use improved the QOL of breast cancer survivors. Post-diagnosis G. lucidum use was associated with better social well-being scores, but poorer physical well-being scores.

  14. Does sunlight exposure improve survival in patients with non-small cell lung cancer?

    Science.gov (United States)

    Mutlu, Hasan; Buyukcelik, Abdullah; Aksahin, Arzu; Kibar, Mustafa; Cihan, Yasemin Benderli; Kaya, Eser; Seyrek, Ertugrul; Yavuz, Sinan; Erden, Abdulsamet; Calikusu, Zuleyha; Aslan, Tuncay; Akca, Zeki

    2013-01-01

    Some epidemiological studies reported that sunlight exposure and highvitamin D levels may decrease the morbidity and mortality related to cancer. We aimed to evaluate whether sunlight exposure has an impact on survival in patients with non small cell lung cancer. A total of 546 patients with NSCLC from two different regions (Kayseri and Adana) differing according to sunlight exposure were analysed retrospectively. The median overall survival (OS) rates were 11. 6 (CI: 9.50-13.6) and 15.6 months (CI: 12.4-18.8) for Kayseri and Adana, respectively, in all patients (p=0.880). There were no differences between groups in terms of OS. While there is strong evidence regarding inverse relationship between cancer incidence and sunlight exposure, it is still controversial whether sunlight exposure is a good prognostic factor for survival in patients with lung cancer.

  15. Incidence of and survival from oligodendroglioma in Denmark, 1943-2002

    DEFF Research Database (Denmark)

    Nielsen, Malene Schjønning; Christensen, Helle Collatz; Kosteljanetz, Michael;

    2008-01-01

    case per 100,000 person-years, but varied somewhat when viewed across isolated periods. Comparison of the incidence rate before and after the introduction of CT scanning did not reveal a significant difference in the incidence rate. The median survival increased from 1.4 years (95% confidence interval......,304 cases of oligodendroglioma were included in the study. We calculated sex- and age-specific incidence rates in 5-year age intervals and for 5-year calendar periods. Overall survival was estimated by the Kaplan-Meier method. In the period 1943-2002, the incidence rate of oligodendroglioma was less than 1......We established the nationwide, population-based incidence of oligodendroglioma in Denmark during 59 years of monitoring and compared the overall survival of patients with oligodendroglial tumors during the periods 1943-1977 and 1978-2002. On the basis of reports in the Danish Cancer Registry, 1...

  16. Trends in adult leukemia incidence and survival in Denmark, 1943-2003

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Nielsen, Ove Juul; Johansen, Christoffer

    2009-01-01

    The etiology of leukemia is largely unknown. Ecological data indicating trends in incidence and survival can provide information about changes in risk factors, can reflect underlying changes in diagnostic classification, and can measure therapeutic advances. From the records of the Danish Cancer...... Registry with registration starting from 1943, we calculated age-specific, period-specific, and age-standardized (world standard) incidence rates of chronic lymphoid leukemia (CLL), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), and acute myeloid leukemia (AML) for persons above the age...... of 18. Kaplan-Meier survival curves and median survival times were calculated. Between 1943 and 2003, there were 26,036 cases of leukemia reported. The age-specific incidence rates of CLL, CML, and AML were higher for older men and women, while the incidence rates of ALL by age were more homogeneous...

  17. Removal of ring artifacts in computed tomographic imaging using iterative center weighted median filter.

    Science.gov (United States)

    Sadi, Fazle; Lee, Soo Yeol; Hasan, Md Kamrul

    2010-01-01

    A new iterative center weighted median filter (ICWMF) for ring artifact reduction from the micro-computed tomographic (micro-CT) image is proposed in this paper. The center weight of the median filter is computed based on the characteristic of the ring artifact in the mean curve of the projection data. The filter operates on the deviation of the mean curve to smooth the ring generating peaks and troughs iteratively while preserving the details due to image. A convergence criterion for the iterative algorithm is determined from the distribution of the local deviation computed from the mean curve deviation. The estimate of the mean curve obtained using the ICWMF is used to correct the ring corrupted projection data from which reconstruction gives the ring artifact suppressed micro-CT image. Test results on both the synthetic and real images demonstrate that the ring artifacts can be more effectively suppressed using our method as compared to other ring removal techniques reported in the literature. 2009 Elsevier Ltd. All rights reserved.

  18. Comparison of the pulsed MIG welding process for different median current

    Institute of Scientific and Technical Information of China (English)

    Wen Yuanmei; Xue Jiaxiang; Yao Ping; Huang Shisheng

    2009-01-01

    Based on the high speed video system with electrical signals collecting and wavelet analyzing, the welding processes under three different median currents with the same median time were detected. The experimental results show that, when the median current is higher, the input peak energy is lower. And the droplet transfer is almost in spray mode. The welding process is the stablest.

  19. Yttrium-90 Radioembolization for Unresectable Standard-chemorefractory Intrahepatic Cholangiocarcinoma: Survival, Efficacy, and Safety Study

    Energy Technology Data Exchange (ETDEWEB)

    Rafi, Shoaib; Piduru, Sarat M. [Emory University School of Medicine, Division of Interventional Radiology and Image Guided Medicine, Department of Radiology (United States); El-Rayes, Bassel; Kauh, John S. [Emory University School of Medicine, Department of Hematology and Medical Oncology (United States); Kooby, David A.; Sarmiento, Juan M. [Emory University School of Medicine, Department of Surgical Oncology in Surgery (United States); Kim, Hyun S., E-mail: kevin.kim@emory.edu [Emory University School of Medicine, Division of Interventional Radiology and Image Guided Medicine, Department of Radiology (United States)

    2013-04-15

    To assess the overall survival, efficacy, and safety of radioembolization with yttrium-90 (Y90) for unresectable standard-chemorefractory intrahepatic cholangiocarcinoma (ICC). Patients with unresectable standard-chemorefractory ICC treated with Y90 were studied. Survival was calculated from the date of first Y90 procedure. Tumor response was assessed with the Response Evaluation Criteria in Solid Tumors criteria on follow-up computed tomography or magnetic resonance imaging scans. National Cancer Institute Common Terminology Criteria (NCI CTCAE), version 3, were used for complications. Statistical analysis was performed by the Kaplan-Meier estimator by the log rank test. Nineteen patients underwent a total of 24 resin-based Y90 treatments. Median survival from the time of diagnosis and first Y90 procedure was 752 {+-} 193 [95 % confidence interval (CI) 374-1130] and 345 {+-} 128 (95 % CI 95-595) days, respectively. Median survival with Eastern Cooperative Oncology Group (ECOG) performance status 1 (n = 15) and ECOG performance status 2 (n = 4) was 450 {+-} 190 (95 % CI 78-822) and 345 {+-} 227 (95 % CI 0-790) days, respectively (p = .214). Patients with extrahepatic metastasis (n = 11) had a median survival of 404 {+-} 309 (95 % CI 0-1010) days versus 345 {+-} 117 (95 % CI 115-575) days for patients without metastasis (n = 8) (p = .491). No mortality was reported within 30 days from first Y90 radioembolization. One patient developed grade 3 thrombocytopenia as assessed by NCI CTCAE. Fatigue and transient abdominal pain were observed in 4 (21 %) and 6 (32 %) patients, respectively. Y90 radioembolization is effective for unresectable standard-chemorefractory ICC.

  20. Dendritic cell immunotherapy versus bevacizumab plus irinotecan in recurrent malignant glioma patients: a survival gain analysis

    Science.gov (United States)

    Artene, Stefan-Alexandru; Turcu-Stiolica, Adina; Hartley, Richard; Ciurea, Marius Eugen; Daianu, Oana; Brindusa, Corina; Alexandru, Oana; Tataranu, Ligia Gabriela; Purcaru, Stefana Oana; Dricu, Anica

    2016-01-01

    Background The bevacizumab and irinotecan protocol is considered a standard treatment regimen for recurrent malignant glioma. Recent advances in immunotherapy have hinted that vaccination with dendritic cells could become an alternative salvage therapy for the treatment of recurrent malignant glioma. Methods A search was performed on PubMed, Cochrane Library, Web of Science, ScienceDirect, and Embase in order to identify studies with patients receiving bevacizumab plus irinotecan or dendritic cell therapy for recurrent malignant gliomas. The data obtained from these studies were used to perform a systematic review and survival gain analysis. Results Fourteen clinical studies with patients receiving either bevacizumab plus irinotecan or dendritic cell vaccination were identified. Seven studies followed patients that received bevacizumab plus irinotecan (302 patients) and seven studies included patients that received dendritic cell immunotherapy (80 patients). For the patients who received bevacizumab plus irinotecan, the mean reported median overall survival was 7.5 (95% confidence interval [CI] 4.84–10.16) months. For the patients who received dendritic cell immunotherapy, the mean reported median overall survival was 17.9 (95% CI 11.34–24.46) months. For irinotecan + bevacizumab group, the mean survival gain was −0.02±2.00, while that for the dendritic cell immunotherapy group was −0.01±4.54. Conclusion For patients with recurrent malignant gliomas, dendritic cell immunotherapy treatment does not have a significantly different effect when compared with bevacizumab and irinotecan in terms of survival gain (P=0.535) and does not improve weighted survival gain (P=0.620). PMID:27877052

  1. Lung Transplantation and the Routine Use of Cardiopulmonary Bypass and Median Sternotomy: Experience at the Ochsner Multi-Organ Transplant Institute

    Science.gov (United States)

    Bates, Michael; Factor, Matthew; Parrino, P. Eugene; Bansal, Aditya; Rampolla, Reinaldo; Seoane, Leonardo; Mena, Jose; Gaudet, Matthew; Smith, William; McFadden, P. Michael

    2017-01-01

    Background: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups. Methods: After institutional review board approval, we conducted a retrospective review of the entire program using the Ochsner lung transplant database to identify patients in the non-CPB group from 1990-2005 and in the CPB group from 2010-2014. We calculated 1- and 3-year survival rates for each patient and reviewed medical records for evidence of stroke, the need for operative reexploration, and venous stenosis. We also performed a subgroup analysis of the first 20 consecutive patients undergoing lung transplantation on CPB with median sternotomy from February 2010 through April 2011 to examine intraoperative blood product use, the quantity of blood products administered, CPB cannulation and pump complications, ischemic time, and primary graft dysfunction. Results: Of the 208 patients in the non-CPB group, 74% had 1-year graft survival and 55% had 3-year survival following transplantation. After February 2010, 79 patients underwent lung transplantation on CPB with median sternotomy, and 90% of those patients had 1-year graft survival. Of the 46 patients available for 3-year follow-up, 59% were alive with functional grafts. The difference in 1-year survival rates between the 2 cohorts was statistically significant. Two deaths, 3 strokes, and 5 reexplorations of the chest for bleeding occurred during the perioperative time period in the CPB group, but no mortality was associated with these perioperative events. One patient who had perioperative

  2. Survival and clinical outcome of dogs with ischaemic stroke

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Toft, Nils; Westrup, Ulrik

    2013-01-01

    The objectives of the present study were to investigate survival time, possible predictors of survival and clinical outcome in dogs with ischaemic stroke. A retrospective study of dogs with a previous diagnosis of ischaemic stroke diagnosed by magnetic resonance imaging (MRI) was performed....... The association between survival and the hypothesised risk factors was examined using univariable exact logistic regression. Survival was examined using Kaplan-Meier and Cox regression. Twenty-two dogs were identified. Five dogs (23%) died within the first 30days of the stroke event. Median survival in 30-day...... survivors was 505days. Four dogs (18%) were still alive by the end of the study. Right-sided lesions posed a significantly increased risk of mortality with a median survival time in dogs with right-sided lesions of 24days vs. 602days in dogs with left sided lesions (P=0.006). Clinical outcome was considered...

  3. Pigmented villonodular synovitis of the elbow with rdial, median and ulnar nerve compression

    Science.gov (United States)

    Lu, Hui; Chen, Qiang; Shen, Hui

    2015-01-01

    Pigmented villonodular synovitis (PVNS) is a rare, idiopathic proliferative disorder of the synovium. While, PVNS of elbow is extremely rare. We report an 82-year-old female patient with 20-year-history of gradually increased PVNS in her left elbow. The multiple masses were located in anterior, medial and lateral of elbow. Her radial, median and ulnar nerves were compressed by the tumor. We resected tumor of extra-articular part piecemeally and released the compression of nerves. After the surgery, the patient gained a functional recovery. Two years after surgery she had a tumor recurrence, but without any symptoms of nerve compression syndromes. We discussed its clinical diagnosis, radiological features, MRI findings, pathophysiology, and treatment. PMID:26823718

  4. Median cleft of mandible and lower lip with ankyloglossia and ectopic minor salivary gland on tongue

    Directory of Open Access Journals (Sweden)

    Rana Roshani

    2004-01-01

    Full Text Available Median cleft of lower lip and mandible is a rare anomaly. This Cleft has also been described as Cleft No. 30 of Tessier′s classification. In minor forms only lower lip is cleft. Frequently, the cleft extends into the mandibular symphysis and the tongue is attached to the cleft alveolar margin. At times the tongue may be bifid or absent, hyoid absent, thyroid cartilage underdeveloped, strap muscles atrophic, manubrium sterni absent, clavicles widely spaced etc. The earliest report of this anomaly was by Couronne′ in 1819. Since then very few cases have been reported in literature with variations. We describe a male child who presented at the age of 6 months with an ectopic salivary gland on the dorsum of the tongue in addition to median cleft of lower lip, ankyloglossia and notching of the mandible. Excision of mass on dorsum of tongue, release of ankyloglossia and lip from the alveolus followed by repair was done. No bony work was done since the mandible was only notched. On post-operative follow-up at 18 months, dentition was delayed in both maxillary as well as mandibular teeth and there was a gap between the lower central incisors. At the age of 2 years 4 months, the dentition is still not complete and the gap between the lower central incisors is very apparent. There is a supernumerary upper central incisor on right side. There is no mobility between the two segments of mandible. Speech is normal. A regular follow-up will be done to study the eruption of permanent central incisors at the age of 7 years and till eruption of all permanent teeth to assess the occlusion and to decide whether any bony work is needed or not.

  5. Survival and death of epiblast cells during embryonic stem cell derivation revealed by long-term live-cell imaging with an Oct4 reporter system.

    Science.gov (United States)

    Yamagata, Kazuo; Ueda, Jun; Mizutani, Eiji; Saitou, Mitinori; Wakayama, Teruhiko

    2010-10-01

    Despite the broad literature on embryonic stem cells (ESCs), their derivation process remains enigmatic. This may be because of the lack of experimental systems that can monitor this prolonged cellular process. Here we applied a live-cell imaging technique to monitor the process of ESC derivation over 10 days from morula to outgrowth phase using an Oct4/eGFP reporter system. Our imaging reflects the 'natural' state of ESC derivation, as the ESCs established after the imaging were both competent in chimeric mice formation and germ-line transmission. Using this technique, ESC derivation in conventional conditions was imaged. After the blastocoel was formed, the intensity of Oct4 signals attenuated in the trophoblast cells but was maintained in the inner cell mass (ICM). Thereafter, the Oct4-positive cells scattered and their number decreased along with apoptosis of the other Oct4-nagative cells likely corresponds to trophoblast and hypoblast cells, and then only the surviving Oct4-positive cells proliferated and formed the colony. All embryos without exception passed through this cell death phase. Importantly, the addition of caspase inhibitor Z-VAD-FMK to the medium dramatically suppressed the loss of Oct4-positive cells and also other embryo-derived cells, suggesting that the cell deaths was induced by a caspase-dependent apoptotic pathway. Next we imaged the ESC derivation in 3i medium, which consists of chemical compounds that can suppress differentiation. The most significant difference between the conventional and 3i methods was that there was no obvious cell death in 3i, so that the colony formation was rapid and all of the Oct4-positive cells contributed to the formation of the outgrown colony. These data indicate that the prevention of cell death in epiblast cells is one of the important events for the successful establishment of ESCs. Thus, our imaging technique can advance the understanding of the time-dependent cellular changes during ESC derivation.

  6. Study of recurrent branch of median nerve (Thenar's muscular branch in relation to the flexor retinaculum and median in 64 hands (32 Men

    Directory of Open Access Journals (Sweden)

    Amirsadri R

    1998-07-01

    Full Text Available Variation of recurred branch of median nerve in relation to the median and flexor retinaculum are significant for both hand surgeons and specialists always. In this study, 64 cadaver hands (32 men have been dissected. The median nerve was identified at the proximal edge of the flexor retinaculum, and in order to expose carpal tunnel the ligament was divided, and the above subjects were studied. The results are: 1 The relation of recurrent nerve to the flexor retinaculum was classified into 4 types: A In (53.1% of subjects, this branch arises from the median after the flexor retinaculum. B In (31.3% of subjects, it arises from the median in the carpal tunnel and the moves around the lower edge of flexor retinaculum and enters the thenar region. C In (14.1% of subjects, it arises from the median in the carpal tunnel and pierces the flexor retinaculum. D In (1.56% of subjects it arises, in the carpal tunnel and it divides into two subbranches here. One follows pattern A and the other pattern C. 2 In this step, the relation of the recurrent branch to the median nerve was studied. The results show that inspite of this image even though most often the recurrent branch arises from the lateral side of median, in (68.75% of subjects it arises from it's anterior surface. The MC Nemar test reveals that there is no relation between manifestation of mentioned patterns with right or left hands.

  7. Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

    OpenAIRE

    Ragel, Brian T.; Park, Gregory C.; Sid Brevard

    2011-01-01

    Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity inj...

  8. 76 FR 39474 - Monthly Median Cost of Funds Reporting, and Publication of Cost of Funds Indices

    Science.gov (United States)

    2011-07-06

    ... Mae) and to the Federal Home Loan Mortgage Corporation (FHLMC or Freddie Mac) that use these indices... determine, after notice and opportunity for comment, that (A) the new indices are based upon data... values and changes of 17 publicly available indices on a monthly basis from January 1990 through...

  9. Strategical Report on Removal of Blurring in an Original Image Using Non Linear Median Filter Technique

    Directory of Open Access Journals (Sweden)

    G. Sasikala

    2014-11-01

    Full Text Available In real world application, the original signal, image, motion pictures or any another transform the removing of blur is a still challenging issue for the researchers. There have been several published algorithm, techniques and new methodologies. But each approach has its own assumptions, advantages and limitations. This study explores a technique of how image enhancement and denoising are useful in motion recording and storing for various applications such as digital still camera, video mail camera, video conferencing camera, surveillance camera, web camera, wireless camera, toy camera and digital video recorder.

  10. Minimally invasive repair of pectus excavatum in an adolescent with a history of a median sternotomy as an infant

    Directory of Open Access Journals (Sweden)

    Lauren Huckaby

    2014-10-01

    Full Text Available The report by Nuss et al., in 1998 of their 10-year experience with minimally invasive repair of pectus excavatum introduced the possibility of a less invasive approach for the correction of chest wall abnormalities. This procedure is now well-accepted around the world, although serious complications such as intraoperative cardiac perforation and postoperative bar displacement have been reported. The Nuss procedure has been performed concurrently with sternotomy for cardiac operations. However, there have been no reports of minimally invasive pectus excavatum correction in a child with a remote history of a median sternotomy. With IRB approval (Protocol #1308002283 we report the successful completion of a Nuss procedure in an adolescent with a history of a median sternotomy in infancy. During the procedure, thoracoscopy on the right side revealed significant adhesions of the lung and pericardium to the posterior sternum. Additional trocars were placed bilaterally to facilitate visualization and to allow for lysis of the adhesions with bipolar cautery. Passage of the bar was accomplished uneventfully and the patient has an excellent cosmetic outcome 28 months following the operation. We believe that a previous median sternotomy should not be viewed as a contraindication to the minimally invasive repair of pectus excavatum.

  11. Comparing two classifications of cancer cachexia and their association with survival in patients with unresected pancreatic cancer.

    Science.gov (United States)

    Wesseltoft-Rao, Nima; Hjermstad, Marianne J; Ikdahl, Tone; Dajani, Olav; Ulven, Stine M; Iversen, Per Ole; Bye, Asta

    2015-01-01

    There is no universally accepted definition of cancer cachexia. Two classifications have been proposed; the 3-factor classification requiring ≥ 2 of 3 factors; weight loss ≥ 10%, food intake ≤ 1500 kcal/day, and C-reactive protein ≥ 10 mg/l, and the consensus classification requiring weight loss >5% the past 6 mo, or body mass index 2%. Precachexia is the initial stage of the cachexia trajectory, identified by weight loss ≤ 5%, anorexia and metabolic change. We examined the consistency between the 2 classifications, and their association with survival in a palliative cohort of 45 (25 men, median age of 72 yr, range 35-89) unresected pancreatic cancer patients. Computed tomography images were used to determine sarcopenia. Height/weight/C-reactive protein and survival were extracted from medical records. Food intake was self-reported. The agreement for cachexia and noncachexia was 78% across classifications. Survival was poorer in cachexia compared to noncachexia (3-factor classification, P = 0.0052; consensus classification, P = 0.056; when precachexia was included in the consensus classification, P = 0.027). Both classifications showed a trend toward lower median survival (P cachexia. In conclusion, the two classifications showed good overall agreement in defining cachectic pancreatic cancer patients, and cachexia was associated with poorer survival according to both.

  12. Survival Estimates for the Passage of Spring-Migrating Juvenile Salmonids through Snake and Columbia River Dams and Reservoirs, 2003-2004 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Steven G.; Muir, William D.; Zabel, Richard W. (NOAA Fisheries Science Center, Seattle, WA)

    2004-01-01

    For juvenile chinook salmon Oncorhynchus tshawytscha, sockeye salmon O. nerka, and steelhead O. mykiss that migrate through reservoirs, hydroelectric projects, and free-flowing sections of the Snake and Columbia Rivers, survival estimates are essential to develop effective strategies for recovering depressed stocks. Many management strategies were based on estimates of system survival (Raymond 1979; Sims and Ossiander 1981) derived in a river system considerably different from today's (Williams and Matthews 1995; Williams et al. 2001). Knowledge of the magnitude, locations, and causes of smolt mortality under present passage conditions, and under conditions projected for the future, are necessary to develop strategies that will optimize smolt survival during migration. From 1993 through 2002, the National Marine Fisheries Service (NMFS) and the University of Washington (UW) demonstrated the feasibility of using three statistical models to estimate survival of PIT-tagged (Prentice et al. 1990a) juvenile salmonids passing through Snake River dams and reservoirs (Iwamoto et al. 1994; Muir et al. 1995, 1996, 2001a, 2003; Smith et al. 1998, 2000a,b; Hockersmith et al. 1999; Zabel et al. 2001, 2002). Evaluation of assumptions for these models indicated that all were generally satisfied, and accurate and precise survival estimates were obtained. In 2003, NMFS and UW completed the eleventh year of the study. Flow levels during the early portion of the 2003 spring migration were similar to 2002, and only slightly higher than in the drought conditions during 2001. However, flow levels were much greater during the later part of the migration in 2003. Spill levels were similar to 2002, much higher than in 2001. Research objectives were to: (1) estimate reach survival and travel time in the Snake and Columbia Rivers throughout the yearling chinook salmon and steelhead migrations; (2) evaluate relationships between survival estimates and migration conditions; and (3

  13. A method for determining the median line of measured cylindrical and conical surfaces

    Science.gov (United States)

    Janecki, Dariusz; Zwierzchowski, Jarosław

    2015-08-01

    The paper presents a novel method for the determination of the median line of the cylindrical and conical surfaces. This method can be incorporated into virtually any cylindricity measurement strategy, including the bird-cage strategy and the helical line strategy. In the study, a median line was determined by minimizing the functional made up of two components. The form of the first component results from the classic definition of the median line provided in the corresponding standard. The other, termed the bending energy, is responsible for ensuring appropriate smoothness of the median line. In order to solve this variational problem, the median line was approximated by means of linear combination of cubic B-spline functions. A simulation and experiments were conducted to establish the suitability of the algorithm developed for the determination of the median line using the helical-line and the cross-section measurement strategy.

  14. British Thoracic Society Study on cryptogenic fibrosing alveolitis: response to treatment and survival

    Science.gov (United States)

    Rudd, Robin M; Prescott, Robin J; Chalmers, J C; Johnston, Ian D A

    2007-01-01

    Background and objective The initial results of a survey of 588 patients with a clinical presentation of cryptogenic fibrosing alveolitis (CFA) also known as idiopathic pulmonary fibrosis, have been published. This article reports further results pertaining to response to treatment and survival. Methods Data on the treatment given and lung function response were collected over 4–6 years. Survival data were collected over 10 years. Results Treatment was given to 445 (76%) patients, 55% were given prednisolone alone and the remainder another immunosuppressive agent, usually with prednisolone. Treated patients had worse lung function initially. At 3 months after study entry, treated patients were more likely to have improved forced vital capacity (FVC) than the untreated patients. Patients whose FVC improved were younger (p = 0.001 analysis of variance (ANOVA)) and had lower initial FVC (p<0.001, ANOVA). Patients who responded to treatment at 3 months or at 1 year survived longer than those who remained stable, who in turn survived longer than those who deteriorated (p = 0.002). These differences were largely accounted for by patients with better lung function surviving longer. Younger age at entry, female sex and higher percentage predicted FVC and reduced carbon monoxide transfer factor at study entry were associated with greater chances of survival at 4 years. Overall median survival from entry was 2.43 years (95% confidence interval (CI) 2.17 to 3.18). Conclusions About a third of patients with CFA showed improved lung function after initiation of corticosteroid or immunosuppressive treatment, and those who improved survived longer. Poorer lung function, male sex and age are adverse prognostic features. Overall survival was poor. PMID:16769717

  15. Factors Associated With Survival Following Radium-223 Treatment for Metastatic Castration-resistant Prostate Cancer.

    Science.gov (United States)

    Wong, William W; Anderson, Eric M; Mohammadi, Homan; Daniels, Thomas B; Schild, Steve E; Keole, Sameer R; Choo, C Richard; Tzou, Katherine S; Bryce, Alan H; Ho, Thai H; Quevedo, Fernando J; Vora, Sujay A

    2017-04-26

    Radium-223 ((223)Ra) improves survival in patients with metastatic castration-resistant prostate cancer (mCRPC). This retrospective analysis was performed to better understand its efficacy in routine clinical practice and identify factors associated with survival. Sixty-four patients with mCRPC who received (223)Ra between 2013 and 2015 were the basis of this retrospective study. Clinical outcomes and patient characteristics were obtained. Potential prognostic factors for survival were evaluated by univariate analysis using the log-rank test and multivariate analysis using the Cox proportional hazard method. The median survival was 12.9 months. Twenty-one patients (33%) developed a skeletal event, and the median time to the first skeletal event was 4.4 months. In univariate analysis, factors significantly associated with survival included: no prior chemotherapy, ≤ 5 bone metastases, baseline prostate-specific antigen (PSA) ≤ 36 ng/mL, baseline alkaline phosphatase (ALP)  12 g/dL, ALP response after (223)Ra treatment, PSA decrease during (223)Ra treatment, and absence of > 25% PSA increase during (223)Ra treatment. In multivariate analysis, 4 factors remained significant: no prior chemotherapy, ≤ 5 bone metastases, baseline ALP < 115 U/L, and ALP response after (223)Ra treatment. When (223)Ra is administered in routine clinical practice, clinical outcomes can be more variable than those reported in the randomized study owing to patient heterogeneity. Four factors were identified to be significantly associated with survival after (223)Ra treatment. These pretreatment factors may be used as stratification factors in future studies to investigate whether (223)Ra would be more effective for patients with newly diagnosed metastatic disease that is sensitive to androgen deprivation therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Long-term survival in advanced melanoma patients using repeated therapies: successive immunomodulation improving the odds?

