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Sample records for short median survival

  1. Median survival time of patients after transcatheter chemo-embolization for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Haider, Z.; Haq, T.; Munir, K.; Usman, M.U.; Azeemuddin, M.

    2006-01-01

    Objective: To determine the effect on survival after trans arterial chemo embolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). Design: Longitudinal cohort study. Place and Duration of Study: Radiology Department, The Aga Khan University Hospital, Stadium Road, Karachi, from December 1997 to September 2005. Patients and Methods: Patients undergoing TACE procedure for HCC were prospectively followed. Forty three patients were enrolled from December 1997 to March 2003 in the study and subjected to chemo embolization therapy. Eight out of 43 patients were excluded from the study, who lost to follow-up. All the patients were followed till their death. Median and mean survival were calculated. Results: The median survival of these 35 patients was 410 days (13.6 months), with 95% confidence interval (236 days lower bound and 536 days upper bound). Mean survival time was 603 days (20.1 months) with 95% confidence interval (394 days lower bound and 812 days upper bound). There was significant difference in mean survival time (in days) by Child's Pugh class (X2 = 12.384; df=2, p-value=0.002). Conclusion: The study showed that TACE is an effective palliative treatment. TACE increases the median survival time. (author)

  2. Median Survival Time of Endometrial Cancer Patients with Lymphovascular Invasion at the Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Asyikeen, Wan Adnan Wan Nor; Siti-Azrin, Ab Hamid; Jalil, Nur Asyilla Che; Zin, Anani Aila Mat; Othman, Nor Hayati

    2016-11-01

    Endometrial cancer is the most common gynaecologic malignancy among females worldwide. The purpose of this study was to determine the median survival time of endometrial cancer patients at the Hospital Universiti Sains Malaysia (USM). A list of 121 endometrial cancer cases registered at Hospital USM between 2000 until 2011 was retrospectively reviewed. The survival time of the endometrial cancer patients was estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare the survival of the patients based on socio-demographics and clinical presentation. Only 108 patients, 87.0%, were included who were of Malay ethnicity. Previous history included menopause in 67.6% of patients and diabetes mellitus in 39.8% of patients; additionally, 63.4% of patients were nulliparous. Tumour staging was as follows: 24.5% stage I, 10.8% stage II, 26.5% stage III and 38.2% stage IV. The overall median survival time of the endometrial cancer patients was 70.20 months (95% confidence interval (CI): 51.79, 88.61). The significant factors were age, the presence of lymphovascular invasion and treatment received. The overall survival of endometrial cancer was low. A prospective study needs to be carried out to discover more effective and accurate tests for the early detection of endometrial cancer.

  3. 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.

  4. Cost per median overall survival month associated with abiraterone acetate and enzalutamide for treatment of patients with metastatic castration-resistant prostate cancer.

    Science.gov (United States)

    Pilon, Dominic; Queener, Marykay; Lefebvre, Patrick; Ellis, Lorie A

    2016-08-01

    To calculate costs per median overall survival (OS) month in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate plus prednisone (AA + P) or enzalutamide. Median treatment duration and median OS data from published Phase 3 clinical trials and prescribing information were used to calculate costs per median OS month based on wholesale acquisition costs (WACs) for patients with mCRPC treated with AA + P or enzalutamide. Sensitivity analyses were performed to understand how variations in treatment duration and treatment-related monitoring recommendations influenced cost per median OS month. Cost-effectiveness estimates of other Phase 3 trial outcomes were also explored: cost per month of chemotherapy avoided and per median radiographic progression-free survival (rPFS) month. The results demonstrated that AA + P has a lower cost per median OS month than enzalutamide ($3231 vs 4512; 28% reduction), based on the following assumptions: median treatment duration of 14 months for AA + P and 18 months for enzalutamide, median OS of 34.7 months for AA + P and 35.3 months for enzalutamide, and WAC per 30-day supply of $8007.17 for AA + P vs $8847.98 for enzalutamide. Sensitivity analyses showed that accounting for recommended treatment-related monitoring costs or assuming identical treatment durations for AA + P and enzalutamide (18 months) resulted in costs per median OS month 8-27% lower for AA + P than for enzalutamide. Costs per month of chemotherapy avoided were $4448 for AA + P and $5688 for enzalutamide, while costs per month to achieve median rPFS were $6794 for AA + P and $7963 for enzalutamide. This cost-effectiveness analysis demonstrated that costs per median OS month, along with costs of other Phase 3 trial outcomes, were lower for AA + P than for enzalutamide. The findings were robust to sensitivity analyses. These results have important implications

  5. Evaluation of median survival patients with acute lymphoblastic leukemia exposed ionizing radiation by the Chornobyl accident, depending on the aminoacid composition of stromal fibroblasts bone marrow and indicators of myelogram

    International Nuclear Information System (INIS)

    Bebeshko, V.G.; Bruslova, K.M.; Tsvjetkova, N.M.; Pushkar'ova, T.Yi.; Panchenko, L.M.; Yatsemirs'kij, S.N.; Volodyina, T.T.; Lyashenko, L.O.

    2015-01-01

    The aminoacid composition in the stromal fibroblasts of bone marrow and indexes of hemogram in children with acute lymphoblastic leukemias, which exposed to radiation from the Chornobyl accident, for evaluation of the median survival was investigated. In the study 54 patients with acute lymphoblastic leukemia, residents of Kyiv, Zhytomyr and Chernihiv regions of Ukraine were involved. Effectiveness of stromal fibroblasts colony forming units of bone marrow and aminoacid composition of fibroblasts were studied. Bone marrow examination was conducted on day 33 and after stop of chemotherapy, the median survival of patients and exposure dose were evaluated. In children with acute leukemias effectiveness of stromal fibroblasts of bone marrow was 2-2.3 times lower than normative. Correlation (r_s = +0.83) between the number of erythroid progenitor cells in the bone marrow and proline content in stromal fibroblasts established . The correlation between patients median survival and number of granulocytes in myelogram (r_s = + 0.82) was proven. Mean exposure doses in patients was (5.86 ±1.11) mSv and it did not correlate with myelogram results, effectiveness of stromal fibroblasts of bone marrow and median survival. The median survival of patients with acute leukemias depends on the content of amino acids in stromal fibroblasts of bone marrow and recover of hematopoiesis after chemotherapy

  6. The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma.

    NARCIS (Netherlands)

    Peeters, K.C.; Marijnen, C.A.; Nagtegaal, I.D.; Kranenbarg, E.K.; Putter, H.; Wiggers, T.; Rütten, H.; Pahlman, L.; Glimelius, B.; Leer, J.W.H.; Velde, C.J. van de

    2007-01-01

    OBJECTIVE: To investigate the efficacy of preoperative short-term radiotherapy in patients with mobile rectal cancer undergoing total mesorectal excision (TME) surgery. SUMMARY BACKGROUND DATA: Local recurrence is a major problem in rectal cancer treatment. Preoperative short-term radiotherapy has

  7. The TME trial after a median follow-up of 6 years - Increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma

    NARCIS (Netherlands)

    Peeters, Koen C. M. J.; Marijnen, Corrie A. M.; Nagtegaal, Iris D.; Kranenbarg, Elma Klein; Putter, Hein; Wiggers, Theo; Rutten, Harm; Pahlman, Lars; Glimelius, Bengt; Leer, Jan Willem; van de Velde, Cornelis J. H.

    2007-01-01

    Objective: To investigate the efficacy of preoperative short-term radiotherapy in patients with mobile rectal cancer undergoing total mesorectal excision (TME) surgery. Summary Background Data: Local recurrence is a major problem in rectal cancer treatment. Preoperative short-term radiotherapy has

  8. 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

  9. Short (

    NARCIS (Netherlands)

    Telleman, Gerdien; den Hartog, Laurens

    2013-01-01

    Aim: This systematic review assessed the implant survival rate of short (<10 mm) dental implants installed in partially edentulous patients. A case report of a short implant in the posterior region have been added. Materials and methods: A search was conducted in the electronic databases of MEDLINE

  10. Retrospective analysis of survival rates and marginal bone loss on short implants in the mandible.

    Science.gov (United States)

    Draenert, Florian G; Sagheb, Keyvan; Baumgardt, Katharina; Kämmerer, Peer W

    2012-09-01

    Short implants have become an interesting alternative to bone augmentation in dental implantology. Design of shorter implants and longer surveillance times are a current research issue. The goal of this study was to show the survival rates of short implants below 9 mm in the partly edentulous mandibular premolar and molar regions with fixed prosthetics. Marginal vertical and 2D bone loss was evaluated additionally. Different implant designs are orientationally evaluated. A total of 247 dental implants with fixed prosthetics (crowns and bridges) in the premolar and molar region of the mandible were evaluated; 47 implants were 9 mm or shorter. Patient data were evaluated to acquire implant survival rates, implant diameter, gender and age. Panoramic X-rays were analysed for marginal bone loss. Average surveillance time was 1327 days. Cumulative survival rate (CSR) of short implants was 98% (1 implants lost) compared to 94% in the longer implants group without significance. Thirty-five of the short implants were Astratech (0 losses) and 12 were Camlog Screw Line Promote Plus (1 loss). Early vertical and two-dimensional marginal bone loss was not significantly different in short and regular length implant group with an average of 0.6 mm and 0.7 mm(2) in short implants over the observation period. Within the limitations of this study, we conclude that short implants with a length of 9 mm or less have equal survival rates compared with longer implants over the observation period of 1-3 years. © 2011 John Wiley & Sons A/S.

  11. Differences between colon and rectal cancer in complications, short-term survival and recurrences.

    Science.gov (United States)

    van der Sijp, Max P L; Bastiaannet, Esther; Mesker, Wilma E; van der Geest, Lydia G M; Breugom, Anne J; Steup, Willem H; Marinelli, Andreas W K S; Tseng, Larissa N L; Tollenaar, Rob A E M; van de Velde, Cornelis J H; Dekker, J W T

    2016-10-01

    Many apparent differences exist in aetiology, genetics, anatomy and treatment response between colon cancer (CC) and rectal cancer (RC). This study examines the differences in patient characteristics, prevalence of complications and their effect on short-term survival, long-term survival and the rate of recurrence between RC and CC. For all stage II-III CC and RC patients who underwent resection with curative intent (2006-2008) in five hospitals in the Netherlands, occurrence of complications, crude survival, relative survival and recurrence rates were compared. A total of 767 CC and 272 RC patients underwent resection. Significant differences were found for age, gender, emergency surgery, T-stage and grade. CC patients experienced fewer complications compared to RC (p = 0.019), but CC patients had worse short-term mortality rates (1.5 versus 6.7 % for 30-day mortality, p = 0.001 and 5.2 versus 9.5 % for 90-day mortality, p = 0.032). The adjusted HR (overall survival) for CC patients with complications was 1.57 (1.23-2.01; p characteristics and clinical outcomes between CC and RC. CC patients have a significantly higher short-term mortality compared to RC patients due to a more severe effect of complications.

  12. The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Alexander Marschall

    Full Text Available To investigate the prognostic value of B-mode and Power Doppler (PD ultrasound of the median nerve for the short- and long-term clinical outcomes of patients with carpal tunnel syndrome (CTS.Prospective study of 135 patients with suspected CTS seen 3 times: at baseline, then at short-term (3 months and long-term (15-36 months follow-up. At baseline, the cross-sectional area (CSA of the median nerve was measured with ultrasound at 4 levels on the forearm and wrist. PD signals were graded semi-quantitatively (0-3. Clinical outcomes were evaluated at each visit with the Boston Questionnaire (BQ and the DASH Questionnaire, as well as visual analogue scales for the patient's assessment of pain (painVAS and physician's global assessment (physVAS. The predictive values of baseline CSA and PD for clinical outcomes were determined with multivariate logistic regression models.Short-term and long-term follow-up data were available for 111 (82.2% and 105 (77.8% patients, respectively. There was a final diagnosis of CTS in 84 patients (125 wrists. Regression analysis revealed that the CSA, measured at the carpal tunnel inlet, predicted short-term clinical improvement according to BQ in CTS patients undergoing carpal tunnel surgery (OR 1.8, p = 0.05, but not in patients treated conservatively. Neither CSA nor PD assessments predicted short-term improvement of painVAS, physVAS or DASH, nor was any of the ultrasound parameters useful for the prediction of long-term clinical outcomes.Ultrasound assessment of the median nerve at the carpal tunnel inlet may predict short-term clinical improvement in CTS patients undergoing carpal tunnel release, but long-term outcomes are unrelated to ultrasound findings.

  13. Sosiaalisen median mahdollisuudet Tilastokeskukselle

    OpenAIRE

    Vesterinen, Anu

    2011-01-01

    Tämän opinnäytetyön aiheena oli sosiaalisen median mahdollisuudet Tilastokeskuksen viestinnässä. Työn tavoitteena oli kartoittaa sosiaalisen median käyttöön liittyviä mahdollisuuksia ja haasteita sekä selvittää siihen liittyviä odotuksia Tilastokeskuksen henkilöstön keskuudessa. Työn teoriaosuudessa tarkasteltiin sosiaalista mediaa käsitteenä ja esiteltiin sosiaalisen median käyttöä organisaation ulkoisen viestinnän välineenä. Opinnäytetyössä selvitettiin teoriatietoon pohjautuen sekä ca...

  14. Functional Median Polish

    KAUST Repository

    Sun, Ying; Genton, Marc G.

    2012-01-01

    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

  15. Sosiaalisen median riskit yritysmaailmassa

    OpenAIRE

    Kilpinen, Joni

    2015-01-01

    Sosiaalisen median palveluista on kirjoitettu lukuisia kirjoja ja artikkeleita, joissa niitä ylistetään varsinkin yritysnäkökulmasta. Vaikka sosiaalinen media on muuttanut olennaisesti tapaa, jolla keskustella, mainostaa, etsiä ja jakaa tietoa, piilee sen palveluiden käytössä kuitenkin erilaisia uhkakuvia. Yritykset ja asiantuntijat pelkäävät sosiaalisen median avoimuuden aiheuttavan suuria tietoturvariskejä. Lisäksi asiantuntijat ovat varoitelleet sosiaalisessa mediassa olevista haittaohjelm...

  16. 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.

  17. Sosiaalisen median markkinointistrategia

    OpenAIRE

    Tran, Jenny

    2017-01-01

    Insinöörityön tavoitteena oli suunnitella toimeksiantajayritykselle sopiva sosiaalisen median markkinointistrategia ja avustaa sen toteutuksessa sekä tuottaen sisältöä sovittuihin kanaviin. Pyrkimyksenä oli myös kouluttaa yrityksen henkilökuntaa käyttämään sosiaalista mediaa yleisellä tasolla ja markkinoinnissa tutustuttamalla heidät sosiaalisen median erilaisiin kanaviin ja mainostyökaluihin. Opinnäytetyössä keskityttiin tutkimaan Facebookissa toimivaa markkinointia ja siinä toimivia mai...

  18. Gene expression profiling of canine osteosarcoma reveals genes associated with short and long survival times

    Directory of Open Access Journals (Sweden)

    Rao Nagesha AS

    2009-09-01

    Full Text Available Abstract Background Gene expression profiling of spontaneous tumors in the dog offers a unique translational opportunity to identify prognostic biomarkers and signaling pathways that are common to both canine and human. Osteosarcoma (OS accounts for approximately 80% of all malignant bone tumors in the dog. Canine OS are highly comparable with their human counterpart with respect to histology, high metastatic rate and poor long-term survival. This study investigates the prognostic gene profile among thirty-two primary canine OS using canine specific cDNA microarrays representing 20,313 genes to identify genes and cellular signaling pathways associated with survival. This, the first report of its kind in dogs with OS, also demonstrates the advantages of cross-species comparison with human OS. Results The 32 tumors were classified into two prognostic groups based on survival time (ST. They were defined as short survivors (dogs with poor prognosis: surviving fewer than 6 months and long survivors (dogs with better prognosis: surviving 6 months or longer. Fifty-one transcripts were found to be differentially expressed, with common upregulation of these genes in the short survivors. The overexpressed genes in short survivors are associated with possible roles in proliferation, drug resistance or metastasis. Several deregulated pathways identified in the present study, including Wnt signaling, Integrin signaling and Chemokine/cytokine signaling are comparable to the pathway analysis conducted on human OS gene profiles, emphasizing the value of the dog as an excellent model for humans. Conclusion A molecular-based method for discrimination of outcome for short and long survivors is useful for future prognostic stratification at initial diagnosis, where genes and pathways associated with cell cycle/proliferation, drug resistance and metastasis could be potential targets for diagnosis and therapy. The similarities between human and canine OS makes the

  19. The influence of scrotonin on survival of Candida guillermondii, irradiated by short-wave ultraviolet

    International Nuclear Information System (INIS)

    Strakhovskaya, M.G.; Frajkin, G.Ya.; Goncharenko, E.N.