    Directory of Open Access Journals (Sweden)

    Coventry BJ

    2015-04-01

    Full Text Available Brendon J Coventry, Dominique Baume, Carrie Lilly Discipline of Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia Background: Patients with advanced metastatic melanoma are often confronted with little prospect of medium- to longer-term survival by any currently available therapeutic means. However, most clinicians are aware of exceptional cases where survival defies the notion of futility. Prolonged survival from immunotherapies, including interleukin-2, vaccines and antibodies to cytotoxic lymphocyte antigen-4, and programmed death-1 receptor inhibitory monoclonal antibody, implies a role for immune system modulation. We aimed to identify cases where exceptional survival from advanced melanoma occurred prior to recent novel therapies to facilitate better understanding of this phenomenon. Methods: Cases of long-term survival of ≥3 years' duration (from diagnosis of metastatic disease were identified from the database of one clinician; these cases were treated before the availability of newer immunotherapies, and they were documented and examined. A literature search for reported outcome measures from published studies using older and recent therapies for advanced melanoma was conducted to enable the comparison of data. Results: Eighteen cases were identified that identified survival of ≥3 years' duration from metastatic disease (12 American Joint Committee on Cancer [AJCC] Stage IV cases; six AJCC III cases diagnosis. These were assessed and reported to detail the clinical course. Standard clinical prognostication methods predicted high risk of early mortality in those patients. No identifiable differences could be detected between these and other patients with similar patterns of disease. At evaluation, 17 patients (94% had survived ≥5 years, and eleven patients (61% had survived ≥10 years (range: 3–15 years. The median survival duration with metastatic disease was 11 years; 15 remained alive and three

  17. The Median-Median Line

    Science.gov (United States)

    Wilson, David C.

    2010-01-01

    Graphing bivariate data in a scatter plot and drawing an approximate line of best fit for the data have become commonly recommended activities for middle school and high school students. The graphing calculator has provided a mechanism for students both to approximate a best-fit line and to calculate the best-fit line using a built-in option. Two…

  18. Acceptable differences in sensory and motor latencies between the median and ulnar nerves.

    Science.gov (United States)

    Grossart, Elizabeth A; Prahlow, Nathan D; Buschbacher, Ralph M

    2006-01-01

    The median and ulnar nerves are often studied during the same electrodiagnostic examination. The sensory and motor latencies of these nerves have been compared to detect a common electrodiagnostic entity: median neuropathy at the wrist. However, this comparison could also be used to diagnose less common ulnar pathology. For this reason, it is important to establish normal values for comparing median and ulnar sensory and motor latencies. Previous research deriving these differences in latency has had some limitations. The purpose of this study was to derive an improved normative database for the acceptable differences in latency between the median and ulnar sensory and motor nerves of the same limb. Median and ulnar sensory and motor latencies were obtained from 219 and 238 asymptomatic risk-factor-free subjects, respectively. An analysis of variance was performed to determine whether physical characteristics, specifically age, race, gender, height, or body mass index (as an indicator of obesity), correlated with differences in latency. Differences in sensory latencies were unaffected by physical characteristics. The upper limit of normal difference between median and ulnar (median longer than ulnar) onset latency was 0.5 ms (97th percentile), whereas the peak latency value was 0.4 ms (97th percentile). The upper limit of normal difference between ulnar-versus-median (ulnar longer than median) onset latency was 0.3 ms (97th percentile), whereas the peak-latency value was 0.5 ms (97th percentile). The mean difference in motor latencies correlated with age, with older subjects having a greater variability. In subjects aged 50 and over, the mean difference in median-versus-ulnar latency was 0.9 ms +/- 0.4 ms. The upper limit of normal difference (median longer than ulnar) was 1.7 ms (97th percentile). The upper limit of normal ulnar motor latency is attained if the ulnar latency comes within 0.3 ms of the median latency. In individuals less than 50 years of age, the

  19. Primary Renal Lymphoma: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    J Zhang

    2014-05-01

    Full Text Available Primary renal lymphoma is very rare. The prognosis is usually poor with median survival less than a year. We report a case in a 55-year old man with a mass in the left kidney detected by ultrasonography and computed tomography. Radical nephrectomy was performed under a preliminary diagnosis of renal cell carcinoma. After the surgery, four courses of chemotherapy were performed. Prognosis may have improved since those reports in the earlier medical literature.

  20. Estimating postoperative survival of gastric cancer patients and factors affecting it in Iran: Based on a TNM-7 Staging System

    Directory of Open Access Journals (Sweden)

    Hojjat Zeraati

    2016-03-01

    Full Text Available Recently, reports have shown that gastric cancer has high abundance in Iran and is at the second level in men, and fourth in total. This study aimed to determine the 5-year survival of gastric cancer patients and to investigate factors affecting the performance, based on TNM-7 staging system. In this study, we investigated 760 patients with gastric cancer since the beginning of 1993 to the end of 2006 in the Iran Cancer Institute who underwent surgery. Survival of these patients was determined after surgery, and the effects of demographic characteristics such as age (during operation, sex, and information on diseases such as cancer site, pathologic type, stage of disease progress (Stage, metastasis and sites of metastases were evaluated. The 5 -year survival probability of patients was 28 %, and median survival time was 25.69 months. Univariate tests showed that sex, cancer site, and pathologic type have no significant effects on patient’s survival. But the probability of 5-year survival significantly decreases with increasing age, and as it is expected, those with metastases were significantly less likely to have 5-year survival, and disease stage was significantly effective on patients’ life (P<0.001. Simultaneous evaluation of different variables’ effects on the probability of survival using the multiple Cox proportional hazards models showed that age and stage disease variables were effective on the survival of patients. The 5-year survival of patients with gastric cancer is low in Iran, although it is improved compared to the past. It seems that one of the main reasons for low survival rate of these patients is a late referral of patients for diagnosis and treatment. Most patients refer in the final stages of the disease, at this stage most patients are affected by lymph nodes metastases, liver and as the result, their treatment will be more difficult.

  1. Long-term follow-up of myelodysplastic syndrome patients with moderate/severe anaemia receiving human recombinant erythropoietin + 13-cis-retinoic acid and dihydroxylated vitamin D3: independent positive impact of erythroid response on survival.

    Science.gov (United States)

    Crisà, Elena; Foli, Cristina; Passera, Roberto; Darbesio, Antonella; Garvey, Kimberly B; Boccadoro, Mario; Ferrero, Dario

    2012-07-01

    We previously reported a 60% erythroid response rate with recombinant erythropoietin + 13-cis retinoic acid + dihydroxylated vitamin D3 in 63 elderly myelodysplastic patients (median age 75 years) with unfavourable features for response to erythropoietin alone [70% transfusion-dependent, 35% refractory anaemia with ring sideroblasts/refractory anaemia with excess of blasts type 1 (RAEB1), 70% with International Prognostic Scoring System (IPSS) Intermediate-1 or -2]. This report updates that case study at a 7-year follow-up, and compared the impact on overall survival of erythroid response to known prognostic factors. The erythroid response duration (median 17 months; 22 in non-RAEB patients, with 20% patients in response after 6 years of therapy) was longer than in most studies with erythropoietin alone. Overall survival (median 55 months in non-RAEB, 15 in RAEB1 patients) was negatively affected by RAEB1 diagnosis, IPSS and WPSS intermediate scores and transfusion-dependence. In the multivariate analysis, erythroid response maintained an independent positive impact on survival, particularly in non-RAEB patients in the first 3 years from diagnosis (90% survival compared to 50% of non-responders). In conclusion, the long-term follow-up confirmed the achievement, by our combined treatment, of fairly long-lasting erythroid response in the majority of MDS patients with unfavourable prognostic features for response to erythropoietin: this translated in a survival benefit that was independent from other prognostic features.

  2. Angiosarcoma arising in the non-operated, sclerosing breast after primary irradiation, surviving 6 years post-resection: A case report and review of the Japanese literature

    Directory of Open Access Journals (Sweden)

    Takaaki Ito

    2016-01-01

    Conclusion: Angiosarcoma may occur in the non-operated breast, post irradiation. The potential difficulties of diagnosing angiosarcoma against background fibrosis should be kept in mind. Initial radical surgery currently represents the only effective treatment for improving survival in these patients.

  3. Leukaemia incidence and survival in children and adolescents in Europe during 1978-1997. Report from the Automated Childhood Cancer Information System project

    NARCIS (Netherlands)

    Coebergh, J. W. W.; Reedijk, A. M. J.; de Vries, E.; Martos, C.; Jakab, Z.; Steliarova-Foucher, E.; Kamps, W. A.

    2006-01-01

    Leukaemias constitute approximately one-third of cancers in children (age 0-14 years) and 10% in adolescents (age 15-19 years). Geographical patterns (1988-1997) and time trends (1978-1997) of incidence and survival from leukaemias in children (n = 29,239) and adolescents (n = 1929) were derived fro

  4. Long-Term Survival in a Patient with Multiple Brain Metastases from Small-Cell Lung Cancer Treated with Gamma Knife Radiosurgery on Four Occasions: A Case Report

    Directory of Open Access Journals (Sweden)

    Ameer L. Elaimy

    2012-01-01

    Full Text Available Brain metastases are the most common cancerous neoplasm in the brain. The treatment of these lesions is challenging and often includes a multimodality management approach with whole-brain radiation therapy, stereotactic radiosurgery, and neurosurgery options. Although advances in biomedical imaging technologies and the treatment of extracranial cancer have led to the overall increase in the survival of brain metastases patients, the finding that select patients survive several years remains puzzling. For this reason, we present the case of a 70-year-old patient who was diagnosed with multiple brain metastases from small-cell lung cancer five years ago and is currently alive following treatment with chemotherapy for the primary cancer and whole-brain radiation therapy and Gamma Knife radiosurgery on four separate occasions for the neurological cancer. Since the diagnosis of brain metastases five years ago, the patient’s primary cancer has remained controlled. Furthermore, multiple repeat GKRS procedures provided this patient with high levels of local tumor control, which in combination with a stable primary cancer led to an extended period of survival and a highly functional life. Further analysis and clinical research will be valuable in assessing the durability of multiple GKRS for brain metastases patients who experience long-term survival.

  5. Synchronous hepatic metastasis and metachronous Krukenberg tumor from advanced colon cancer. A case report with an unexpected disease-free survival

    Directory of Open Access Journals (Sweden)

    Giovanni Li Destri

    2017-01-01

    Conclusion: The authors emphasize that the long term survival in colon cancer with hepatic and ovarian metastases is possible as long as it has an adequate surgical approach, a tailored chemotherapy and an intensive follow-up. Most likely new prognostic markers will have to be identified.

  6. [Evaluation of neck lymph node dissection and extended lymphadenectomy through a collar incision and median sternotomy for lung cancer].

    Science.gov (United States)

    Miyamoto, H; Hata, E; Sakao, Y; Harada, R; Hamada, T

    1995-11-01

    Since 1983, 421 patients have been treated for lung cancer at this institute. Since 1988, neck lymph node dissection (11 cases) and new extended lymphadenectomy through a collar incision and median sternotomy (22 cases) have been conducted. Indications for this new radical operation are scalene, supraclavicular or highest mediastinal node involvement, or superior pulmonary sulcus carcinoma, in patients aged 70 or less without distant metastasis and NSCLC. No major complications and operative mortality were encountered in this study. Patients with scalene or supraclavicular node involvement showed poor prognosis. Postsurgical local recurrence was frequent. Whether resection in N3 disease should be conducted or not, remains a point of controversy. The authors consider that lymphadenectomy should be conducted more extensively. A significant better survival of N2 disease and satisfactory prognosis of patients without metastasis of cervical lymph nodes demonstrates the effectiveness of neck lymph node dissection in the present superradical operation for lung cancer.

  7. Median and ulnar nerve injuries: prognosis and predictors for clinical outcome

    NARCIS (Netherlands)

    J.B. Jaquet (Jean)

    2004-01-01

    textabstractIn chapter 1 the author provide a general introduction on median and ulnar nerve injuries. Furthermore the aims for this thesis, entitled median and ulnar nerve injuries: prognosis and predictors for clinical outcome, are defi ned. Chapter 2 comprises an investigation into the overall fu

  8. Median sternotomy for double lung transplantation with cardiopulmonary bypass in seven consecutive patients

    DEFF Research Database (Denmark)

    Kohno, Mitsutomo; Steinbrüchel, Daniel A

    2012-01-01

    We describe our technique of using median sternotomy to perform double lung transplantations with cardiopulmonary bypass. By sparing the respiratory muscles, median sternotomy is probably less invasive and preserves lung function. Furthermore, it causes less long-term discomfort than intercostal...

  9. The median of the distance between two leaves in a phylogenetic tree

    CERN Document Server

    Mir, Arnau

    2010-01-01

    We establish a limit formula for the median of the distance between two leaves in a fully resolved unrooted phylogenetic tree with n leaves. More precisely, we prove that this median is equal, in the limit, to the square root of 4*ln(2)*n.

  10. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging

    NARCIS (Netherlands)

    Meek, MF; Stenekes, MW; Hoogduin, HM; Nicolai, JPA

    2006-01-01

    The in vivo assessment of axonal projections of the peripheral nervous system has been severely limited by the lack of noninvasive techniques. We examined whether MR diffusion tensor imaging with fiber tracking of the human median nerve is feasible. The median nerve was examined with a 3-T MRI scann

  11. Electromyogram median power frequency in dynamic exercise at medium exercise intensities

    NARCIS (Netherlands)

    Ament, W; Bonga, GJJ; Hof, AL; Verkerke, GJ

    1996-01-01

    The electromyogram (EMG) median power Frequency of the calf muscles was investigated during an exhausting treadmill exercise and a 20-min recovery period. The exercise was an uphill run at a speed of 5 km . h(-1) and a gradient of 20%. During exercise there was no decrease of EMG median power freque

  12. Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Thawait, Gaurav K. [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Subhawong, Ty K.; Eng, John; Carrino, John A.; Chhabra, Avneesh [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Thawait, Shrey K. [Yale University, Bridgeport Hospital, Department of Radiology, Bridgeport, CT (United States); Andreisek, Gustav [University Hospital Zurich, Department of Radiology, Zurich (Switzerland); Belzberg, Alan J. [Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD (United States)

    2012-06-15

    This review provides magnetic resonance neurography (MRN) imaging appearances of median neuropathy proximal to the carpal tunnel. Carpal tunnel syndrome (CTS) and its imaging have been extensively described in the literature; however, there is a relative paucity of information on the MR imaging appearances of different pathologies of the median nerve proximal to the carpal tunnel. (orig.)

  13. Shadow Probability of Detection and False Alarm for Median-Filtered SAR Imagery

    Energy Technology Data Exchange (ETDEWEB)

    Raynal, Ann Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). ISR Analysis and Applications Dept.; Doerry, Armin Walter [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). ISR Mission Engineering Dept.; Miller, John A. [General Atomics Aeronautical Systems, Inc., San Diego, CA (United States). Mission Systems; Bishop, Edward E. [General Atomics Aeronautical Systems, Inc., San Diego, CA (United States). Mission Systems; Horndt, Volker [General Atomics Aeronautical Systems, Inc., San Diego, CA (United States). Mission Systems

    2014-06-01

    Median filtering reduces speckle in synthetic aperture radar (SAR) imagery while preserving edges, at the expense of coarsening the resolution, by replacing the center pixel of a sliding window by the median value. For shadow detection, this approach helps distinguish shadows from clutter more easily, while preserving shadow shape delineations. However, the nonlinear operation alters the shadow and clutter distributions and statistics, which must be taken into consideration when computing probability of detection and false alarm metrics. Depending on system parameters, median filtering can improve probability of detection and false alarm by orders of magnitude. Herein, we examine shadow probability of detection and false alarm in a homogeneous, ideal clutter background after median filter post-processing. Some comments on multi-look processing effects with and without median filtering are also made.

  14. Unilateral axillary arch with two slips entrapping neurovascular bundle in axilla and its innervation by the median nerve

    Directory of Open Access Journals (Sweden)

    Somayaji SN

    2009-10-01

    Full Text Available Axillary arch is an additional muscle bundle of various dimensions extending usually from the latissimus dorsi in the posterior fold of the axilla, to the pectoralis major or other neighboring muscles and bones. In the present case presence of such unusual axillary arch innervated by the median nerve has been reported. During routine dissection of axilla region in one of the upper limbs, the occurrence of axillary arch was observed. The muscle fibers were arising from the belly of latissimus dorsi and were getting inserted to the tendon of coracobrachilais and lateral lip of bicipital groove. As it passed through the axilla it divided into 2 slips, enclosing the axillary vessels and nerves related to them. The fleshy fibers of the axillary arch were innervated by 2 small twigs from the median nerve. Though the occurrence of the axillary arch is very common, axillary arch with 2 slips getting innervated by the median nerve is not been reported so far. Further, a detailed literature review was done and the surgical and clinical importance of the case was discussed.

  15. Survival trends in gastric cancer patients of Northeast China

    Institute of Scientific and Technical Information of China (English)

    HaoZhang; Ling—LingSun; Yan—LiMeng; Guang-YuSong; ]ing-.1ingHu; PingLu; BinJl

    2011-01-01

    AIM: To describe survival trends in patients in Northeast China diagnosed as gastric cancer. METHODS: A review of all inpatient and outpatient records of gastric cancer patients was conducted in the First Affiliated Hospital of China Medical University. All the gastric cancer patients who satisfied the inclusion criteria from January 1, 1980 through December 31, 2003 were included in the study. The main outcomes were based on median survival and 3-year and 5-year survival rates, by decade of diagnosis. RESULTS: From 1980 through 2003, the median survival for patients with gastric cancer (n = 1604) increased from 33 mo to 49 mo. The decade of diagnosis was not significantly associated with patient survival for gastric cancer (P = 0.084 for overall survival, and P = 0.150 for 5-year survival); however, the survival rate of the 2000s was remarkably higher than that of the 1980s (P = 0.019 for overall survival, and P = 0.027 for 5-year survival).CONCLUSION: There was no significant difference of survival among each period; however, the survival rate of the 2000s was remarkably higher than that of the 1980s.

  16. Assessment of Median Nerve Mobility by Ultrasound Dynamic Imaging for Diagnosing Carpal Tunnel Syndrome.

    Directory of Open Access Journals (Sweden)

    Tai-Tzung Kuo

    Full Text Available Carpal tunnel syndrome (CTS is the most common peripheral neuropathy and is characterized by median nerve entrapment at the wrist and the resulting median nerve dysfunction. CTS is diagnosed clinically as the gold standard and confirmed with nerve conduction studies (NCS. Complementing NCS, ultrasound imaging could provide additional anatomical information on pathological and motion changes of the median nerve. The purpose of this study was to estimate the transverse sliding patterns of the median nerve during finger movements by analyzing ultrasound dynamic images to distinguish between normal subjects and CTS patients. Transverse ultrasound images were acquired, and a speckle-tracking algorithm was used to determine the lateral displacements of the median nerve in radial-ulnar plane in B-mode images utilizing the multilevel block-sum pyramid algorithm and averaging. All of the averaged lateral displacements at separate acquisition times within a single flexion-extension cycle were accumulated to obtain the cumulative lateral displacements, which were curve-fitted with a second-order polynomial function. The fitted curve was regarded as the transverse sliding pattern of the median nerve. The R2 value, curvature, and amplitude of the fitted curves were computed to evaluate the goodness, variation and maximum value of the fit, respectively. Box plots, the receiver operating characteristic (ROC curve, and a fuzzy c-means clustering algorithm were utilized for statistical analysis. The transverse sliding of the median nerve during finger movements was greater and had a steeper fitted curve in the normal subjects than in the patients with mild or severe CTS. The temporal changes in transverse sliding of the median nerve within the carpal tunnel were found to be correlated with the presence of CTS and its severity. The representative transverse sliding patterns of the median nerve during finger movements were demonstrated to be useful for

  17. Evaluation of annual survival and mortality rates and longevity of bottlenose dolphins (Tursiops truncatus) at the United States Navy Marine Mammal Program from 2004 through 2013.

    Science.gov (United States)

    Venn-Watson, Stephanie K; Jensen, Eric D; Smith, Cynthia R; Xitco, Mark; Ridgway, Sam H

    2015-04-15

    Objective-To evaluate annual survival and mortality rates and the longevity of a managed population of bottlenose dolphins (Tursiops truncatus). Design-Retrospective cohort study. Animals-103 bottlenose dolphins at the US Navy Marine Mammal Program (MMP). Procedures-Population age structures, annual survival and crude mortality rates, and median age at death for dolphins > 30 days old were determined from 2004 through 2013. Results-During 2004 through 2013, the annual survival rates for MMP dolphins ranged from 0.98 to 1.0, and the annual crude mortality rates ranged from 0% to 5%, with a mean of 2.7%. The median age at death was 30.1 years from 2004 through 2008 and increased to 32 years from 2009 through 2013. The maximum age for a dolphin in the study was 52 years. Conclusions and Clinical Relevance-Results indicated that the annual mortality rates were low and survival rates were high for dolphins in the MMP from 2004 through 2013 and that the median age at death for MMP dolphins during that time was over 10 years greater than that reported in free-ranging dolphins. These findings were likely attributable to the continually improving care and husbandry of managed dolphin populations.

  18. Dietary Pectin Increases Intestinal Crypt Stem Cell Survival following Radiation Injury.

    Directory of Open Access Journals (Sweden)

    Sripathi M Sureban

    Full Text Available Gastrointestinal (GI mucosal damage is a devastating adverse effect of radiation therapy. We have recently reported that expression of Dclk1, a Tuft cell and tumor stem cell (TSC marker, 24h after high dose total-body gamma-IR (TBI can be used as a surrogate marker for crypt survival. Dietary pectin has been demonstrated to possess chemopreventive properties, whereas its radioprotective property has not been studied. The aim of this study was to determine the effects of dietary pectin on ionizing radiation (IR-induced intestinal stem cell (ISC deletion, crypt and overall survival following lethal TBI. C57BL/6 mice received a 6% pectin diet and 0.5% pectin drinking water (pre-IR mice received pectin one week before TBI until death; post-IR mice received pectin after TBI until death. Animals were exposed to TBI (14 Gy and euthanized at 24 and 84h post-IR to assess ISC deletion and crypt survival respectively. Animals were also subjected to overall survival studies following TBI. In pre-IR treatment group, we observed a three-fold increase in ISC/crypt survival, a two-fold increase in Dclk1+ stem cells, increased overall survival (median 10d vs. 7d, and increased expression of Dclk1, Msi1, Lgr5, Bmi1, and Notch1 (in small intestine post-TBI in pectin treated mice compared to controls. We also observed increased survival of mice treated with pectin (post-IR compared to controls. Dietary pectin is a radioprotective agent; prevents IR-induced deletion of potential reserve ISCs; facilitates crypt regeneration; and ultimately promotes overall survival. Given the anti-cancer activity of pectin, our data support a potential role for dietary pectin as an agent that can be administered to patients receiving radiation therapy to protect against radiation-induces mucositis.

  19. Dietary Pectin Increases Intestinal Crypt Stem Cell Survival following Radiation Injury.

    Science.gov (United States)

    Sureban, Sripathi M; May, Randal; Qu, Dongfeng; Chandrakesan, Parthasarathy; Weygant, Nathaniel; Ali, Naushad; Lightfoot, Stan A; Ding, Kai; Umar, Shahid; Schlosser, Michael J; Houchen, Courtney W

    2015-01-01

    Gastrointestinal (GI) mucosal damage is a devastating adverse effect of radiation therapy. We have recently reported that expression of Dclk1, a Tuft cell and tumor stem cell (TSC) marker, 24h after high dose total-body gamma-IR (TBI) can be used as a surrogate marker for crypt survival. Dietary pectin has been demonstrated to possess chemopreventive properties, whereas its radioprotective property has not been studied. The aim of this study was to determine the effects of dietary pectin on ionizing radiation (IR)-induced intestinal stem cell (ISC) deletion, crypt and overall survival following lethal TBI. C57BL/6 mice received a 6% pectin diet and 0.5% pectin drinking water (pre-IR mice received pectin one week before TBI until death; post-IR mice received pectin after TBI until death). Animals were exposed to TBI (14 Gy) and euthanized at 24 and 84h post-IR to assess ISC deletion and crypt survival respectively. Animals were also subjected to overall survival studies following TBI. In pre-IR treatment group, we observed a three-fold increase in ISC/crypt survival, a two-fold increase in Dclk1+ stem cells, increased overall survival (median 10d vs. 7d), and increased expression of Dclk1, Msi1, Lgr5, Bmi1, and Notch1 (in small intestine) post-TBI in pectin treated mice compared to controls. We also observed increased survival of mice treated with pectin (post-IR) compared to controls. Dietary pectin is a radioprotective agent; prevents IR-induced deletion of potential reserve ISCs; facilitates crypt regeneration; and ultimately promotes overall survival. Given the anti-cancer activity of pectin, our data support a potential role for dietary pectin as an agent that can be administered to patients receiving radiation therapy to protect against radiation-induces mucositis.

  20. Assessment of the Flow-Survival Relationship Obtained by Sims and Ossiander (1981) for Snake River Spring/Summer Chinook Salmon Smolts, Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Steward, C.R. (Cleveland R.)

    1994-04-01

    There has been much debate recently among fisheries professionals over the data and functional relationships used by Sims and Ossiander to describe the effects of flow in the Snake River on the survival and travel time of chinook salmon and steelhead smolts. The relationships were based on mark and recovery experiments conducted at various Snake and Columbia River sites between 1964 and 1979 to evaluate the effects of dams and flow regulation on the migratory characteristic`s chinook sa mon and steelhead trout smolts. The reliability of this information is crucial because it forms the logical basis for many of the flow management options being considered today to protect,upriver populations of chinook salmon and steelhead trout. In this paper I evaluate the primary data, assumptions, and calculations that underlie the flow-survival relationship derived by Sims and Ossiander (1981) for chinook salmon smolts.

  1. Survivability enhancement study for C/sup 3/I/BM (communications, command, control and intelligence/battle management) ground segments: Final report

    Energy Technology Data Exchange (ETDEWEB)

    1986-10-30

    This study involves a concept developed by the Fairchild Space Company which is directly applicable to the Strategic Defense Initiative (SDI) Program as well as other national security programs requiring reliable, secure and survivable telecommunications systems. The overall objective of this study program was to determine the feasibility of combining and integrating long-lived, compact, autonomous isotope power sources with fiber optic and other types of ground segments of the SDI communications, command, control and intelligence/battle management (C/sup 3/I/BM) system in order to significantly enhance the survivability of those critical systems, especially against the potential threats of electromagnetic pulse(s) (EMP) resulting from high altitude nuclear weapon explosion(s). 28 figs., 2 tabs.

  2. Interim Report of the Defense Science Board (DSB) Task Force on the Survivability of Systems and Assets to Electromagnetic Pulse (EMP) and other Nuclear Weapon Effects (NWE)

    Science.gov (United States)

    2011-08-01

    major platforms for High Altitude EMP ( HEMP ) protection, and the Navy implemented a requirements review process. United States Strategic Command...Army improving process for independent review of survivability – Air Force committing resources for testing major platforms for HEMP protection...battlespaces where nuclear weapons are threatening or are being employed. The most likely case(s) are use of nuclear weapons by others. Although

  3. Survival of Chinese hamster ovary cells following ultrahigh-dose-rate electron and bremsstrahlung radiation. Final report, September 1988-February 1989

    Energy Technology Data Exchange (ETDEWEB)

    Holahan, P.K.; Meltz, M.L.

    1990-04-01

    The objective of this research was to measure cellular effects of ultrahigh dose rate X rays associated with high-power microwave devices. The intent was to detect differences in effect of ultrahigh dose-rate X rays compared to conventional dose-rate X rays at equivalent total doses. Cell survivability was used as the measure. No differences were noted until a dose of 4 Gray or greater was achieved.

  4. Factors of influence upon overall survival in the treatment of intracranial MPNSTs. Review of the literature and report of a case

    Directory of Open Access Journals (Sweden)

    Wagner Ingo

    2010-11-01

    Full Text Available Abstract Background Intracranial malignant peripheral nerve sheath tumors are rare entities that carry a poor prognosis. To date, there are no established therapeutic strategies for these tumors. Methods We review the present treatment modalities and present the current therapeutic dilemmas. We perform a statistical analysis to evaluate the prognostic factors for Overall Survival of these patients. Additionally, we present our experience with a 64-year-old man with a MPNST of the left cerebellopontine angle. Results To our best knowledge, forty three patients with intracranial MPNSTs, including our case, have been published in the international literature. Our analysis showed gross total resection, radiotherapy and female gender to be beneficial prognostic factors of survival in the univariate analysis. Gross total resection was recognized as the only independent predictor of prolonged Overall Survival. In our case, we performed a gross total resection followed for the first time by stereotactically guided radiotherapy. Conclusion Considering the results of the statistical analysis and the known advantages of the stereotaxy, we suggest aggressive surgery followed by stereotactically guided radiotherapy as therapy of choice.

  5. Development of an Effective Transport Media for Juvenile Spring Chinook Salmon to Mitigate Stress and Improve Smolt Survival During Columbia River Fish Hauling Operations, 1985 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Wedemeyer, Gary A.

    1985-02-01

    Selected transport media consisting of mineral salt additions (Na/sup +/, Cl/sup -/, Ca/sup + +/, PO/sub 4//sup -3/, HCO/sub 3//sup -/, and Mg/sup + +/), mineral salts plus tranquilizing concentrations of tricaine methane sulfonate (MS-222), or MS-222 alone were tested for their ability to mitigate stress and increase smolt survival during single and mixed species hauling of Columbia River spring chinook salmon (Oncorhynchus tshawytscha) and steelhead trout (Salmo gairdneri). Successful stress mitigation was afforded by several formulations as indicated by protection against life-threatening osmoregulatory and other physiological dysfunctions, and against immediate and delayed hauling mortality. Effects on the seawater survival and growth of smolts hauled in transport media were used as the overall criterion of success. Of the fourteen chemical formulations tested, 10 ppM MS-222 emerged as top-rated in terms of ability to mitigate physiological stress during single and mixed species transport of juvenile spring chinook salmon at hauling densities of 0.5 or 1.0 lb/gallon. Immediate and delayed mortalities from hauling stress were also reduced, but benefits to early marine growth and survival were limited to about the first month in seawater. The two physical factors tested (reduced light intensity and water temperature) were generally less effective than mineral salt additions in mitigating hauling stress, but the degree of protection afforded by reduced light intensity was nevertheless judged to be physiologically beneficial. 36 refs., 1 fig., 19 tabs.

  6. Dementia-Free Survival and Risk Factors for Dementia in a Hospital-Based Korean Parkinson's Disease Cohort

    Science.gov (United States)

    Lee, Su-Yun; Ryu, Hyun-Ju; Seo, Jeong-Wook; Noh, Maeng-Seok; Cheon, Sang-Myung

    2017-01-01

    Background and Purpose Few studies of dementia in Parkinson's disease (PD) have had long-term follow-ups. Moreover, information on the duration from the onset to the development of dementia in patients with PD is lacking. The aim of this study was to determine the median dementia-free survival time from the onset of PD to the development of dementia. Methods In total, 1,193 Korean patients with PD were recruited and assessed at regular intervals of 3–6 months. We interviewed the patients and other informants to identify impairments in the activities of daily living. The Hoehn and Yahr stage and scores on the Unified Parkinson's Disease Rating Scale and Mini Mental State Examination were evaluated annually. We used Kaplan-Meier survival analysis to estimate the cumulative proportion of dementia-free patients over time. Risk factors predicting dementia were also evaluated using Cox proportional-hazards regression models. Results The median dementia-free survival time in the Korean PD population was 19.9 years. Among the 119 patients who subsequently developed dementia, the mean duration from the onset of PD to the development of dementia was 10.6 years. A multivariate analysis identified age at onset and education period as the significant predictors of dementia. Conclusions This is the first report on dementia-free survival in patients with PD based on longitudinal data analysis from the disease onset. The median dementia-free survival time in Korean PD patients was found to be longer than expected. PMID:27730764

  7. [Survival changes among AIDS cases in Catalonia, Spain (1981-2001)].

    Science.gov (United States)

    Rius, Cristina; Binefa, Gemma; Montoliu, Alexandra; Esteve, Anna; Ribas, Glòria; Gispert, Rosa; Casabona, Jordi

    2006-07-01

    Our goal was to assess survival changes among AIDS patients in Catalonia. We analyzed AIDS cases older than 13 years notified in the Catalonian AIDS Registry from January 1981 to December 2001. Sex, age, transmission category, AIDS-defining disease and diagnostic period were included. The survival cumulative risk was computed for each diagnostic period with Kaplan-Meier methods. During the study period 13,485 AIDS cases were reported. Median survival time was 0.9 years for 1981-1987, 1.7 for 1988-1993 and 2.4 years for 1994-August 1996. The survival time of 75% of patients diagnosed in September 1996-1997 and 1998-2001 was 1.57 and 2.02 years, respectively. Multivariate analyses showed a higher risk among intravenous drug users (hazard ratio = 1.25; 95% confidence interval, 1.17-1.33) than in homo/bisexual men. When we compared heterosexual and homo/bisexual groups, we found that the result was not significant (hazard ratio = 0.99; 95% confidence interval, 0.92-1.08). The analysis stratified by AIDS-defining disease showed a decrease in the risk of death in most illnesses. Our results confirm the increase in survival in AIDS cases related to highly active antirretroviral therapy (HAART).

  8. Median cleft of the upper lip: A new classification to guide treatment decisions.

    Science.gov (United States)

    de Boutray, Marie; Beziat, Jean-Luc; Yachouh, Jacques; Bigorre, Michèle; Gleizal, Arnaud; Captier, Guillaume

    2016-06-01

    Median cleft of the upper lip (MCL) is a specific and rare entity on the spectrum of facial clefts. MCL have different clinical expressions and can be either isolated or part of multiple malformations. Confusion still exists regarding the explanation and classification of MCL; some cases have been reported in the literature, but no studies carried out a complete review of the literature. This study reviewed cases of MCL in 2 French units and conducted a systematic review of the literature, in order to derive a new classification. Fourteen patients with MCL in the 2 units and 195 cases in the literature were reviewed. They involved complete (42%), incomplete (49%), and minor forms (9%). Epidemiological and clinical data were collected, from which a classification was derived, based on the type of cleft and its belonging to other syndrome(s). Three main groups were distinguished, namely, isolated MCL, MCL within craniofacial malformations, and MCL with extrafacial malformations. Each group and subgroup was associated with a prognosis and led to specific management. This study reviewed all of the various forms of MCL and their associated anomalies, in order to have a global view of MCL and to derive a useful classification scheme to guide management of care. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Does retraction of the sternum during median sternotomy result in brachial plexus injuries?

    Science.gov (United States)

    Healey, Scott; O'Neill, Bridie; Bilal, Haris; Waterworth, Paul

    2013-07-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'does retraction of the sternum during median sternotomy result in brachial plexus injuries or peripheral neuropathies?' Altogether 58 papers were found using the reported search, of which 12 represented the best evidence to answer the question. The authors, date, journal and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Caudal placement of the retractor or relieving the pressure superiorly by removing the upper blades of a retractor (P = 0.02) and use of a caudally placed symmetrical retractor has been shown to reduce neuropathy. Positioning of the patient with 'hands up' positioning showed significant reduction in the incidence of brachial plexus injuries. Furthermore, how wide the retractor is opened and use of an asymmetrical retractor for internal mammary artery (IMA) harvesting are also important factors in quantifying risk of postoperative neuropathy. Wider sternal retraction and longer bypass time did increase the risk of developing postoperative neuropathy. Three asymmetrical retractors were looked at that demonstrates the Delacroix-Chevalier to be the safest (P retractor and using a caudally placed retractor.

  10. Long-term survival and conditional survival of cancer patients in Japan using population-based cancer registry data

    OpenAIRE

    Ito, Yuri; Miyashiro, Isao; Ito, Hidemi; Hosono, Satoyo; Chihara, Dai; Nakata-Yamada, Kayo; Nakayama, Masashi; Matsuzaka, Masashi; Hattori, Masakazu; Sugiyama, Hiromi; Oze, Isao; Tanaka, Rina; Nomura, Etsuko; Nishino, Yoshikazu; Matsuda, Tomohiro

    2014-01-01

    Although we usually report 5-year cancer survival using population-based cancer registry data, nowadays many cancer patients survive longer and need to be followed-up for more than 5 years. Long-term cancer survival figures are scarce in Japan. Here we report 10-year cancer survival and conditional survival using an established statistical approach. We received data on 1 387 489 cancer cases from six prefectural population-based cancer registries in Japan, diagnosed between 1993 and 2009 and ...

  11. Phorbol esters potentiate rapid dopamine release from median eminence and striatal synaptosomes

    Energy Technology Data Exchange (ETDEWEB)

    Shu, C.; Selmanoff, M.

    1988-06-01

    In the present study, we investigated the ability of phorbol esters to potentiate Ca2+-dependent depolarization-induced release of tritium-labeled dopamine ((3H)DA) from median eminence and striatal synaptosomes. Phorbol esters potentiated (3H)DA release in a concentration-dependent manner in both kinds of dopaminergic nerve terminals and with a potency series similar to that reported for stimulation of protein kinase-C (PKC) activity in other cell systems. Evoked (3H)DA release was increased by 12-O-tetradecanoylphorbol-13-acetate (TPA; 10(-7) M) after 1, 3, 5, and 10 sec of depolarization. The effect of TPA was suppressed by sphingosine, a PKC inhibitor. TPA enhanced (3H)DA release evoked by high K+, veratridine or the Ca2+ ionophore A23187. Phorbol ester potentiation was found to be depolarization dependent, as it was present from 30-75 mM, but not at 5-20 mM external K+. Potentiation was seen at all external Ca2+ concentrations studied between 0.01-3 mM. However, in the absence of external free Ca2+ (i.e. with 0.1 mM EGTA), the phorbol effect was not present. These data indicate that an increase in intrasynaptosomal Ca2+ concentration is necessary for the enhancement of (3H)DA release by phorbol esters to occur. The combination of TPA and the Ca2+ ionophore A23187 does not show the marked synergism observed in some other systems, that is maximal release was not reinstated. This suggests that in dopaminergic nerve terminals, activation of PKC has a modulatory, rather than a mediating, effect on release. Recently, we have shown that hyperprolactinemia stimulated (3H)DA release from median eminence synaptosomes by an external Ca2+-independent mechanism which might involve the PKC pathway. However, in the present work we found that the TPA and PRL effects on evoked (3H)DA release were additive, suggesting that two independent mechanisms are involved.

  12. Sosiaalisen median hyödyntäminen hotellin markkinointiviestinnässä

    OpenAIRE

    Veikkolainen, Markus

    2011-01-01

    Sosiaalisen median eli yhteisöllisen median suosio on kasvanut kovaa vauhtia viime vuosina. Maailmanlaajuisesti sosiaalista mediaa käyttää satoja miljoonia ihmisiä päivittäin. Suomessa sosiaalisen median käyttäjiä on reilusti yli miljoona. Sosiaalinen media käsittää internetissä olevat sovellukset, mitkä mahdollistavat ihmisten välisen vapaan tiedon jakamisen ja kommunikoinnin. Tunnetuimpia sovelluksia ovat muun muassa yhteisöpalvelu Facebook sekä videopalvelu Youtube. Monet hotellit ovat hav...

  13. Median Filter Noise Reduction of Image and Backpropagation Neural Network Model for Cervical Cancer Classification

    Science.gov (United States)

    Wutsqa, D. U.; Marwah, M.

    2017-06-01

    In this paper, we consider spatial operation median filter to reduce the noise in the cervical images yielded by colposcopy tool. The backpropagation neural network (BPNN) model is applied to the colposcopy images to classify cervical cancer. The classification process requires an image extraction by using a gray level co-occurrence matrix (GLCM) method to obtain image features that are used as inputs of BPNN model. The advantage of noise reduction is evaluated by comparing the performances of BPNN models with and without spatial operation median filter. The experimental result shows that the spatial operation median filter can improve the accuracy of the BPNN model for cervical cancer classification.

  14. An improved video median noise reduction algorithm for ambulance vehicle terminal monitoring system

    Science.gov (United States)

    Ma, Xian-Min; Zhang, Hang

    2012-04-01

    An improved video median noise reduction algorithm is presented for 120 vehicle terminal monitoring system in this paper. The noise causes of the video images in many 120 ambulance vehicle video terminal monitor equipments are analyzed, and the space rigid body model of self-adaptive median noise reduction filter is established to decrease the noises of the video image transmission process. The noise reduction experiment of video images shows that the proposed video median noise reduction algorithm is superior to the traditional adaptive filtering method, because the new method has the superiority of space-time joint noise reduction.

  15. Survival patterns in United States (US medicare enrollees with non-CML myeloproliferative neoplasms (MPN.

    Directory of Open Access Journals (Sweden)

    Gregory L Price

    Full Text Available PURPOSE: Non-CML myeloproliferative neoplasms (MPN include essential thrombocythemia (ET, polycythemia vera (PV, and myelofibrosis (MF. Reported median overall survival (OS ranges from a few to several years for MF, a decade or more for ET and PV. The study objective was to compare US survival rates of ET, PV, and MF patients with matched non-MPN/non-cancer controls in a nationally representative database. PATIENTS AND METHODS: Data were taken retrospectively from the Survey, Epidemiology, and End Results (SEER-Medicare linked database. Medicare enrollees with a new SEER MPN diagnosis between Jan 1, 2001 and Dec 31, 2007 were eligible. First MPN diagnosis was required at or after Medicare enrollment to allow for continuous follow-up. Non-MPN/non-cancer control groups were selected from Medicare separately for each MPN subtype and demographically matched to cases at a ratio of 5:1. Survival was determined starting from the case diagnosis date using the Kaplan-Meier method. RESULTS: A total of 3,364 MPN patients (n = 1,217 ET; 1,625 PV; 522 MF met the inclusion criteria and were matched to controls. Mean age was 78.4, 76.1, and 77.4 years for ET, PV, and MF, respectively, and percent female was 63, 50, and 41. Median OS was significantly (p<0.05 lower for MPN cases vs. controls (ET: 68 vs. 101 months; PV: 65 vs. 104; MF: 24 vs. 106. CONCLUSIONS: In the US Medicare population, survival in MF patients was worse than that of patients with ET or PV and significantly worse than matched controls. Survival of patients with ET or PV was substantially inferior to matched controls. These findings have implications for the clinical management of MPN patients and underscore the need for effective therapies in all MPN subtypes.

  16. Eight years experience in the management of median arcuate ligament syndrome by decompression, celiac ganglion sympathectomy, and selective revascularization.

    Science.gov (United States)

    Sultan, Sherif; Hynes, Niamh; Elsafty, Naisrin; Tawfick, Wael

    2013-11-01

    We aim to review an 8-year experience of median arcuate ligament syndrome (MALS) with chronic gastrointestinal ischemia (CGI) and evaluate clinical outcomes of arcuate ligament decompression, celiac sympathectomy, and selective revascularization. Between December 2002 and March 2012, of 25 patients referred with symptoms of CGI, 11 patients (10 women and 1 man) had clinical signs of abdominal angina and radiological evidence of MALS. Mean age was 50 ± 20.4 years. Median symptom duration was 34 months. All patients had median arcuate decompression and celiac sympathectomy. In all, 8 did not require revascularization, 2 had retrograde celiac and/or superior mesenteric artery (SMA) stenting, and 1 had SMA bypass. There was no mortality. The 30-day morbidity was 9%. Mean follow-up was 60 months. Eight patients noted complete relief of abdominal pain, and 1 reported some improvement. The MALS is not solely a vascular compression syndrome. The neurological component requires careful celiac plexus sympathectomy in addition to arcuate ligament decompression.

  17. Effects of smartphone overuse on hand function, pinch strength, and the median nerve.

    Science.gov (United States)

    İnal, Esra Erkol; Demİrcİ, kadİr; Çetİntürk, Azİze; Akgönül, Mehmet; Savaş, Serpİl

    2015-08-01

    In this study we investigated the flexor pollicis longus (FPL) tendon and median nerve in smartphone users by ultrasonography to assess the effects of smartphone addiction on the clinical and functional status of the hands. One hundred two students were divided into 3 groups: non-users, and high or low smartphone users. Smartphone Addiction Scale (SAS) scores and grip and pinch strengths were recorded. Pain in thumb movement and rest and hand function were evaluated on the visual analog scale (VAS) and the Duruöz Hand Index (DHI), respectively. The cross-sectional areas (CSAs) of the median nerve and the FPL tendon were calculated bilaterally using ultrasonography. Significantly higher median nerve CSAs were observed in the dominant hands of the high smartphone users than in the non-dominant hands (PSmartphone overuse enlarges the median nerve, causes pain in the thumb, and decreases pinch strength and hand functions. © 2015 Wiley Periodicals, Inc.

  18. New England observed and predicted median August stream/river temperature points

    Data.gov (United States)

    U.S. Environmental Protection Agency — The shapefile contains points with associated observed and predicted median August stream/river temperatures in New England based on a spatial statistical network...

  19. Prevalence of HIV infection and median CD4 counts among health ...

    African Journals Online (AJOL)

    Prevalence of HIV infection and median CD4 counts among health care workers in South Africa. ... Outcome measures. HIV prevalence and CD4 ... By occupation, prevalence was highest among student nurses (13.8%) and nurses (13.7%).

  20. Removing Noises Induced by Gamma Radiation in Cerenkov Luminescence Imaging Using a Temporal Median Filter

    Science.gov (United States)

    Li, Yang; Zhan, Yonghua; Kang, Fei; Wang, Jing

    2016-01-01

    Cerenkov luminescence imaging (CLI) can provide information of medical radionuclides used in nuclear imaging based on Cerenkov radiation, which makes it possible for optical means to image clinical radionuclide labeled probes. However, the exceptionally weak Cerenkov luminescence (CL) from Cerenkov radiation is susceptible to lots of impulse noises introduced by high energy gamma rays generating from the decays of radionuclides. In this work, a temporal median filter is proposed to remove this kind of impulse noises. Unlike traditional CLI collecting a single CL image with long exposure time and smoothing it using median filter, the proposed method captures a temporal sequence of CL images with shorter exposure time and employs a temporal median filter to smooth a temporal sequence of pixels. Results of in vivo experiments demonstrated that the proposed temporal median method can effectively remove random pulse noises induced by gamma radiation and achieve a robust CLI image. PMID:27648450

  1. Removing Noises Induced by Gamma Radiation in Cerenkov Luminescence Imaging Using a Temporal Median Filter

    Directory of Open Access Journals (Sweden)

    Xu Cao

    2016-01-01

    Full Text Available Cerenkov luminescence imaging (CLI can provide information of medical radionuclides used in nuclear imaging based on Cerenkov radiation, which makes it possible for optical means to image clinical radionuclide labeled probes. However, the exceptionally weak Cerenkov luminescence (CL from Cerenkov radiation is susceptible to lots of impulse noises introduced by high energy gamma rays generating from the decays of radionuclides. In this work, a temporal median filter is proposed to remove this kind of impulse noises. Unlike traditional CLI collecting a single CL image with long exposure time and smoothing it using median filter, the proposed method captures a temporal sequence of CL images with shorter exposure time and employs a temporal median filter to smooth a temporal sequence of pixels. Results of in vivo experiments demonstrated that the proposed temporal median method can effectively remove random pulse noises induced by gamma radiation and achieve a robust CLI image.

  2. STUDY OF COMMUNICATIONS BETWEEN MUSCULOCUTANEOUS NERVE AND MEDIAN NERVE IN ADULT CADAVER

    Directory of Open Access Journals (Sweden)

    Gangulappa Derangula

    2017-07-01

    Full Text Available BACKGROUND Variations of the musculocutaneous nerve and the median nerve, like the communications between the two, may prove valuable in the traumatology of the shoulder joint and upper arm region. These variations are important in the procedure of blocking the brachial plexus and in clinical neurology. MATERIALS AND METHODS The present study was conducted on 100 upper limbs belonging to 50 cadavers (Right 50 &left 50 obtained from the Department of Anatomy, Kakatiya medical college, Warangal, Telangana. Dissection of the infraclavicular part of the brachial plexus was done. The variations in the origin, course and communications with the median nerve were noted. RESULTS In 2% of the limbs the nerve was found to give one communicating branch to the median nerve after piercing the coracobrachialis. CONCLUSION Knowledge of possible variations between musculocutaneous nerve and median nerve is necessary to general surgeons, plastic surgeons, neurologists and orthopaedic surgeons.

  3. Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use.

    Directory of Open Access Journals (Sweden)

    Hoi-Chi Woo

    Full Text Available Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public's concern whether hand activities while using smartphones can lead to median nerve problems.The aims of this study were to 1 develop kinematic graphs and 2 investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities.Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1 thumb opposition with the wrist in neutral position, 2 thumb opposition with the wrist in ulnar deviation and 3 pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1 cross-sectional area (CSA, 2 flattening ratio (FR, 3 rotational displacement (RD and 4 translational displacement (TD of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1 two successive time points during a single hand activity and 2 different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities.Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex

  4. Comparative Survival Study (CSS) of Hatchery PIT-tagged Spring/Summer Chinook; Migration Years 1997-2002 Mark/Recapture Activities and Bootstrap Analysis, 2003-2004 Biennial Report.

    Energy Technology Data Exchange (ETDEWEB)

    Berggren, Thomas J.; Franzoni, Henry; Basham, Larry R. (Columbia Basin Fish and Wildlife Authority, Fish Passage Center, Portland, OR)

    2003-11-01

    Granite Dam. When D = 1, there is no difference in survival rate after hydrosystem passage. When D < 1, then transported smolts die at a greater rate after release below Bonneville Dam than smolts that have migrated in-river to below Bonneville Dam Major objectives of the CSS include: (1) development of a long-term index of transport SAR to in-river SAR for Snake River hatchery and wild spring and summer Chinook smolts measured at Lower Granite Dam; (2) develop a long-term index of survival rates from release of smolts at Snake River hatcheries to return of adults to the hatcheries; (3) compute and compare the overall SARs for selected upriver and downriver spring and summer Chinook hatchery and wild stocks; and (4) begin a time series of SARs for use in hypothesis testing and in the regional long-term monitoring and evaluation program. Primary CSS focus in this report is for wild and hatchery spring/summer Chinook that outmigrated in 1997 to 2002 and their respective adult returns through 2004.

  5. Determination of Median Nerve Somatosensory Evoked Potentials in 27 Patients with Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    刘雅丽; 尤春景; 黄杰; 刘培玲

    2002-01-01

    Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using up per extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients' activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovin dba standard, upper extremity median nerve SEP was graded in accordance with N20. The correla tion between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that up per extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r1 =0. 6925, P1<0. 01). The correlation coefficient between SEP N20 grades and patients' ADL grades was r2= 0. 5015, P2<0.01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.

  6. Analyzing the influence of median cross-section design on highway safety using vehicle dynamics simulations.

    Science.gov (United States)

    Stine, Jason S; Hamblin, Bridget C; Brennan, Sean N; Donnell, Eric T

    2010-11-01

    Although vehicle dynamics simulations have long been used in vehicle design and crash reconstruction, their use for highway design is rare. This paper investigates the safety of highway medians through iterative simulations of off-road median encroachments. The commercially available software CarSim was used to simulate over one hundred thousand encroachments, representing the entire passenger vehicle fleet and a wide range of encroachment angles, departure speeds, steering inputs, and braking inputs. Each individual simulation output was then weighted using data from previous studies to reflect the probability of each specific accident scenario occurring in a real-life median encroachment. Results of this analysis illustrate the relative influence of median cross-section geometry on the resulting accident outcomes. The simulations indicate that the overall safety of a highway median depends on the occurrence of both vehicle rollover and median crossover events, and the cross-section shape, slope, and width are all shown to greatly affect each of these incidents. An evaluation of the simulation results was conducted with vehicle trajectories from previous experimental crash tests. Further assessment of the aggregate simulation results to actual crash data was achieved through comparison with several databases of crash statistics. Both efforts showed a strong agreement between the simulations and the real-life crash data.

  7. Modeling Nonlinear Adsorption with a Single Chemical Parameter: Predicting Chemical Median Langmuir Binding Constants.