    1982-01-01

    A study was made on the influence of serotonin on survival of Candida quilliermondu yeast irradiated by 254 nm short-wave ultraviolet. It was established that incubation with serotonin, leading to its penetration inside cells causes two opposite effects - protection from ultraviolet inactivation in preliminary incubation and intensification of cells death in postradiation incubation. Serotonin action is similar to the effects induced in C. guillermondii yeast by 334 nm long-wave ultraviolet light, that is serotonin possesses photomimetic effect. The data obtained are considered as conformaition of participation of serotonin photoinduced synthesis in manifestation of effects of long-wave ultraviolet light action on yeast

  20. FBLN4 as candidate gene associated with long-term and short-term survival with primary glioblastoma

    Directory of Open Access Journals (Sweden)

    Li F

    2017-01-01

    Full Text Available Fubin Li,1,* Yiping Li,1,* Kewei Zhang,1,* Ye Li,1,* Ping He,1,* Yujia Liu,1,* Hongyan Yuan,2,* Honghua Lu,1,* Jinxiang Liu,1,* Songtian Che,3,* Zhenju Li,4,* Li Bie1,5 1Department of Neurosurgery of the First Clinical Hospital, 2Department of Immunology, Norman Bethune College of Medicine, 3Department of Neurosurgery of the Second Clinical Hospital, 4Department of Neurosurgery of the Fourth Clinical Hospital, Jilin University, Changchun, People’s Republic of China; 5Department of Pathology and Laboratory Medicine, School of Medicine, University of California – Irvine, Irvine, CA, USA *These authors contributed equally to this work Background: Glioblastoma multiforme (GBM is the most common malignant and lethal type of primary central nervous system tumor in humans. In spite of its high lethality, a small percentage of patients have a relatively good prognosis, with median survival times of 36 months or longer. The identification of clinical subsets of GBM associated with distinct molecular genetic profiles has made it possible to design therapies tailored to treat individual patients. Methods: We compared microarray data sets from long-term survivors (LTSs and short-term survivors (STSs to screen for prognostic biomarkers in GBM patients using the WebArrayDB platform. We focused on FBLN4, IGFBP-2, and CHI3L1, all members of a group of 10 of the most promising, differentially regulated gene candidates. Using formalin-fixed paraffin-embedded GBM samples, we corroborated the relationship between these genes and patient outcomes using methylation-specific polymerase chain reaction (PCR for MGMT methylation status and quantitative reverse transcription PCR for expression of these genes. Results: Expression levels of the mRNAs of these 3 genes were higher in the GBM samples than in normal brain samples and these 3 genes were significantly upregulated in STSs compared to the levels in LTS samples (P<0.01. Furthermore, Kaplan–Meier analysis

  1. Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schmeel, Frederic Carsten; Simon, Birgit; Luetkens, Julian Alexander; Traeber, Frank; Schmeel, Leonard Christopher; Schild, Hans Heinz; Hadizadeh, Dariusch Reza [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Radiology, Bonn (Germany); Sabet, Amir [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Essen, Universitaet Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Ezziddin, Samer [University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universitaet Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Saarland, Universitaet des Saarlandes, Department of Nuclear Medicine, Homburg (Germany)

    2017-03-15

    To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with {sup 90}Yttrium-microspheres (SIRT). Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS. Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p < 0.001), hepatic tumour burden <50 % (8 vs. 5 months; p = 0.018), Eastern Cooperative Oncology Group performance scale <1 (10 vs. 4 months; p = 0.012) and progressive disease according to Response and Evaluation Criteria in Solid Tumours (8 vs. 3 months; p = 0.001). On multivariate analysis, optimal functional imaging response and hepatic tumour burden remained independent predictors of OS. Functional imaging response assessment using minADC changes on DWI may predict survival in CRC shortly after SIRT. (orig.)

  2. Short-term azithromycin treatment promotes cornea allograft survival in the rat.

    Science.gov (United States)

    Wacker, Katrin; Denker, Sophy; Hildebrand, Antonia; Eberwein, Philipp; Reinhard, Thomas; Schwartzkopff, Johannes

    2013-01-01

    Any inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. The purpose of this study is to analyze the anti-inflammatory effect of azithromycin (AZM) following experimental keratoplasty in rats. Corneal transplants were performed between Fisher-donor and Lewis-recipient rats. Recipients were postoperatively treated three times daily with AZM, miglyol, ofloxacin or dexamethasone eye drops. As an additional control, AZM was applied following syngeneic keratoplasty. Furthermore, short-term treatments with AZM for seven days perioperatively or with AZM only three days prior to the transplantation were compared to appropriate controls. All transplants were monitored clinically for opacity, edema, and vascularization. Infiltrating CD45(+), CD4(+), CD8(+), CD25(+), CD161(+) and CD163(+) cells were quantified via immunohistochemistry. AZM significantly promoted corneal graft survival compared with miglyol or ofloxacin treatment. This effect was comparable to topical dexamethasone. No adverse AZM effect was observed. Histology confirmed a significant reduction of infiltrating leukocytes. The short-term application of AZM for three days prior to transplantation or for seven days perioperatively reduced corneal graft rejection significantly compared with the controls. Along with antibiotic properties, topical AZM has a strong anti-inflammatory effect. Following keratoplasty, this effect is comparable to topical dexamethasone without the risk of steroid-induced adverse effects. Short-term treatment with AZM three days prior to the transplantation was sufficient to promote graft survival in the rat keratoplasty model. We therefore suggest further assessing the anti-inflammatory function of topical AZM following keratoplasty in humans.

  3. Short-term azithromycin treatment promotes cornea allograft survival in the rat.

    Directory of Open Access Journals (Sweden)

    Katrin Wacker

    Full Text Available Any inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. The purpose of this study is to analyze the anti-inflammatory effect of azithromycin (AZM following experimental keratoplasty in rats.Corneal transplants were performed between Fisher-donor and Lewis-recipient rats. Recipients were postoperatively treated three times daily with AZM, miglyol, ofloxacin or dexamethasone eye drops. As an additional control, AZM was applied following syngeneic keratoplasty. Furthermore, short-term treatments with AZM for seven days perioperatively or with AZM only three days prior to the transplantation were compared to appropriate controls. All transplants were monitored clinically for opacity, edema, and vascularization. Infiltrating CD45(+, CD4(+, CD8(+, CD25(+, CD161(+ and CD163(+ cells were quantified via immunohistochemistry.AZM significantly promoted corneal graft survival compared with miglyol or ofloxacin treatment. This effect was comparable to topical dexamethasone. No adverse AZM effect was observed. Histology confirmed a significant reduction of infiltrating leukocytes. The short-term application of AZM for three days prior to transplantation or for seven days perioperatively reduced corneal graft rejection significantly compared with the controls.Along with antibiotic properties, topical AZM has a strong anti-inflammatory effect. Following keratoplasty, this effect is comparable to topical dexamethasone without the risk of steroid-induced adverse effects. Short-term treatment with AZM three days prior to the transplantation was sufficient to promote graft survival in the rat keratoplasty model. We therefore suggest further assessing the anti-inflammatory function of topical AZM following keratoplasty in humans.

  4. 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...

  5. Survival of a planet in short-period Neptunian desert under effect of photoevaporation

    Science.gov (United States)

    Ionov, Dmitry E.; Pavlyuchenkov, Yaroslav N.; Shematovich, Valery I.

    2018-06-01

    Despite the identification of a great number of Jupiter-like and Earth-like planets at close-in orbits, the number of `hot Neptunes' - the planets with 0.6-18 times of Neptune mass and orbital periods less than 3 d - turned out to be very small. The corresponding region in the mass-period distribution was assigned as the `short-period Neptunian desert'. The common explanation of this fact is that the gaseous planet with few Neptune masses would not survive in the vicinity of host star due to intensive atmosphere outflow induced by heating from stellar radiation. To check this hypothesis, we performed numerical simulations of atmosphere dynamics for a hot Neptune. We adopt the previously developed self-consistent 1D model of hydrogen-helium atmosphere with suprathermal electrons accounted. The mass-loss rates as a function of orbital distances and stellar ages are presented. We conclude that the desert of short-period Neptunes could not be entirely explained by evaporation of planet atmosphere caused by the radiation from a host star. For the less massive Neptune-like planet, the estimated upper limits of the mass-loss may be consistent with the photoevaporation scenario, while the heavier Neptune-like planets could not lose the significant mass through this mechanism. We also found the significant differences between our numerical results and widely used approximate estimates of the mass-loss.

  6. Molecular profiling of short-term and long-term surviving patients identifies CD34 mRNA level as prognostic for glioblastoma survival

    DEFF Research Database (Denmark)

    Michaelsen, Signe Regner; Urup, Thomas; Olsen, Lars Rønn

    2018-01-01

    Despite extensive treatment, overall survival (OS) for glioblastoma (GBM) remains poor. A small proportion of patients present long survival over 3 years, but the underlying molecular background separating these long-term survivors (LTS) from short-term survivors (STS) are insufficiently understood....... Accordingly, study aim was to identify independent prognostic biomarkers for survival. Study cohort consisted of 93 primary GBM patients treated with radiation-, chemo- and bevacizumab therapy, among which 14 STS (OS ≤ 12 months) and 6 LTS (OS ≥ 36 months) were identified, all confirmed being IDH wild......-type. RNA expression levels in diagnostic tumor specimen for 792 genes were analyzed by NanoString technology. While no differences were found with regard to GBM subtype between LTS versus STS, comparative analysis of individual genes identified 14 significantly differently expressed candidate genes...

  7. Effects of low or high doses of short wavelength ultraviolet light (UVB) on Langerhans cells and skin allograft survival

    International Nuclear Information System (INIS)

    Odling, K.A.; Halliday, G.M.; Muller, H.K.

    1987-01-01

    Donor C57BL mouse shaved dorsal trunk or tail skin was exposed to high (200 mJ/cm 2 ) or low (40 mJ/cm 2 ) doses of short wavelength ultraviolet light (UVB) before grafting on to the thorax of BALB/c mouse recipients of the same sex. Skin grafted 1-14 days following a single high dose of UVB irradiation was ultrastructurally depleted of LC and survived significantly longer than unirradiated skin before being rejected. After a 21-day interval between exposure and grafting when LC were again present in the epidermis there was no significant difference between treated and control graft survival. Exposure to low dose UVB irradiation only significantly increased graft survival for skin transplanted 1-3 days after irradiation; skin grafted 4 days following irradiation survived for a similar period to unirradiated control skin grafts. Electronmicroscopy showed that the low UVB dose did not deplete LC from the epidermis. We conclude that after low dose UVB treatment the class II MHC antigens on the LC Plasma membrane were lost temporarily, thus prolonging graft survival, but when the plasma membrane antigens were re-expressed graft survival returned to normal. In contrast, high-dose UVB irradiation prolonged graft survival by depleting LC from the epidermis, with graft survival only returning to control values as LC repopulated the epidermis

  8. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses

    DEFF Research Database (Denmark)

    Christophersen, Mogens Teken; Dupont, Nana Hee; Berg-Sørensen, Kristina S.

    2014-01-01

    Background: Outcomes of colic treatment are of great interest to clinicians, horse owners and insurers. One commonly used criterion of success is the overall short-term survival rate. This is used as to compare treatments and to measure quality of veterinary care, but may be biased by demographic...... the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners ’ attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias...

  9. Radiobiological effects of tritiated water short-term exposure on V79 clonogenic cell survival

    DEFF Research Database (Denmark)

    Siragusa, Mattia; Fredericia, Nina Pil Møntegaard; Jensen, Mikael

    2018-01-01

    We set out to improve the accuracy of absorbed dose calculations for in-vitro measurements of the Relative Biological Effectiveness (RBE) of tritiated water (HTO) for the clonogenic cell survival assay, also considering the influence of the end-of-track Linear Energy Transfer (LET) of low-energy...... in suspension are usually comparable to those for adherent cells. RBEs calculated at the 10% survival fraction through the use of the average energy are almost similar to those obtained with the beta-spectrum. For adherent cells, an RBE of 1.6 was found when HTO cell survival curves were compared to acute γ...

  10. Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system.

    Science.gov (United States)

    Keegan, Theresa H M; Kurian, Allison W; Gali, Kathleen; Tao, Li; Lichtensztajn, Daphne Y; Hershman, Dawn L; Habel, Laurel A; Caan, Bette J; Gomez, Scarlett L

    2015-05-01

    We examined the combined influence of race/ethnicity and neighborhood socioeconomic status (SES) on short-term survival among women with uniform access to health care and treatment. Using electronic medical records data from Kaiser Permanente Northern California linked to data from the California Cancer Registry, we included 6262 women newly diagnosed with invasive breast cancer. We analyzed survival using multivariable Cox proportional hazards regression with follow-up through 2010. After consideration of tumor stage, subtype, comorbidity, and type of treatment received, non-Hispanic White women living in low-SES neighborhoods (hazard ratio [HR] = 1.28; 95% confidence interval [CI] = 1.07, 1.52) and African Americans regardless of neighborhood SES (high SES: HR = 1.44; 95% CI = 1.01, 2.07; low SES: HR = 1.88; 95% CI = 1.42, 2.50) had worse overall survival than did non-Hispanic White women living in high-SES neighborhoods. Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival. Strategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients.

  11. Impact of short course hormonal therapy on overall and cancer specific survival after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Beyer, David C.; McKeough, Timothy; Thomas, Theresa

    2005-01-01

    Purpose: To review the impact of prior hormonal therapy on 10-year overall and prostate cancer specific survival after primary brachytherapy. Methods and Materials: A retrospective review was performed on the Arizona Oncology Services tumor registry for 2,378 consecutive permanent prostate brachytherapy cases from 1988 through 2001. Hormonal therapy was administered before the implant in 464 patients for downsizing of the prostate or at the discretion of the referring physician. All deceased patients with known clinical recurrence were considered to have died of prostate cancer, irrespective of the immediate cause of death. Risk groups were defined, with 1,135 favorable (prostate-specific antigen [PSA] 70 years (p = 0.0013), Gleason score ≥ 7 (p = 0.0005), and prior hormone use (p = 0.0065) on overall survival. Conclusions: At 10 years, in prostate cancer patients receiving brachytherapy, overall survival is worse in men receiving neoadjuvant hormonal therapy, compared with hormone naive patients. This does not appear to be due to other known risk factors for survival (i.e., stage, grade, PSA, age) on multivariate analysis. The leading causes of death were cardiovascular, prostate cancer, and other cancers with no obvious discrepancy between the two groups. This finding is unexpected and requires confirmation from other centers

  12. Effect of initial lactate level on short-term survival in patients with out-of-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Tuba Sarıaydın, MD

    2017-12-01

    Full Text Available Purpose: This study evaluated whether serum lactate levels (SLL at admission in patients with cardiac arrest (CA can predict successful return of spontaneous circulation (ROSC or short-term survival, especially within the first 24 h. Materials and methods: This prospective, observational study was conducted in the emergency department (ED of a training and research hospital from April 2015 through February 2016. It included all patients older than 18 years who presented to the ED during the study period with non-traumatic out-of-hospital cardiac arrest (OHCA. The study measured two outcomes: whether ROSC was achieved and whether short-term survival was achieved. ROSC was defined as the presence of spontaneous circulation for the first hour after cardiopulmonary resuscitation (CPR. Survival was defined as having survived for a minimum of 24 h after ROSC. Results: The study included 140 patients who were admitted to the ED with OHCA. ROSC was achieved in 55 patients (39.3%, and survival for 24 h following CA was achieved in 42 patients (30%. The mean SLL in the ROSC (+ and ROSC (- groups were 9.1 ± 3.2 mmol/L and 9.8 ± 2.9 mmol/L, respectively. The mean SLL in the survivor and non-survivor groups were 8.6 ± 2.9 mmol/L and 10 ± 3.1 mmol/L, respectively. These differences were not statistically significant (p = 0.1. A multivariate regression model assessing the factors that predicted both ROSC and 24-h survival showed the odds ratio (OR of initial SLL was 1.3 (95% CI: 1.05–1.6 and 1.1 (95% CI: 0.9–1.3, respectively. Conclusions: This study showed that in OHCA patients, SLL on admission was not associated with increased ROSC achievement or 24-h survival. Keywords: Cardiac arrest, Out-of-hospital cardiac arrest (OHCA, Return of spontaneous circulation (ROSC, Serum lactate, Emergency department

  13. 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 .

  14. Brown Trout removal effects on short-term survival and movement of Myxobolus cerebralis-resistant rainbow trout

    Science.gov (United States)

    Fetherman, Eric R.; Winkelman, Dana L.; Bailey, Larissa L.; Schisler, George J.; Davies, K.

    2015-01-01

    Following establishment of Myxobolus cerebralis (the parasite responsible for salmonid whirling disease) in Colorado, populations of Rainbow Trout Oncorhynchus mykissexperienced significant declines, whereas Brown Trout Salmo trutta densities increased in many locations across the state, potentially influencing the success of M. cerebralis-resistant Rainbow Trout reintroductions. We examined the effects of Brown Trout removal on the short-term (3-month) survival and movement of two crosses of reintroduced, M. cerebralis-resistant Rainbow Trout in the Cache la Poudre River, Colorado. Radio frequency identification passive integrated transponder tags and antennas were used to track movements of wild Brown Trout and stocked Rainbow Trout in reaches where Brown Trout had or had not been removed. Multistate mark–recapture models were used to estimate tagged fish apparent survival and movement in these sections 3 months following Brown Trout removal. A cross between the German Rainbow Trout and Colorado River Rainbow Trout strains exhibited similar survival and movement probabilities in the reaches, suggesting that the presence of Brown Trout did not affect its survival or movement. However, a cross between the German Rainbow Trout and Harrison Lake Rainbow Trout exhibited less movement from the reach in which Brown Trout had been removed. Despite this, the overall short-term benefits of the removal were equivocal, suggesting that Brown Trout removal may not be beneficial for the reintroduction of Rainbow Trout. Additionally, the logistical constraints of conducting removals in large river systems are substantial and may not be a viable management option in many rivers.

  15. Sodium nitroprusside enhanced cardiopulmonary resuscitation improves short term survival in a porcine model of ischemic refractory ventricular fibrillation.