    Science.gov (United States)

    Davis, Craig Warren; Di Toro, Dominic M

    2015-07-07

    Procedures for accurately predicting linear partition coefficients onto various sorbents (e.g., organic carbon, soils, clay) are reliable and well established. However, similar procedures for the prediction of sorption parameters of nonlinear isotherm models are not. The purpose of this paper is to present a procedure for predicting nonlinear isotherm parameters, specifically the median Langmuir binding constants, K̃L, obtained utilizing the single-chemical parameter log-normal Langmuir isotherm developed in the accompanying work. A reduced poly parameter linear free energy relationship (pp-LFER) is able to predict median Langmuir binding constants for graphite, charcoal, and Darco granular activated carbon (GAC) adsorption data. For the larger F400 GAC data set, a single pp-LFER model was insufficient, as a plateau is observed for the median Langmuir binding constants of larger molecular volume sorbates. This volumetric cutoff occurs in proximity to the median pore diameter for F400 GAC. A log-linear relationship exists between the aqueous solubility of these large compounds and their median Langmuir binding constants. Using this relationship for the chemicals above the volumetric cutoff and the pp-LFER below the cutoff, the median Langmuir binding constants can be predicted with a root-mean square error for graphite (n = 13), charcoal (n = 11), Darco GAC (n = 14), and F400 GAC (n = 44) of 0.129, 0.307, 0.407, and 0.424, respectively.

  8. [Safety of repeat median sternotomy in the palliative treatment of patients with univentricular heart].

    Science.gov (United States)

    Díliz-Nava, Héctor; Meléndez-Sagaón, Isis; Tamaríz-Cruz, Orlando; García-Benitez, Luis; Araujo-Martínez, Aric; Palacios-Macedo, Alexis

    2017-01-13

    Establish the morbidity and mortality of patients with univentricular hearts who underwent repeat median sternotomy at the Instituto Nacional de Pediatría METHOD: We retrospectively review the clinical charts of all patient who underwent repeat median sternotomy from 2001 to 2016. Sixty-five patients underwent 76 surgeries through repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy with a mean age of 36months (range 4-176months) and a mean weight of 12.2kg (range 3.2-21.5kg). Forty patients had a Glenn procedure and 19 patients had a Fontan procedure. There were 17 patients with second repeat median sternotomy, mean age of 89months (range 48-156months) and mean weight of 22.7kg (14.4-41kg). In all 17 patients a Fontan procedure was done. Section of the right coronary artery with electrocardiographic changes and a right atrium tear that caused hypotension, occurred during first repeat sternotomy. An aortic tear occurred during a second repeat sternotomy with massive bleeding and consequent death. This represents a 3.9% of reentry injury. We conclude that repeat median sternotomy is a safe procedure. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release

    Directory of Open Access Journals (Sweden)

    Stepić Nenad

    2008-01-01

    Full Text Available Background/Aim. The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome (CTS is represented by recovering the nerves sensibility, conductivity, condition and strength. Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve's conduction speed. Methods. In this study 40 patients with CTS were randomly divided in the two groups. In the first group (n = 20 we performed the surgical decompression of the median nerve by the open release of the carpal tunnel, and in the second group (n = 20 we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression. We performed the electrodiagnostic (ED examinations 7, 30 and 90 days after the surgery, and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve. Results. Significant differences in examined ED respective variable values in different time intervals were obtained. At the final measurements, 90 days after the surgical procedure, both groups evidenced a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients (t = -2.116; p = 0.043. Conclusion. Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve.

  10. Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.

    Science.gov (United States)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik; Hansen, Steen Møller; Gerds, Thomas A; Kragholm, Kristian; Hansen, Carolina Malta; Karlsson, Lena; Lippert, Freddy K; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

    2016-12-20

    Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective was to examine the association of bystander CPR with survival as time to advanced treatment increases. We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry. Multiple logistic regression analysis was used to examine the association between time from 911 call to emergency medical service arrival (response time) and survival according to whether bystander CPR was provided (yes or no). Reported are 30-day survival chances with 95% bootstrap confidence intervals. With increasing response times, adjusted 30-day survival chances decreased for both patients with bystander CPR and those without. However, the contrast between the survival chances of patients with versus without bystander CPR increased over time: within 5 minutes, 30-day survival was 14.5% (95% confidence interval [CI]: 12.8-16.4) versus 6.3% (95% CI: 5.1-7.6), corresponding to 2.3 times higher chances of survival associated with bystander CPR; within 10 minutes, 30-day survival chances were 6.7% (95% CI: 5.4-8.1) versus 2.2% (95% CI: 1.5-3.1), corresponding to 3.0 times higher chances of 30-day survival associated with bystander CPR. The contrast in 30-day survival became statistically insignificant when response time was >13 minutes (bystander CPR vs no bystander CPR: 3.7% [95% CI: 2.2-5.4] vs 1.5% [95% CI: 0.6-2.7]), but 30-day survival was still 2.5 times higher associated with bystander CPR. Based on the model and Danish out-of-hospital cardiac arrest statistics, an additional 233 patients could potentially be saved annually if response time was reduced from 10 to 5 minutes and 119 patients if response time was reduced from 7 (the median

  11. Long-term Survival, Organ Function, and Malignancy after Hematopoietic Stem Cell Transplantation for Fanconi Anemia.

    Science.gov (United States)

    Bonfim, Carmem; Ribeiro, Lisandro; Nichele, Samantha; Bitencourt, Marco; Loth, Gisele; Koliski, Adriana; Funke, Vaneuza A M; Pilonetto, Daniela V; Pereira, Noemi F; Flowers, Mary E D; Velleuer, Eunike; Dietrich, Ralf; Fasth, Anders; Torres-Pereira, Cassius C; Pedruzzi, Paola; Eapen, Mary; Pasquini, Ricardo

    2016-07-01

    We report on long-term survival in 157 patients with Fanconi anemia (FA) who survived 2 years or longer after their first transplantation with a median follow-up of 9 years. Marrow failure (80%) was the most common indication for transplantation. There were 20 deaths beyond 2 years after transplantation, with 12 of the deaths occurring beyond 5 years after transplantation. Donor chimerism was available for 149 patients: 112 (76%) reported > 95% chimerism, 27 (18%) reported 90% to 95% chimerism, and 8 (5%) reported 20% to 89% donor chimerism. Two patients have < 20% donor chimerism. The 10- and 15-year probabilities of survival were 90% and 79%, respectively. Results of multivariate analysis showed higher mortality risks for transplantations before 2003 (hazard ratio [HR], 7.87; P = .001), chronic graft-versus-host disease (GVHD) (HR, 3.80; P = .004) and squamous cell carcinoma after transplantation (HR, 38.17; P < .0001). The predominant cause of late mortality was squamous cell carcinoma, with an incidence of 8% and 14% at 10 and 15 years after transplantation, respectively, and was more likely to occur in those with chronic GVHD. Other causes of late mortality included chronic GVHD, infection, graft failure, other cancers, and hemorrhage. Although most patients are disease free and functional long term, our data support aggressive surveillance for long periods to identify those at risk for late mortality.

  12. Migrational Characteristics, Biological Observations, and Relative Survival of Juvenile Salmonids Entering the Columbia River Estuary, 1966-1983, 1985 Final Report of Research.

    Energy Technology Data Exchange (ETDEWEB)

    Dawley, Earl M.

    1986-04-01

    Natural runs of salmonids in the Columbia River basin have decreased as a result of hydroelectric-dam development, poor land- and forest-management, and over-fishing. This has necessitated increased salmon culture to assure adequate numbers of returning adults. Hatchery procedures and facilities are continually being modified to improve both the efficiency of production and the quality of juveniles produced. Initial efforts to evaluate changes in hatchery procedures were dependent upon adult contributions to the fishery and returns to the hatchery. Procedures were developed for sampling juvenile salmon and steelhead entering the Columbia River estuary and ocean plume. The sampling of hatchery fish at the terminus of their freshwater migration assisted in evaluating hatchery production techniques and identifying migrational or behavioral characteristics that influence survival to and through the estuary. The sampling program attempted to estimate survival of different stocks and define various aspects of migratory behavior in a large river, with flows during the spring freshet from 4 to 17 thousand cubic meters per second (m/sup 3//second).

  13. Naegleria meningitis : a rare survival.

    Directory of Open Access Journals (Sweden)

    Jain R

    2002-10-01

    Full Text Available Acute amebic meningoencephalitis caused by free-living amebae naegleria fowleri is extremely rare and uniformly fatal with only seven survivals reported till date. An interesting case of naegleria meningitis diagnosed by wet mount cytology of cerebrospinal fluid (CSF and treated with amphoterecin B, rifampicin and ornidazole with complete recovery is presented. In cases of suspected pyogenic meningitis, if CSF staining, antigen detection or culture is negative for bacteria, a wet mount cytology of CSF for naegleria is suggested. Early treatment with amphoterecin B and rifampicin may improve survival.

  14. Adjuvant Autologous Melanoma Vaccine for Macroscopic Stage III Disease: Survival, Biomarkers, and Improved Response to CTLA-4 Blockade

    Directory of Open Access Journals (Sweden)

    Michal Lotem

    2016-01-01

    Full Text Available Background. There is not yet an agreed adjuvant treatment for melanoma patients with American Joint Committee on Cancer stages III B and C. We report administration of an autologous melanoma vaccine to prevent disease recurrence. Patients and Methods. 126 patients received eight doses of irradiated autologous melanoma cells conjugated to dinitrophenyl and mixed with BCG. Delayed type hypersensitivity (DTH response to unmodified melanoma cells was determined on the vaccine days 5 and 8. Gene expression analysis was performed on 35 tumors from patients with good or poor survival. Results. Median overall survival was 88 months with a 5-year survival of 54%. Patients attaining a strong DTH response had a significantly better (p=0.0001 5-year overall survival of 75% compared with 44% in patients without a strong response. Gene expression array linked a 50-gene signature to prognosis, including a cluster of four cancer testis antigens: CTAG2 (NY-ESO-2, MAGEA1, SSX1, and SSX4. Thirty-five patients, who received an autologous vaccine, followed by ipilimumab for progressive disease, had a significantly improved 3-year survival of 46% compared with 19% in nonvaccinated patients treated with ipilimumab alone (p=0.007. Conclusion. Improved survival in patients attaining a strong DTH and increased response rate with subsequent ipilimumab suggests that the autologous vaccine confers protective immunity.

  15. The impact of bevacizumab treatment on survival and quality of life in newly diagnosed glioblastoma patients

    DEFF Research Database (Denmark)

    Poulsen, Hans Skovgaard; Urup, Thomas; Michaelsen, Signe Regner;

    2014-01-01

    Glioblastoma multiforme (GBM) remains one of the most devastating tumors, and patients have a median survival of 15 months despite aggressive local and systemic therapy, including maximal surgical resection, radiation therapy, and concomitant and adjuvant temozolomide. The purpose of antineoplastic...

  16. The influence of pulmonary metastasectomy on survival in osteosarcoma and soft-tissue sarcomas: a retrospective analysis of survival outcomes, hospitalizations and requirements of home oxygen therapy.

    Science.gov (United States)

    Salah, Samer; Fayoumi, Said; Alibraheem, Abdellatif; Massad, Ehab; Abdel Jalil, Riad; Yaser, Sameer; Albadainah, Faisal; Albaba, Hamzeh; Maakoseh, Mohammad

    2013-08-01

    Pulmonary metastasectomy for sarcoma is a widely accepted practice. Nevertheless, no previous studies has been reported the outcomes following metastasectomy compared with chemotherapy for patients with resectable and isolated pulmonary metastases. Our aim is to compare these modalities for the subset of patients with resectable metastases. Furthermore, the outcomes for patients with unresectable lung metastases are reported. Sarcoma patients with isolated lung metastases were identified and their computed axial tomography scans were reviewed by a thoracic surgeons' committee. Patients were divided into three groups: A: patients with resectable metastases treated with metastasectomy (n=29), B: patients with resectable metastases who received systemic therapy (n=17) and C: patients with unresectable metastases (n=25). Survival outcomes were plotted and compared through log-rank test for osteosarcoma and non-osteosarcoma patients. Seventy-one patients (32 with osteosarcoma and 39 with non-osteosarcoma) were eligible. Progression-free survival (PFS) was superior in patients who belonged to Group A compared with Groups B and C (8.0, 4.3 and 2.2 months, respectively, P=0.0002). Furthermore, overall survival (OS) was superior in patients who belonged to Group A compared with Groups B and C (39.6, 20.0 and 7.8 months, respectively, Posteosarcoma patients showed superior PFS and OS for Group A vs B (median PFS 21.6 and 3.65 months, respectively, P=0.011 and median OS 34.0 and 12.4 months, respectively, P=0.0044). For non-osteosarcoma patients, there were no such significant survival differences between Groups A and B. Overall, patients who belonged to Group A had significantly lower mean percentage of their follow-up time spent admitted at hospital, and a trend towards lower requirements for home oxygen therapy. Pulmonary metastasectomy is associated with improved survival of osteosarcoma patients with resectable lung metastases. For non-osteosarcoma patients, the survival

  17. Incidence of and survival after glottic squamous cell carcinoma in Denmark from 1971 to 2011-A report from the Danish Head and Neck Cancer Group

    DEFF Research Database (Denmark)

    Lyhne, Nina Munk; Johansen, Jørgen; Kristensen, Claus Andrup

    2016-01-01

    .4 to 0.6). The 5-year DSM was 16% (15–17%) and the 5-year OS was 63% (61–64). The hazard rate of DSM adjusted for patient characteristics, tumour characteristics and waiting-time was significantly lower in the 2000s (p ...Aim To describe the incidence, disease-specific mortality (DSM), and overall survival (OS) of patients with glottic squamous cell carcinomas (SCC) in Denmark from 1971–2011 in a national population-based cohort of consecutive patients. Materials and methods All patients diagnosed with glottic SCC...... and national registries. Results In total 5132 patients with glottic SCC were included. The yearly number of new cases increased from 107 in the 1970s to 139 in the 2000s. Overall, the incidence increased from 1.9 to 2.6 per 100,000, with a more prominent increase in men (3.5 to 4.7) compared with women (0...

  18. Theater nuclear forces survivability and security. An Issue Evaluation Plan for fixed storage sites. Final report, 1 April-30 June 1979

    Energy Technology Data Exchange (ETDEWEB)

    Budd, A.S.; Hauser, F.H.; Kennedy, L.W.; Levy, P.H.

    1979-10-01

    This document is an Issue Evaluation Plan (IEP) which presents an approach to improving the operational effectiveness of the TNF by developing survivability and security (S2) options for use while nuclear weapons are in storage at Fixed Storage Sites (FSS). As such, it is one of three IEPs dealing with logistics issues. This IEP provides the Defense Nuclear Agency (DNA) with a description of the FSS issue, a scoping of the analytical and test approaches that might be employed in dealing with the issue, an initial S2 assessment of some aspects of weapons storage, a list of possible improvement options which could be developed, and a recommended FSS S2 Evaluation Plan. Its purpose is to provide DNA with the information necessary for making decisions regarding the development of S2 improvements to be used while nuclear weapons are stored at fixed sites in the TNF.

  19. Influence of positive surgical margin status after radical nephroureterectomy on upper urinary tract urothelial carcinoma survival.

    Science.gov (United States)

    Colin, Pierre; Ouzzane, Adil; Yates, David R; Audenet, François; François, Audenet; Pignot, Géraldine; Arvin-Berod, Alexis; Merigot de Treigny, Olivier; Laurent, Guy; Valeri, Antoine; Irani, Jacques; Jacques, Irani; Saint, Fabien; Gardic, Solène; Gres, Pascal; Rozet, François; Neuzillet, Yann; Ruffion, Alain; Rouprêt, Morgan

    2012-10-01

    The influence of a positive surgical margin (PSM) on survival outcome of post radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UUT-UC) is unclear. The objectives of this study were to determine the significance of PSM on cancer-specific survival (CSS), recurrence-free survival (RFS), and metastasis-free survival (MFS) post RNU. From a multicenter collaborative database, data on SM status, stage, grade, lymph node status, lymphovascular invasion (LVI), tumor location, follow-up, and survival was retrieved for 472 patients. Patients underwent open RNU with bladder cuff excision. Clinicopathological features were compared using χ(2) or Fisher exact test and unpaired t test for categorical and continuous variables, respectively. Survival was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards regression models were calculated. Median follow-up was 27.5 months (12.1-49.3 months). PSM was identified in 44 patients (9.3%) and correlated with pT stage (p = 0.002), grade (p < 0.001), LVI (p < 0.001), and location (p < 0.001). Univariate analyses revealed that PSM was a poor prognostic factor for CSS, RFS, and MFS (p = 0.003, 0.04, and <0.001, respectively). The 5-yr CSS and MFS for PSM was 59.1 and 51.6%, respectively, compared with 83.3 and 79.3% for patients with negative SM. Multivariate analyses revealed that SM status was an independent predictor of MFS [hazard ratio 2.7; p = 0.001). PSM after RNU is an important prognostic factor for developing UUT-UC metastases. The status of the surgical margin should be systematically reported on the pathological report and may be a useful variable to include in nomogram risk prediction tools.

  20. Impact of maximum Standardized Uptake Value (SUVmax evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT on survival for patients with advanced renal cell carcinoma: a preliminary report

    Directory of Open Access Journals (Sweden)

    Miura Takeshi

    2010-12-01

    Full Text Available Abstract Background In this era of molecular targeting therapy when various systematic treatments can be selected, prognostic biomarkers are required for the purpose of risk-directed therapy selection. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG accumulation, as evaluated by positron emission tomography, can be used to predict the prognosis of patients. The purpose of this study was to evaluate the impact of the maximum standardized uptake value (SUVmax from 18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT on survival for patients with advanced renal cell carcinoma (RCC. Methods A total of 26 patients with advanced or metastatic RCC were enrolled in this study. The FDG uptake of all RCC lesions diagnosed by conventional CT was evaluated by 18F-FDG PET/CT. The impact of SUVmax on patient survival was analyzed prospectively. Results FDG uptake was detected in 230 of 243 lesions (94.7% excluding lung or liver metastases with diameters of less than 1 cm. The SUVmax of 26 patients ranged between 1.4 and 16.6 (mean 8.8 ± 4.0. The patients with RCC tumors showing high SUVmax demonstrated poor prognosis (P = 0.005 hazard ratio 1.326, 95% CI 1.089-1.614. The survival between patients with SUVmax equal to the mean of SUVmax, 8.8 or more and patients with SUVmax less than 8.8 were statistically different (P = 0.0012. This is the first report to evaluate the impact of SUVmax on advanced RCC patient survival. However, the number of patients and the follow-up period were still not extensive enough to settle this important question conclusively. Conclusions The survival of patients with advanced RCC can be predicted by evaluating their SUVmax using 18F-FDG-PET/CT. 18F-FDG-PET/CT has potency as an "imaging biomarker" to provide helpful information for the clinical decision-making.

  1. Survival analysis of cholangiocarcinoma: A 10-year experience in Malaysia

    Institute of Scientific and Technical Information of China (English)

    Ahmad Ramzi Yusoff; Mohd Muzammil Abdul Razak; Yoong Boon Koon; R Vijeyasingam; Siti Zuraidah Mahmud

    2012-01-01

    AIM: To investigate the clinical features and survival of patients treated for cholangiocarcinoma in our institution and to analyze the factors affecting their survival. METHODS: This retrospective cohort study assessed patients diagnosed with cholangiocarcinoma between January 1997 and December 2007 at the University Malaya Medical Centre in Malaysia. The clinical data and associated outcomes were collected using a structured proforma. RESULTS: Of the 69 patients diagnosed with cholangiocarcinoma, 38 (55%) were male; mean patient age was 61 years. Twelve patients(17%) had intrahepatic, 38 (55%) had perihilar and 19 (28%) had distal tumors. Only 12 patients underwent curative surgery, including seven R0 resections. Only one patient died within 30 d after surgery. The overall median survival was 4 mo, whereas the median survival of R0 resected patients was 16 mo. The overall 1-, 2- and 3-year cumulative survival rates were 67%, 17% and 17%, respectively. Survival rates were significantly associated with curative resection (P= 0.002), intrahepatic tumor (P = 0.003), negative margin status (P = 0.013), early tumor stage (P = 0.016), higher tumor differentiation (P = 0.032) and absence of jaundice (P = 0.038). Multivariate analysis showed that tumor location was a significant independent predictor of patient survival. CONCLUSION: Curative, margin-negative resection of early stage, well-differentiated intrahepatic tumors is associated with improved patient survival.

  2. August Median Streamflow on Ungaged Streams in Eastern Aroostook County, Maine

    Science.gov (United States)

    Lombard, Pamela J.; Tasker, Gary D.; Nielsen, Martha G.

    2003-01-01

    Methods for estimating August median streamflow were developed for ungaged, unregulated streams in the eastern part of Aroostook County, Maine, with drainage areas from 0.38 to 43 square miles and mean basin elevations from 437 to 1,024 feet. Few long-term, continuous-record streamflow-gaging stations with small drainage areas were available from which to develop the equations; therefore, 24 partial-record gaging stations were established in this investigation. A mathematical technique for estimating a standard low-flow statistic, August median streamflow, at partial-record stations was applied by relating base-flow measurements at these stations to concurrent daily flows at nearby long-term, continuous-record streamflow- gaging stations (index stations). Generalized least-squares regression analysis (GLS) was used to relate estimates of August median streamflow at gaging stations to basin characteristics at these same stations to develop equations that can be applied to estimate August median streamflow on ungaged streams. GLS accounts for varying periods of record at the gaging stations and the cross correlation of concurrent streamflows among gaging stations. Twenty-three partial-record stations and one continuous-record station were used for the final regression equations. The basin characteristics of drainage area and mean basin elevation are used in the calculated regression equation for ungaged streams to estimate August median flow. The equation has an average standard error of prediction from -38 to 62 percent. A one-variable equation uses only drainage area to estimate August median streamflow when less accuracy is acceptable. This equation has an average standard error of prediction from -40 to 67 percent. Model error is larger than sampling error for both equations, indicating that additional basin characteristics could be important to improved estimates of low-flow statistics. Weighted estimates of August median streamflow, which can be used when

  3. June and August median streamflows estimated for ungaged streams in southern Maine

    Science.gov (United States)

    Lombard, Pamela J.

    2010-01-01

    Methods for estimating June and August median streamflows were developed for ungaged, unregulated streams in southern Maine. The methods apply to streams with drainage areas ranging in size from 0.4 to 74 square miles, with percentage of basin underlain by a sand and gravel aquifer ranging from 0 to 84 percent, and with distance from the centroid of the basin to a Gulf of Maine line paralleling the coast ranging from 14 to 94 miles. Equations were developed with data from 4 long-term continuous-record streamgage stations and 27 partial-record streamgage stations. Estimates of median streamflows at the continuous-record and partial-record stations are presented. A mathematical technique for estimating standard low-flow statistics, such as June and August median streamflows, at partial-record streamgage stations was applied by relating base-flow measurements at these stations to concurrent daily streamflows at nearby long-term (at least 10 years of record) continuous-record streamgage stations (index stations). Weighted least-squares regression analysis (WLS) was used to relate estimates of June and August median streamflows at streamgage stations to basin characteristics at these same stations to develop equations that can be used to estimate June and August median streamflows on ungaged streams. WLS accounts for different periods of record at the gaging stations. Three basin characteristics-drainage area, percentage of basin underlain by a sand and gravel aquifer, and distance from the centroid of the basin to a Gulf of Maine line paralleling the coast-are used in the final regression equation to estimate June and August median streamflows for ungaged streams. The three-variable equation to estimate June median streamflow has an average standard error of prediction from -35 to 54 percent. The three-variable equation to estimate August median streamflow has an average standard error of prediction from -45 to 83 percent. Simpler one-variable equations that use only

  4. Long-term survival in Patau syndrome.

    Science.gov (United States)

    Tunca, Y; Kadandale, J S; Pivnick, E K

    2001-04-01

    A female patient with an extra chromosome 13 (Patau syndrome) is described. There are only five previous reports of patients with trisomy 13 who have survived past the first decade. It is concluded that non-lethal congenital anomalies and aggressive medical care play an important role in the survival of patients with trisomy 13.

  5. Mission-Driven Media: Not Just Survival, but Success. A Report of the Aspen Institute Forum on Diversity and the Media (Aspen, Colorado, July 11-14, 2001).

    Science.gov (United States)

    Levi, Titus

    This report of the Aspen Institute Forum on Diversity and the Media, supported and funded by the Ford Foundation, is not a typical Aspen Institute forum report. It explores an issue--the sustainability of mission-driven media--and through this discussion becomes a kind of resource guide for managers and others who desire to preserve and promote…

  6. Calculation of statistic estimates of kinetic parameters from substrate uncompetitive inhibition equation using the median method

    Directory of Open Access Journals (Sweden)

    Pedro L. Valencia

    2017-04-01

    Full Text Available We provide initial rate data from enzymatic reaction experiments and tis processing to estimate the kinetic parameters from the substrate uncompetitive inhibition equation using the median method published by Eisenthal and Cornish-Bowden (Cornish-Bowden and Eisenthal, 1974; Eisenthal and Cornish-Bowden, 1974. The method was denominated the direct linear plot and consists in the calculation of the median from a dataset of kinetic parameters Vmax and Km from the Michaelis–Menten equation. In this opportunity we present the procedure to applicate the direct linear plot to the substrate uncompetitive inhibition equation; a three-parameter equation. The median method is characterized for its robustness and its insensibility to outlier. The calculations are presented in an Excel datasheet and a computational algorithm was developed in the free software Python. The kinetic parameters of the substrate uncompetitive inhibition equation Vmax, Km and Ks were calculated using three experimental points from the dataset formed by 13 experimental points. All the 286 combinations were calculated. The dataset of kinetic parameters resulting from this combinatorial was used to calculate the median which corresponds to the statistic estimator of the real kinetic parameters. A comparative statistical analyses between the median method and the least squares was published in Valencia et al. [3].

  7. Calculation of statistic estimates of kinetic parameters from substrate uncompetitive inhibition equation using the median method.

    Science.gov (United States)

    Valencia, Pedro L; Astudillo-Castro, Carolina; Gajardo, Diego; Flores, Sebastián

    2017-04-01

    We provide initial rate data from enzymatic reaction experiments and tis processing to estimate the kinetic parameters from the substrate uncompetitive inhibition equation using the median method published by Eisenthal and Cornish-Bowden (Cornish-Bowden and Eisenthal, 1974; Eisenthal and Cornish-Bowden, 1974). The method was denominated the direct linear plot and consists in the calculation of the median from a dataset of kinetic parameters Vmax and Km from the Michaelis-Menten equation. In this opportunity we present the procedure to applicate the direct linear plot to the substrate uncompetitive inhibition equation; a three-parameter equation. The median method is characterized for its robustness and its insensibility to outlier. The calculations are presented in an Excel datasheet and a computational algorithm was developed in the free software Python. The kinetic parameters of the substrate uncompetitive inhibition equation Vmax , Km and Ks were calculated using three experimental points from the dataset formed by 13 experimental points. All the 286 combinations were calculated. The dataset of kinetic parameters resulting from this combinatorial was used to calculate the median which corresponds to the statistic estimator of the real kinetic parameters. A comparative statistical analyses between the median method and the least squares was published in Valencia et al. [3].

  8. Median Sternotomy or Right Thoracotomy Techniques for Total Artificial Heart Implantation in Calves.

    Science.gov (United States)

    Karimov, Jamshid H; Moazami, Nader; Sunagawa, Gengo; Kobayashi, Mariko; Byram, Nicole; Sale, Shiva; Such, Kimberly A; Horvath, David J; Golding, Leonard A R; Fukamachi, Kiyotaka

    2016-10-01

    The choice of optimal operative access technique for mechanical circulatory support device implantation ensures successful postoperative outcomes. In this study, we retrospectively evaluated the median sternotomy and lateral thoracotomy incisions for placement of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in a bovine model. The CFTAH was implanted in 17 calves (Jersey calves; weight range, 77.0-93.9 kg) through a median sternotomy (n = 9) or right thoracotomy (n = 8) for elective chronic implantation periods of 14, 30, or 90 days. Similar preoperative preparation, surgical techniques, and postoperative care were employed. Implantation of the CFTAH was successfully performed in all cases. Both methods provided excellent surgical field visualization. After device connection, however, the median sternotomy approach provided better visualization of the anastomoses and surgical lines for hemostasis confirmation and repair due to easier device displacement, which is severely limited following right thoracotomy. All four animals sacrificed after completion of the planned durations (up to 90 days) were operated through full median sternotomy. Our data demonstrate that both approaches provide excellent initial field visualization. Full median sternotomy provides larger viewing angles at the anastomotic suture line after device connection to inflow and outflow ports.

  9. Sensoric Protection after Median Nerve Injury: Babysitter-Procedure Prevents Muscular Atrophy and Improves Neuronal Recovery

    Directory of Open Access Journals (Sweden)

    Benedicta E. Beck-Broichsitter

    2014-01-01

    Full Text Available The babysitter-procedure might offer an alternative when nerve reconstruction is delayed in order to overcome muscular atrophy due to denervation. In this study we aimed to show that a sensomotoric babysitter-procedure after median nerve injury is capable of preserving irreversible muscular atrophy. The median nerve of 20 female Wistar rats was denervated. 10 animals received a sensory protection with the N. cutaneous brachii. After six weeks the median nerve was reconstructed by autologous nerve grafting from the contralateral median nerve in the babysitter and the control groups. Grasping tests measured functional recovery over 15 weeks. At the end of the observation period the weight of the flexor digitorum sublimis muscle was determined. The median nerve was excised for histological examinations. Muscle weight (P<0.0001 was significantly superior in the babysitter group compared to the control group at the end of the study. The histological evaluation revealed a significantly higher diameter of axons (P=0.0194, nerve fiber (P=0.0409, and nerve surface (P=0.0184 in the babysitter group. We conclude that sensory protection of a motor nerve is capable of preserving muscule weight and we may presume that metabolism of the sensory nerve was sufficient to keep the target muscle’s weight and vitality.

  10. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Khalil, C.; Hancart, C.; Thuc, V.Le; Cotten, A. [Service de Radiologie Osteoarticulaire, Hopital Roger Salengro, CHRU de Lille (France); Chantelot, C. [Clinique d' Orthopedie, Hopital Roger Salengro, CHRU de Lille (France); Chechin, D. [Philips Medical Systems, Suresnes (France)

    2008-10-15

    The purpose was to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and tractography of the human median nerve with a 1.5-T MR scanner and to assess potential differences in diffusion between healthy volunteers and patients suffering from carpal tunnel syndrome. The median nerve was examined in 13 patients and 13 healthy volunteers with MR DTI and tractography using a 1.5-T MRI scanner with a dedicated wrist coil. T1-weighted images were performed for anatomical correlation. Mean fractional anisotropy (FA) and mean apparent diffusion coefficient (ADC) values were quantified in the median nerve on tractography images. In all subjects, the nerve orientation and course could be detected with tractography. Mean FA values were significantly lower in patients (p=0.03). However, no statistically significant differences were found for mean ADC values. In vivo assessment of the median nerve in the carpal tunnel using DTI with tractography on a 1.5-T MRI scanner is possible. Microstructural parameters can be easily obtained from tractography images. A significant decrease of mean FA values was found in patients suffering from chronic compression of the median nerve. Further investigations are necessary to determine if mean FA values may be correlated with the severity of nerve entrapment. (orig.)

  11. Median Fisher Discriminator: a robust feature extraction method with applications to biometrics

    Institute of Scientific and Technical Information of China (English)

    Jian YANG; Jingyu YANG; David ZHANG

    2008-01-01

    In existing Linear Discriminant Analysis (LDA) models,the class population mean is always estimated by the class sample average.In small sample size problems,such as face and palm recognition,however,the class sample average does not suffice to provide an accurate estimate of the class population mean based on a few of the given samples,particularly when there are outliers in the training set.To overcome this weakness,the class median vector is used to estimate the class population mean in LDA modeling.The class median vector has two advantages over the class sample average:(1) the class median (image) vector preserves useful details in the sample images,and (2) the class median vector is robust to outliers that exist in the training sample set.In addition,a weighting mechanism is adopted to refine the characterization of the within-class scatter so as to further improve the robustness of the proposed model.The proposed Median Fisher Discriminator (MFD) method was evaluated using the Yale and the AR face image databases and the PolyU (Polytechnic University) palmprint database.The experimental results demonstrated the robustness and effectiveness of the proposed method.

  12. An evaluation of survival of space maintainers: a six-year follow-up study.

    Science.gov (United States)

    Tulunoglu, Ozlem; Ulusu, Tezer; Genç, Yasemin

    2005-02-15

    The aim of this study was to evaluate the median survival time of fixed and removable space maintainers related to age groups, gender, and their distribution in upper and lower dental arches. The adherence of patients to a periodic recall program and the success rate of different types of space maintainers related to different arches were also evaluated. This study included 663 patients aged between 4-15 years old that were treated between the years of 1997 and 2002. The patients were categorized into four main groups: lost to follow-up, failed, successful, and censored at the end of study. Three hundred forty-five space maintainers were considered lost to follow-up, 83 were considered failed, 206 successful, and 20 censored-at-end. The overall median survival time of the appliances was 6.51 months. Median survival time was 7.25 months in the 4-6 age group, 6.35 months in the 7-12 age group, and 7.0 months in the 13+ age groups. Median survival time was 5.76 months in girls and 7.11 months in boys. Median survival time of space maintainers was 7.17 months for maxilla and 6.69 months in the mandible. Median survival time was 5.25 months for space maintainers fabricated in both arches.

  13. Median Hetero-Associative Memories Applied to the Categorization of True-Color Patterns

    Science.gov (United States)

    Vázquez, Roberto A.; Sossa, Humberto

    Median associative memories (MED-AMs) are a special type of associative memory based on the median operator. This type of associative model has been applied to the restoration of gray scale images and provides better performance than other models, such as morphological associative memories, when the patterns are altered with mixed noise. Despite of his power, MED-AMs have not been applied in problems involving true-color patterns. In this paper we describe how a median hetero-associative memory (MED-HAM) could be applied in problems that involve true-color patterns. A complete study of the behavior of this associative model in the restoration of true-color images is performed using a benchmark of 14400 images altered by different type of noises. Furthermore, we describe how this model can be applied to an image categorization problem.

  14. AN AMELIORATED DETECTION STATISTICS FOR ADAPTIVE MASK MEDIAN FILTRATION OF HEAVILY NOISED DIGITAL IMAGES

    Directory of Open Access Journals (Sweden)

    Geeta Hanji

    2016-11-01

    Full Text Available Noise reduction is an important area of research in image processing applications. The performance of the digital image noise filtering method primarily depends upon the accuracy of noise detection scheme. This paper presents an effective detector based, adaptive mask, median filtration of heavily noised digital images affected with fixed value (or salt and pepper impulse noise. The proposed filter presents a novel approach; an ameliorated Rank Ordered Absolute Deviation (ROAD statistics to judge whether the input pixel is noised or noise free. If a pixel is detected as corrupted, it is subjected to adaptive mask median filtration; otherwise, it is kept unchanged. Extensive experimental results and comparative performance evaluations demonstrate that the proposed filter outperforms the existing decision type, median based filters with powerful noise detectors in terms of objective performance measures and visual retrieviation accuracy.

  15. The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study.

    Science.gov (United States)

    Ural, Fatma Gülçin; Öztürk, Gökhan Tuna

    2017-01-01

    The aim of this study was to explore the acupuncture effect on the cross-sectional area (CSA) of the median nerve at the wrist in patients with carpal tunnel syndrome (CTS) and, additionally, to identify whether clinical, electrophysiological, and ultrasonographic changes show any association. Forty-five limbs of 27 female patients were randomly divided into two groups (acupuncture and control). All patients used night wrist splint. The patients in the acupuncture group received additional acupuncture therapy. Visual analog scale (VAS), Duruöz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were noted before and after the treatment in both groups. VAS, DHI, Quick DASH scores, and electrophysiological measurements were improved in both groups. The median nerve CSA significantly decreased in the acupuncture group, whereas there was no change in the control group. After acupuncture therapy, the patients with CTS might have both clinical and morphological improvement.

  16. Anomalous Innervation of the Median Nerve in the Arm in the Absence of the Musculocutaneous Nerve

    Directory of Open Access Journals (Sweden)

    Khursheed Raza

    2017-03-01

    Full Text Available The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent. The branches of the median nerve supplied the biceps brachii and brachialis muscles and the last branch continued as the lateral cutaneous nerve of the forearm. These variations may present atypically in cases of arm flexor paralysis or sensory loss on the lateral forearm. Knowledge of these variations is important in surgeries and during the administration of regional anaesthesia near the shoulder joint and upper arm.

  17. PSO Algorithm based Adaptive Median Filter for Noise Removal in Image Processing Application

    Directory of Open Access Journals (Sweden)

    Ruby Verma

    2016-07-01

    Full Text Available A adaptive Switching median filter for salt and pepper noise removal based on genetic algorithm is presented. Proposed filter consist of two stages, a noise detector stage and a noise filtering stage. Particle swarm optimization seems to be effective for single objective problem. Noise Dictation stage works on it. In contrast to the standard median filter, the proposed algorithm generates the noise map of corrupted Image. Noise map gives information about the corrupted and non-corrupted pixels of Image. In filtering, filter calculates the median of uncorrupted neighbouring pixels and replaces the corrupted pixels. Extensive simulations are performed to validate the proposed filter. Simulated results show refinement both in Peak signal to noise ratio (PSNR and Image Quality Index value (IQI. Experimental results shown that proposed method is more effective than existing methods.

  18. PENERAPAN METODE LEAST MEDIAN SQUARE-MINIMUM COVARIANCE DETERMINANT (LMS-MCD DALAM REGRESI KOMPONEN UTAMA

    Directory of Open Access Journals (Sweden)

    I PUTU EKA IRAWAN

    2014-01-01

    Full Text Available Principal Component Regression is a method to overcome multicollinearity techniques by combining principal component analysis with regression analysis. The calculation of classical principal component analysis is based on the regular covariance matrix. The covariance matrix is optimal if the data originated from a multivariate normal distribution, but is very sensitive to the presence of outliers. Alternatives are used to overcome this problem the method of Least Median Square-Minimum Covariance Determinant (LMS-MCD. The purpose of this research is to conduct a comparison between Principal Component Regression (RKU and Method of Least Median Square - Minimum Covariance Determinant (LMS-MCD in dealing with outliers. In this study, Method of Least Median Square - Minimum Covariance Determinant (LMS-MCD has a bias and mean square error (MSE is smaller than the parameter RKU. Based on the difference of parameter estimators, still have a test that has a difference of parameter estimators method LMS-MCD greater than RKU method.

  19. Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer

    DEFF Research Database (Denmark)

    Axelsson, C K; Düring, M; Christiansen, P M;

    2009-01-01

    BACKGROUND: This study examined whether axillary lymph node dissection (ALND) with removal of many normal lymph nodes resulted in a reduced rate of axillary recurrence and better survival, as reported in recent studies. METHODS: The follow-up analyses were based on 8657 patients with node-negative...... primary breast cancer treated solely by surgery. Median follow-up was 9 years. RESULTS: The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2.1 to 0.4 per cent; P = 0.037), local recurrence (from 7.4 to 3.8 per cent; P

  20. AN UNSYMMETRICAL TRIMMED MEDIAN USING DISTANCE MEASURE AND MIDPOINT FILTER FOR THE REMOVAL OF SALT AND PEPPER NOISE

    Directory of Open Access Journals (Sweden)

    K. Chithra

    2016-08-01

    Full Text Available Image denoising was a preprocessing step in image processing used to remove the noise while retaining as much as possible the important features. The fluctuations in the pixel value caused by the unwanted disturbance were known as noise. Hence, noise reduction techniques have to be used to improve the quality of the image. This article reports on the results of a research algorithm that uses median, midpoint and mean for the reduction of salt and pepper noise from the grayscale images. The median value was calculated for the uncorrupted pixels which are having the minimum distance. The proposed algorithm was tested using Euclidean distance, D4 distance and D8 distance as the distance measures. In this approach, the 3x3 window was selected as initial window size and the window size was made adaptive based on the noise density. The proposed filter was experimented using standard Lena image, 200 iris images, sample Plant images, sample MRI images and sample CT images in JPG/JPEG (Joint Photographic Experts Group format. These grayscale images used as a test image were induced with salt and pepper noise density ranging from 10% to 90%. The simulated results proved that the proposed approach performs better than the MDBUTMF, AMMF, MNF, IUTMMF, and HYBRID filtering algorithms reported in the literature in terms of PSNR, IEF and MSE

  1. Quantifying the benefits of Mediterranean diet in terms of survival.

    Science.gov (United States)

    Bellavia, Andrea; Tektonidis, Thanasis G; Orsini, Nicola; Wolk, Alicja; Larsson, Susanna C

    2016-05-01

    Beneficial effects of Mediterranean diet (MD) have been consistently documented. However, to fully understand the public health implications of MD adherence, an informative step is to quantify these effects in terms of survival time differences. The aim of this study was to evaluate the impact of MD on survival, presenting results in terms of differences in median age at death. We used data from 71,333 participants from a large population-based cohort of Swedish men and women, followed-up between January 1, 1998, and December 31, 2012. A total score of MD, ranging from 0 to 8, was calculated by including information on vegetables and fruits consumption, legumes and nuts, non-refined/high fiber grains, fermented dairy products, fish, red meat, use of olive oil/rapeseed oil, and moderate alcohol intake. Multivariable-adjusted differences in median age at death were estimated with Laplace regression and presented as a function of the MD score. During 15 years of follow-up we documented 14,697 deaths. We observed a linear dose-response association between the MD score and median age at death, with higher score associated with longer survival. The difference in median age at death between participants with the extreme scores (0 vs 8) of MD was up to 2 years (23 months, 95 % CI: 16-29). In this study we documented that adherence to MD may accrue benefits up to 2 years of longer survival.

  2. Clinicopathologic and survival analysis of resected ampullary adenocarcinoma.

    Science.gov (United States)

    Doepker, Matthew P; Thompson, Zachary J; Centeno, Barbara A; Kim, Richard D; Wong, Joyce; Hodul, Pamela J

    2016-08-01

    Ampullary adenocarcinoma (AAC) is a rare neoplasm. We sought to determine the clinicopathologic factors contributing to the overall survival (OS) and recurrence-free (RFS) survival. Patients (pts) with resected AAC were identified from 1996 to 2015 and reviewed for clinicopathologic factors and correlated with outcome. We identified and evaluated 106 pts diagnosed with AAC. The median age was 70.2 years (range 41-86) and 60 (56.6%) were male. Overall, 105 pts (99.1%) had a pancreaticoduodenectomy. An R0 resection was achieved in 101 (95%) pts. Median follow-up was 19 months with a median OS of 49.3 months. Lymph node metastasis and poorly differentiated tumors adversely affected OS on multivariate analysis (MVA). Twenty patients (18.9%) developed recurrence. The median RFS was 27 months. RFS was adversely affected by lymph node count and metastasis, tumor differentiation, and histological subtype on MVA. Survival was not affected by the addition of adjuvant therapy. Retrieval of ≤12 lymph nodes and lymph node ratio ≥0.10 resulted in worse OS on Kaplan-Meier analysis. Our data show retrieval of ≤12 nodes, involvement of nodes with AAC, moderately or poorly differentiated tumors, and pancreaticobiliary subtype adversely affected survival, while the use of adjuvant therapy demonstrated no significant benefit. J. Surg. Oncol. 2016;114:170-175. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. The geometric median on Riemannian manifolds with application to robust atlas estimation.

    Science.gov (United States)

    Fletcher, P Thomas; Venkatasubramanian, Suresh; Joshi, Sarang

    2009-03-01

    One of the primary goals of computational anatomy is the statistical analysis of anatomical variability in large populations of images. The study of anatomical shape is inherently related to the construction of transformations of the underlying coordinate space, which map one anatomy to another. It is now well established that representing the geometry of shapes or images in Euclidian spaces undermines our ability to represent natural variability in populations. In our previous work we have extended classical statistical analysis techniques, such as averaging, principal components analysis, and regression, to Riemannian manifolds, which are more appropriate representations for describing anatomical variability. In this paper we extend the notion of robust estimation, a well established and powerful tool in traditional statistical analysis of Euclidian data, to manifold-valued representations of anatomical variability. In particular, we extend the geometric median, a classic robust estimator of centrality for data in Euclidean spaces. We formulate the geometric median of data on a Riemannian manifold as the minimizer of the sum of geodesic distances to the data points. We prove existence and uniqueness of the geometric median on manifolds with non-positive sectional curvature and give sufficient conditions for uniqueness on positively curved manifolds. Generalizing the Weiszfeld procedure for finding the geometric median of Euclidean data, we present an algorithm for computing the geometric median on an arbitrary manifold. We show that this algorithm converges to the unique solution when it exists. In this paper we exemplify the robustness of the estimation technique by applying the procedure to various manifolds commonly used in the analysis of medical images. Using this approach, we also present a robust brain atlas estimation technique based on the geometric median in the space of deformable images.

  4. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 4

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between Jun 21 and July 22, 1995. Nest monitoring, radio-telemetry, and...

  5. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, In Relation to Habitat Progress Report No. 2

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between April 15 and May 15, 1995. This early phase of the study constitutes...

  6. Reproductive Success and Nestling Survival of white-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 6

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This final report documents progress on the White-faced Ibis population ecology study between August 24 and September 22, 1995. Vegetation sampling, color marking,...

  7. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 3

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between May 15 June 21, 1995. This phase of the study constitutes early...

  8. Reproductive Success and Nestling Survival of white-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 6

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This final report documents progress on the White-faced Ibis population ecology study between August 24 and September 22, 1995. Vegetation sampling, color marking,...

  9. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 5

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between July 22 and August 24, 1995. Vegetation sampling, nest monitoring,...

  10. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat: Progress Report No. 1

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between March 20 and April 15, 1995. This early phase of the study only...

  11. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 5

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between July 22 and August 24, 1995. Vegetation sampling, nest monitoring,...

  12. Reproductive Success and Nestling Survival of White-faced Ibis in Northwest Nevada, in Relation to Habitat Progress Report No. 3

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The following report documents progress on the White-faced Ibis population ecology study between May 15 June 21, 1995. This phase of the study constitutes early...

  13. Spherical/gyroid phase diagram of the diblock copolymer in the median selective solvent

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The effect of the median selective solution on the lamellar,spherical and gyroid structures is studied. The self-consistent field equations of the diblock copolymer solution are solved by using the reciprocal space method. It is shown that the spherical and gyroid phases have the lowest free energy in the certain range of the solution concentration. Furthermore,the phase diagram of the ordered structures in the diblock copolymer solution with the median selective solvent is calculated,which is consistent with the experimental results.

  14. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Haakma, Wieke; Jongbloed, Bas A.; Froeling, Martijn

    2016-01-01

    Objectives To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. Methods We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls...... (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA...... nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p nerves...

  15. Analysis of association between posterior crossbite, median line deviation and facial asymmetry

    OpenAIRE

    Santos, R. R.; Garbin,Artênio José Isper; Saliba, O. [UNESP; Garbin, C. A. S. [UNESP

    2014-01-01

    Facial asymmetry is a common human characteristic and can occur on many levels, originate of genetic factors, and can be caused by traumas or due to cross bite and/or muscular disability. The aim of this study was to evaluate the relation between posterior crossbite, median line deviation and facial asymmetry. For this study 70 children aged between 3 and 10 years-old were examined and photographed. Using Microsoft Office Power Point 2007, horizontal lines and one vertical line on median line...

  16. A case of fibrolipomatous hamartoma of the median nerve with macrodactyly

    Directory of Open Access Journals (Sweden)

    Sathish Arakeri

    2012-07-01

    Full Text Available Fibrolipomatous hamartoma of nerve is a tumor-like lipomatous process principally involving affecting young persons. The median nerve is most commonly affectedinvolved. The lesion is characterized by a soft slowly growing mass, surrounding and infiltrating major nerves and their branches. It may cause symptoms of compression neuropathy and is associated with macrodactyly in one third of cases. Here, we present a case of Fibrolipomatous hamartoma of nerve in the wrist of a young man arising from median nerve. Debulking of the tumour was performed.

  17. ECG baseline wander correction based on mean-median filter and empirical mode decomposition.

    Science.gov (United States)

    Xin, Yi; Chen, Yu; Hao, Wei Tuo

    2014-01-01

    A novel approach of ECG baseline wander correction based on mean-median filter and empirical mode decomposition is presented in this paper. The low frequency parts of the original signals were removed by the mean median filter in a nonlinear way to obtain the baseline wander estimation, then its series of IMFs were sifted by t-test after empirical mode decomposition. The proposed method, tested by the ECG signals in MIT-BIH Arrhythmia database and European ST_T database, is more effective compared with other baseline wander removal methods.

  18. Improving the Stability of the LMF Adaptive Algorithm Using the Median Filteer

    DEFF Research Database (Denmark)

    Bysted, Tommy Kristensen; Rusu, Corneliu

    1998-01-01

    The stability of the LMF (Least Mean Fourth) adaptive algorithm is improved by using the median of the gradient instead of the raw gradient for updating the coefficients of the adaptive filter. This operation has two advantages: first it improves the performance of the LMF in impulse noise...... environments and secondly it enables the use of larger step-size of the adaptive algorithm especially when the signals are corrupted by noise. The disadvantages are a small raise in the computational complexity and slower convergence than the LMF. Two examples are given which illustrates the behavior...... of the Median LMF compared to the LMF algorithm....

  19. SOSIAALISEN MEDIAN MARKKINOINTIVIESTINTÄ JA KÄYTTÖ LIIGA-OTTELUIDEN MARKKINOINNISSA

    OpenAIRE

    Lahdenperä, Johanna

    2016-01-01

    Opinnäytetyön aiheena oli tutkia miten sosiaalista mediaa hyödynnetään ottelutapahtumien markkinoinnissa. Lähtökohtana tutkimukselle oli kaksi Jääkiekon SM-liigan jääkiekkoseuraa ja niiden sosiaalisen median käyttö. Tavoitteena oli selvittää sosiaalisen median merkitys otteluiden markkinoinnissa. Opinnäyteyössä tutkitaan myös, miten ja millainen markkinointiviestintä sosiaalisessa mediassa vaikuttaa kannattajiin. Teoreettisessa osuudessa käsitellään sosiaalisessa mediassa tapahtuvaa markkinoi...

  20. Median and quantile tests under complex survey design using SAS and R.

    Science.gov (United States)

    Pan, Yi; Caudill, Samuel P; Li, Ruosha; Caldwell, Kathleen L

    2014-11-01

    Techniques for conducting hypothesis testing on the median and other quantiles of two or more subgroups under complex survey design are limited. In this paper, we introduce programs in both SAS and R to perform such a test. A detailed illustration of the computations, macro variable definitions, input and output for the SAS and R programs are also included in the text. Urinary iodine data from National Health and Nutrition Examination Survey (NHANES) are used as examples for comparing medians between females and males as well as comparing the 75th percentiles among three salt consumption groups.

  1. Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas.

    Science.gov (United States)

    Lasolle, Hélène; Cortet, Christine; Castinetti, Fréderic; Cloix, Lucie; Caron, Philippe; Delemer, Brigitte; Desailloud, Rachel; Jublanc, Christel; Lebrun-Frenay, Christine; Sadoul, Jean-Louis; Taillandier, Luc; Batisse-Lignier, Marie; Bonnet, Fabrice; Bourcigaux, Nathalie; Bresson, Damien; Chabre, Olivier; Chanson, Philippe; Garcia, Cyril; Haissaguerre, Magalie; Reznik, Yves; Borot, Sophie; Villa, Chiara; Vasiljevic, Alexandre; Gaillard, Stephan; Jouanneau, Emmanuel; Assié, Guillaume; Raverot, Gérald

    2017-06-01

    Only few retrospective studies have reported an efficacy rate of temozolomide (TMZ) in pituitary tumors (PT), all around 50%. However, the long-term survival of treated patients is rarely evaluated. We therefore aimed to describe the use of TMZ on PT in clinical practice and evaluate the long-term survival. Multicenter retrospective study by members of the French Society of Endocrinology. Forty-three patients (14 women) treated with TMZ between 2006 and 2016 were included. Most tumors were corticotroph (n = 23) or lactotroph (n = 13), and 14 were carcinomas. Clinical/pathological characteristics of PT, as well as data from treatment evaluation and from the last follow-up were recorded. A partial response was considered as a decrease in the maximal tumor diameter by more than 30% and/or in the hormonal rate by more than 50% at the end of treatment. The median treatment duration was 6.5 cycles (range 2-24), using a standard regimen for most and combined radiotherapy for six. Twenty-two patients (51.2%) were considered as responders. Silent tumor at diagnosis was associated with a poor response. The median follow-up after the end of treatment was 16 months (0-72). Overall survival was significantly higher among responders (P = 0.002); however, ten patients relapsed 5 months (0-57) after the end of TMZ treatment, five in whom TMZ was reinitiated without success. Patients in our series showed a 51.2% response rate to TMZ, with an improved survival among responders despite frequent relapses. Our study highlights the high variability and lack of standardization of treatment protocols. © 2017 European Society of Endocrinology.

  2. Studying DDT Susceptibility at Discriminating Time Intervals Focusing on Maximum Limit of Exposure Time Survived by DDT Resistant Phlebotomus argentipes (Diptera: Psychodidae): an Investigative Report.