    Science.gov (United States)

    Yannopoulos, Demetris; Bartos, Jason A; George, Stephen A; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P

    2017-01-01

    Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. SNPeCPR will increase short term (4-h) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5min. Basic life support was performed for 10min. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3min. CPR continued for a total of 45min, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60min, if unsuccessful. SNPeCPR animals received 2mg of SNP at minute 10 followed by 1mg every 5min until ROSC. Standard ACLS animals received 0.5mg epinephrine every 5min until ROSC. Primary endpoints were ROSC and 4-h survival. All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-h survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. SNPeCPR significantly improved ROSC and 4-h survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Short-Term and Long-Term Survival and Virulence of Legionella pneumophila in the Defined Freshwater Medium Fraquil.

    Directory of Open Access Journals (Sweden)

    Nilmini Mendis

    Full Text Available Legionella pneumophila (Lp is the etiological agent responsible for Legionnaires' disease, a potentially fatal pulmonary infection. Lp lives and multiplies inside protozoa in a variety of natural and man-made water systems prior to human infection. Fraquil, a defined freshwater medium, was used as a highly reproducible medium to study the behaviour of Lp in water. Adopting a reductionist approach, Fraquil was used to study the impact of temperature, pH and trace metal levels on the survival and subsequent intracellular multiplication of Lp in Acanthamoeba castellanii, a freshwater protozoan and a natural host of Legionella. We show that temperature has a significant impact on the short- and long-term survival of Lp, but that the bacterium retains intracellular multiplication potential for over six months in Fraquil. Moreover, incubation in Fraquil at pH 4.0 resulted in a rapid decline in colony forming units, but was not detrimental to intracellular multiplication. In contrast, variations in trace metal concentrations had no impact on either survival or intracellular multiplication in amoeba. Our data show that Lp is a resilient bacterium in the water environment, remaining infectious to host cells after six months under the nutrient-deprived conditions of Fraquil.

  17. Enriched enteral nutrition may improve short-term survival in stage IV gastric cancer patients: A randomized, controlled trial.

    Science.gov (United States)

    Klek, Stanislaw; Scislo, Lucyna; Walewska, Elzbieta; Choruz, Ryszard; Galas, Aleksander

    2017-04-01

    The aim of the study was to determine whether the postoperative use of enteral nutrition enriched with arginine, glutamine, and omega-3 fatty acids influences survival in patients diagnosed with stomach cancer. For the purpose of the study, the second wave of the trial performed in 2003 to 2009 was done. Ninety-nine patients who underwent surgery for gastric cancer (27 F, 72 M, mean age: 62.9 y) met the inclusion criteria. Of those, 54 were randomized to standard and 45 to enriched enteral nutrition (EEN). In all patients, short- and long-term (5 y) survival was analyzed. Analysis of the overall survival time did not reveal differences between groups (P = 0.663). Until the end of the third month, however, there were nine deaths in the standard enteral nutrition group and no deaths in the EEN group (16.7% versus 0.0%, P = 0.004). The univariate analyses suggested that the EEN group may have lower risk, especially during the first year after intervention. A significant reduction in the risk of death was seen during the early period after surgery (first 6 mo) in the EEN group in stage IV patients (hazard ratio = 0.25, P = 0.049). The use of enriched enteral diet did not influence, however, the risk of dying when patients were analyzed together. The study does not support the beneficial effect of enriched enteral nutrition in long-term survival; however, the positive impact on the stage IV patients suggests the need for further, more detailed studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Short-term cessation of sex work and injection drug use: evidence from a recurrent event survival analysis.

    Science.gov (United States)

    Gaines, Tommi L; Urada, Lianne A; Martinez, Gustavo; Goldenberg, Shira M; Rangel, Gudelia; Reed, Elizabeth; Patterson, Thomas L; Strathdee, Steffanie A

    2015-06-01

    This study quantitatively examined the prevalence and correlates of short-term sex work cessation among female sex workers who inject drugs (FSW-IDUs) and determined whether injection drug use was independently associated with cessation. We used data from FSW-IDUs (n=467) enrolled into an intervention designed to increase condom use and decrease sharing of injection equipment but was not designed to promote sex work cessation. We applied a survival analysis that accounted for quit-re-entry patterns of sex work over 1-year stratified by city, Tijuana and Ciudad Juarez, Mexico. Overall, 55% of participants stopped sex work at least once during follow-up. Controlling for other characteristics and intervention assignment, injection drug use was inversely associated with short-term sex work cessation in both cities. In Ciudad Juarez, women receiving drug treatment during follow-up had a 2-fold increase in the hazard of stopping sex work. In both cities, income from sources other than sex work, police interactions and healthcare access were independently and significantly associated with shorter-term cessation. Short-term sex work cessation was significantly affected by injection drug use. Expanded drug treatment and counseling coupled with supportive services such as relapse prevention, job training, and provision of alternate employment opportunities may promote longer-term cessation among women motivated to leave the sex industry. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Median mental sinus in twins.

    Science.gov (United States)

    Ong, S T; Ngeow, W C

    1999-05-01

    Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection.

  20. The effect of retraining of nurses on cardiopulmonary resuscitationsuccess rate and short-term and long-term survival in patients revived

    Directory of Open Access Journals (Sweden)

    Dahi M

    2015-02-01

    Full Text Available Background and Objective: Cardiopulmonary resuscitation (CPR is performed in order to restore the functioning of two most important body organs the heart and brain. The present study was performed to investigate the effect of retraining of nurses on CPR success rate and short-term and long-term CPR survival. Materials and Method: The study population of the present quasi-experimental study consisted of all nurses of Taleghani Hospital affiliated with Shahid Beheshti University, Tehran, Iran, in 2011. The study subjects (n = 400 were selected using convenience and purposive sampling method. The patient survival rate during the first 24 hours (short-term survival and discharge from the hospital (long-term survival after CPR were reported. Then, the study subjects, in groups of 20, participated in CPR training courses. Short-term (24 hours and long-term (discharge from hospital in good mental status survival subsequent to CPR were reevaluated and compared with pre-training results. Data were analyzed using SPSS software version 20, and t-test and chi-square test. Results: Retraining promoted CPR success rates. This increase in the short-term success rate was not significant, but the increase in long-term success rate was statistically significant (P = 0.007. Conclusion: Periodic retraining of nurses may improve CPR success rate particularly long-term survival or discharge from hospital. Therefore, further studies on long-term success of CPR considering confounding factors are recommended

  1. Predicting short-term mortality and long-term survival for hospitalized US patients with alcoholic hepatitis.

    Science.gov (United States)

    Cuthbert, Jennifer A; Arslanlar, Sami; Yepuri, Jay; Montrose, Marc; Ahn, Chul W; Shah, Jessica P

    2014-07-01

    No study has evaluated current scoring systems for their accuracy in predicting short and long-term outcome of alcoholic hepatitis in a US population. We reviewed electronic records for patients with alcoholic liver disease (ALD) admitted to Parkland Memorial Hospital between January 2002 and August 2005. Data and outcomes for 148 of 1,761 admissions meeting pre-defined criteria were collected. The discriminant function (DF) was revised (INRdf) to account for changes in prothrombin time reagents that could potentially affect identification of risk using the previous DF threshold of >32. Admission and theoretical peak scores were calculated by use of the Model for End-stage Liver Disease (MELD). Analysis models compared five different scoring systems. INRdf was closely correlated with the old DF (r (2) = 0.95). Multivariate analysis of the data showed that survival for 28 days was significantly associated with a scoring system using a combination of age, bilirubin, coagulation status, and creatinine (p short-term mortality (p 50 % mortality at four weeks and >80 % mortality at six months without specific treatment.

  2. Median forehead flap - beyond classic indication

    Directory of Open Access Journals (Sweden)

    Cristian R. Jecan

    2016-11-01

    Full Text Available Introduction. The paramedian forehead flap is one of the best options for reconstruction of the median upper two-thirds of the face due to its vascularity, color, texture match and ability to resurface all or part of the reconstructed area. The forehead flap is the gold standard for nasal soft tissue reconstruction and the flap of choice for larger cutaneous nasal defects having a robust pedicle and large amount of tissue. Materials and Methods. We are reporting a clinical series of cutaneous tumors involving the nose, medial canthus, upper and lower eyelid through a retrospective review of 6 patients who underwent surgical excision of the lesion and primary reconstruction using a paramedian forehead flap. Results. The forehead flap was used for total nose reconstruction, eyelids and medial canthal reconstruction. All flaps survived completely and no tumor recurrence was seen in any of the patients. Cosmetic and functional results were favorable. Conclusions. The forehead flap continues to be one of the best options for nose reconstruction and for closure of surgical defects of the nose larger than 2 cm. Even though is not a gold standard, median forehead flap can be an advantageous technique in periorbital defects reconstruction.

  3. Effect of BRCA1/2 mutation on short-term and long-term breast cancer survival: a systematic review and meta-analysis.

    Science.gov (United States)

    Lee, Eun-Ha; Park, Sue K; Park, Boyoung; Kim, Sung-Won; Lee, Min Hyuk; Ahn, Sei Hyun; Son, Byung Ho; Yoo, Keun-Young; Kang, Daehee

    2010-07-01

    Reports of BRCA genetic mutations and risk of death or recurrence are inconsistent. This study aimed to compare overall and disease-free breast cancer survival rates between BRCA1/2 mutation carriers and non-carriers for short-term and long-term outcomes separately. We searched the PUBMED and EMBASE databases and retrieved 452 articles using keywords that included breast cancer, BRCA mutation, and survival. Seventeen articles were selected for systematic review and among them 11 were included in our meta-analysis. We used the random-effects model to calculate the summary hazard ratio and corresponding 95% confidence interval. BRCA1 mutation carriers had significantly lower short-term and long-term overall survival rates (OSR) relative to non-carriers (HR = 1.92 [95% CI = 1.45-2.53]; 1.33 [1.12-1.58], respectively), while both short-term and long-term OSR of BRCA2 carriers did not differ from non-carriers (HR = 1.30 [95% CI = 0.95-1.76]; 1.12 [95% CI = 0.86-1.45], respectively). For short-term progression-free survival rate (PFSR), BRCA1 mutation carriers had a significantly lower rate than non-carriers (HR = 1.54 [95% CI = 1.12-2.12]), while BRCA2 mutation carriers had a similar PFSR (HR = 1.23 [95% CI = 0.96-1.58]). For long-term PFSRs, we found no significant results. Our results suggest that BRCA1 mutation decreases short-term and long-term OSRs and short-term PFSR, however, BRCA2 mutation does not affect either short-term or long-term survival rate, which is attributed to the different carcinogenic pathways for BRCA1 and BRCA2.

  4. Survival and death of seeds during liquid nitrogen storage: a case study on seeds with short lifespans.

    Science.gov (United States)

    Ballesteros, D; Pence, V C

    The low temperature of liquid nitrogen is assumed to stop ageing and preserve viability indefinitely, however there are few validating data sets. The use of seeds to test these assumptions is important because other cryopreserved systems lack quantitative measures of viability to allow comparisons among timed points. To evaluate survival of a collection of seeds with short lifespans stored 12-20 years in liquid nitrogen. Seeds from 11 species (26 accessions) were removed from cryostorage and evaluated for germination and normal growth. Germination of Plantago cordata and Betula spp. seeds did not decrease significantly during cryostorage. However, Populus deltoides and most Salix spp. accessions showed a significant decrease in germination, with further loss observed when P. deltoides seedlings were followed to the young plant stage. Seeds of initial low quality showed greater deterioration during cryostorage. Cryostorage maintained viability of Salix and Populus seeds longer than other temperatures. However, ageing was not completely stopped and seed longevity was shorter than that predicted for many other species. A high initial seed quality is important in order to obtain the maximum benefit of cryostorage.

  5. Radiomic features from the peritumoral brain parenchyma on treatment-naive multi-parametric MR imaging predict long versus short-term survival in glioblastoma multiforme: Preliminary findings

    Energy Technology Data Exchange (ETDEWEB)

    Prasanna, Prateek; Patel, Jay; Madabhushi, Anant; Tiwari, Pallavi [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States); Partovi, Sasan [University Hospitals Case Medical Center, Case Western Reserve School of Medicine, Cleveland, OH (United States)

    2017-10-15

    Despite 90 % of glioblastoma (GBM) recurrences occurring in the peritumoral brain zone (PBZ), its contribution in patient survival is poorly understood. The current study leverages computerized texture (i.e. radiomic) analysis to evaluate the efficacy of PBZ features from pre-operative MRI in predicting long- (>18 months) versus short-term (<7 months) survival in GBM. Sixty-five patient examinations (29 short-term, 36 long-term) with gadolinium-contrast T{sub 1w}, FLAIR and T{sub 2w} sequences from the Cancer Imaging Archive were employed. An expert manually segmented each study as: enhancing lesion, PBZ and tumour necrosis. 402 radiomic features (capturing co-occurrence, grey-level dependence and directional gradients) were obtained for each region. Evaluation was performed using threefold cross-validation, such that a subset of studies was used to select the most predictive features, and the remaining subset was used to evaluate their efficacy in predicting survival. A subset of ten radiomic 'peritumoral' MRI features, suggestive of intensity heterogeneity and textural patterns, was found to be predictive of survival (p = 1.47 x 10{sup -5}) as compared to features from enhancing tumour, necrotic regions and known clinical factors. Our preliminary analysis suggests that radiomic features from the PBZ on routine pre-operative MRI may be predictive of long- versus short-term survival in GBM. (orig.)

  6. Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock.

    Science.gov (United States)

    Garan, A Reshad; Eckhardt, Christina; Takeda, Koji; Topkara, Veli K; Clerkin, Kevin; Fried, Justin; Masoumi, Amirali; Demmer, Ryan T; Trinh, Pauline; Yuzefpolskaya, Melana; Naka, Yoshifumi; Burkhoff, Dan; Kirtane, Ajay; Colombo, Paolo C; Takayama, Hiroo

    2017-11-01

    Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied. We collected acute myocardial infarction details with demographic and hemodynamic variables. Primary outcomes were survival to discharge and recovery from MCSD (i.e. survival without heart replacement therapy including durable ventricular assist device or heart transplant). One hundred and twenty-four patients received extra-corporeal membrane oxygenation or short-term surgical ventricular assist device following acute myocardial infarction from 2007 to 2016; 89 received extra-corporeal membrane oxygenation and 35 short-term ventricular assist device. Fifty-five (44.4%) died in the hospital and 69 (55.6%) survived to discharge. Twenty-six (37.7%) required heart replacement therapy (four transplant, 22 durable ventricular assist device) and 43 (62.3%) were discharged without heart replacement therapy. Age and cardiac index at MCSD implantation were predictors of survival to discharge; patients over 60 years with cardiac index <1.5 l/min per m 2 had a low likelihood of survival. The angiographic result after revascularization predicted recovery from MCSD (odds ratio 9.00, 95% confidence interval 2.45-32.99, p=0.001), but 50% of those optimally revascularized still required heart replacement therapy. Cardiac index predicted recovery from MCSD among this group (odds ratio 4.06, 95% confidence interval 1.45-11.55, p=0.009). Among AMI-CS patients requiring short-term MCSDs, age and cardiac index predict survival to discharge. Angiographic result and cardiac index predict ventricular recovery but 50

  7. Five Roots Pattern of Median Nerve Formation

    Directory of Open Access Journals (Sweden)

    Konstantinos Natsis

    2016-04-01

    Full Text Available An unusual combination of median nerve’s variations has been encountered in a male cadaver during routine educational dissection. In particular, the median nerve was formed by five roots; three roots originated from the lateral cord of the brachial plexus joined individually the median nerve’s medial root. The latter (fourth root was united with the lateral (fifth root of the median nerve forming the median nerve distally in the upper arm and not the axilla as usually. In addition, the median nerve was situated medial to the brachial artery. We review comprehensively the relevant variants, their embryologic development and their potential clinical applications.

  8. The Ultrasonographic Findings of Bifid Median Nerve

    International Nuclear Information System (INIS)

    Park, Hee Jin; Park, Noh Hyuck; Joh, Joon Hee; Lee, Sung Moon

    2009-01-01

    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 (ΔCSA) 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. ΔCSA 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

  9. MEDIAN: Wireless broadband LAN for multimedia applications

    NARCIS (Netherlands)

    Vliet, P.J. van

    1998-01-01

    MEDIAN is one of the projects in the mobile domain of the Advanced Communications Technologies and Services (ACTS) programme of the European Commission. The main obiective of the MEDIAN project is to evaluate and implement a high speed Wireless Customer Premises / Local Area Network (WCPN/WLAN)

  10. Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

    Science.gov (United States)

    Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

    2011-01-01

    A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

  11. Short-term exposure to predation affects body elemental composition, climbing speed and survival ability in Drosophila melanogaster

    Directory of Open Access Journals (Sweden)

    Indrikis Krams

    2016-08-01

    Full Text Available Factors such as temperature, habitat, larval density, food availability and food quality substantially affect organismal development. In addition, risk of predation has a complex impact on the behavioural and morphological life history responses of prey. Responses to predation risk seem to be mediated by physiological stress, which is an adaptation for maintaining homeostasis and improving survivorship during life-threatening situations. We tested whether predator exposure during the larval phase of development has any influence on body elemental composition, energy reserves, body size, climbing speed and survival ability of adult Drosophila melanogaster. Fruit fly larvae were exposed to predation by jumping spiders (Phidippus apacheanus, and the percentage of carbon (C and nitrogen (N content, extracted lipids, escape response and survival were measured from predator-exposed and control adult flies. The results revealed predation as an important determinant of adult phenotype formation and survival ability. D. melanogaster reared together with spiders had a higher concentration of body N (but equal body C, a lower body mass and lipid reserves, a higher climbing speed and improved adult survival ability. The results suggest that the potential of predators to affect the development and the adult phenotype of D. melanogaster is high enough to use predators as a more natural stimulus in laboratory experiments when testing, for example, fruit fly memory and learning ability, or when comparing natural populations living under different predation pressures.

  12. Switching non-local median filter

    Science.gov (United States)

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

    2015-06-01

    This paper describes a novel image filtering method for removal of random-valued impulse noise superimposed on grayscale images. Generally, it is well known that switching-type median filters are effective for impulse noise removal. In this paper, we propose a more sophisticated switching-type impulse noise removal method in terms of detail-preserving performance. Specifically, the noise detector of the proposed method finds out noise-corrupted pixels by focusing attention on the difference between the value of a pixel of interest (POI) and the median of its neighboring pixel values, and on the POI's isolation tendency from the surrounding pixels. Furthermore, the removal of the detected noise is performed by the newly proposed median filter based on non-local processing, which has superior detail-preservation capability compared to the conventional median filter. The effectiveness and the validity of the proposed method are verified by some experiments using natural grayscale images.

  13. MEAN OF MEDIAN ABSOLUTE DERIVATION TECHNIQUE MEAN ...

    African Journals Online (AJOL)

    eobe

    development of mean of median absolute derivation technique based on the based on the based on .... of noise mean to estimate the speckle noise variance. Noise mean property ..... Foraging Optimization,” International Journal of. Advanced ...

  14. 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...

  15. Effect of timing and duration of a single chest compression pause on short-term survival following prolonged ventricular fibrillation.

    Science.gov (United States)

    Walcott, Gregory P; Melnick, Sharon B; Walker, Robert G; Banville, Isabelle; Chapman, Fred W; Killingsworth, Cheryl R; Ideker, Raymond E

    2009-04-01

    Pauses during chest compressions are thought to have a detrimental effect on resuscitation outcome. The Guidelines 2005 have recently eliminated the post-defibrillation pause. Previous animal studies have shown that multiple pauses of increasing duration decrease resuscitation success. We investigated the effect of varying the characteristics of a single pause near defibrillation on resuscitation outcome. Part A: 48 swine were anesthetized, fibrillated for 7min and randomized. Chest compressions were initiated for 90s followed by defibrillation and then resumption of chest compressions. Four groups were studied-G2000: 40s pause beginning 20s before, and ending 20s after defibrillation, A1: a 20s pause just before defibrillation, A2: a 20s pause ending 30s prior to defibrillation, and group A3: a 10s pause ending 30s prior to defibrillation. Part B: 12 swine (Group B) were studied with a protocol identical to Part A but with no pause in chest compressions. Primary endpoint was survival to 4h. The survival rate was significantly higher for groups A1, A2, A3, and B (5/12, 7/12, 5/12, and 5/12 survived) than for the G2000 group (0/12, p<0.05). Survival did not differ significantly among groups A1, A2, A3, and B. These results suggest that the Guidelines 2005 recommendation to omit the post-shock pulse check and immediately resume chest compressions may be an important resuscitation protocol change. However, these results also suggest that clinical maneuvers further altering a single pre-shock chest compression pause provide no additional benefit.

  16. Effect of timing and duration of a single chest compression pause on short-term survival following prolonged ventricular fibrillation☆

    Science.gov (United States)

    Walcott, Gregory P.; Melnick, Sharon B.; Walker, Robert G.; Banville, Isabelle; Chapman, Fred W.; Killingsworth, Cheryl R.; Ideker, Raymond E.

    2014-01-01

    Background Pauses during chest compressions are thought to have a detrimental effect on resuscitation outcome. The Guidelines 2005 have recently eliminated the post-defibrillation pause. Previous animal studies have shown that multiple pauses of increasing duration decrease resuscitation success. We investigated the effect of varying the characteristics of a single pause near defibrillation on resuscitation outcome. Methods Part A: 48 swine were anesthetized, fibrillated for 7 min and randomized. Chest compressions were initiated for 90 s followed by defibrillation and then resumption of chest compressions. Four groups were studied—G2000: 40 s pause beginning 20 s before, and ending 20 s after defibrillation, A1: a 20 s pause just before defibrillation, A2: a 20 s pause ending 30 s prior to defibrillation, and group A3: a 10 s pause ending 30 s prior to defibrillation. Part B: 12 swine (Group B) were studied with a protocol identical to Part A but with no pause in chest compressions. Primary endpoint was survival to 4 h. Results The survival rate was significantly higher for groups A1, A2, A3, and B (5/12, 7/12, 5/12, and 5/12 survived) than for the G2000 group (0/12, p < 0.05). Survival did not differ significantly among groups A1, A2, A3, and B. Conclusions These results suggest that the Guidelines 2005 recommendation to omit the post-shock pulse check and immediately resume chest compressions may be an important resuscitation protocol change. However, these results also suggest that clinical maneuvers further altering a single pre-shock chest compression pause provide no additional benefit. PMID:19185411

  17. Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: a retrospective cohort study

    OpenAIRE

    Walters Matthew; Briggs Andrew; Redpath Adam; Chalmers Jim WT; Gillies Michelle; Jhund Pardeep S; Lewsey James D; Macpherson Karen J; Langhorne Peter; Capewell Simon; McMurray John JV; MacIntyre Kate

    2011-01-01

    Abstract Background To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH) in Scotland over a 20 year period. Methods A retrospective cohort study using routine hospital discharge data linked to death records. Results Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84%) survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the...

  18. A single dose of an inhibitor of cyclooxygenase 2, meloxicam, administered shortly after irradiation increases survival of lethally irradiated mice

    Czech Academy of Sciences Publication Activity Database

    Hofer, Michal; Pospíšil, Milan; Dušek, L.; Hoferová, Zuzana; Weiterová, Lenka

    2011-01-01

    Roč. 176, č. 2 (2011), s. 269-272 ISSN 0033-7587 R&D Projects: GA ČR(CZ) GA305/08/0158 Grant - others:GA ČR(CZ) GAP303/11/0128 Program:GA Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : cyclooxygenase-2 inhibition * lethal irradiation * survival Subject RIV: BO - Biophysics Impact factor: 2.684, year: 2011

  19. On Preliminary Test Estimator for Median

    OpenAIRE

    Okazaki, Takeo; 岡崎, 威生

    1990-01-01

    The purpose of the present paper is to discuss about estimation of median with a preliminary test. Two procedures are presented, one uses Median test and the other uses Wilcoxon two-sample test for the preliminary test. Sections 3 and 4 give mathematical formulations of such properties, including mean square errors with one specified case. Section 5 discusses their optimal significance levels of the preliminary test and proposes their numerical values by Monte Carlo method. In addition to mea...

  20. Application of the BAR score as a predictor of short- and long-term survival in liver transplantation patients.

    Science.gov (United States)

    de Campos Junior, Ivan Dias; Stucchi, Raquel Silveira Bello; Udo, Elisabete Yoko; Boin, Ilka de Fátima Santana Ferreira

    2015-01-01

    The balance of risk (BAR) is a prediction system after liver transplantation. To assess the BAR system, a retrospective observational study was performed in 402 patients who had transplant surgery between 1997 and 2012. The BAR score was computed for each patient. Receiver operating characteristic curve analysis with the Hosmer-Lemeshow test was used to calculate sensitivity, specificity, and model calibration. The cutoff value with the best Youden index was selected. Statistical analysis employed the Kaplan-Meier method (log-rank test) for survival, the Mann-Whitney test for group comparison, and multiple logistic regression analysis. 3-month survival was 46% for BAR ≥ 11 and 77% for BAR BAR ≥ 11 and 69% for BAR BAR ≥ 11 [odds ratio (OR) 3.08; 95% confidence interval (CI) 1.75-5.42; p = 0.001] and intrasurgical use of packed red blood cells (RBC) above 6 units (OR 4.49; 95% CI 2.73-7.39; p = 0.001). For survival BAR ≥ 11 (OR 2.94; 95% CI 1.67-5.16; p = 0.001) and RBC >6 units (OR 2.99; 95% CI 1.92-4.64; p = 0.001). Our study contributes to the incorporation of the BAR system into Brazilian transplantation centers.

  1. The Danish Shoulder Arthroplasty Registry: clinical outcome and short-term survival of 2,137 primary shoulder replacements

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe; Jakobsen, John; Brorson, Stig

    2012-01-01

    The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. Data are reported electronically by the surgeons. Patient-reported outcome is collected 10-14 months postoperatively using the Western Ontario osteoarthritis of the shoulder index (WOOS). 2,137 primary shoulder arthroplasties...... (70% women) were reported to the registry between January 2006 and December 2008. Mean age at surgery was 69 years (SD 12). The most common indications were a displaced proximal humeral fracture (54%) or osteoarthritis (30%). 61% were stemmed hemiarthroplasties, 28% resurfacing hemiarthroplasties, 8......% reverse shoulder arthroplasties, and 3% total arthroplasties. Median WOOS was 59% (IQR: 37-82). 5% had been revised by the end of June 2010. The most frequent indications for revision were dislocation or glenoid attrition....

  2. Median and ulnar neuropathies in university guitarists.

    Science.gov (United States)

    Kennedy, Rachel H; Hutcherson, Kimberly J; Kain, Jennifer B; Phillips, Alicia L; Halle, John S; Greathouse, David G

    2006-02-01

    Descriptive study. To determine the presence of median and ulnar neuropathies in both upper extremities of university guitarists. Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Guitarists and plucked-string musicians are at risk for entrapment neuropathies in the upper extremities and are prone to mild neurologic deficits. Twenty-four volunteer male and female guitarists (age range, 18-26 years) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Individuals were excluded if they were pregnant or had a history of recent upper extremity or neck injury. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. Six subjects had positive findings on provocative testing of the median and ulnar nerves. Otherwise, these guitarists had normal upper extremity neural and musculoskeletal function based on the history and physical examinations. When comparing the subjects' nerve conduction study values with a chart of normal nerve conduction studies values, 2 subjects had prolonged distal motor latencies (DMLs) of the left median nerve of 4.3 and 4.7 milliseconds (normal, DMLs are compatible with median neuropathy at or distal to the wrist. Otherwise, all electrophysiological variables were within normal limits for motor, sensory, and F-wave (central) values. However, comparison studies of median and ulnar motor latencies in the same hand demonstrated prolonged differences of greater than 1.0 milliseconds that affected the median nerve in 2 additional subjects, and identified contralateral limb involvement in a subject with a prolonged distal latency. The other 20

  3. Methodology to predict long-term cancer survival from short-term data using Tobacco Cancer Risk and Absolute Cancer Cure models

    International Nuclear Information System (INIS)

    Mould, R F; Lederman, M; Tai, P; Wong, J K M

    2002-01-01

    Three parametric statistical models have been fully validated for cancer of the larynx for the prediction of long-term 15, 20 and 25 year cancer-specific survival fractions when short-term follow-up data was available for just 1-2 years after the end of treatment of the last patient. In all groups of cases the treatment period was only 5 years. Three disease stage groups were studied, T1N0, T2N0 and T3N0. The models are the Standard Lognormal (SLN) first proposed by Boag (1949 J. R. Stat. Soc. Series B 11 15-53) but only ever fully validated for cancer of the cervix, Mould and Boag (1975 Br. J. Cancer 32 529-50), and two new models which have been termed Tobacco Cancer Risk (TCR) and Absolute Cancer Cure (ACC). In each, the frequency distribution of survival times of defined groups of cancer deaths is lognormally distributed: larynx only (SLN), larynx and lung (TCR) and all cancers (ACC). All models each have three unknown parameters but it was possible to estimate a value for the lognormal parameter S a priori. By reduction to two unknown parameters the model stability has been improved. The material used to validate the methodology consisted of case histories of 965 patients, all treated during the period 1944-1968 by Dr Manuel Lederman of the Royal Marsden Hospital, London, with follow-up to 1988. This provided a follow-up range of 20- 44 years and enabled predicted long-term survival fractions to be compared with the actual survival fractions, calculated by the Kaplan and Meier (1958 J. Am. Stat. Assoc. 53 457-82) method. The TCR and ACC models are better than the SLN model and for a maximum short-term follow-up of 6 years, the 20 and 25 year survival fractions could be predicted. Therefore the numbers of follow-up years saved are respectively 14 years and 19 years. Clinical trial results using the TCR and ACC models can thus be analysed much earlier than currently possible. Absolute cure from cancer was also studied, using not only the prediction models which

  4. 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.

  5. Large window median filtering on Clip7

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, K N

    1983-07-01

    Median filtering has been found to be a useful operation to perform on images in order to reduce random noise while preserving edges of objects. However, in some cases, as the resolution of the image increases, so too does the required window size of the filter. For parallel array processors, this leads to problems when dealing with the large amount of data involved. That is to say that there tend to be problems over slow access of data from pixels over a large neighbourhood, lack of available storage of this data during the operation and long computational times for finding the median. An algorithm for finding the median, designed for use on byte wide architecture parallel array processors is presented together with its implementation on Clip7, a scanning array of such processors. 6 references.

  6. Thrombosed persistent median artery causing carpal tunnel syndrome associated with bifurcated median nerve: A case report

    International Nuclear Information System (INIS)

    Salter, M.; Sinha, N. R.; Szmigielski, W.

    2011-01-01

    Background: Carpal tunnel syndrome is a sporadically occurring abnormality due to compression of median nerve. It is exceedingly rare for it to be caused by thrombosis of persistent median artery. Case Report: A forty two year old female was referred for ultrasound examination due to ongoing wrist pain, not relived by pain killers and mild paraesthesia on the radial side of the hand. High resolution ultrasound and Doppler revealed a thrombosed persistent median artery and associated bifurcated median nerve. The thrombus resolved on treatment with anticoagulants. Conclusions: Ultrasound examination of the wrist when done for patients with carpal tunnel syndrome should preferably include looking for persistent median artery and its patency. (authors)

  7. Switching non-local vector median filter

    Science.gov (United States)

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

    2016-04-01

    This paper describes a novel image filtering method that removes random-valued impulse noise superimposed on a natural color image. In impulse noise removal, it is essential to employ a switching-type filtering method, as used in the well-known switching median filter, to preserve the detail of an original image with good quality. In color image filtering, it is generally preferable to deal with the red (R), green (G), and blue (B) components of each pixel of a color image as elements of a vectorized signal, as in the well-known vector median filter, rather than as component-wise signals to prevent a color shift after filtering. By taking these fundamentals into consideration, we propose a switching-type vector median filter with non-local processing that mainly consists of a noise detector and a noise removal filter. Concretely, we propose a noise detector that proactively detects noise-corrupted pixels by focusing attention on the isolation tendencies of pixels of interest not in an input image but in difference images between RGB components. Furthermore, as the noise removal filter, we propose an extended version of the non-local median filter, we proposed previously for grayscale image processing, named the non-local vector median filter, which is designed for color image processing. The proposed method realizes a superior balance between the preservation of detail and impulse noise removal by proactive noise detection and non-local switching vector median filtering, respectively. The effectiveness and validity of the proposed method are verified in a series of experiments using natural color images.

  8. Intraneural synovial sarcoma of the median nerve

    Directory of Open Access Journals (Sweden)

    Rahul Kasukurthi

    2010-06-01

    Full Text Available Synovial sarcomas are soft-tissue malignancies with a poor prognosis and propensity for distant metastases. Although originally believed to arise from the synovium, these tumors have been found to occur anywhere in the body. We report a rare case of synovial sarcoma arising from the median nerve. To our knowledge, this is the twelfth reported case of intraneural synovial sarcoma, and only the fourth arising from the median nerve. Because the diagnosis may not be apparent until after pathological examination of the surgical speci­men, synovial sarcoma should be kept in mind when dealing with what may seem like a benign nerve tumor.

  9. Robust median estimator in logisitc regression

    Czech Academy of Sciences Publication Activity Database

    Hobza, T.; Pardo, L.; Vajda, Igor

    2008-01-01

    Roč. 138, č. 12 (2008), s. 3822-3840 ISSN 0378-3758 R&D Projects: GA MŠk 1M0572 Grant - others:Instituto Nacional de Estadistica (ES) MPO FI - IM3/136; GA MŠk(CZ) MTM 2006-06872 Institutional research plan: CEZ:AV0Z10750506 Keywords : Logistic regression * Median * Robustness * Consistency and asymptotic normality * Morgenthaler * Bianco and Yohai * Croux and Hasellbroeck Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.679, year: 2008 http://library.utia.cas.cz/separaty/2008/SI/vajda-robust%20median%20estimator%20in%20logistic%20regression.pdf

  10. Optimal design of work zone median crossovers.

    Science.gov (United States)

    2010-09-01

    The use of temporary median crossovers in work zones allows for the closure of one side of a multi-lane roadway while : maintaining two-way traffic on the opposite side. This process provides the ability for construction and maintenance crews : to co...

  11. Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Walters Matthew

    2011-03-01

    Full Text Available Abstract Background To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH in Scotland over a 20 year period. Methods A retrospective cohort study using routine hospital discharge data linked to death records. Results Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84% survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the study period. In 2005, incidence in women was 12.8 (95% CI 11.5 to 14.2 and in men 7.9 (95% CI 6.9 to 9.1. 30 day case fatality in individuals hospitalised with SAH declined substantially, falling from 30.0% in men and 33.9% in women in 1986-1990 to 24.5% in men and 29.1% in women in 2001-2005. For both men and women, the largest reductions were observed in those aged between 40 to 59 years. After adjustment for age, socio-economic status and co-morbidity, the odds of death at 30 days in 2005 compared to odds of death in 1986 was 0.64 (0.54 to 0.76, p Conclusions Incidence rates for SAH remained stable between 1986 and 2005 suggesting that a better understanding of SAH risk factors and their reduction is needed. 30 day case fatality rates have declined substantially, particularly in middle-age. However, they remain high and it is important to ensure that this is not due to under-diagnosis or under-treatment.