    Science.gov (United States)

    Rama, Aarti; Kesari, Shreekant; Das, Pradeep; Kumar, Vijay

    2017-07-24

    Extensive application of routine insecticide i.e., dichlorodiphenyltrichloroethane (DDT) to control Phlebotomus argentipes (Diptera: Psychodidae), the proven vector of visceral leishmaniasis in India, had evoked the problem of resistance/tolerance against DDT, eventually nullifying the DDT dependent strategies to control this vector. Because tolerating an hour-long exposure to DDT is not challenging enough for the resistant P. argentipes, estimating susceptibility by exposing sand flies to insecticide for just an hour becomes a trivial and futile task.Therefore, this bioassay study was carried out to investigate the maximum limit of exposure time to which DDT resistant P. argentipes can endure the effect of DDT for their survival. The mortality rate of laboratory-reared DDT resistant strain P. argentipes exposed to DDT was studied at discriminating time intervals of 60 min and it was concluded that highly resistant sand flies could withstand up to 420 min of exposure to this insecticide. Additionally, the lethal time for female P. argentipes was observed to be higher than for males suggesting that they are highly resistant to DDT's toxicity. Our results support the monitoring of tolerance limit with respect to time and hence points towards an urgent need to change the World Health Organization's protocol for susceptibility identification in resistant P. argentipes.

  3. Long-term survival of diffuse large B cell lymphoma of the trigeminal region extending to the Meckel's cave treated by CHASER therapy: case report.

    Science.gov (United States)

    Tanaka, Toshihide; Kato, Naoki; Itoh, Kuniaki; Hasegawa, Yuzuru

    2014-01-01

    A 52-year-old man with a history of malignant lymphoma of the cecum presented with lancinating facial pain in the left. Magnetic resonance imaging (MRI) revealed a tumor in the Meckel's cave extending along the trigeminal nerve. The tumor was partially removed via left retrosigmoid lateral suboccipital craniotomy. Histological examination showed findings consistent with diffuse large B cell lymphoma, which was later confirmed to be metastatic lesion from the cecal lesion. Postoperative chemotherapy with cyclophosphamide, high dose, cytarabine, steroid (dexamethasone), etoposide, and rituximab (CHASER) followed by whole brain irradiation (30 Gy) resulted in complete remission. Although facial pain persisted, the patient's general condition remained favorable and he did not experience recurrence over the 51-month follow-up period. Histological confirmation and awareness of malignant lymphoma are very important to determine the therapeutic strategy and to avoid misdiagnosis or delayed diagnosis. Long-term survival of patients with metastatic malignant lymphoma in the Meckel's cave extending along the trigeminal nerve was very rare. In addition, metastatic malignant lymphoma in the extra-axial and peripheral nervous tissue might be different from primary central nervous system lymphoma in the white matter, since the efficacy of chemotherapeutic agents against malignant lymphomas in the extra-axial regions is not attenuated by the blood brain barrier.

  4. Effects of Flow on the Migratory Behavior and Survival of Juvenile Fall and Summer Chinook Salmon in John Day Reservior, 1982 Annual Report of Research.

    Energy Technology Data Exchange (ETDEWEB)

    Miller, David R.; Sims, Carl W.

    1983-11-01

    The National Marine Fisheries Service in cooperation with the Bonneville Power Administration is conducting a 6-year study of the effects of instream flows on the passage time, survival, and migrational behavior of juvenile fall and summer (O-age) chinook salmon in John Day Reservoir. In 1982, the second year of the study, research activities concentrated on refining distribution and behavior data in John Day Reservoir and on releasing and recapturing marked fish needed to define flow/travel time relationships. Twenty-two groups (61,887 fish) of marked O-age chinook salmon were wire-tagged, branded, and released into the tailrace at McNary Dam, and forty-four groups (13,128 fish) were branded and released into the reservoir at various other sites. Sampling at the John Day Dam airlift facility captured 54,647 subyearling chinook salmon including 482 marked recoveries. Additional marks (279) were recovered from purse seine samples taken at various sites throughout the reservoir. The average passage time to John Day Dam for marked O-age chinook salmon released in the McNary tailrace was 23 days. Weekend flow reductions at McNary Dam did not affect passage time of subyearling chinook salmon in John Day Reservoir. There was no statistical evidence to indicate that instream flows affected either the rate of movement or residence time of O-age chinook salmon in John Day Reservoir.

  5. Astrocytes Upregulate Survival Genes in Tumor Cells and Induce Protection from Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sun-Jin Kim

    2011-03-01

    Full Text Available In the United States, more than 40% of cancer patients develop brain metastasis. The median survival for untreated patients is 1 to 2 months, which may be extended to 6 months with conventional radiotherapy and chemotherapy. The growth and survival of metastasis depend on the interaction of tumor cells with host factors in the organ microenvironment. Brain metastases are surrounded and infiltrated by activated astrocytes and are highly resistant to chemotherapy. We report here that coculture of human breast cancer cells or lung cancer cells with murine astrocytes (but not murine fibroblasts led to the up-regulation of survival genes, including GSTA5, BCL2L1, and TWIST1, in the tumor cells. The degree of up-regulation directly correlated with increased resistance to all tested chemotherapeutic agents. We further show that the up-regulation of the survival genes and consequent resistance are dependent on the direct contact between the astrocytes and tumor cells through gap junctions and are therefore transient. Knocking down these genes with specific small interfering RNA rendered the tumor cells sensitive to chemotherapeutic agents. These data clearly demonstrate that host cells in the microenvironment influence the biologic behavior of tumor cells and reinforce the contention that the organ microenvironment must be taken into consideration during the design of therapy.

  6. Two different approaches to the affective profiles model: median splits (variable-oriented) and cluster analysis (person-oriented).

    Science.gov (United States)

    Garcia, Danilo; MacDonald, Shane; Archer, Trevor

    2015-01-01

    Background. The notion of the affective system as being composed of two dimensions led Archer and colleagues to the development of the affective profiles model. The model consists of four different profiles based on combinations of individuals' experience of high/low positive and negative affect: self-fulfilling, low affective, high affective, and self-destructive. During the past 10 years, an increasing number of studies have used this person-centered model as the backdrop for the investigation of between and within individual differences in ill-being and well-being. The most common approach to this profiling is by dividing individuals' scores of self-reported affect using the median of the population as reference for high/low splits. However, scores just-above and just-below the median might become high and low by arbitrariness, not by reality. Thus, it is plausible to criticize the validity of this variable-oriented approach. Our aim was to compare the median splits approach with a person-oriented approach, namely, cluster analysis. Method. The participants (N = 2, 225) were recruited through Amazons' Mechanical Turk and asked to self-report affect using the Positive Affect Negative Affect Schedule. We compared the profiles' homogeneity and Silhouette coefficients to discern differences in homogeneity and heterogeneity between approaches. We also conducted exact cell-wise analyses matching the profiles from both approaches and matching profiles and gender to investigate profiling agreement with respect to affectivity levels and affectivity and gender. All analyses were conducted using the ROPstat software. Results. The cluster approach (weighted average of cluster homogeneity coefficients = 0.62, Silhouette coefficients = 0.68) generated profiles with greater homogeneity and more distinctive from each other compared to the median splits approach (weighted average of cluster homogeneity coefficients = 0.75, Silhouette coefficients = 0.59). Most of the

  7. Annual Report to the Nation on the status of cancer, 1975-2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer.

    Science.gov (United States)

    Edwards, Brenda K; Noone, Anne-Michelle; Mariotto, Angela B; Simard, Edgar P; Boscoe, Francis P; Henley, S Jane; Jemal, Ahmedin; Cho, Hyunsoon; Anderson, Robert N; Kohler, Betsy A; Eheman, Christie R; Ward, Elizabeth M

    2014-05-01

    The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year's report includes the prevalence of comorbidity at the time of first cancer diagnosis among patients with lung, colorectal, breast, or prostate cancer and survival among cancer patients based on comorbidity level. Data on cancer incidence were obtained from the NCI, the CDC, and the NAACCR; and data on mortality were obtained from the CDC. Long-term (1975/1992-2010) and short-term (2001-2010) trends in age-adjusted incidence and death rates for all cancers combined and for the leading cancers among men and women were examined by joinpoint analysis. Through linkage with Medicare claims, the prevalence of comorbidity among cancer patients who were diagnosed between 1992 through 2005 residing in 11 Surveillance, Epidemiology, and End Results (SEER) areas were estimated and compared with the prevalence in a 5% random sample of cancer-free Medicare beneficiaries. Among cancer patients, survival and the probabilities of dying of their cancer and of other causes by comorbidity level, age, and stage were calculated. Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2001 through 2010. Overall incidence rates decreased in men and stabilized in women. The prevalence of comorbidity was similar among cancer-free Medicare beneficiaries (31.8%), breast cancer patients (32.2%), and prostate cancer patients (30.5%); highest among lung cancer patients (52.9%); and intermediate among colorectal cancer patients (40.7%). Among all cancer patients and especially for patients diagnosed with local and

  8. Survival following interstitial brachytherapy for recurrent malignant glioma.

    Science.gov (United States)

    Kitchen, N D; Hughes, S W; Taub, N A; Sofat, A; Beaney, R P; Thomas, D G

    1994-01-01

    The treatment of recurrent malignant glioma is difficult and at present largely disappointing. Furthermore the results of any treatment modality need to be interpreted with knowledge regarding patient selection and timing of treatment. The results of interstitial brachytherapy using iodine-125 in 23 patients are presented. There were no operative complications. Median survival time from tumour recurrence and implantation was 36 and 25 weeks respectively. Karnofsky Performance Status (KPS) was significantly associated with survival, though patient age, original tumour histology, prior chemotherapy, and time to recurrence were not. Treatment does confer modest survival benefit as compared to controls, but our results are not as impressive as others. Reasons for this finding are discussed.

  9. Long-term survival of patients with hepatocellular carcinoma with inferior vena cava tumor thrombus treated with sorafenib combined with transarterial chemoembolization:report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    Heng-Jun Gao; Li Xu; Yao-Jun Zhang; Min-Shan Chen

    2014-01-01

    The prognosis of hepatocellular carcinoma (HCC) with tumor thrombus formation in the main vasculature is extremely poor. Sorafenib combined with transarterial chemoembolization is a novel treatment approach for advanced HCC. In this study, we report two HCC patients with inferior vena cava tumor thrombus who underwent the combination treatment. The overall survival times for these two patients were 44 months and 35 months, respectively. Our report suggests that sorafenib combined with transarterial chemoembolization may be a viable choice for patients with advanced HCC even with inferior vena cava tumor thrombus. Further studies are required to verify the efficacy and safety of this combination therapy for patients with advanced HCC with inferior vena cava tumor thrombus.

  10. Multinationals and plant survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2010-01-01

    The aim of this paper is twofold: first, to investigate how different ownership structures affect plant survival, and second, to analyze how the presence of foreign multinational enterprises (MNEs) affects domestic plants’ survival. Using a unique and detailed data set on the Swedish manufacturing...... sector, I am able to separate plants into those owned by foreign MNEs, domestic MNEs, exporting non-MNEs, and purely domestic firms. In line with previous findings, the result, when conditioned on other factors affecting survival, shows that foreign MNE plants have lower survival rates than non......-MNE plants. However, separating the non-MNEs into exporters and non-exporters, the result shows that foreign MNE plants have higher survival rates than non-exporting non-MNEs, while the survival rates of foreign MNE plants and exporting non-MNE plants do not seem to differ. Moreover, the simple non...

  11. Dialysis vintage, body composition, and survival in peritoneal dialysis patients.

    Science.gov (United States)

    Avram, Morrell M; Mittman, Neal; Fein, Paul A; Agahiu, Samuel; Hartman, William; Chattopadhyay, Neil; Matza, Betty

    2012-01-01

    The relationship between dialysis vintage (length of time on dialysis), body composition, and survival has been reported in hemodialysis patients. In the present study, we examined the association ofdialysis vintage with body composition and survival in peritoneal dialysis (PD) patients. At enrollment, body composition in 65 PD patients was determined by bioelectrical impedance analysis. Patients (mean age at enrollment: 54 years) were followed for up to 11 years maximum. At enrollment, the mean, median, and maximum dialysis vintages were 51, 34, and 261 months respectively. After adjusting for age, race, sex, and diabetes status, dialysis vintage was indirectly correlated (partial correlation coefficients) with body weight (r = -0.40, p = 0.001), body mass index (r = -0.40, p = 0.002), body surface area (r = -0.39, p = 0.002), body cell mass (r = -0.39, p = 0.002), total body fat weight (r = -0.30, p = 0.02), and fat percentage of body weight (r = -0.31, p = 0.018), and directly correlated with extracellular mass to body cell mass ratio (r = 0.27, p = 0.039). The observed cumulative survival was significantly higher (p = 0.007) in patients with a dialysis vintage at enrollment of 35 months or less, than in patients with dialysis vintage at enrollment of more than 35 months. In the multivariate Cox regression analysis, adjusting for age, race, sex, and diabetes, dialysis vintage at enrollment remained an independent predictor of mortality (relative risk: 1.010; p = 0.002). Increase in relative risk of death with increasing dialysis vintage may be partly explained by the association of vintage with unfavorable changes in body composition and the nutrition status of patients over time.

  12. Re-analysis results using medians of the data from the JaCVAM-organized international validation study of the in vivo rat alkaline comet assay.

    Science.gov (United States)

    Uno, Yoshifumi; Omori, Takashi

    2015-07-01

    The data from the JaCVAM-organized international validation study of the in vivo rat alkaline comet assay were reported and analyzed statistically using the simple means of % tail DNA. However, OECD test guideline TG 489 recommends use of the median for data analysis due to the hierarchical nature of the data. Comparison between the simple mean approach and the median based approach for positive/negative/equivocal chemical calls was conducted using the % tail DNA data for the 40 chemicals tested in the JaCVAM-organized international validation study of the in vivo rat alkaline comet assay, using liver and stomach as target organs. In the liver, two genotoxic chemicals, o-anisidine and 9-aminoacridine hydrochloride monohydrate, were positive using the median based approach but negative using the simple mean approach, and two genotoxic chemicals, 2-acetylaminofluorene and busulfan were equivocal using the median based approach but negative using the simple mean approach. In contrast, cadmium chloride (genotoxic carcinogen) was equivocal in both organs using the median based approach, while positive and equivocal in liver and stomach, respectively, using the simple mean approach. Two data sets of sodium arsenite showed equivocal and negative results for liver using the median based approach, although both data sets were equivocal using the simple mean approach. Overall, there are no large differences in terms of the genotoxic call between both approaches. However, the median based approach recommended in OECD TG 489 has an advantage toward higher precision within the groups treated with a test chemical, whereas the approach might show the lower values for the effect.

  13. Childhood Hodgkin International Prognostic Score (CHIPS) Predicts event-free survival in Hodgkin Lymphoma: A Report from the Children's Oncology Group.

    Science.gov (United States)

    Schwartz, Cindy L; Chen, Lu; McCarten, Kathleen; Wolden, Suzanne; Constine, Louis S; Hutchison, Robert E; de Alarcon, Pedro A; Keller, Frank G; Kelly, Kara M; Trippet, Tanya A; Voss, Stephan D; Friedman, Debra L

    2017-04-01

    Early response to initial chemotherapy in Hodgkin lymphoma (HL) measured by computed tomography (CT) and/or positron emission tomography (PET) after two to three cycles of chemotherapy may inform therapeutic decisions. Risk stratification at diagnosis could, however, allow earlier and potentially more efficacious treatment modifications. We developed a predictive model for event-free survival (EFS) in pediatric/adolescent HL using clinical data known at diagnosis from 1103 intermediate-risk HL patients treated on Children's Oncology Group protocol AHOD0031 with doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide (ABVE-PC) chemotherapy and radiation. Independent predictors of EFS were identified and used to develop and validate a prognostic score (Childhood Hodgkin International Prognostic Score [CHIPS]). A training cohort was randomly selected to include approximately half of the overall cohort, with the remainder forming the validation cohort. Stage 4 disease, large mediastinal mass, albumin (<3.5), and fever were independent predictors of EFS that were each assigned one point in the CHIPS.  Four-year EFS was 93.1% for patients with CHIPS = 0, 88.5% for patients with CHIPS = 1, 77.6% for patients with CHIPS = 2, and 69.2% for patients with CHIPS = 3. CHIPS was highly predictive of EFS, identifying a subset (with CHIPS 2 or 3) that comprises 27% of intermediate-risk patients who have a 4-year EFS of <80% and who may benefit from early therapeutic augmentation.  Furthermore, CHIPS identified higher risk patients who were not identified by early PET or CT response. CHIPS is a robust and inexpensive approach to predicting risk in patients with intermediate-risk HL that may improve ability to tailor therapy to risk factors known at diagnosis. © 2016 Wiley Periodicals, Inc.

  14. Graphics and statistics for cardiology: survival analysis.

    Science.gov (United States)

    May, Susanne; McKnight, Barbara

    2017-03-01

    Reports of data in the medical literature frequently lack information needed to assess the validity and generalisability of study results. Some recommendations and standards for reporting have been developed over the last two decades, but few are available specifically for survival data. We provide recommendations for tabular and graphical representations of survival data. We argue that data and analytic software should be made available to promote reproducible research.

  15. 16 CFR Figure 2 to Part 1203 - ISO Headform-Basic, Reference, and Median Planes

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false ISO Headform-Basic, Reference, and Median Planes 2 Figure 2 to Part 1203 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR BICYCLE HELMETS Pt. 1203, Fig. 2 Figure 2 to Part...

  16. Median Nerve Deformation and Displacement in the Carpal Tunnel during Index Finger and Thumb Motion

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Yoshii, Yuichi; Villarraga, Hector R.; Henderson, Jacqueline; Cha, Stephen S.; An, Kai-Nan; Amadio, Peter C.

    2010-01-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound Thirty wrists from 15 asymptomatic volunteers were evaluated Cross-sectional images during motion from full extension t

  17. The "p"-Median Model as a Tool for Clustering Psychological Data

    Science.gov (United States)

    Kohn, Hans-Friedrich; Steinley, Douglas; Brusco, Michael J.

    2010-01-01

    The "p"-median clustering model represents a combinatorial approach to partition data sets into disjoint, nonhierarchical groups. Object classes are constructed around "exemplars", that is, manifest objects in the data set, with the remaining instances assigned to their closest cluster centers. Effective, state-of-the-art implementations of…

  18. The primary Maxillary Central Incisor in the Solitary Median Maxillary Central Incisor syndrome

    DEFF Research Database (Denmark)

    Kjaer, I; Balslev-Olesen, M

    2012-01-01

    Solitary Median Maxillary Central Incisor (SMMCI) is a developmental anomaly in the permanent dentition with one single central incisor in the maxilla, positioned exactly in the midline. This condition has been associated with extra- and intraoral malformations in the frontonasal segment of the c...

  19. Relation between B-mode Gray-scale Median and Clinical Features of Carotid Stenosis Vulnerability

    NARCIS (Netherlands)

    Kolkert, Joé L.; Meerwaldt, Robbert; Loonstra, Jan; Schenk, Miranda; Palen, van der Job; Dungen, van den Jan J.; Zeebregts, Clark J.

    2014-01-01

    Background Vulnerability of the carotid plaque might be useful as a predictor for ischemic stroke risk. The gray-scale median (GSM) of the carotid plaque at B-mode imaging has been described as an objective tool to quantify vulnerability. However, its use is disputed in the published literature. Thi

  20. Relation between B-mode Gray-scale Median and Clinical Features of Carotid Stenosis Vulnerability

    NARCIS (Netherlands)

    Kolkert, Joe L.; Meerwaldt, Robbert; Loonstra, Jan; Schenk, Miranda; van der Palen, Job; van den Dungen, Jan J.; Zeebregts, Clark J.

    2014-01-01

    Background: Vulnerability of the carotid plaque might be useful as a predictor for ischemic stroke risk. The gray-scale median (GSM) of the carotid plaque at B-mode imaging has been described as an objective tool to quantify vulnerability. However, its use is disputed in the published literature. Th

  1. PROJECTIONS OF DORSAL AND MEDIAN RAPHE NUCLEI TO DORSAL AND VENTRAL STRIATUM

    Directory of Open Access Journals (Sweden)

    G. R. Hassanzadeh G. Behzadi

    2007-08-01

    Full Text Available The ascending serotonergic projections are derived mainly from mesencephalic raphe nuclei. Topographical projections from mesencephalic raphe nuclei to the striatum were examined in the rat by the retrograde transport technique of HRP (horseradish peroxidase. In 29 rats stereotaxically injection of HRP enzyme were performed in dorsal and ventral parts of striatum separately. The extent of the injection sites and distribution of retrogradely labeled neuronal cell bodies were drawed on representative sections using a projection microscope. Following ipsilateral injection of HRP into the dorsal striatum, numerous labeled neurons were seen in rostral portion of dorsal raphe (DR nucleus. In the same level the cluster of labeled neurons were hevier through caudal parts of DR. A few neurons were also located in lateral wing of DR. More caudally some labeled neurons were found in lateral, medial line of DR. In median raphe nucleus (MnR the labeled neurons were scattered only in median portion of this nucleus. The ipsilateral injection of HRP into the ventral region of striatum resulted on labeling of numerous neurons in rostral, caudal and lateral portions of DR. Through the caudal extension of DR on 4th ventricle level, a large number of labeled neurons were distributed along the ventrocaudal parts of DR. In MnR, labeled neurons were observed only in median part of this nucleus. These findings suggest the mesencephalic raphe nuclei projections to caudo-putamen are topographically organized. In addition dorsal and median raphe nuclei have a stronger projection to the ventral striatum.

  2. Effects of Thai Dancing on Median Neurodynamic Response During 4-Hour Computer Use.

    Science.gov (United States)

    Mekhora, Keerin; Septham, Chatdao; Jalayondeja, Wattana

    2015-06-01

    To investigate the effects of Thai dancing on median neurodynamic response during 4-hour computer use. Twenty-four healthy participants aged 20-30 years performed 5 minutes of Thai dancing including Prom See Na, Yoong Fon Hang, Sod Soy Mala, Lor Keaw and Cha Nee Rai Mai during a 10-minute break of 4-hour computer use. All participants were assessed for nerve tension by elbow range of motion ofupper limb neurodynamic test 1 (ULNT1) and components of quick test. The discomfort was measured by visual analogue discomfort scale (VADS). These measurements were assessed before and after computer work. The statistical analyses employed paired t-test for continuous outcome and Friedman's test. The median nerve tension (indicated by elbow range of motion) was significantly reduced at before and after work, when 5 minutes of Thai dancing was introduced during the break. While components of the quick test emphasized that Thai dance immediately helped reduce the median nerve tension. The VADS in eight body areas increased over the period of 4 hours, but decreased after performing Thai dancing (pdancing helped relieve median nerve tension and body discomfort. It may be recommended as an exercise during break for computer users who continuously work to prevent WMSDs.

  3. The problem of margin calculation and its reduction via the p-median problem model

    NARCIS (Netherlands)

    Goldengorin, B.; Krushynskyi, D.; Kuzmenko, V.; Mastorakis, NE; Demiralp, M; Mladenov,; Bojkovic, Z

    2009-01-01

    The paper deals with a model for calculation of the regulatory margin on brokerage accounts. The model is based on the p-Median problem (PMP) that is known to be NP-hard. We use a pseudo-Boolean representation of the PMP and propose several problem size reduction and preprocessing techniques. Our co

  4. Median power frequency of the surface electromyogram and blood lactate concentration in incremental cycle ergometry

    NARCIS (Netherlands)

    Jansen, R; Ament, W; Verkerke, GJ; Hof, AL

    1997-01-01

    The electromyogram (EMG) median power frequency of the vastus lateralis and flexor digitorum superficialis muscles was measured in 12 subjects during cycle ergometry with step-wise increasing exercise intensities up to 100% of VO2max. Blood lactate concentration was measured to investigate the relat

  5. MEDIAN PARAPETELLAR VERSUS MIDVASTUS APPROACH ON THE OUTCOMES IN TOTAL KNEE REPLACEMENT

    Directory of Open Access Journals (Sweden)

    Gokarakonda Sree Vamsi

    2015-02-01

    Full Text Available Background: The most common approaches used in Total Knee Replacement surgery are Midvastus, subvastus, median parapetellar, lateral patellar and trivector approach. There is uncertainty as to the best surgical approach to the knee joint for knee replacement. Median parapetellar approach is the standard of practice, but off late quadriceps sparing approaches as like subvastus and midvastus are performed. Subvastus approach has its own limitation of less joint exposure. In our clinical setup, orthopaedic surgeons perform median parapetellar and midvastus approach. The present study has compared outcome of knee function between a standard median parapetellar arthrotomy and mid vastus arthrotomy for patients undergone primary total knee arthroplasty. The post op quadriceps function depend on the type of surgical approach Materials and methods: 30 subjects were recruited who had undergone Total knee arthroplasty with Median parapetellar and Midvastus approach at Sri Ramachandra medical hospital; received standard physiotherapy care. The pre-op and post quadriceps angle were measured and the quadriceps, hamstrings isometric muscle strength and 6 minute walk test of the patients were recorded at the time of discharge and after one month of follow-up, and the data were statistically analyzed. Results: Median parapetellar and Midvastus approach were significant within the groups; with respect to quadriceps angle (QA (p<0.05, isometric strength of quadriceps (QS (p<0.05 and 6 minute walk test (WT (p<0.05. On comparing between the groups at one month follow-up isometric strength of hamstrings (HS (p<0.01 and 6 minute walk test (p<0.01 were found to be significant. Discussion: Findings show that Mid-vastus approach provides better results in terms of quadriceps angle, isometric strength of quadriceps and 6 minute walk test compared to median parapetellar approach. Conclusion: Study concludes that, the isometric strength of quadriceps and hamstrings has

  6. Elevated manganese concentrations in drinking water may be beneficial for fetal survival.

    Science.gov (United States)

    Rahman, Syed Moshfiqur; Akesson, Agneta; Kippler, Maria; Grandér, Margaretha; Hamadani, Jena Derakhshani; Streatfield, Peter Kim; Persson, Lars-Åke; El Arifeen, Shams; Vahter, Marie

    2013-01-01

    Elevated exposure to the essential element manganese (Mn) can be toxic. Manganese concentrations in ground water vary considerably, and reported associations between Mn and early-life mortality and impaired development have raised concern. We assessed the effects of drinking water Mn exposure during pregnancy upon fetal and infant survival. In this population-based cohort study, we identified the outcomes of pregnancies registered between February 2002 and April 2003 in Matlab, Bangladesh. Using inductively coupled plasma mass spectrometry, we measured the concentrations of Mn and other elements in the pregnant women's drinking water. A total of 1,875 women were included in the analysis of spontaneous abortions (n=158) and 1,887 women in the perinatal mortality analysis (n=70). Water Mn ranged from 3.0-6,550 µg/L (median=217 µg/L). The adjusted odds ratio (OR) for spontaneous abortion was 0.65 (95% CI 0.43-0.99) in the highest water Mn tertile (median=1,292 µg/L) as compared to the lowest tertile (median=56 µg/L). The corresponding OR for perinatal mortality was 0.69 (95% CI 0.28-1.71), which increased to 0.78 (95% CI 0.29-2.08) after adjustment for BMI and place of delivery (home/health facility; n=1,648). Elevated water Mn concentrations during pregnancy appear protective for the fetus, particularly in undernourished women. This effect may be due to the element's role in antioxidant defense.