  12. 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.

  13. 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.

  14. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis.

    Science.gov (United States)

    Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

    2014-06-01

    Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (PALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

  15. CT morphology of benign median nerve tumors

    International Nuclear Information System (INIS)

    Feyerabend, T.; Schmitt, R.; Lanz, U.; Warmuth-Metz, M.; Wuerzburg Univ.

    1990-01-01

    Computed tomography (CT) was performed in 3 patients with benign tumors of the median nerve, histologically confirmed as neurilemmoma, fibrolipoma and hemangioma. The neurilemmoma showed a ring-shaped contrast enhancement. The fibrolipoma presented with areas of solid soft tissue and areas of fat. The hemangioma was a solid tumor with a lacunar, vascular contrast enhancement. According to our experience and to the previous literature CT gives useful information regarding the anatomic location, size, and relationship of peripheral nerve sheath tumors to surrounding structures, and may help to differentiate between various tumor types. (orig.)

  16. A comparison of freeway median crash frequency, severity, and barrier strike outcomes by median barrier type.

    Science.gov (United States)

    Russo, Brendan J; Savolainen, Peter T

    2018-08-01

    Median-crossover crashes are among the most hazardous events that can occur on freeways, often resulting in severe or fatal injuries. The primary countermeasure to reduce the occurrence of such crashes is the installation of a median barrier. When installation of a median barrier is warranted, transportation agencies are faced with the decision among various alternatives including concrete barriers, beam guardrail, or high-tension cable barriers. Each barrier type differs in terms of its deflection characteristics upon impact, the required installation and maintenance costs, and the roadway characteristics (e.g., median width) where installation would be feasible. This study involved an investigation of barrier performance through an in-depth analysis of crash frequency and severity data from freeway segments where high-tension cable, thrie-beam, and concrete median barriers were installed. A comprehensive manual review of crash reports was conducted to identify crashes in which a vehicle left the roadway and encroached into the median. This review also involved an examination of crash outcomes when a barrier strike occurred, which included vehicle containment, penetration, or re-direction onto the travel lanes. The manual review of crash reports provided critical supplementary information through narratives and diagrams not normally available through standard fields on police crash report forms. Statistical models were estimated to identify factors that affect the frequency, severity, and outcomes of median-related crashes, with particular emphases on differences between segments with varying median barrier types. Several roadway-, traffic-, and environmental-related characteristics were found to affect these metrics, with results varying across the different barrier types. The results of this study provide transportation agencies with important guidance as to the in-service performance of various types of median barrier. Copyright © 2018 Elsevier Ltd. All rights

  17. Short-term Automated Quantification of Radiologic Changes in the Characterization of Idiopathic Pulmonary Fibrosis Versus Nonspecific Interstitial Pneumonia and Prediction of Long-term Survival.

    Science.gov (United States)

    De Giacomi, Federica; Raghunath, Sushravya; Karwoski, Ronald; Bartholmai, Brian J; Moua, Teng

    2018-03-01

    Fibrotic interstitial lung diseases presenting with nonspecific and overlapping radiologic findings may be difficult to diagnose without surgical biopsy. We hypothesized that baseline quantifiable radiologic features and their short-term interval change may be predictive of underlying histologic diagnosis as well as long-term survival in idiopathic pulmonary fibrosis (IPF) presenting without honeycombing versus nonspecific interstitial pneumonia (NSIP). Forty biopsy-confirmed IPF and 20 biopsy-confirmed NSIP patients with available high-resolution chest computed tomography 4 to 24 months apart were studied. CALIPER software was used for the automated characterization and quantification of radiologic findings. IPF subjects were older (66 vs. 48; P<0.0001) with lower diffusion capacity for carbon monoxide and higher volumes of baseline reticulation (193 vs. 83 mL; P<0.0001). Over the interval period, compared with NSIP, IPF patients experienced greater functional decline (forced vital capacity, -6.3% vs. -1.7%; P=0.02) and radiologic progression, as noted by greater increase in reticulation volume (24 vs. 1.74 mL; P=0.048), and decrease in normal (-220 vs. -37.7 mL; P=0.045) and total lung volumes (-198 vs. 58.1 mL; P=0.03). Older age, male gender, higher reticulation volumes at baseline, and greater interval decrease in normal lung volumes were predictive of IPF. Both baseline and short-term changes in quantitative radiologic findings were predictive of mortality. Baseline quantitative radiologic findings and assessment of short-term disease progression may help characterize underlying IPF versus NSIP in those with difficult to differentiate clinicoradiologic presentations. Our study supports the possible utility of assessing serial quantifiable high-resolution chest computed tomographic findings for disease differentiation in these 2 entities.

  18. 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.

  19. 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

  20. Back-reactions, short-circuits, leaks and other energy wasteful reactions in biological electron transfer: redox tuning to survive life in O(2).

    Science.gov (United States)

    Rutherford, A William; Osyczka, Artur; Rappaport, Fabrice

    2012-03-09

    The energy-converting redox enzymes perform productive reactions efficiently despite the involvement of high energy intermediates in their catalytic cycles. This is achieved by kinetic control: with forward reactions being faster than competing, energy-wasteful reactions. This requires appropriate cofactor spacing, driving forces and reorganizational energies. These features evolved in ancestral enzymes in a low O(2) environment. When O(2) appeared, energy-converting enzymes had to deal with its troublesome chemistry. Various protective mechanisms duly evolved that are not directly related to the enzymes' principal redox roles. These protective mechanisms involve fine-tuning of reduction potentials, switching of pathways and the use of short circuits, back-reactions and side-paths, all of which compromise efficiency. This energetic loss is worth it since it minimises damage from reactive derivatives of O(2) and thus gives the organism a better chance of survival. We examine photosynthetic reaction centres, bc(1) and b(6)f complexes from this view point. In particular, the evolution of the heterodimeric PSI from its homodimeric ancestors is explained as providing a protective back-reaction pathway. This "sacrifice-of-efficiency-for-protection" concept should be generally applicable to bioenergetic enzymes in aerobic environments. Copyright © 2012 Federation of European Biochemical Societies. All rights reserved.

  1. Understanding cancer survivors' information needs and information-seeking behaviors for complementary and alternative medicine from short- to long-term survival: a mixed-methods study.

    Science.gov (United States)

    Scarton, Lou Ann; Del Fiol, Guilherme; Oakley-Girvan, Ingrid; Gibson, Bryan; Logan, Robert; Workman, T Elizabeth

    2018-01-01

    The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. A mixed-methods approach was used with cancer survivors from the "Assessment of Patients' Experience with Cancer Care" 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT). Seventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families' and friends' provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM. Patients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients.

  2. Short-term survival of the trabecular metal cup is similar to that of standard cups used in acetabular revision surgery.

    Science.gov (United States)

    Mohaddes, Maziar; Rolfson, Ola; Kärrholm, Johan

    2015-02-01

    The use of trabecular metal (TM) cups in revision surgery has increased worldwide during the last decade. Since the introduction of the TM cup in Sweden in 2006, this design has gradually replaced other uncemented designs used in Sweden. According to data from the Swedish Hip Arthroplasty Register (SHAR) in 2012, one-third of all uncemented first-time cup revisions were performed using a TM cup. We compared the risk of reoperation and re-revision for TM cups and the 2 other most frequently used cup designs in acetabular revisions reported to the SHAR. The hypothesis was that the performance of TM cups is as good as that of established designs in the short term. The study population consisted of 2,384 patients who underwent 2,460 revisions during the period 2006 through 2012. The most commonly used cup designs were the press-fit porous-coated cup (n = 870), the trabecular metal cup (n = 805), and the cemented all-polyethylene cup (n = 785). 54% of the patients were female, and the median age at index revision was 72 (19-95) years. Reoperation was defined as a second surgical intervention, and re-revision-meaning exchange or removal of the cup-was used as endpoint. The mean follow-up time was 3.3 (0-7) years. There were 215 reoperations, 132 of which were re-revisions. The unadjusted and adjusted risk of reoperation or re-revision was not significantly different for the TM cup and the other 2 cup designs. Our data support continued use of TM cups in acetabular revisions. Further follow-up is necessary to determine whether trabecular metal cups can reduce the re-revision rate in the long term, compared to the less costly porous press-fit and cemented designs.

  3. 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

  4. Median Nerve Conduction in Healthy Nigerians: Normative Data

    African Journals Online (AJOL)

    of median nerve disease using multiple studies, and rendering ... Aim: To develop normative values for motor and sensory median nerve ..... Table 5: Comparison of median motor nerve conduction study parameters to studies elsewhere. Study.

  5. Relationships between the Brook Street Terrane and Median Tectonic Zone (Median Batholith) : evidence from Jurassic conglomerates

    International Nuclear Information System (INIS)

    Tulloch, A.J.; Kimbrough, D.L.; Landis, C.A.; Mortimer, N.; Johnston, M.R.

    1999-01-01

    U-Pb zircon ages of 237-180 Ma and c. 280 Ma of seven granitoid clasts from the Rainy River Conglomerate which lies within the eastern Median Tectonic Zone (Median Batholith) in Nelson, and the Barretts Formation of the Brook Street Terrane in Southland, constrain the depositional ages of both units to be no older than c. 180-200 Ma (Early Jurassic). The minimum age of the Rainy River Conglomerate is constrained by the 147 +2 -1 Ma (Latest Jurassic) emplacement age of the One Mile Gabbronorite (new name: previously western Buller Diorite). The ages and chemistry of five of the granitoid clasts are broadly compatible with derivation from rocks that are now represented by Triassic plutons of the Median Tectonic Zone (Median Batholith), although ages as young as 180 Ma are slightly outside the range of the latter as currently exposed in New Zealand. The age (273-290 Ma, 237 +/- 3 Ma) and chemistry of the other two clasts (one each from Rainy River Conglomerate and Barretts Formation) suggest derivation from the Brook Street Terrane. Similarity in stratigraphic age, depositional characteristics, granitoid clast ages and composition between Rainy River Conglomerate and Barretts Formation suggests that they are broadly correlative and collectively overlapped a combined Brook Street Terrane - Median Batholith (MTZ) before the Late Jurassic (147 +2 -1 Ma). Sedimentary overlap may also have continued across to Middle Jurassic conglomeratic strata in the Murihiku Terrane to the east of the Brook Street Terrane. A U-Pb zircon age of 261 +/- 2 Ma is reported for Pourakino Trondhjemite of the Brook Street Terrane. (author). 56 refs., 10 figs., 4 tabs

  6. Does Full Wound Rupture following Median Pilonidal Closure Alter Long-Term Recurrence Rate?

    Science.gov (United States)

    Doll, Dietrich; Matevossian, Edouard; Luedi, Markus M; Schneider, Ralf; van Zypen, Dominic; Novotny, Alexander

    2015-01-01

    The purpose of this study was to examine the recurrence rate of wound rupture in primary pilonidal sinus disease (PSD) after median closure. A total of 583 patients from the German military cohort were interviewed. We compared the choice of surgical therapy, wound dehiscence (if present) and long-term recurrence-free survival for patients with primary open treatment, marsupialization and primary median treatment (closed vs. secondary open, respectively). Actuarial recurrence rate was determined using the Kaplan-Meier calculation with a follow-up of up to 20 years after primary PSD surgery. Patients with excision followed by primary open wound treatment showed a significantly lower 5- than 10-year recurrence rate (8.3 vs. 11.2%) compared to the patients with primary midline closure (17.4 vs. 20.5%, p = 0.03). The 20-year recurrence rate was 28% in primary open wound treatment versus 44% in primary midline closure without wound rupture. In contrast to these findings, long-term recurrence rates following secondary open wound treatment (12.2% at 5 years vs. 17.1% at 10 years) tended to be higher (although not significantly, p = 0.57) compared to primary open treatment (8.3% at 5 years vs. 11.2% at 10 years). There was no statistical difference in long-term recurrence rates between secondary open and primary midline closure (p = 0.7). Hence, despite only a short wound closure time experienced before wound rupture, the patient does not fully benefit from an open wound treatment in terms of recurrence rate. The postoperative pilonidal sinus wound rupture of primary midline closures did not significantly increase the 5- and 10-year long-term recurrence rates compared to uneventfully healing primary midline closures. © 2015 S. Karger AG, Basel.

  7. Performance evaluation of cable median barrier systems in Texas.

    Science.gov (United States)

    2009-08-01

    Since 2003, the Texas Department of Transportation (TxDOT) has embarked on an aggressive campaign to install : median barriers to prevent cross-median crashes on freeway facilities statewide. In the few years prior to 2003, : virtually all fatalities...

  8. Development of guidelines for cable median barrier systems in Texas.

    Science.gov (United States)

    2009-12-01

    Since 2003, the Texas Department of Transportation (TxDOT) has embarked on an aggressive campaign to install : median barriers to prevent cross-median crashes on freeway facilities statewide. In the few years prior to 2003, : virtually all fatalities...

  9. Short-term effects of avian predation variation on population size and local survival of the multimammate rat, Mastomys natalensis (Rodentia, Muridae)

    DEFF Research Database (Denmark)

    Gulck, T. van; Stocks, R.; Verhagen, Ron

    1998-01-01

    The influence of avian predation on population size and local survival of Mastomys natalensis rats in Tanzania was studied in a capture-recapture study over a six month period on experimental fields with decreased, controlled and increased predation pressure. Bird observations indicated that the ......The influence of avian predation on population size and local survival of Mastomys natalensis rats in Tanzania was studied in a capture-recapture study over a six month period on experimental fields with decreased, controlled and increased predation pressure. Bird observations indicated...... that the placement of perches increased local hunting activity of at least the Black Shouldered Kite but there were no obvious effects on rodent population size or survival. In a single field where avian predation was prevented by covering the field with a net, an increase in survival was observed. The opposite...

  10. Improved Metastasis- and Disease-Free Survival With Preoperative Sequential Short-Course Radiation Therapy and FOLFOX Chemotherapy for Rectal Cancer Compared With Neoadjuvant Long-Course Chemoradiotherapy: Results of a Matched Pair Analysis.

    Science.gov (United States)

    Markovina, Stephanie; Youssef, Fady; Roy, Amit; Aggarwal, Sonya; Khwaja, Shariq; DeWees, Todd; Tan, Benjamin; Hunt, Steven; Myerson, Robert J; Chang, Daniel T; Parikh, Parag J; Olsen, Jeffrey R

    2017-10-01

    To compare treatment and toxicity outcomes between a phase 2 institutional trial of near total neoadjuvant therapy (nTNT) for locally advanced rectal cancer and a similar historical control cohort treated at Washington University in St. Louis with the current US standard of care, defined as neoadjuvant chemoradiotherapy (NCRT), total mesorectal excision (TME), and adjuvant FOLFOX chemotherapy; to expand the comparison to an additional institution, patients treated with similar NCRT at Stanford University were included. Sixty-nine patients with cT3-4N0-2M0 rectal adenocarcinoma enrolled on the Washington University in St. Louis phase 2 study of nTNT were included for analysis. Patients treated at the same institution with conventional NCRT and adjuvant FOLFOX were matched for exact cTNM stage. Forty-one patients treated with NCRT at Stanford University were included in a second analysis. Kaplan-Meier analysis with log-rank test was used to compare local control, distant metastasis-free survival, disease-free survival, and overall survival. Median follow-up was 49 and 54 months for nTNT and NCRT, respectively. Pathologic complete response and T-downstaging rates were 28% versus 16% (P=.21) and 75% versus 41% (P<.001) in the nTNT and NCRT cohorts, respectively. Three-year disease-free survival (85% vs 68%, P=.032) was significantly better in the nTNT group. Actuarial 3-year local control (92% vs 96%, P=.36) and overall survival (96% vs 88%, P=.67) were similar. The Stanford cohort had significantly lower clinical stage. After controlling for clinical stage, age, tumor location, institution, and number of chemotherapy cycles, nTNT treatment remained significantly associated with lower risk of recurrence (P=.006). Patients treated with nTNT had higher T-downstaging and superior distant metastasis-free survival and disease-free survival compared with conventional NCRT when matched for tumor location and exact cTNM stage. Near total neoadjuvant therapy remained a

  11. Permasalahan P-Hub Median Dengan Lintasan Terpendek

    OpenAIRE

    Pasaribu, Raja David

    2013-01-01

    Hub are facilities that serve as sorting, switching, and transhipment in a transportation network. P-hub median problem is a discrete case location allocation problem which all hub is fully connected. In this paper will be intoduced Mixed Integrer Linear Programming (MILP) formulation models of cost for p-hub median problem allocation for uncapacitaced single allocation p-hub median(USApHMP). In this paper also introduced Floyd-Warshall shortest path algorithm to solve p-hub median problems a...

  12. Papillary carcinoma in median aberrant thyroid (ectopic) - case report.

    Science.gov (United States)

    Hebbar K, Ashwin; K, Shashidhar; Deshmane, Vijaya Laxmi; Kumar, Veerendra; Arjunan, Ravi

    2014-06-01

    Median ectopic thyroid may be encountered anywhere from the foramen caecum to the diaphragm. Non lingual median aberrant thyroid (incomplete descent) usually found in the infrahyoid region and malignant transformation in this ectopic thyroid tissue is very rare. We report an extremely rare case of papillary carcinoma in non lingual median aberrant thyroid in a 25-year-old female. The differentiation between a carcinoma arising in the median ectopic thyroid tissue and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is also discussed.

  13. Impact of patient-prosthesis mismatch following aortic valve replacement on short-term survival: a retrospective single center analysis of 632 consecutive patients with isolated stented biological aortic valve replacement.

    Science.gov (United States)

    Hoffmann, Grischa; Ogbamicael, Selam Abraham; Jochens, Arne; Frank, Derk; Lutter, Georg; Cremer, Jochen; Petzina, Rainer

    2014-09-01

    The impact of patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) on short-term and long-term mortality remains controversial. The objective of this study was to evaluate the incidence and severity of PPM and its impact on short-term survival in a large cohort of patients treated with isolated stented biological AVR in a single institution. We analyzed retrospectively data of 632 consecutive patients with aortic stenosis undergoing isolated stented biological AVR between January 2007 and February 2012 at our institution. PPM was defined as an indexed effective orifice area ≤ 0.85 cm(2)/m(2). Statistical analyses were performed to identify influencing variables on valve size implanted. Of the 632 patients investigated, 46% were females and mean age was 71.9 ± 10.4 years. PPM was observed in 93.8% (593 of 632 patients). In 71% of the patients, moderate (0.65-0.85 cm(2)/m(2)) PPM was present and in 22.8% severe (body mass index, and body surface area as simultaneous predictors of the valve size implanted (R(2)= 0.39). PPM had no discernable impact on short-term survival, although it was present in 93.8% of our patients following isolated stented biological AVR. Georg Thieme Verlag KG Stuttgart · New York.

  14. High serum levels of YKL-40 in patients with squamous cell carcinoma of the head and neck are associated with short survival

    DEFF Research Database (Denmark)

    Roslind, A.; Johansen, J.S.; Christensen, L.J.

    2008-01-01

    by immunohistochemistry in 50 patients. Pretreatment serum YKL-40 was elevated in 53%. Patients with high serum YKL-40 had shorter survival than patients with normal serum YKL-40 (33 vs. 84 months; p = 0.008). Multivariate Cox analysis including pretreatment serum YKL-40, age, sex, primary tumor site, TNM classification...... and treatment demonstrated that TNM classification (HR = 2.61, p = 0.02) and serum YKL-40 (log-transformed continuous variable: HR = 1.55, p classification (HR = 5.77, p = 0.001) and serum...... YKL-40 (dichotomous variable: HR = 2.75, p = 0.01) were independent predictors of recurrence-free survival. During follow-up after radiotherapy, a high serum YKL-40 (log-transformed continuous variable) in patients with TNM Stage III and TV disease predicted poorer OS within 6 months (HR = 1.95, p

  15. High serum levels of YKL-40 in patients with squamous cell carcinoma of the head and neck are associated with short survival

    DEFF Research Database (Denmark)

    Roslind, Anne; Johansen, Julia S; Christensen, Ib J

    2008-01-01

    by immunohistochemistry in 50 patients. Pretreatment serum YKL-40 was elevated in 53%. Patients with high serum YKL-40 had shorter survival than patients with normal serum YKL-40 (33 vs. 84 months; p = 0.008). Multivariate Cox analysis including pretreatment serum YKL-40, age, sex, primary tumor site, TNM classification...... and treatment demonstrated that TNM classification (HR = 2.61, p = 0.02) and serum YKL-40 (log-transformed continuous variable: HR = 1.55, p...

  16. Cancer survival classification using integrated data sets and intermediate information.

    Science.gov (United States)

    Kim, Shinuk; Park, Taesung; Kon, Mark

    2014-09-01

    Although numerous studies related to cancer survival have been published, increasing the prediction accuracy of survival classes still remains a challenge. Integration of different data sets, such as microRNA (miRNA) and mRNA, might increase the accuracy of survival class prediction. Therefore, we suggested a machine learning (ML) approach to integrate different data sets, and developed a novel method based on feature selection with Cox proportional hazard regression model (FSCOX) to improve the prediction of cancer survival time. FSCOX provides us with intermediate survival information, which is usually discarded when separating survival into 2 groups (short- and long-term), and allows us to perform survival analysis. We used an ML-based protocol for feature selection, integrating information from miRNA and mRNA expression profiles at the feature level. To predict survival phenotypes, we used the following classifiers, first, existing ML methods, support vector machine (SVM) and random forest (RF), second, a new median-based classifier using FSCOX (FSCOX_median), and third, an SVM classifier using FSCOX (FSCOX_SVM). We compared these methods using 3 types of cancer tissue data sets: (i) miRNA expression, (ii) mRNA expression, and (iii) combined miRNA and mRNA expression. The latter data set included features selected either from the combined miRNA/mRNA profile or independently from miRNAs and mRNAs profiles (IFS). In the ovarian data set, the accuracy of survival classification using the combined miRNA/mRNA profiles with IFS was 75% using RF, 86.36% using SVM, 84.09% using FSCOX_median, and 88.64% using FSCOX_SVM with a balanced 22 short-term and 22 long-term survivor data set. These accuracies are higher than those using miRNA alone (70.45%, RF; 75%, SVM; 75%, FSCOX_median; and 75%, FSCOX_SVM) or mRNA alone (65.91%, RF; 63.64%, SVM; 72.73%, FSCOX_median; and 70.45%, FSCOX_SVM). Similarly in the glioblastoma multiforme data, the accuracy of miRNA/mRNA using IFS

  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. Dual pathology proximal median nerve compression of the forearm.

    Science.gov (United States)

    Murphy, Siun M; Browne, Katherine; Tuite, David J; O'Shaughnessy, Michael

    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. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Short-Term Exposure to Lambda-Cyhalothrin Negatively Affects the Survival and Memory-Related Characteristics of Worker Bees Apis mellifera.

    Science.gov (United States)

    Liao, Chun-Hua; He, Xu-Jiang; Wang, Zi-Long; Barron, Andrew B; Zhang, Bo; Zeng, Zhi-Jiang; Wu, Xiao-Bo

    2018-07-01

    Pesticides are considered one of the major contemporary stressors of honey bee health. In this study, the effects of short-term exposure to lambda-cyhalothrin on lifespan, learning, and memory-related characteristics of Apis mellifera were systematically examined. Short-term exposure to lambda-cyhalothrin in worker bees reduced lifespan, affected learning and memory performance, reduced the homing ability, and influenced the expression levels of two learning and memory-related genes of A. mellifera. This research identifies the nature of the sublethal effects of lambda-cyhalothrin on bees and the level of exposure that can be harmful to bee health. This new information will assist in establishing guidelines for the safe use of lambda-cyhalothrin in the field.

  20. 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...

  1. High levels of microRNA-21 in the stroma of colorectal cancers predict short disease-free survival in stage II colon cancer patients

    DEFF Research Database (Denmark)

    Nielsen, Boye Schnack; Jørgensen, Stine; Fog, Jacob Ulrik

    2011-01-01

    Approximately 25% of all patients with stage II colorectal cancer will experience recurrent disease and subsequently die within 5 years. MicroRNA-21 (miR-21) is upregulated in several cancer types and has been associated with survival in colon cancer. In the present study we developed a robust...... in situ hybridization assay using high-affinity Locked Nucleic Acid (LNA) probes that specifically detect miR-21 in formalin-fixed paraffin embedded (FFPE) tissue samples. The expression of miR-21 was analyzed by in situ hybridization on 130 stage II colon and 67 stage II rectal cancer specimens. The mi...... relative to the nuclear density (TBR) obtained using a red nuclear stain. High TBR (and TB) estimates of miR-21 expression correlated significantly with shorter disease-free survival (p = 0.004, HR = 1.28, 95% CI: 1.06-1.55) in the stage II colon cancer patient group, whereas no significant correlation...

  2. Short communication: Survival of honey bees (Apis mellifera) infected with Crithidia mellificae (Langridge and McGhee: ATCC® 30254™) in the presence of Nosema ceranae

    Energy Technology Data Exchange (ETDEWEB)

    Higes, M.; Rodríguez-García, C.; Gómez-Moracho, T.; Meana, A.; Bartolomé, C.; Maside, X.; Barrios, L.; Martín-Hernández, R.

    2016-11-01

    Crithidia mellificae, a trypanosomatid parasite of Apis mellifera, has been proposed to be one of the pathogens responsible for the serious honey bee colony losses produced worldwide in the last decade, either alone or in association with Nosema ceranae. Since this pathogenic effect contradicts the results of the experimental infections originally performed by Langridge and McGhee nearly 40 years ago, we investigated the potential linkage of this protozoan with colony decline under laboratory conditions. Nosema-free and trypanosomatid-free honey bees from three different colonies were experimentally infected with fresh C. mellificae spheroid forms (reference strain ATCC30254), with N. ceranae fresh spores and with both parasites at the same time. Replicate cages were kept at 27 °C and used to analyse survival. C. mellificae spheroid forms did not reduce significantly the survival of the worker bees (64.5% at 30 days post-infection vs. 77.8% for the uninfected bees used as controls; differences were non statistically significant) under these experimental conditions. In contrast, the cages infected with N. ceranae exhibited higher rates of mortality from the 20th day post-infection onwards, irrespective of the presence of C. mellificae, suggesting that the spheroid forms of the latter have no pathological effect on A. mellifera. (Author)

  3. Surviving Sengstaken.

    Science.gov (United States)

    Jayakumar, S; Odulaja, A; Patel, S; Davenport, M; Ade-Ajayi, N

    2015-07-01

    To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis. Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). 19 children [10 male, age 1 (0.4-16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula. Varices were secondary to: biliary atresia (n=8), portal vein thrombosis (n=5), alpha-1-anti-trypsin deficiency (n=1), cystic fibrosis (n=1), intrahepatic cholestasis (n=1), sclerosing cholangitis (n=1) and nodular hyperplasia with arterio-portal shunt (n=1). Three children deteriorated rapidly and did not survive to have post-SBT endoscopy. The child with an aortooesophageal fistula underwent aortic stent insertion and subsequently oesophageal replacement. Complications included gastric mucosal ulceration (n=3, 16%), pressure necrosis at lips and cheeks (n=6, 31%) and SBT dislodgment (n=1, 6%). Six (31%) children died. The remaining 13 have been followed up for 62 (2-165) months; five required liver transplantation, two underwent a mesocaval shunt procedure and 6 have completed endoscopic variceal obliteration and are under surveillance. SBT can be an effective, albeit temporary, life-saving manoeuvre in children with catastrophic haematemesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Sosiaalisen median markkinoinnin vuosikello Weecos Oy:lle

    OpenAIRE

    Heinämäki, Lotta; Huuskonen, Leena

    2015-01-01

    Opinnäytetyön tarkoitus oli luoda kokonaisvaltainen ja selkeä suunnitelma Weecos Oy:n markkinointitoimenpiteille valituissa sosiaalisen median kanavissa. Weecos on vuonna 2012 perustettu ekologisia yrityksiä yhteen keräävä verkkokauppa-alusta. Pienestä koostaan johtuen se ei ole pystynyt toteuttamaan sosiaalisen median markkinointia toivomallaan tavalla ja markkinoinnin suunnittelu ja toteutus on ollut epäsäännöllistä. Markkinointisuunnitelman tavoitteena oli helpottaa yrityksen markkinoi...

  5. Efficient Scalable Median Filtering Using Histogram-Based Operations.

    Science.gov (United States)

    Green, Oded

    2018-05-01

    Median filtering is a smoothing technique for noise removal in images. While there are various implementations of median filtering for a single-core CPU, there are few implementations for accelerators and multi-core systems. Many parallel implementations of median filtering use a sorting algorithm for rearranging the values within a filtering window and taking the median of the sorted value. While using sorting algorithms allows for simple parallel implementations, the cost of the sorting becomes prohibitive as the filtering windows grow. This makes such algorithms, sequential and parallel alike, inefficient. In this work, we introduce the first software parallel median filtering that is non-sorting-based. The new algorithm uses efficient histogram-based operations. These reduce the computational requirements of the new algorithm while also accessing the image fewer times. We show an implementation of our algorithm for both the CPU and NVIDIA's CUDA supported graphics processing unit (GPU). The new algorithm is compared with several other leading CPU and GPU implementations. The CPU implementation has near perfect linear scaling with a speedup on a quad-core system. The GPU implementation is several orders of magnitude faster than the other GPU implementations for mid-size median filters. For small kernels, and , comparison-based approaches are preferable as fewer operations are required. Lastly, the new algorithm is open-source and can be found in the OpenCV library.

  6. 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.

  7. Acute pulmonary embolism: prediction of cor pulmonale and short-term patient survival from assessment of cardiac dimensions in routine multidetector-row CT

    International Nuclear Information System (INIS)

    Engeike, C.; Rummeny, E.; Marten, K.

    2006-01-01

    Purpose: evaluation of the prognostic value of morphological cardiac parameters in patients with suspected and incidental acute pulmonary embolism (PE) using multidetector-row chest CT (MSCT). Materials and methods: 2335 consecutive MSCT scans were evaluated for the presence of PE. The arterial enhancement and analysability of pulmonary arteries and the heart were assessed as parameters of the scan quality. The diastolic right and left ventricular short axes (RV D , LV D ) and the interventricular septal deviation (ISD) were measured in all PE-positive patients and the echocardiography reports were reviewed. The clinical data assessment included cardio-respiratory and other co-morbidities, systemic anticoagulant therapy (ACT), and the 30-day outcome. Predictors of acute cor pulmonale and the short-term outcome were calculated by univariate and multivariate logistic regressions including odds ratios (OR) and ROC analyses using positive (PPV) and negative predictive values (NPV). Results: 90 patients with acute PE were included (36 with clinically suspected PE, 54 with incidental PE). 26 patients had cardio-respiratory co-morbidities. Four patients underwent systemic thrombolysis, 43 underwent anticoagulation in therapeutic doses, 19 underwent anticoagulation in prophylactic doses, and 24 patients did not undergo ACT. 15 of 41 patients had echocardiographic evidence of acute cor pulmonale. 8 patients died within 30 days. The RV D was the best independent predictor of acute cor pulmonale (p = 0,002, OR = 9.16, PPV = 0.68, NPV=1 at 4.49 cm cut off) and short-term outcome (p= 0,0005, OR = 2.82, PPV = 0.23, NPV = 0.98 at 4.75 cm cut off). The RV D /LV D ratio had a PPV of 0.85 for cor pulmonale. (orig.)

  8. Short communication: Jersey × Holstein crossbreds compared with pure Holsteins for body weight, body condition score, fertility, and survival during the first three lactations.

    Science.gov (United States)

    Heins, B J; Hansen, L B; Hazel, A R; Seykora, A J; Johnson, D G; Linn, J G

    2012-07-01

    Crossbred cows (n=80) resulting from the use of Jersey (JE) semen on their pure Holstein (HO) dams were compared with pure HO cows (n=77) for body weight, body condition score, fertility, and survival during their first 3 lactations. Cows were in 2 research herds of the University of Minnesota and calved from September 2003 to June 2008. The JE × HO crossbred cows had significantly less body weight during the first (-56 kg), second (-67 kg), and third (-82 kg) lactations than pure HO cows. However, JE × HO cows had significantly greater body condition score during the first (2.94 vs. 2.84), second (2.97 vs. 2.84), and third (2.99 vs. 2.87) lactations than pure HO cows. For fertility, JE × HO cows had fewer days to first breeding during the first (-10.6d), second (-8.4d), and third (-12.3d) lactations than pure HO cows. Crossbred cows were not significantly different from pure HO cows for number of services during first lactation; however, JE × HO cows had significantly fewer services (2.2) than pure HO cows (2.7) during the second lactation. Also, JE × HO cows had significantly fewer days open than pure HO cows in the first (-24 d), second (-42 d), and third (-42 d) lactations. For survival, JE × HO cows were not significantly different from pure HO cows for percentage of cows calving a second time; however, a tendency existed for a higher percentage of JE × HO cows (63.8%) than pure HO cows (49.4%) to calve a third time, and a higher percentage of JE × HO cows calved a third time within 28, 34, and 40 mo of first calving than pure HO cows. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  9. Whole-Body Exposure to 28Si-Radiation Dose-Dependently Disrupts Dentate Gyrus Neurogenesis and Proliferation in the Short Term and New Neuron Survival and Contextual Fear Conditioning in the Long Term.