  7. Denoising of 4D cardiac micro-CT data using median-centric bilateral filtration

    Science.gov (United States)

    Clark, D.; Johnson, G. A.; Badea, C. T.

    2012-02-01

    Bilateral filtration has proven an effective tool for denoising CT data. The classic filter uses Gaussian domain and range weighting functions in 2D. More recently, other distributions have yielded more accurate results in specific applications, and the bilateral filtration framework has been extended to higher dimensions. In this study, brute-force optimization is employed to evaluate the use of several alternative distributions for both domain and range weighting: Andrew's Sine Wave, El Fallah Ford, Gaussian, Flat, Lorentzian, Huber's Minimax, Tukey's Bi-weight, and Cosine. Two variations on the classic bilateral filter, which use median filtration to reduce bias in range weights, are also investigated: median-centric and hybrid bilateral filtration. Using the 4D MOBY mouse phantom reconstructed with noise (stdev. ~ 65 HU), hybrid bilateral filtration, a combination of the classic and median-centric filters, with Flat domain and range weighting is shown to provide optimal denoising results (PSNRs: 31.69, classic; 31.58 median-centric; 32.25, hybrid). To validate these phantom studies, the optimal filters are also applied to in vivo, 4D cardiac micro-CT data acquired in the mouse. In a constant region of the left ventricle, hybrid bilateral filtration with Flat domain and range weighting is shown to provide optimal smoothing (stdev: original, 72.2 HU; classic, 20.3 HU; median-centric, 24.1 HU; hybrid, 15.9 HU). While the optimal results were obtained using 4D filtration, the 3D hybrid filter is ultimately recommended for denoising 4D cardiac micro-CT data, because it is more computationally tractable and less prone to artifacts (MOBY PSNR: 32.05; left ventricle stdev: 20.5 HU).

  8. Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study

    Science.gov (United States)

    Hung, Ming-Szu; Chen, I-Chuan; Lee, Chuan-Pin; Huang, Ru-Jiun; Chen, Pau-Chung; Tsai, Ying-Huang; Yang, Yao-Hsu

    2017-01-01

    Long-term use of statins has been reported to reduce the risk of death in patients with lung cancer. This study investigated the effect of statin use among patients with lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) therapy. A nationwide, population-based case-control study was conducted using the Taiwan National Health Insurance Research Database. From January 1, 1997 to December 31, 2012, a total of 1,707 statin and 6,828 non-statin matched lung cancer cohorts with EGFR-TKIs treatment were studied. Statin use was associated with a reduced risk of death (HR: 0.58, 95% CI: 0.54–0.62, p < 0.001). In addition, statin use was associated with a significantly longer median progression-free survival (8.3 months, 95% CI: 7.6–8.9 vs. 6.1 months, 95% CI: 6.0–6.4, p < 0.001) and median overall survival (35.5 months, 95% CI: 33.8–38.1 vs. 23.9 months, 95% CI: 23.4–24.7, p < 0.001). In conclusion, statins might potentially enhance the therapeutic effect and increase survival in patients with lung cancer receiving EGFR-TKI therapy. PMID:28158206

  9. Design and Analysis of Salmonid Tagging Studies in the Columbia Basin, Volume XIV; Appraisal of the Relationship between Tag Detection Efficiency at Bonneville Dam and the Precision in Estuarine and Marine Survival Estimates on Returning PIT Tagged Chinook Salmon, 2000 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Comas, Jose A.; Skalski, John R. (University of Washington, School of Fisheries, Seattle, WA)

    2000-07-01

    In the advent of the installation of a PIT-tag interrogation system in the Cascades Island fish ladder at Bonneville Dam, this report provides guidance on the anticipated precision of salmonid estuarine and marine survival estimates, for various levels of system-wide adult detection probability at Bonneville Dam. Precision was characterized by the standard error of the survival estimates and the coefficient of variation of the survival estimates. The anticipated precision of salmonid estuarine and marine survival estimates was directly proportional to the number of PIT-tagged smolts released and to the system-wide adult detection efficiency at Bonneville Dam, as well as to the in-river juvenile survival above Lower Granite Dam. Moreover, for a given release size and system-wide adult detection efficiency, higher estuarine and marine survivals did also produce more precise survival estimates. With a system-wide detection probability of P{sub BA} = 1 at Bonneville Dam, the anticipated CVs for the estuarine and marine survival ranged between 41 and 88% with release sizes of 10,000 smolts. Only with the 55,000 smolts being released from sites close to Lower Granite Dam and under high estuarine and marine survival, could CVs of 20% be attained with system detection efficiencies of less than perfect detection (i.e., P{sub BA} < 1).

  10. Parathyroid carcinoma survival: improvements in the era of intact parathyroid hormone monitoring?

    Directory of Open Access Journals (Sweden)

    Steve R. Martinez

    2013-02-01

    Full Text Available The intact parathyroid hormone (iPTH assay is a critical test in the diagnosis and management of PTH-mediated hypercalcemia, including parathyroid carcinoma (PCa. We hypothesized that the survival of patients diagnosed with PCa has improved since adoption of the iPTH assay into clinical practice. We identified all confirmed cases of PCa within the Surveillance, Epidemiology and End Results database from 1973 to 2006. Patients were categorized into two eras based upon introduction of the iPTH assay: 1973 to 1997 (era I and 1997 to 2006 (era II, when the iPTH assay was in standard use. We estimated overall survival (OS and disease-specific survival (DSS using the Kaplan-Meier method, with differences among survival curves assessed via log rank. Multivariate Cox proportional hazards models compared the survival rates between treatment eras while controlling for patient age, sex, race/ethnicity, tumor size, nodal status, extent of disease, and type of surgery. Multivariate models included patients undergoing potentially curative surgery and excluded those with dis- tant metastases. Risks of overall and disease-specific mortality were reported as hazard ratios with 95% confidence intervals. Study criteria were met by 370 patients. Median survival was 15.6 years. Five-year rates of OS and DSS were 78% and 88% for era I and 82% and 96% for era II. On multivariate analysis, age, black race, and unknown extent of disease predicted an increased risk of death from any cause. Treatment era did not predict OS. No factor predicted PCa-specific mortality. In multivariate analysis, neither OS nor DSS have improved in the current era that utilizes iPTH for the detection and management of PCa.

  11. Clinical and Genetic Modifiers of Long-term Survival in Heart Failure

    Science.gov (United States)

    Cresci, Sharon; Kelly, Reagan J; Cappola, Thomas P; ScM; Diwan, Abhinav; Dries, Daniel; Kardia, Sharon LR; Dorn, Gerald W

    2009-01-01

    Objective To identify genetic modifiers of β-blocker (BB) response and long-term survival in heart failure (HF). Background Differences in BB treatment effect between Caucasians and African Americans with HF have been reported. Methods Prospective cohort study of 2,460 patients (711 African American; 1,749 Caucasian) enrolled between 1999 and 2007. 2039 (81.7%) were treated with BB. Each was genotyped for β1-adrenergic receptor (ADRB1) Arg389>Gly and G-protein receptor kinase 5 (GRK5) Gln41>Leu polymorphisms, which are more prevalent among African Americans than Caucasians. Primary endpoint was survival time from HF onset. Results There were 765 deaths during follow up (median 46 months). BB treatment increased survival in Caucasians (Log Rank P=0.00038) but not African Americans (Log Rank P=0.327). Among patients not taking BB, ADRB1 Gly389 was associated with decreased survival in Caucasians (HR = 1.98, 95% CI = 1.1 − 3.7, P = 0.03) while GRK5 Leu41 was associated with improved survival in African Americans (HR = 0.325, CI = 0.133 − 0.796, P = 0.01). ADRB1 Gly389 GRK5 Gln41Gln African Americans derived similar survival benefit from BB therapy (HR = 0.385 95% CI = 0.182 − 0.813, P = 0.012) as ADRB1 Gly389 GRK5 Gln41Gln Caucasians (HR = 0.529, 95% CI = 0.326 − 0.858, P=0.0098). Conclusions These data demonstrate that differences caused by β-adrenergic receptor signaling pathway gene polymorphisms, rather than race, are the major factors contributing to apparent differences in BB treatment effect between Caucasians and African Americans; proper evaluation of treatment response should account for genetic variance. PMID:19628119

  12. Survival after laryngectomy: a review of 133 patients with laryngeal carcinoma.

    Science.gov (United States)

    Papadas, Theodoros A; Alexopoulos, Evangelos C; Mallis, Antony; Jelastopulu, Eleni; Mastronikolis, Nicholas S; Goumas, Panos

    2010-07-01

    Survival trends in survival for laryngeal cancer in Europe are varied. Five-year survival varied around 60-64% but numbers below 50% have been commonly reported. The aim of this study was to assess the factors influencing survival in patients with laryngeal cancer in our region. A total of 128 male and 5 female patients with larynx cancer (91 glottic and 42 supraglottic) were treated at Patras University Hospital between March 1992 and August 2004. Except 3, all were smokers and 56 (41%) heavy alcohol users. Postsurgical staging showed that most had been classified at stages III (38%) and IV (49%). By histology, 31 tumors were classified as poorly differentiated, 78 as moderately differentiated and 23 as well differentiated. All patients underwent laryngectomy with extension of the procedure where appropriate. Also, a total of 45 patients received adjuvant therapy (either chemotherapy or radiotherapy). Farmers, construction workers, professional drivers and mechanics and coffee shop and bar employees account for more than 70% of patients. Results showed that 64 (48.1%) patients died during the follow-up, 58 (43.6%) of them died from cause related to their disease. With a median follow-up of 25 months, the 5-year disease-free survival (DFS) was 53% and the 5-year overall survival (OS) was 45%. Significant prognostic factors for OS included patient age, advanced staging, heavy alcohol use and poor tumor differentiation while for DFS affected mainly by poor tumor differentiation. We conclude that the disease stage at presentation, tumor grade and alcohol consumption prove to be important predictors for the OS as well as the DFS in our series.

  13. The survival of vital and non-vital deciduous molar teeth following pulpotomy.

    Science.gov (United States)

    Hill, M W

    2007-09-01

    There is scant evidence supporting the criteria for establishing the suitability of a deciduous molar for a pulpotomy. Although some criteria, such as patient age, are logical the importance of other factors on tooth survival has not been established. All pulpotomies performed at 20 school dental clinics over a period of 15 months were reported together with date of birth, gender, tooth treated, presenting signs and symptoms, pulp status and date and method of treatment. Operators performed the treatment according to their usual procedures. Data were analysed statistically using Statview 5.0 (SAS Institute). The outcome of pulpotomy of 465 deciduous teeth in 403 patients was evaluated. The mean age of the patients was 7.4 +/- 0.1 years. Two hundred and seventy-two teeth were vital and 193 were non-vital. One hundred and ninety-six teeth were treated with the one-step formocresol method and 269 with the two-step formocresol method. The age and gender of the patients did not differ between the vital and non-vital groups. There was no influence of mode of treatment on the asymptomatic survival of the teeth in the mouth. The median survival times were significantly longer in vital (32.7 +/- 1.4 months) than non-vital teeth (20.4 +/- 3.0 months; p < 0.0001). The only factors significantly influencing the survival of pulpotomized teeth were the age of the patient (p < 0.0001), the non-vitality of the pulp (p < 0.0001) and the presence of a radiolucency (p = 0.031). Both vital and non-vital teeth were able to survive for extended periods following pulpotomy but the presence of an associated radiolucency or a non-vital pulp at the time of treatment is negatively associated with time of survival.

  14. Treatment patterns and survival outcomes in patients with cervical cancer complicated by complete uterine prolapse: a systematic review of literature.

    Science.gov (United States)

    Matsuo, Koji; Fullerton, Morgan E; Moeini, Aida

    2016-01-01

    Cervical cancer complicated by complete uterine prolapse is a rare clinical entity and uniform management recommendations have yet to be determined. The aim of the current review was to examine the effects of management patterns on survival outcomes in cervical cancer patients with complete uterine prolapse. A systematic review of the literature was conducted using three public search engines. This included case reports with detailed descriptions of tumor characteristics, cancer management, and survival outcomes. Treatment patterns and tumor characteristics were correlated to survival outcomes. There were 78 patients with cervical cancer with complete uterine prolapse. Their mean age was 63.7 years. The median duration of prolapse was 147.9 months and 22.2% of the patients experienced persistent/recurrent prolapse after cancer treatment. The mean tumor size was 8.9 cm and squamous cell carcinoma (83.9%) was the most common histologic type. The majority of patients (56.2%) had stage I cancer. Tumor characteristics were similar across the treatment patterns. Survival outcomes were more favorable with surgery-based treatment (48 patients) than with radiation-based treatment (30 patients): 5-year recurrence-free survival rate 72.0% vs. 62.9% (p = 0.057), and 5-year disease-specific overall survival rate 77.0% vs. 68.2% (p = 0.017). After controlling for age and stage, surgery-based therapy remained an independent prognostic factor for better disease-specific overall survival outcome (hazard ratio 0.32, 95% confidence interval 0.11 - 0.94, adjusted p = 0.039). Although limited in study size, our results at least suggest that surgery-based treatment may have a positive effect on survival outcome in cervical cancer patients with complete uterine prolapse.

  15. Incidence and survival from lung cancer in Greenland is comparable to survival in the Nordic countries

    DEFF Research Database (Denmark)

    Gelvan, Allan; Risum, Signe; Langer, Seppo W

    2015-01-01

    referred to treatment at Queen Ingrid's Hospital. On 1 February 2014, treatment results, survival, and prognostic variables were analysed. RESULTS: The mean age at diagnosis was 63 years. Non-small cell lung cancer (NSCLC) was diagnosed in 145 patients (84%); 56% had squamous cell carcinoma, 34% had......INTRODUCTION: Oncological treatment of lung cancer has been available in Greenland since 2004. We evaluated patient characteristics and survival rates for the first six years of local lung cancer treatment. METHODS: From September 2004 to August 2010, a total of 173 patients with lung cancer were...... of the 142 treated patients (86%). Of these, 36 patients (30%) received second-line chemotherapy.The median survival of patients undergoing primary lobectomy/pneumonectomy, palliative chemotherapy, and no treatment was 76.3 months, 11.8 months, and 2.0 months, respectively (p

  16. Long-term survival case of a recurrent colon cancer owing to successful resection of a tumor at hepaticojejunostomy: report of a case.

    Science.gov (United States)

    Natsume, Seiji; Shimizu, Yasuhiro; Sano, Tsuyoshi; Senda, Yoshiki; Ito, Seiji; Komori, Koji; Abe, Tetsuya; Yanagisawa, Akio; Yamao, Kenji

    2015-12-01

    With advances in surgical procedures and perioperative management, hepato-biliary-pancreatic surgery, including hepatectomy and pancreaticoduodenectomy, has been employed for recurrent colon cancer. However, no report has described a case of major hepatectomy with the combined resection of hepaticojejunostomy following pancreaticoduodenectomy for locoregionally recurrent colon cancer. Here, such a case is reported. The patient, a 37-year-old woman, had undergone pancreaticoduodenectomy for lymph node recurrence along the extrahepatic bile duct from cecal cancer. Thirteen months later, a biliary stricture was found at the hepaticojejunostomy site and right hepatectomy was performed. The resected specimen showed a papillary tumor at the hepaticojejunostomy. Based on its histological features, the pathogenesis of this tumor was considered to be intramural recurrence via lymphatic vessels. Although she underwent resection of a lymph node recurrence at her mesentery 12 months later, she has remained well thereafter, without any sign of further recurrence during 5 years of follow-up after hepatectomy.

  17. Ten-Year Survival in Patients with Idiopathic Pulmonary Fibrosis After Lung Transplantation

    NARCIS (Netherlands)

    ten Klooster, Liesbeth; Nossent, George D.; Kwakkel-van Erp, Johanna M.; van Kessel, Diana A.; Oudijk, Erik J.; van de Graaf, Ed A.; Luijk, Bart; Hoek, Rogier A.; van den Blink, Bernt; van Hal, Peter Th.; Verschuuren, Erik A.; van der Bij, Wim; van Moorsel, Coline H; Grutters, Jan C

    2015-01-01

    Introduction Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal fibrosing lung disease with a median survival of approximately 3 years after diagnosis. The only medical option to improve survival in IPF is lung transplantation (LTX). The purpose of this study was to evaluate trajectory

  18. Disseminated tumor cells in pancreatic cancer-an independent prognosticator of disease progression and survival

    NARCIS (Netherlands)

    Effenberger, Katharina E.; Schroeder, Cornelia; Eulenburg, Christine; Reeh, Matthias; Tachezy, Michael; Riethdorf, Sabine; Vashist, Yogesh K.; Izbicki, Jakob R.; Pantel, Klaus; Bockhorn, Maximilian

    2012-01-01

    Pancreatic cancer is one of the most devastating cancers with a 6-month median survival and a 5-year survival rate of 35%. Still important aspects of its aggressive biology remain elusive and advanced therapeutic regimens have not been substantially successful. We investigated the prognostic role of

  19. Survivability in warship design

    NARCIS (Netherlands)

    Keuning, P.J.; Smit, C.S.

    2002-01-01

    The initiative taken by the AVT panel to organise this symposium on combat survivability is much welcomed. From our perspective, the possibilities for the survivability experts within NATO to exchange their research efforts have always been rather limited. This symposium under sponsorship of the AVT

  20. Survival in Extreme Conditions.

    Science.gov (United States)

    Bloom, Martin; Halsema, James

    1983-01-01

    Explores the psychosocial and environmental configurations involved in the survival of 500 civilians in a Japanese internment camp in the Philippines during World War II. Although conditions were very harsh, the survival rate of this group was better than expected. Discusses available demographic, social organizational, and cultural information.…

  1. Survivability in warship design

    NARCIS (Netherlands)

    Keuning, P.J.; Smit, C.S.

    2002-01-01

    The initiative taken by the AVT panel to organise this symposium on combat survivability is much welcomed. From our perspective, the possibilities for the survivability experts within NATO to exchange their research efforts have always been rather limited. This symposium under sponsorship of the AVT

  2. Surviving a Suicide Attempt

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Harrasi

    2016-09-01

    Full Text Available Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors and protective factors (like religious affiliation and family support. All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  3. Prediction of survival with alternative modeling techniques using pseudo values.

    Directory of Open Access Journals (Sweden)

    Tjeerd van der Ploeg

    Full Text Available BACKGROUND: The use of alternative modeling techniques for predicting patient survival is complicated by the fact that some alternative techniques cannot readily deal with censoring, which is essential for analyzing survival data. In the current study, we aimed to demonstrate that pseudo values enable statistically appropriate analyses of survival outcomes when used in seven alternative modeling techniques. METHODS: In this case study, we analyzed survival of 1282 Dutch patients with newly diagnosed Head and Neck Squamous Cell Carcinoma (HNSCC with conventional Kaplan-Meier and Cox regression analysis. We subsequently calculated pseudo values to reflect the individual survival patterns. We used these pseudo values to compare recursive partitioning (RPART, neural nets (NNET, logistic regression (LR general linear models (GLM and three variants of support vector machines (SVM with respect to dichotomous 60-month survival, and continuous pseudo values at 60 months or estimated survival time. We used the area under the ROC curve (AUC and the root of the mean squared error (RMSE to compare the performance of these models using bootstrap validation. RESULTS: Of a total of 1282 patients, 986 patients died during a median follow-up of 66 months (60-month survival: 52% [95% CI: 50%-55%]. The LR model had the highest optimism corrected AUC (0.791 to predict 60-month survival, followed by the SVM model with a linear kernel (AUC 0.787. The GLM model had the smallest optimism corrected RMSE when continuous pseudo values were considered for 60-month survival or the estimated survival time followed by SVM models with a linear kernel. The estimated importance of predictors varied substantially by the specific aspect of survival studied and modeling technique used. CONCLUSIONS: The use of pseudo values makes it readily possible to apply alternative modeling techniques to survival problems, to compare their performance and to search further for promising

  4. Increasing incidence and survival in oral cancer

    DEFF Research Database (Denmark)

    Schmidt Karnov, Kirstine; Grønhøj, Christian; Jensen, David Hebbelstrup

    2017-01-01

    regression analysis in relation to location, gender, age, and calendar year at diagnosis. RESULTS: Altogether, 8299 patients with oral cancer were identified, 5062 (61%) of whom were males and 3237 (39%) were females. The median age at diagnosis was 63 years. The AAIR of patients with OC increased from 1......BACKGROUND: Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980...... to 2014. MATERIAL AND METHODS: This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980-2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox...

  5. Survival and risk of leukaemia in polycythaemia vera and essential thrombocythaemia treated with oral radiophosphorus. Are safer drugs available?

    Energy Technology Data Exchange (ETDEWEB)

    Brandt, L.; Anderson, H. [University Hospital, Department of Oncology and Southern Swedish Regional Rumour Registry, Lund (Sweden)

    1995-01-01

    For 366 patients with polycythaemia vera (PV) or essential thrombocythaemia (ET) diagnosed 1971-1990, oral administration of 32-P was used as myelosuppressive treatment. Retreatment was not restricted to any defined interval and the number of treatments or the total dose were not limited. For 107 patients, follow-up was > 10 years. 15 of these presented with life-threatening occlusive vascular symptoms and their survival was short. For the remaining 92 patients 5-yr survival was not significantly worse than for a Swedish population matched for age and sex. Survival at 10 yr was lower, 51% versus 66% expected. Acute myeloid leukaemia (AML) was diagnosed in 11 of the 107 patients (10.3%). In the whole material of 366 patients, 17 have developed AML with a median time of 8.5 yr from start of treatment. There was a maximum incidence of 4% per yr after 8-12 yr. Later, the incidence decreased. The median annual dose of 32-P for the AML patients was 100 MBq and was not significantly larger than for a matched control group surviving without AML, 95 MBq. The results are compared with reports on PV or ET patients treated with busulphan (Bu) or hydroxyurea (HU). With comparable periods of follow-up there are no indications that an adequate myelosuppression with oral 32-P will be associated with shorter survival or higher incidence of AML than treatment with Bu or HU. It is concluded that, for the time being, oral administration of 32-P is an acceptable standard treatment in PV and ET. (au) (20 refs.).

  6. Survival of trisomy 18 (Edwards syndrome) and trisomy 13 (Patau Syndrome) in England and Wales: 2004-2011.

    Science.gov (United States)

    Wu, Jianhua; Springett, Anna; Morris, Joan K

    2013-10-01

    The aim of this study is to determine the survival of live births with trisomy 18 and trisomy 13 and their variants. Information on live births with trisomy 18 or trisomy 13 recorded in the National Down Syndrome Cytogenetic Register (NDSCR) was linked by the NHS Information Centre to obtain information about survival. Survival was known for 326 (88%) of live births with trisomy 18 and 142 (82%) of live births with trisomy 13 born in England and Wales between 2004 and 2011. The median survival time for live births with full trisomy 18 was 14 days and with full trisomy 13 was 10 days, the 3-month survival was 20% and 18%, respectively, and the 1-year survival for both syndromes was 8%. The 1-year survival for live births with trisomy 18 mosaicism (n = 17) was 70%, for those with trisomy 13 mosaicism (n = 5) was 80% and for those with partial trisomy 13 (Robertsonian translocations) (n = 17) was 29%. This study is based on the largest data set on survival for live births with trisomy 18 and trisomy 13. Although median survival for these children is 2 weeks or less, about one in five survive for 3 months or more and about 1 in 12 survive for 1 year or more. We suggest that these survival rates are used in counselling as well as the median survival time.

  7. Vincristine, adriamycin, and mitomycin (VAM) therapy for previously treated breast cancer. A preliminary report.

    Science.gov (United States)

    Oster, M W; Park, Y

    1983-01-15

    Fifteen patients with metastatic breast cancer previously treated with chemotherapy were treated with a regimen consisting of vincristine, Adriamycin, and mitomycin. Eleven patients (73%) responded with three complete and eight partial responses. The median duration of response was eight months. While all four nonresponders died within five months, the median duration of survival of responders was 18 months. Toxicity was significant but tolerable. Thus, this preliminary report suggests that this regimen is active in advanced previously treated breast cancer, providing meaningful remissions with acceptable toxicity.

  8. Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

    Science.gov (United States)

    Niessen, C.; Thumann, S.; Beyer, L.; Pregler, B.; Kramer, J.; Lang, S.; Teufel, A.; Jung, E. M.; Stroszczynski, C.; Wiggermann, P.

    2017-01-01

    Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests. The overall median survival time was 26.3 months; the median survival of patients with primary land secondary liver cancer did not significantly differ (26.8 vs. 19.9 months; p = 0.41). Patients with a tumor diameter >3 cm (p Child-Pugh class B or C cirrhosis died significantly earlier than patients with Child-Pugh class A (p < 0.05). Patients with very early stage HCC survived significantly longer than patients with early stage HCC with a median survival of 22.3 vs. 13.7 months (p < 0.05). PMID:28266600

  9. Video Denoising based on Stationary Wavelet Transform and Center Weighted Median Filter

    Directory of Open Access Journals (Sweden)

    Soundarya K

    2014-01-01

    Full Text Available Noise removal using wavelet has the characteristic of preserving signal uniqueness even if noise is going to be minimized. Images are getting corrupted by impulse noise during image acquisition and transmission. A new median filter termed as the center weighted median filter (CWMF in the wavelet coefficient domain combined with stationary wavelet transform (SWT is proposed for video denoising. This filter iteratively smoothes the noisy wavelet coefficients variances preserving the edge information contained in the large magnitude wavelet coefficients. This Paper deals with uncompressed video of .avi format. The proposed algorithm works well for suppressing Gaussian noise with noise density from 10 to 70% while preserving image details. Simulation results show that higher peak signal to noise ratio can be obtained as compared to other recent image denoising methods.

  10. Poisson noise reduction from X-ray images by region classification and response median filtering

    Indian Academy of Sciences (India)

    THAKUR KIRTI; KADAM JITENDRA; SAPKAL ASHOK

    2017-06-01

    Medical imaging is perturbed with inherent noise such as speckle noise in ultrasound, Poisson noise in X-ray and Rician noise in MRI imaging. This paper focuses on X-ray image denoising problem. X-ray image quality could be improved by increasing dose value; however, this may result in cell death or similar kinds of issues. Therefore, image processing techniques are developed to minimise noise instead of increasing dose value for patient safety. In this paper, usage of modified Harris corner point detector to predict noisy pixels and responsive median filtering in spatial domain is proposed. Experimentation proved that the proposed work performs better than simple median filter and moving average (MA) filter. The results are very close to non-local means Poisson noise filter which is one of the current state-of-the-art methods. Benefits of the proposed work are simple noise prediction mechanism, good visual quality and less execution time.

  11. Robust K-Median and K-Means Clustering Algorithms for Incomplete Data

    Directory of Open Access Journals (Sweden)

    Jinhua Li

    2016-01-01

    Full Text Available Incomplete data with missing feature values are prevalent in clustering problems. Traditional clustering methods first estimate the missing values by imputation and then apply the classical clustering algorithms for complete data, such as K-median and K-means. However, in practice, it is often hard to obtain accurate estimation of the missing values, which deteriorates the performance of clustering. To enhance the robustness of clustering algorithms, this paper represents the missing values by interval data and introduces the concept of robust cluster objective function. A minimax robust optimization (RO formulation is presented to provide clustering results, which are insensitive to estimation errors. To solve the proposed RO problem, we propose robust K-median and K-means clustering algorithms with low time and space complexity. Comparisons and analysis of experimental results on both artificially generated and real-world incomplete data sets validate the robustness and effectiveness of the proposed algorithms.

  12. Median and Morphological Specialized Processors for a Real-Time Image Data Processing

    Directory of Open Access Journals (Sweden)

    Kazimierz Wiatr

    2002-01-01

    Full Text Available This paper presents the considerations on selecting a multiprocessor MISD architecture for fast implementation of the vision image processing. Using the author′s earlier experience with real-time systems, implementing of specialized hardware processors based on the programmable FPGA systems has been proposed in the pipeline architecture. In particular, the following processors are presented: median filter and morphological processor. The structure of a universal reconfigurable processor developed has been proposed as well. Experimental results are presented as delays on LCA level implementation for median filter, morphological processor, convolution processor, look-up-table processor, logic processor and histogram processor. These times compare with delays in general purpose processor and DSP processor.

  13. Vector Nonlocal Euclidean Median: Principal Bundle Captures The Nature of Patch Space

    CERN Document Server

    Lin, Chen-Yun; Qi, Xin Jessica; Wu, Hau-Tieng

    2016-01-01

    We extensively study the rotational group structure inside the patch space by introducing the fiber bundle structure. The rotational group structure leads to a new image denoising algorithm called the \\textit{vector non-local Euclidean median} (VNLEM). The theoretical aspect of VNLEM is studied, which explains why the VNLEM and traditional non-local mean/non-local Euclidean median (NLEM) algorithm work. The numerical issue of the VNLEM is improved by taking the orientation feature in the commonly applied scale-invariant feature transform (SIFT), and a theoretical analysis of the robustness of the orientation feature in the SIFT is provided. The VNLEM is applied to an image database of 1,361 images and compared with the NLEM. Different image quality assessments based on the error-sensitivity or the human visual system are applied to evaluate the performance. The results confirmed the potential of the VNLEM algorithm.

  14. Effect of the Steindler procedure on the median nerve branches to the medial epicondylar muscles.

    Science.gov (United States)

    Chantelot, C; Feugas, C; Migaud, H; Guillem, F; Chapnikoff, D; Fontaine, C

    2000-06-01

    Usually the median nerve gives off six branches to the muscles arising from the medial epicondyle, which could be tightened during Steindler's procedure. We studied these branches before and after Steindler's procedure in 20 fresh cadavers and observed a considerable variation in the origin of the branches. The muscular branches arising from the median nerve did not seem to limit the mobilization of the medial epicondyle when performing Steindler's transfer. The limitation of the flexion observed after Steindler's procedure was mainly related to the tension of the transferred forearm flexor muscles. The variability of the origin of the branch to the flexor digitorum superficialis muscle could explain a lesion of this branch when Steindler's procedure is carried out with Brunelli's modification. The lateral transfer and the anterior transfer on to the humeral shaft did not influence the limitation of elbow flexion or result in tightness in any nerve branch to the transferred muscles.

  15. APPLICATION OF MEDIAN-EFFECT IN QUANTITATIVE ANALYSIS OF ANTITUMOR DRUGS IN VITRO

    Institute of Scientific and Technical Information of China (English)

    HE Song; SHEN Wei; SHEN Ding-ming

    2005-01-01

    Objective: To analyze quantitatively the synergistic and antagonistic effects of combined oxymatrine (OMT) and 5-fluorouracil (5-GU) on a cell line of human liver cancer (HepG2) with median-effect principle in vitro. Methods: The median-effect principle and MTT method were used in the quantitative analysis of effects of the two drugs. Results: Cytotoxic activity of the individual drugs enhanced as drug concentration increased. As fa=0.41, a CI equal to 1 indicated additivity; fa0.41, a CI greater than 1 indicated antagonism. The sequence of administration did not influence the cytotoxic activity of the combined antitumor drugs. The ratio of drug concentration was a factor that can influence the killing effect. Conclusion: The combined drugs interaction (CI<1) was synergistic at lower concentration and antagonistic at higher concentration. The ratio of drug concentration is a factor that can influence the killing effect.

  16. In uncertainty we trust: a median voter model with risk aversion

    Directory of Open Access Journals (Sweden)

    Pavel A. Yakovlev

    2011-12-01

    Full Text Available The principal-agent problem and uncertainty are some of the key factors affecting financial and political markets. Fear of the unknown plays an important role in human decision making, including voting. This article describes a theoretical model where voter risk aversion towards uncertainty gives political incumbents a significant advantage over their challengers, exacerbating the principal-agent problem between voters and legislators. The model presented predicts that a rise in voter uncertainty concerning the challenger allows the incumbent to deviate from the median voter’s policy preference without losing the election. This model reconciles the paradoxical coexistence of ideological shirking and high incumbent reelection rates without abandoning the elegant median voter framework.

  17. The Inverse 1-Median Problem on Tree Networks with Variable Real Edge Lengths

    Directory of Open Access Journals (Sweden)

    Longshu Wu

    2013-01-01

    Full Text Available Location problems exist in the real world and they mainly deal with finding optimal locations for facilities in a network, such as net servers, hospitals, and shopping centers. The inverse location problem is also often met in practice and has been intensively investigated in the literature. As a typical inverse location problem, the inverse 1-median problem on tree networks with variable real edge lengths is discussed in this paper, which is to modify the edge lengths at minimum total cost such that a given vertex becomes a 1-median of the tree network with respect to the new edge lengths. First, this problem is shown to be solvable in linear time with variable nonnegative edge lengths. For the case when negative edge lengths are allowable, the NP-hardness is proved under Hamming distance, and strongly polynomial time algorithms are presented under l1 and l∞ norms, respectively.

  18. Simultaneous estimation and variable selection in median regression using Lasso-type penalty.

    Science.gov (United States)

    Xu, Jinfeng; Ying, Zhiliang

    2010-06-01

    We consider the median regression with a LASSO-type penalty term for variable selection. With the fixed number of variables in regression model, a two-stage method is proposed for simultaneous estimation and variable selection where the degree of penalty is adaptively chosen. A Bayesian information criterion type approach is proposed and used to obtain a data-driven procedure which is proved to automatically select asymptotically optimal tuning parameters. It is shown that the resultant estimator achieves the so-called oracle property. The combination of the median regression and LASSO penalty is computationally easy to implement via the standard linear programming. A random perturbation scheme can be made use of to get simple estimator of the standard error. Simulation studies are conducted to assess the finite-sample performance of the proposed method. We illustrate the methodology with a real example.

  19. Digitaalisen markkinoinnin ja sosiaalisen median hyödyntäminen kampaamoalalla : Pienyritykset

    OpenAIRE

    Myllymäki, Hanna

    2016-01-01

    Tämän opinnäytetyön aiheena oli digitaalisen markkinoinnin ja sosiaalisen median hyödyntäminen kampaamoalalla, erityisesti pienissä yrityksissä. Tavoitteena oli opastaa lukijaa ymmärtämään digitaalisen markkinoinnin ja sosiaalisen median keskeisimmät perusteet ja antaa neuvoja parturi-kampaamoalan yrittäjälle, joka ei ole vielä huomioinut tai osannut hyödyntää niiden työkaluja. Työn teoriaosuudessa käsiteltiin mitä markkinointiviestintä on ja mitä sosiaalisen media on. Tämän lisäksi käsit...

  20. A study of median nerve entrapment neuropathy at wrist in uremic patients

    OpenAIRE

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy seen in uremic patients. The study was undertaken to estimate the frequency of CTS in uremic patients and to identify the most sensitive electrodiagnostic test. Study was conducted on 80 subjects of age 30–60 years. End-stage kidney disease patients were recruited for the clinical evaluation, motor nerve conduction studies (NCS), sensory NCS, F wave study and median-versus-ulnar comparison studies (palm-to-wrist mixed compa...

  1. Tractability results for the Double-Cut-and-Join circular median problem

    CERN Document Server

    Mahmoody-Ghaidary, Ahmad; Stacho, Ladislav

    2011-01-01

    The circular median problem in the Double-Cut-and-Join (DCJ) distance asks to find, for three given genomes, a fourth circular genome that minimizes the sum of the mutual distances with the three other ones. This problem has been shown to be NP-complete. We show here that, if the number of vertices of degree 3 in the breakpoint graph of the three input genomes is fixed, then the problem is tractable

  2. Kalman-median Compound Filter for Gaussian and Impulse Noise Reduction on Digital Images

    OpenAIRE

    山森, 一人; 山田, 義治; 相川, 勝

    2013-01-01

    This paper proposes an image restoration method from degraded images which include additive gaussian noise and impulse noise. This method tries to achieve image restoration by using combination of canonical state space model kalman filter and median filter. Kalman filter estimates internal state of a dynamic system based on system model. The canonical state space models are described by two equations; state equation that expresses a transition process of the region including the focusing pixe...

  3. Pudendal and median nerve sensory perception threshold: a comparison between normative studies.

    Science.gov (United States)

    Quaghebeur, Jörgen; Wyndaele, Jean Jacques

    2014-12-01

    For the evaluation of sensory innervation, normative data are necessary as a comparison. To compare our current perception thresholds (CPTs) with normative data from other research. Healthy volunteers were assessed for 2000, 250, and 5 Hz CPTs of the median and pudendal nerve and data were compared with other studies. Normative data in the studied group n = 41 (male: 21; female: 20) for the median nerve, 2 kHz, 250 Hz, and 5 Hz were respectively: 241.85 ± 67.72 (140-444); 106.27 ± 39.12 (45-229); 82.05 ± 43.40 (13-271). Pudendal nerve CPTs 250 Hz were: 126.44 ± 69.46 (6-333). For men 2 kHz: 349.95 ± 125.76 (100-588); 5 Hz: 132.67 ± 51.81 (59-249) and women 2 kHz:226.20 ± 119.65 (64-528); 5 Hz: 92.45 ± 44.66 (35-215). For the median nerve no statistical differences for gender were shown. For the pudendal nerve, only 250 Hz showed no difference for gender (t-test: 0.516). Comparison of our data with CPTs of other normative data showed no agreement for the pudendal nerve. For the median nerve only 2 kHz showed agreement in three studies and for 5 Hz with one study. Comparing normative data of multiple studies shows a variety of results and poor agreement. Therefore, referring to normative data of other studies should be handled with caution.

  4. Effective median sternotomy closure in high-risk open heart patients.

    Science.gov (United States)

    Bek, Eugene L; Yun, Kwok L; Kochamba, Gary S; Pfeffer, Thomas A

    2010-04-01

    We describe a novel surgical technique with a median sternotomy closure in high-risk open heart patients. In contrast to conventional sternal closure, in which sternal wires are passed through the intercostal space, the novel technique in sternal closure passes sternal wires transcostally or through costo-chondral joints. Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Functional connectivity of the dorsal and median raphe nuclei at rest

    OpenAIRE

    Beliveau, Vincent; Svarer, Claus; Frokjaer, Vibe G; Knudsen, Gitte M; Greve, Douglas N.; Fisher, Patrick M.

    2015-01-01

    Serotonin (5-HT) is a neurotransmitter critically involved in a broad range of brain functions and implicated in the pathophysiology of neuropsychiatric illnesses including major depression, anxiety and sleep disorders. Despite being widely distributed throughout the brain, there is limited knowledge on the contribution of 5-HT to intrinsic brain activity. The dorsal raphe (DR) and median raphe (MR) nuclei are the source of most serotonergic neurons projecting throughout the brain and thus pr...

  6. Single-stage repair of aortic coarctation and multiple concomitant cardiac lesions through a median sternotomy.

    Science.gov (United States)

    Kervan, Umit; Yurdakok, Okan; Genc, Bahadir; Ozen, Anil; Saritas, Ahmet; Kucuker, Seref Alp; Pac, Mustafa

    2013-01-01

    Through a median sternotomy, we performed a single-stage repair of severe aortic coarctation, ventricular septal defect, patent foramen ovale, and mitral valve insufficiency. The severe aortic coarctation was repaired by interposing a synthetic graft between the distal ascending aorta and the descending aorta. We first repaired the coarctation with the 38-year-old man on cardiopulmonary bypass, before aortic cross-clamping, in order to shorten the cross-clamp time.

  7. Carbon dioxide-laser microsurgical median glossotomy for resection of lingual dermoid cysts.

    Directory of Open Access Journals (Sweden)

    Kristien Corvers

    2016-07-01

    Full Text Available Dermoid cysts are epithelial-lined cavities with skin adnexae in the capsule. Only 7% present in the head and neck. Between 2004 and 2013, 4 patients with a lingual dermoid cyst underwent a microsurgical carbon dioxide (CO² laser resection via a median sagittal glossotomy approach. This approach is an elegant technique combining superior visualization, hemostasis, and little postoperative edema with good wound healing, allowing for perfect function preservation of the tongue.

  8. Design and Analysis of Salmonid Tagging Studies in the Columbia Basin, Volume VI; Assessment of Season-Wide Survival of Snake River Yearling Chinook Salmon, 1994-1996 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Skalski, John R.; Perez-Comas, Jose A. (University of Washington, School of Fisheries, Fisheries Research Institute, Seattle, WA); Smith, Steven G. (National Marine Fisheries Service, Northwest Fisheries Science Center, Seattle, WA)

    1998-06-01

    Project 8910700, Epidemiological Survival Methods, was developed to provide statistical guidance on design and analysis of PIT-tag (Passive Integrated Transponder) survival studies to the Northwest fisheries community.

  9. Sustained disease-free survival achieved with withdrawal of immunosuppression after rapid relapse of myelodysplastic syndrome following myeloablative allogeneic hematopoietic transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Hamilton Betty K

    2013-01-01

    Full Text Available Abstract Introduction Relapse after allogeneic hematopoietic stem cell transplantation in patients with myelodysplasia is a challenging problem with limited treatment options. Attempts to induce a graft-versus-leukemia effect have been used with limited success. In patients with myelodysplasia, sustained complete remissions have generally been limited to patients with long-term remission after transplant and those with low numbers of marrow blasts. Case presentation We report the case of a 41-year-old Caucasian woman with relapsed myelodysplastic syndrome and a high blast percentage six months after undergoing an allogeneic transplant who achieved a sustained complete remission after withdrawal of immunosuppression alone. Conclusion This case highlights the importance of a reasonable period of observation after withdrawing immunosuppression to induce graft-versus-leukemia, and the potential effectiveness of that approach.

  10. The prevalence of median neuropathy at wrist in systemic sclerosis patients at Srinagarind Hospital

    Directory of Open Access Journals (Sweden)

    Thanaporn Nimitbancha

    2015-01-01

    Full Text Available Objectives: To determine the prevalence and factor related with median neuropathy at wrist (MNW in systemic sclerosis patients. Study Design: Cross-sectional study. Setting: Srinagarind Hospital, Khon Kaen, Thailand. Participants: Systemic sclerosis patients who attended the Scleroderma Clinic, Srinagarind Hospital. Materials and Methods: Seventyfive systemic sclerosis patients were prospectively evaluated by questionnaire, physical examination, and electrodiagnostic study. The questionnaire consisted of the symptoms, duration, and type of systemic sclerosis. The physical examination revealed skin score of systemic sclerosis, pinprick sensation of median nerve distribution of both hands, and weakness of both abductor pollicis brevis muscles. The provocative test which were Tinel′s sign and Phalen′s maneuver were also examined. Moreover, electrodiagnostic study of the bilateral median and ulnar nerves was conducted. Results: The prevalence of MNW in systemic sclerosis patients was 44% - percentage of mild, moderate, and severe were 28%, 9.3%, and 6.7%, respectively. The prevalence of asymptomatic MNW was 88%. There were no association between the presence of MNW and related factors of systemic sclerosis. Conclusions: MNW is one of the most common entrapment neuropathies in systemic sclerosis patients. Systemic sclerosis patients should be screened for early signs of MNW.

  11. DEVELOPMENT OF A NEW RECURSIVE MEDIAN FILTERING SCHEME FOR PROCESSING POTENTIOMETER SIGNAL IN CSRDM OF PFBR

    Directory of Open Access Journals (Sweden)

    M. Mohana

    2012-07-01

    Full Text Available Prototype Fast Breeder Reactor (PFBR which is in advanced stage of construction at Kalpakkam has two shutdown systems, namely - Control & Safety Rod Drive Mechanisms (CSRDM and Diverse Safety Rod Drive Mechanisms (DSRDM. Since response time of Electromagnet (EM present in CSRDM is an important safety parameter, it is measured and monitored periodically. In PFBR, measurement of response time of EM is done by Current Decay method. An alternate approach to measure EM response time is Displacement Method, wherein it is proposed to utilise the existing potentiometer in CSRDM for position monitoring to measure EM response time. In light of this, a study was carried out to probe the feasibility of its implementation. To aid in the study, a new Recursive Median filtering scheme termed as ‘Multipass recursive median filter with variable window’ was developed to process the unconditioned potentiometer signal in Displacement method. EM response time obtained from Displacement Method and that obtained through Current decay method were found to be in good agreement with each other. This paper details the new Recursive Median filtering scheme developed.

  12. Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

    Science.gov (United States)

    Wilson, Katherine E.; Tat, Jimmy

    2017-01-01

    Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS) symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N). Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s) was significantly lower than flexed 30° (3.37 cm/s), flexed 15° (3.27 cm/s), and extended 30° (3.29 cm/s). Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s) than with force (3.56 cm/s). A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression.

  13. Duration of symptomatology and median segmental sensory latency in 993 carpal tunnel syndrome hands (668 cases

    Directory of Open Access Journals (Sweden)

    KOUYOUMDJIAN JOAO ARIS

    1999-01-01

    Full Text Available According to median sensory nerve action potential onset-latency to index finger in a 140 mm fixed distance, 993 carpal tunnel syndrome (CTS hands from 668 patients were grouped into MIld (3.0 to 3.5 ms, 384 hands, MOderate (3.6 to 4.4 ms, 332 hands, SEvere (> 4.4 ms, 135 hands and UNrecordable (142 hands and correlated with CTS symptomatology duration. All patients have sensory antidromic median-radial latency difference (MRD e > or = 1.0 ms without any doubt about CTS diagnosis. Patients with systemic disease, trauma or previous surgery were excluded. There is a remarkable cumulative percentage increase from 1 to 12 months in group UN (3.5% to 38.7%, 11 folds, much less than the group MI (13.8% to 54.6%, 3.9 folds. There is also a remarkable non-cumulative percentage increase in group UN, from 1 to 4-12 months; the group MI had a relatively uniform distribution in all symptomatic duration groups from 1 to > 60 months. The conclusion is that median nerve compression at carpal tunnel can lead to unrecordable potentials in a relatively short period from 1 to 12 months of evolution, suggesting acute/subacute deterioration. Electrophysiological evaluation must be done periodically in patients that underwent clinical treatment, since cumulative 38.7% of group UN was found in 12 months period.

  14. Mechanical comparison of monofilament nylon leader and orthopaedic wire for median sternotomy closure.

    Science.gov (United States)

    McCready, D J; Bell, J C; Ness, M G; Tarlton, J F

    2015-08-01

    To compare the mechanical properties of monofilament nylon leader and orthopaedic wire for median sternotomy closure in the dog. Median sternotomy was performed in 14 canine cadaver sternums with the manubrium intact. The sternotomy was closed with either 80 lb monofilament nylon leader or 20G orthopaedic stainless steel wire in a peristernal figure of 8 pattern. Constructs were loaded in a servohydraulic material testing machine. Load at yield, maximum load, stiffness, displacement and mode of failure were compared between constructs subjected to a single cycle load to failure. No significant differences were found in load at yield, maximum load, stiffness or displacement between the monofilament nylon leader and the stainless steel wire constructs. No implant failure was evident in the stainless steel wire constructs. Four of the monofilament nylon leader constructs failed by pulling of the nylon through the crimp. Monofilament nylon leader is mechanically comparable to stainless steel wire and potentially a suitable alternative for closure of median sternotomy in the dog. © 2015 British Small Animal Veterinary Association.

  15. A switching median filter with boundary discriminative noise detection for extremely corrupted images.

    Science.gov (United States)

    Ng, Pei-Eng; Ma, Kai-Kuang

    2006-06-01

    A novel switching median filter incorporating with a powerful impulse noise detection method, called the boundary discriminative noise detection (BDND), is proposed in this paper for effectively denoising extremely corrupted images. To determine whether the current pixel is corrupted, the proposed BDND algorithm first classifies the pixels of a localized window, centering on the current pixel, into three groups--lower intensity impulse noise, uncorrupted pixels, and higher intensity impulse noise. The center pixel will then be considered as "uncorrupted," provided that it belongs to the "uncorrupted" pixel group, or "corrupted." For that, two boundaries that discriminate these three groups require to be accurately determined for yielding a very high noise detection accuracy--in our case, achieving zero miss-detection rate while maintaining a fairly low false-alarm rate, even up to 70% noise corruption. Four noise models are considered for performance evaluation. Extensive simulation results conducted on both monochrome and color images under a wide range (from 10% to 90%) of noise corruption clearly show that our proposed switching median filter substantially outperforms all existing median-based filters, in terms of suppressing impulse noise while preserving image details, and yet, the proposed BDND is algorithmically simple, suitable for real-time implementation and application.

  16. Post-natal development of the median eminence of the guinea pig.

    Science.gov (United States)

    Silverman, A J; Desnoyers, P

    1975-11-01

    The ultrastructure of the median eminence of neonatal (newborn) 1-, 3-, 5-, and 10-day old) and adult guinea pigs was studied to determine the dynamic changes occurring in this structure during early life. At birth the portal vasculature consists of the Mantelplexus and a few, non-fenestrated capillary loops. The number of ansae and the degree of fenestration increase rapidly after birth. The abundance of cytoplasmic and ciliary projections into the ventricular recess and the large numbers of organelles indicate that the ependymal cells are more active in the neonatal period than in the adult male. Moreover, the ependymal endfeet cover most of the surface area of the primary portal plexus during this time. The neuronal layers of the median eminence are difficult to distinguish at birth due to the lack of myelinated fibers in the zona interna. Significant myelination appears on day 3 but is not complete until day 10. There is a progressive increase in the numbers of Herring bodies and large neuro-secretory granules (1,500-1,700 A) during this same time period. In the zona externa, few nerve terminals abut on the perivascular space until day 3. Increases in numbers of granules per axon profile were noted for each day after birth. Despite the relatively long gestation period of the guinea pig (68-72 days), the morphologic appearance of the median eminence at birth suggests that the neurovascular link controlling anterior pituitary function is not yet complete.

  17. A study of median nerve entrapment neuropathy at wrist in uremic patients.

    Science.gov (United States)

    Shende, V S; Sharma, R D; Pawar, S M; Waghmare, S N

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy seen in uremic patients. The study was undertaken to estimate the frequency of CTS in uremic patients and to identify the most sensitive electrodiagnostic test. Study was conducted on 80 subjects of age 30-60 years. End-stage kidney disease patients were recruited for the clinical evaluation, motor nerve conduction studies (NCS), sensory NCS, F wave study and median-versus-ulnar comparison studies (palm-to-wrist mixed comparison study, digit 4 sensory latencies study and lumbrical-interossei comparison study). Among three different diagnostic modalities, frequency of CTS was found to be 17.5% with clinical evaluation, 15% with routine NCS studies and 25% with median-versus-ulnar comparison studies. Among the median-versus-ulnar comparison studies, lumbrical-interossei comparison study was found to be most sensitive (90%). The comparative tests for CTS are more sensitive compared to routine NCS and clinical examination. Among the comparative tests, lumbrical-interossei comparison study is the most sensitive. Early diagnosis of CTS may help patients of uremia to seek proper treatment at an appropriate time.

  18. Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

    Directory of Open Access Journals (Sweden)

    Katherine E. Wilson

    2017-01-01

    Full Text Available Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N. Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s was significantly lower than flexed 30° (3.37 cm/s, flexed 15° (3.27 cm/s, and extended 30° (3.29 cm/s. Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s than with force (3.56 cm/s. A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression.

  19. Distributions of median nutrient and chlorophyll concentrations across the Red River Basin, USA.

    Science.gov (United States)

    Longing, D; Haggard, B E

    2010-01-01

    Acquisition and compilation of water-quality data for an 11-yr time period (1996-2006) from 589 stream and river stations were conducted to support nutrient criteria development for the multistate Red River Basin shared by Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. Ten water-quality parameters were collected from six data sources (USGS, Arkansas Department of Environmental Quality, Louisiana Department of Environmental Quality, Oklahoma Conservation Commission, Oklahoma Water Resources Board, and Texas Commission on Environmental Quality), and an additional 13 parameters were acquired from at least one source. Median concentrations of water-quality parameters were calculated at each individual station and frequency distributions (minimum, 10th, 25th, 50th, 75th, 90th percentiles, and maximum) of the median concentrations were calculated. Across the Red River Basin, median values for total nitrogen (TN), total phosphorus (TP), and sestonic chlorophyll-a (chl-a) ranged from water-quality parameters as the first step to support states in developing nutrient criteria to protect designated uses in the multijurisdictional Red River Basin.

  20. Median prior constrained TV algorithm for sparse view low-dose CT reconstruction.

    Science.gov (United States)

    Liu, Yi; Shangguan, Hong; Zhang, Quan; Zhu, Hongqing; Shu, Huazhong; Gui, Zhiguo

    2015-05-01

    It is known that lowering the X-ray tube current (mAs) or tube voltage (kVp) and simultaneously reducing the total number of X-ray views (sparse view) is an effective means to achieve low-dose in computed tomography (CT) scan. However, the associated image quality by the conventional filtered back-projection (FBP) usually degrades due to the excessive quantum noise. Although sparse-view CT reconstruction algorithm via total variation (TV), in the scanning protocol of reducing X-ray tube current, has been demonstrated to be able to result in significant radiation dose reduction while maintain image quality, noticeable patchy artifacts still exist in reconstructed images. In this study, to address the problem of patchy artifacts, we proposed a median prior constrained TV regularization to retain the image quality by introducing an auxiliary vector m in register with the object. Specifically, the approximate action of m is to draw, in each iteration, an object voxel toward its own local median, aiming to improve low-dose image quality with sparse-view projection measurements. Subsequently, an alternating optimization algorithm is adopted to optimize the associative objective function. We refer to the median prior constrained TV regularization as "TV_MP" for simplicity. Experimental results on digital phantoms and clinical phantom demonstrated that the proposed TV_MP with appropriate control parameters can not only ensure a higher signal to noise ratio (SNR) of the reconstructed image, but also its resolution compared with the original TV method.