    Science.gov (United States)

    Whoolery, Cody W; Walker, Angela K; Richardson, Devon R; Lucero, Melanie J; Reynolds, Ryan P; Beddow, David H; Clark, K Lyles; Shih, Hung-Ying; LeBlanc, Junie A; Cole, Mara G; Amaral, Wellington Z; Mukherjee, Shibani; Zhang, Shichuan; Ahn, Francisca; Bulin, Sarah E; DeCarolis, Nathan A; Rivera, Phillip D; Chen, Benjamin P C; Yun, Sanghee; Eisch, Amelia J

    2017-11-01

    Astronauts traveling to Mars will be exposed to chronic low doses of galactic cosmic space radiation, which contains highly charged, high-energy (HZE) particles. 56 Fe-HZE-particle exposure decreases hippocampal dentate gyrus (DG) neurogenesis and disrupts hippocampal function in young adult rodents, raising the possibility of impaired astronaut cognition and risk of mission failure. However, far less is known about how exposure to other HZE particles, such as 28 Si, influences hippocampal neurogenesis and function. To compare the influence of 28 Si exposure on indices of neurogenesis and hippocampal function with previous studies on 56 Fe exposure, 9-week-old C57BL/6J and Nestin-GFP mice (NGFP; made and maintained for 10 or more generations on a C57BL/6J background) received whole-body 28 Si-particle-radiation exposure (0, 0.2 and 1 Gy, 300 MeV/n, LET 67 KeV/μ, dose rate 1 Gy/min). For neurogenesis assessment, the NGFP mice were injected with the mitotic marker BrdU at 22 h postirradiation and brains were examined for indices of hippocampal proliferation and neurogenesis, including Ki67 + , BrdU + , BrdU + NeuN + and DCX + cell numbers at short- and long-term time points (24 h and 3 months postirradiation, respectively). In the short-term group, stereology revealed fewer Ki67 + , BrdU + and DCX + cells in 1-Gy-irradiated group relative to nonirradiated control mice, fewer Ki67 + and DCX + cells in 0.2 Gy group relative to control group and fewer BrdU + and DCX + cells in 1 Gy group relative to 0.2 Gy group. In contrast to the clearly observed radiation-induced, dose-dependent reductions in the short-term group across all markers, only a few neurogenesis indices were changed in the long-term irradiated groups. Notably, there were fewer surviving BrdU + cells in the 1 Gy group relative to 0- and 0.2-Gy-irradiated mice in the long-term group. When the short- and long-term groups were analyzed by sex, exposure to radiation had a similar effect on neurogenesis indices

  10. Sosiaalisen median markkinointisuunnitelma uudelle hoitoalan konseptoidulle työvaatemallistolle

    OpenAIRE

    Leppälä, Sanna

    2017-01-01

    Opinnäytetyössä pohdittiin keinoja saada uuden konseptoidun työvaatemalliston näkyvyyttä esille sosiaalisen median keinoin. Toimeksiantaja-yrityksenä toimi suomalainen Virtually Oy ja kohteena oli sen uusi hoitajille suunnattu työvaatemallisto. Malliston ympärille halutaan luoda kestävä brändi ja sosiaalisen median markkinointi on tukemassa brändin tunnettavuutta ja myyntiä. Sosiaalinen media ei yritysten välisessä liiketoiminnassa toimi ainoana markkinoinnin työkaluna, vaan se on tukemas...

  11. Sosiaalisen median rooli mikroyrittäjän ostoprosessissa

    OpenAIRE

    Martikainen, Inkeri

    2014-01-01

    Opinnäytetyön tavoite oli selvittää sosiaalisen median rooli mikroyrittäjän ostoprosessissa; miten mikroyrittäjä hakee tietoa sosiaalisesta mediasta ja millainen vaikutus sieltä löytyvillä käyttäjäarvioilla on ostopäätökseen. Opinnäytetyö tehtiin erään finanssialan yrityksen toimeksiantona. Opinnäytetyön tarkoituksena oli antaa digitaalisen markkinoinnin ammattilaisille tietoa siitä, miten mikroyrittäjiä voidaan tavoittaa sosiaalisen median kautta, ja saada näin uusia asiakkaita. Tutkimus...

  12. Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms

    Directory of Open Access Journals (Sweden)

    Heidi Sarkozy, PA-C, BS

    2014-08-01

    Full Text Available Summary: A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis.

  13. 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.

  14. Sosiaalisen median rooli kunnan viestinnässä

    OpenAIRE

    Selkämaa, Kati

    2016-01-01

    Opinnäytetyön tavoitteena oli selvittää sosiaalisen median roolia kunnan viestinnässä sekä tutkia, miten sosiaalista mediaa hyödynnetään kuntien viestinnässä. Teoriaosuudessa tarkasteltiin sosiaalista mediaa, tutustuttiin sen tunnetuimpiin sovelluksiin sekä perehdyttiin kuntien viestintään yleisesti. Työssä tarkasteltiin myös kuntien viestintään vaikuttavia ja sitä sääteleviä lakeja. Kuntien sosiaalisen median käyttöön tutustuttiin Kuntaliiton tekemän viestintätutkimuksen tulosten pohjalt...

  15. Supratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years.

    Science.gov (United States)

    Luyken, Cordelia; Blümcke, Ingmar; Fimmers, Rolf; Urbach, Horst; Wiestler, Otmar D; Schramm, Johannes

    2004-07-01

    Supratentorial gangliogliomas (GGs) are rare tumors of the central nervous system and are commonly associated with chronic seizures. To date, only case reports and small series of patients with short-term follow-up have been available for the assessment of the potential of GGs to recur and progress. Data from 184 patients who underwent resection of GGs between 1988 and 2001 were available from the University of Bonn Epilepsy Surgery Center (Bonn, Germany). Analysis of factors that influenced tumor recurrence and patient survival, such as preoperative history, age at operation, tumor location, histopathologic findings (including immunohistochemical findings), extent of tumor resection, and recurrence evaluated on postoperative magnetic resonance imaging (MRI), was performed. The median follow-up period was 8 years (range, 1-14 years). One hundred seventy-eight patients (97%) presented with long-term seizures (> or = 2 years). The median age at surgery was 26 years (range, 2-65 years). Tumor location was temporal in 79% of patients and frontal in 12% of patients. Eleven tumors (6%) were classified as World Health Organization (WHO) Grade 2 lesions, and 2 tumors were classified as anaplastic WHO Grade 3 lesions. For 38 patients (21%), postoperative MRIs revealed residual tumors. Two years after surgery, 5 patients (3%) experienced tumor recurrence, which resulted in malignant progression in 3 patients (2%) and death in 2 patients (1%). Eighty-four percent of patients with epilepsy had complete and sustained seizure relief. The calculated 7.5-year recurrence-free survival rate was 97%. Lower rates of recurrence were found in patients with tumors classified as WHO Grade 1 lesions (P < 0.0001), patients with temporal lesions (P < 0.0001), patients who underwent complete tumor resection (P = 0.0278), and patients with long-standing epilepsy (P < 0.0001). Supratentorial GGs are benign tumors, and the surgical goal for patients with GG should be complete resection. Residual

  16. Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986-2005: a retrospective cohort study.

    Science.gov (United States)

    Macpherson, Karen J; Lewsey, James D; Jhund, Pardeep S; Gillies, Michelle; Chalmers, Jim W T; Redpath, Adam; Briggs, Andrew; Walters, Matthew; Langhorne, Peter; Capewell, Simon; McMurray, John J V; MacIntyre, Kate

    2011-03-29

    To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH) in Scotland over a 20 year period. A retrospective cohort study using routine hospital discharge data linked to death records. Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84%) survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the study period. In 2005, incidence in women was 12.8 (95% CI 11.5 to 14.2) and in men 7.9 (95% CI 6.9 to 9.1). 30 day case fatality in individuals hospitalised with SAH declined substantially, falling from 30.0% in men and 33.9% in women in 1986-1990 to 24.5% in men and 29.1% in women in 2001-2005. For both men and women, the largest reductions were observed in those aged between 40 to 59 years. After adjustment for age, socio-economic status and co-morbidity, the odds of death at 30 days in 2005 compared to odds of death in 1986 was 0.64 (0.54 to 0.76), p p = 0.4 in those 70 years and above. Incidence rates for SAH remained stable between 1986 and 2005 suggesting that a better understanding of SAH risk factors and their reduction is needed. 30 day case fatality rates have declined substantially, particularly in middle-age. However, they remain high and it is important to ensure that this is not due to under-diagnosis or under-treatment.

  17. Brain malformation in single median maxillary central incisor

    DEFF Research Database (Denmark)

    Kjaer, I; Wagner, Aa; Thomsen, L L

    2009-01-01

    Clinical and radiographic examinations and MR scan of a 12-year-old girl with SMMCI (single median maxillary central incisor) showed impaired growth and a midline defect involving the central incisor, cranium and the midline structures in the brain, falx cerebri and pituitary gland. She had a sev...

  18. 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...

  19. Prevalence and anatomical pattern of the median artery among ...

    African Journals Online (AJOL)

    Knowledge of the anatomy of median arteries is important in the diagnosis and management of carpal tunnel and pronator teres syndromes, reconstructive surgery in the forearm, minimizing inadvertent vascular injury as well as in limiting operative complications due to unexpected bleeding. The anatomical pattern displays ...

  20. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Introduction: Carpal tunnel syndrome (CTS) is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation ...

  1. Ranking Exponential Trapezoidal Fuzzy Numbers by Median Value

    Directory of Open Access Journals (Sweden)

    S. Rezvani

    2013-12-01

    Full Text Available In this paper, we want represented a method for ranking of two exponential trapezoidal fuzzy numbers. A median value is proposed for the ranking of exponential trapezoidal fuzzy numbers. For the validation the results of the proposed approach are compared with different existing approaches.

  2. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Mona Mokhtar El Bardawil

    2013-10-22

    Oct 22, 2013 ... tient clinic of the Physical Medicine Rheumatology and Reha- bilitation ... F-wave to calculate axillary F central loop (AFCL) latency of median and ..... amplitude which substantially results from the block of faster ... Postoperative electrophysiological follow up for ... Regional rheumatic pain syndromes. In:.

  3. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    numerical methods such as anisotropic diffusion and multiresolution schemes. Some steps ... Roth & Black (2005) have developed a framework for learning a generic and expressive image priors that ..... This paper presents a new approach for image inpainting by propagating median information .... J. Graphics Tools 9(1):.

  4. 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...

  5. Bayesian median regression for temporal gene expression data

    Science.gov (United States)

    Yu, Keming; Vinciotti, Veronica; Liu, Xiaohui; 't Hoen, Peter A. C.

    2007-09-01

    Most of the existing methods for the identification of biologically interesting genes in a temporal expression profiling dataset do not fully exploit the temporal ordering in the dataset and are based on normality assumptions for the gene expression. In this paper, we introduce a Bayesian median regression model to detect genes whose temporal profile is significantly different across a number of biological conditions. The regression model is defined by a polynomial function where both time and condition effects as well as interactions between the two are included. MCMC-based inference returns the posterior distribution of the polynomial coefficients. From this a simple Bayes factor test is proposed to test for significance. The estimation of the median rather than the mean, and within a Bayesian framework, increases the robustness of the method compared to a Hotelling T2-test previously suggested. This is shown on simulated data and on muscular dystrophy gene expression data.

  6. 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.

  7. Lapset median käyttäjinä

    OpenAIRE

    Jalonen, Taru; Suomela, Sonja

    2010-01-01

    Laurea-ammattikorkeakoulu Tiivistelmä Hyvinkää Sosiaali-, terveys- ja liikunta-ala Hoitotyön koulutusohjelma Terveydenhoitaja AMK Sairaanhoitaja AMK Taru Jalonen, Sonja Suomela Lapset median käyttäjinä Vuosi ‎2010‎ Sivumäärä ‎63‎ Tämän opinnäytetyön tarkoituksena oli selvittää lasten tottumuksia ja kokemuksia mediasta sekä ‎niiden herättämiä tunteita. Lisäksi selvitimme lasten käyttämiä mediaympäristöjä sekä median ‎näkymistä lasten leikeissä. Tämä työ on os...

  8. 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.

  9. Depression and Liver Transplant Survival.

    Science.gov (United States)

    Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

    Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  10. Survival analysis

    International Nuclear Information System (INIS)

    Badwe, R.A.

    1999-01-01

    The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

  11. Median Robust Extended Local Binary Pattern for Texture Classification.

    Science.gov (United States)

    Liu, Li; Lao, Songyang; Fieguth, Paul W; Guo, Yulan; Wang, Xiaogang; Pietikäinen, Matti

    2016-03-01

    Local binary patterns (LBP) are considered among the most computationally efficient high-performance texture features. However, the LBP method is very sensitive to image noise and is unable to capture macrostructure information. To best address these disadvantages, in this paper, we introduce a novel descriptor for texture classification, the median robust extended LBP (MRELBP). Different from the traditional LBP and many LBP variants, MRELBP compares regional image medians rather than raw image intensities. A multiscale LBP type descriptor is computed by efficiently comparing image medians over a novel sampling scheme, which can capture both microstructure and macrostructure texture information. A comprehensive evaluation on benchmark data sets reveals MRELBP's high performance-robust to gray scale variations, rotation changes and noise-but at a low computational cost. MRELBP produces the best classification scores of 99.82%, 99.38%, and 99.77% on three popular Outex test suites. More importantly, MRELBP is shown to be highly robust to image noise, including Gaussian noise, Gaussian blur, salt-and-pepper noise, and random pixel corruption.

  12. Median Filtering Methods for Non-volcanic Tremor Detection

    Science.gov (United States)

    Damiao, L. G.; Nadeau, R. M.; Dreger, D. S.; Luna, B.; Zhang, H.

    2016-12-01

    Various properties of median filtering over time and space are used to address challenges posed by the Non-volcanic tremor detection problem. As part of a "Big-Data" effort to characterize the spatial and temporal distribution of ambient tremor throughout the Northern San Andreas Fault system, continuous seismic data from multiple seismic networks with contrasting operational characteristics and distributed over a variety of regions are being used. Automated median filtering methods that are flexible enough to work consistently with these data are required. Tremor is characterized by a low-amplitude, long-duration signal-train whose shape is coherent at multiple stations distributed over a large area. There are no consistent phase arrivals or mechanisms in a given tremor's signal and even the durations and shapes among different tremors vary considerably. A myriad of masquerading noise, anthropogenic and natural-event signals must also be discriminated in order to obtain accurate tremor detections. We present here results of the median methods applied to data from four regions of the San Andreas Fault system in northern California (Geysers Geothermal Field, Napa, Bitterwater and Parkfield) to illustrate the ability of the methods to detect tremor under diverse conditions.

  13. Angiotensin converting enzyme 1 in the median preoptic nucleus contributes to chronic intermittent hypoxia hypertension.

    Science.gov (United States)

    Faulk, Katelynn E; Nedungadi, T Prashant; Cunningham, J Thomas

    2017-05-01

    Obstructive sleep apnea is associated with hypertension and cardiovascular disease. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in sleep apnea patients and is associated with increased sympathetic nerve activity and a sustained diurnal increase in blood pressure. The renin angiotensin system has been associated with hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1, which cleaves angiotensin I to the active counterpart angiotensin II, is present within the central nervous system and has been shown to be regulated by AP-1 transcription factors, such as ΔFosB. Our previous study suggested that this transcriptional regulation in the median preoptic nucleus contributes to the sustained blood pressure seen following chronic intermittent hypoxia. Viral mediated delivery of a short hairpin RNA against angiotensin converting enzyme 1 in the median preoptic nucleus was used along with radio-telemetry measurements of blood pressure to test this hypothesis. FosB immunohistochemistry was utilized in order to assess the effects of angiotensin converting enzyme 1 knockdown on the activity of nuclei downstream from median preoptic nucleus. Angiotensin converting enzyme 1 knockdown within median preoptic nucleus significantly attenuated the sustained hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1 seems to be partly responsible for regulating downstream regions involved in sympathetic and blood pressure control, such as the paraventricular nucleus and the rostral ventrolateral medulla. The data suggest that angiotensin converting enzyme 1 within median preoptic nucleus plays a critical role in the sustained hypertension seen in chronic intermittent hypoxia. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  14. Clinical Outcomes following median to radial nerve transfers

    Science.gov (United States)

    Ray, Wilson Z.; Mackinnon, Susan E.

    2010-01-01

    Purpose In this study the authors evaluate the clinical outcomes in patients with radial nerve palsy who underwent nerve transfers utilizing redundant fascicles of median nerve (innervating the flexor digitorum superficialis and flexor carpi radialis muscles) to the posterior interosseous nerve and the nerve to the extensor carpi radialis brevis. Methods A retrospective review of the clinical records of 19 patients with radial nerve injuries who underwent nerve transfer procedures using the median nerve as a donor nerve were included. All patients were evaluated using the Medical Research Council (MRC) grading system. Results The mean age of patients was 41 years (range 17 – 78 years). All patients received at least 12 months of follow-up (20.3 ± 5.8 months). Surgery was performed at a mean of 5.7 ± 1.9 months post-injury. Post-operative functional evaluation was graded according to the following scale: grades MRC 0/5 - MRC 2/5 were considered poor outcomes, while MRC of 3/5 was a fair result, MRC grade 4/5 was a good result, and grade 4+/5 was considered an excellent outcome. Seventeen patients (89%) had a complete radial nerve palsy while two patients (11%) had intact wrist extension but no finger or thumb extension. Post-operatively all patients except one had good to excellent recovery of wrist extension. Twelve patients recovered good to excellent finger and thumb extension, two patients had fair recovery, five patients had a poor recovery. Conclusions The radial nerve is a commonly injured nerve, causing significant morbidity in affected patients. The median nerve provides a reliable source of donor nerve fascicles for radial nerve reinnervation. This transfer was first performed in 1999 and evolved over the subsequent decade. The important nuances of both surgical technique and motor re-education critical for to the success of this transfer have been identified and are discussed. PMID:21168979

  15. A Rank Test on Equality of Population Medians

    OpenAIRE

    Pooi Ah Hin

    2012-01-01

    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, ap...

  16. Data Visualization of Item-Total Correlation by Median Smoothing

    Directory of Open Access Journals (Sweden)

    Chong Ho Yu

    2016-02-01

    Full Text Available This paper aims to illustrate how data visualization could be utilized to identify errors prior to modeling, using an example with multi-dimensional item response theory (MIRT. MIRT combines item response theory and factor analysis to identify a psychometric model that investigates two or more latent traits. While it may seem convenient to accomplish two tasks by employing one procedure, users should be cautious of problematic items that affect both factor analysis and IRT. When sample sizes are extremely large, reliability analyses can misidentify even random numbers as meaningful patterns. Data visualization, such as median smoothing, can be used to identify problematic items in preliminary data cleaning.

  17. SOSIAALISEN MEDIAN HYÖDYNTÄMINEN KUNTOKESKUS BALANCEN MARKKINOINNISSA

    OpenAIRE

    Arvola, Timo

    2011-01-01

    Tässä opinnäytetyössä oli kyse kehittämistehtävästä. Kehittämistehtävän tarkoitus oli tarkastella voiko Kuntokes-kus Balance hyödyntää sosiaalista mediaa markkinoinnissaan. Empiirisessä osassa on ohje Facebook-sivun luomi-seen. Teorian alussa tarkastellaan sosiaalista mediaa käsitteenä. Sosiaalisesta mediasta käsitteenä siirrytään sosiaalisen median sovelluksiin ja niiden ominaisuuksiin. Sovelluksista käsitellään Facebook, Youtube, Twitter, Wikipedia, blogit, Movescount ja HeiaHeia. ...

  18. Nuorten sosiaalisen median käyttö tiedonhankinnassa

    OpenAIRE

    Simolin, Annina

    2017-01-01

    Opinnäytetyön toimeksiantajana on Hämeen ammattikorkeakoulun strateginen viestintä, joka vastaa muun muassa opiskelijahankinnasta. HAMKilla on tällä hetkellä käytössään useita sosiaalisen median kanavia, ja työllä haluttiin selvittää mistä kanavista ja mitä tietoa nuoret erityisesti hakevat jatko-opintoja suunnitellessaan. Lisäksi haluttiin selvittää miten nuoret haluavat itse olla yhteydessä oppilaitoksiin hakuaikana. Teoriaosiossa on käsitelty nuorten mediakäyttäytymistä sekä useita sosiaal...

  19. A comparison of the recording of comorbidity in primary and secondary care by using the Charlson Index to predict short-term and long-term survival in a routine linked data cohort.

    Science.gov (United States)

    Crooks, C J; West, J; Card, T R

    2015-06-05

    Hospital admission records provide snapshots of clinical histories for a subset of the population admitted to hospital. In contrast, primary care records provide continuous clinical histories for complete populations, but might lack detail about inpatient stays. Therefore, combining primary and secondary care records should improve the ability of comorbidity scores to predict survival in population-based studies, and provide better adjustment for case-mix differences when assessing mortality outcomes. Cohort study. English primary and secondary care 1 January 2005 to 1 January 2010. All patients 20 years and older registered to a primary care practice contributing to the linked Clinical Practice Research Datalink from England. The performance of the Charlson index with mortality was compared when derived from either primary or secondary care data or both. This was assessed in relation to short-term and long-term survival, age, consultation rate, and specific acute and chronic diseases. 657,264 people were followed up from 1 January 2005. Although primary care recorded more comorbidity than secondary care, the resulting C statistics for the Charlson index remained similar: 0.86 and 0.87, respectively. Higher consultation rates and restricted age bands reduced the performance of the Charlson index, but the index's excellent performance persisted over longer follow-up; the C statistic was 0.87 over 1 year, and 0.85 over all 5 years of follow-up. The Charlson index derived from secondary care comorbidity had a greater effect than primary care comorbidity in reducing the association of upper gastrointestinal bleeding with mortality. However, they had a similar effect in reducing the association of diabetes with mortality. These findings support the use of the Charlson index from linked data and show that secondary care comorbidity coding performed at least as well as that derived from primary care in predicting survival. Published by the BMJ Publishing Group Limited

  20. The mean, the median, and the St. Petersburg paradox.

    Science.gov (United States)

    Hayden, Benjamin Y; Platt, Michael L

    2009-06-01

    The St. Petersburg Paradox is a famous economic and philosophical puzzle that has generated numerous conflicting explanations. To shed empirical light on this phenomenon, we examined subjects' bids for one St. Petersburg gamble with a real monetary payment. We found that bids were typically lower than twice the smallest payoff, and thus much lower than is generally supposed. We also examined bids offered for several hypothetical variants of the St. Petersburg Paradox. We found that bids were weakly affected by truncating the gamble, were strongly affected by repeats of the gamble, and depended linearly on the initial "seed" value of the gamble. One explanation, which we call the median heuristic , strongly predicts these data. Subjects following this strategy evaluate a gamble as if they were taking the median rather than the mean of the payoff distribution. Finally, we argue that the distribution of outcomes embodied in the St. Petersburg paradox is so divergent from the Gaussian form that the statistical mean is a poor estimator of expected value, so that the expected value of the St. Petersburg gamble is undefined. These results suggest that this classic paradox has a straightforward explanation rooted in the use of a statistical heuristic.

  1. Wound infection after median sternotomy during the war in Croatia.

    Science.gov (United States)

    Jelić, I; Anić, D; Alfirević, I; Kalinić, S; Ugljen, R; Letica, D; Ante Korda, Z; Vucemilo, I; Bulat, C; Predrijevac, M; Corić, V; Husar, J; Jelic, M; Hulina, D; Depina, I; Dadić, D

    1996-12-01

    From 1990 to 1994 at Clinical Hospital Center, Zagreb, 1904 median sternotomies were performed for cardiac operations. Patients shared the same intensive care unit (ICU) with the wounded persons, admitted to the hospital from battlefield. Infection developed in 124 patients, an incidence of 6.51%. Methicillin resistant Staphylococcus aureus (MRSA) was isolated from 90, methicillin resistant Staphylococcus epidermidis (MRSE) from 19, and gram negative bacilli (GNB) from 56 patients, Pseudomonas aeruginosa in 2, and Clostridium pneumoniae in 1 case. Ninety-six patients (5.04%) developed superficial localized infection of subcutaneous tissues and they were treated with frequent dressing changes with antibiotic-soaked gauze in combination with systemic antibiotics. Twenty-eight patients (1.47%) developed mediastinitis and sternal dehiscence. They were treated by operative debridement followed by reclosure of the sternum with continuous antibiotic irrigation. We obtained satisfactory results with our method of closure of sternum which is a modification of Robicsek's technique. Nine of them required further operation. In seven cases we performed muscle flaps and in two omentoplasty. One hundred and twenty patients were discharged in satisfactory condition. The uncontrolled mediastinal sepsis caused death in 4 patients. Higher infection rate after median sternotomy during 1991 and 1992 could be possibly explained with the war circumstances in Croatia, and especially with MRSA strain becoming endemic in surgical ICU.

  2. A Rare Variation of the Human Median Nerve Direction

    Directory of Open Access Journals (Sweden)

    Barfi

    2016-04-01

    Full Text Available Introduction The brachial plexus, a complex network of nerves, innervates to the upper limbs. Variation in the course of the nerves in the upper limb is common. Case Presentation This paper describes two cases of upper limb variations in a cadaver dissected at Lorestan University of Medical Sciences. In the first variation, the median nerve in the arm has a different route, so that the median moves deep into the brachialis muscle. In the latter case, after piercing the coracobrachialis muscle a musculocutaneous nerve exists between the brachialis and biceps and goes to the lateral region of the forearm. This is known as the lateral cutaneous nerve of the forearm nerve, and innervates the skin of the lateral part of the forearm and the dorsal part of the hand. Conclusions Because of the possibility of damage to the brachial plexus branches is high in upper limb injuries and surgeries, full knowledge of normal anatomy and variations of these branches is essential for orthopedic specialists, neurosurgeons, radiologists, and anatomists.

  3. 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.)

  4. Median sep and blink reflex in thyroid diseases.

    Science.gov (United States)

    Oflazoğlu, B; Somay, G; Us, O; Surardamar, A; Tanridağ, T

    2006-11-01

    Pathological disturbances of thyroid hormones is associated with central and peripheral nervous system disturbances. The aim of this study is to evaluate median nerve stimulated somatosensory evoked potential (SEP) and blink reflex of thyroid patients (hypo and hyperthyroidism). Median SEP was performed in 40 patients (21 with hyperthyroidism and 19 with hypothyroidism). We evaluated the latencies of N9, N11, N13, P9, P11, P14, N20 and P25 waves and the N9-N20, N9-N13, N13-N20 and P14-N20 interpeak latencies. We compared the results of patients with the control group (26 persons). We found that the N20 latency was longer in patients with hyperthyroidism than in the control group and the difference was statistically significant. There was not any statistically significant difference regarding the N9, N11, N13, P9, P11, P14, N20 and P25 latencies and the N9-N20, N9-N13, N13-N20 and P14-N20 interpeak latencies between hypothyroid patients and controls. We performed the blink reflex study in 28 of 40 patients (14 patients with hyperthyroidism and 14 patients with hypothyroidism). Comparing the R1, R2, CR2 (contralateral R2) latencies and durations of the patients and controls, we found that R2 and CR2 duration was shorter in patients with hyperthyroidism. This difference was statistically significant.

  5. The mean, the median, and the St. Petersburg paradox

    Directory of Open Access Journals (Sweden)

    Benjamin Y. Hayden

    2009-06-01

    Full Text Available The St.~Petersburg Paradox is a famous economic and philosophical puzzle that has generated numerous conflicting explanations. To shed empirical light on this phenomenon, we examined subjects' bids for one St.~Petersburg gamble with a real monetary payment. We found that bids were typically lower than twice the smallest payoff, and thus much lower than is generally supposed. We also examined bids offered for several hypothetical variants of the St.~Petersburg Paradox. We found that bids were weakly affected by truncating the gamble, were strongly affected by repeats of the gamble, and depended linearly on the initial ``seed'' value of the gamble. One explanation, which we call the extit{median} extit{heuristic}, strongly predicts these data. Subjects following this strategy evaluate a gamble as if they were taking the median rather than the mean of the payoff distribution. Finally, we argue that the distribution of outcomes embodied in the St.~Petersburg paradox is so divergent from the Gaussian form that the statistical mean is a poor estimator of expected value, so that the expected value of the St.~Petersburg gamble is undefined. These results suggest that this classic paradox has a straightforward explanation rooted in the use of a statistical heuristic.

  6. 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.

  7. 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.

  8. Modelling survival: exposure pattern, species sensitivity and uncertainty.

    Science.gov (United States)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight; Cedergreen, Nina; Charles, Sandrine; Ducrot, Virginie; Focks, Andreas; Gabsi, Faten; Gergs, André; Goussen, Benoit; Jager, Tjalling; Kramer, Nynke I; Nyman, Anna-Maija; Poulsen, Veronique; Reichenberger, Stefan; Schäfer, Ralf B; Van den Brink, Paul J; Veltman, Karin; Vogel, Sören; Zimmer, Elke I; Preuss, Thomas G

    2016-07-06

    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 well GUTS, calibrated with short-term survival data of Gammarus pulex exposed to four pesticides, can forecast effects of longer-term pulsed exposures. Thirdly, we tested the ability of GUTS to estimate 14-day median effect concentrations of malathion for a range of species and use these estimates to build species sensitivity distributions for different exposure patterns. We find that GUTS adequately predicts survival across exposure patterns that vary over time. When toxicity is assessed for time-variable concentrations species may differ in their responses depending on the exposure profile. This can result in different species sensitivity rankings and safe levels. The interplay of exposure pattern and species sensitivity deserves systematic investigation in order to better understand how organisms respond to stress, including humans.

  9. The Clustered, Regularly Interspaced, Short Palindromic Repeats-associated Endonuclease 9 (CRISPR/Cas9)-created MDM2 T309G Mutation Enhances Vitreous-induced Expression of MDM2 and Proliferation and Survival of Cells.

    Science.gov (United States)

    Duan, Yajian; Ma, Gaoen; Huang, Xionggao; D'Amore, Patricia A; Zhang, Feng; Lei, Hetian

    2016-07-29

    The G309 allele of SNPs in the mouse double minute (MDM2) promoter locus is associated with a higher risk of cancer and proliferative vitreoretinopathy (PVR), but whether SNP G309 contributes to the pathogenesis of PVR is to date unknown. The clustered regularly interspaced short palindromic repeats (CRISPR)-associated endonuclease (Cas) 9 from Streptococcus pyogenes (SpCas9) can be harnessed to manipulate a single or multiple nucleotides in mammalian cells. Here we delivered SpCas9 and guide RNAs using dual adeno-associated virus-derived vectors to target the MDM2 genomic locus together with a homologous repair template for creating the mutation of MDM2 T309G in human primary retinal pigment epithelial (hPRPE) cells whose genotype is MDM2 T309T. The next-generation sequencing results indicated that there was 42.51% MDM2 G309 in the edited hPRPE cells using adeno-associated viral CRISPR/Cas9. Our data showed that vitreous induced an increase in MDM2 and subsequent attenuation of p53 expression in MDM2 T309G hPRPE cells. Furthermore, our experimental results demonstrated that MDM2 T309G in hPRPE cells enhanced vitreous-induced cell proliferation and survival, suggesting that this SNP contributes to the pathogenesis of PVR. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  10. Sosiaalisen median merkitys mikroyrityksille - Case: TallFits Oy

    OpenAIRE

    Nousiainen, Ari; Koskivuori, Timo

    2011-01-01

    Tämän opinnäytetyön aiheena on sosiaalinen media mikroyritysten näkökulmasta. Työssä käsi-tellään sosiaalista mediaa ja markkinoinnissa tapahtunutta muutosta sekä niitä toimintatapoja, joita interaktiivinen mediaympäristö yrityksille ja sen asiakkaille tarjoaa. Työn tavoitteena on tuottaa tietoa sosiaalisen median hyödyistä ja haasteista mikroyrityksille ja lisätä koh-deyrityksemme TallFits Oy:n myyntiä ja löydettävyyttä. Tavoitteiden saavuttamiseksi opinnäytetyömme tarkoituksena oli tehd...

  11. Mesopontine median raphe regulates hippocampal ripple oscillation and memory consolidation.

    Science.gov (United States)

    Wang, Dong V; Yau, Hau-Jie; Broker, Carl J; Tsou, Jen-Hui; Bonci, Antonello; Ikemoto, Satoshi

    2015-05-01

    Sharp wave-associated field oscillations (∼200 Hz) of the hippocampus, referred to as ripples, are believed to be important for consolidation of explicit memory. Little is known about how ripples are regulated by other brain regions. We found that the median raphe region (MnR) is important for regulating hippocampal ripple activity and memory consolidation. We performed in vivo simultaneous recording in the MnR and hippocampus of mice and found that, when a group of MnR neurons was active, ripples were absent. Consistently, optogenetic stimulation of MnR neurons suppressed ripple activity and inhibition of these neurons increased ripple activity. Notably, using a fear conditioning procedure, we found that photostimulation of MnR neurons interfered with memory consolidation. Our results demonstrate a critical role of the MnR in regulating ripples and memory consolidation.

  12. Dose dependency of the frequency of micronucleated binucleated clone cells and of division related median clone sizes difference. Pt. 2

    International Nuclear Information System (INIS)

    Hagemann, G,; Kreczik, A.; Treichel, M.

    1996-01-01

    Following irradiation of the progenitor cells the clone growth of CHO cells decreases as a result of cell losses. Lethally acting expressions of micronuclei are produced by heritable lethal mutations. The dependency of the frequency of micronucleated binucleated clone cells and of the median clone sizes difference on the radiation dose was measured and compared to non-irradiated controls. Using the cytokinesis-block-micronucleus-method binucleated cells with micronuclei were counted as ratio of all binucleated cells within a clone size distribution. This ratio (shortened: micronucleus yield) was determined for all clone size distributions, which had been exposed to different irradiation doses and incubation times. The micronucleus yields were compared to the corresponding median clone sizes differences. The micronucleus yield is linearly dependent on the dose and is independent of the incubation time. The same holds true for the division related median clone sizes difference, which as a result is also linearly dependent on the micronucleus yield. Due to the inevitably errors of the cell count of micronucleated binucleated cells, an automatic measurement of the median clone sizes differences is the preferred method for evaluation of cellular radiation sensitivity for heritable lethal mutations. This value should always be determined in addition, if clone survival fractions are used as predictive test because it allows for an estimation of the remission probability of surviving cells. (orig.) [de

  13. Green and sustainable median on a divided multilane highway

    Science.gov (United States)

    Ambak, K.; Bajuri, F. A. A.; Yusoff, N. A.; Madun, A.; Prasetijo, J.

    2017-11-01

    The road system in Malaysia showed good growth with increasing number of vehicles on the road. However, statistic of road accident is still at an alarming rate. There are many factor can contribute to the occurrence of an accident. If the accident was caused by road facilities such as street furniture, it is shown that the street furniture was failed to improve the safety of the road users. In this study, a new concept of materials for the construction of road dividers was purpose. The sustainable materials such as laterite soil, Cow Grass, tires and PVC pipes was used to replace the cement and iron guardrails in road divider construction. The main objectives of this study is to design characteristics of a road divider using natural material such as laterite soil, sand, grass and recycle material like used a tyre. A series of experiments such as test liquid limit, plastic limit test, standard proctor test and observations of root growth in 30 days were conducted. The result shows that the plastic index value of 35% was obtained. From the proctor compaction test, the optimum water content was 23% and maximum dry density at 15.3 kN/m3. This value was used to build a prototype of green and sustainable raised road median. The suitability of sand used as the medium in irrigation system was approved. Permeability of sand is 10-2 mm/s to 10 mm/s which is having a high rate of flow. The growth of Cow Grass roots was increased by 4.9 cm in 30 days. This shows that, the grass is suitable to grow in laterite soil and can be used as vegetation material. Through the impact test conducted on a model with a scale of 1:7.5, indicate the initial damage occurred when a force reaches 10N. However, the condition of the model is still stable. From the impact test conducted, the prototype of green and sustainable raised road median has a good potential to be used as existing road divider as it can absorb the impact of an accident.

  14. Etiology and mechanisms of ulnar and median forearm nerve injuries

    Directory of Open Access Journals (Sweden)

    Puzović Vladimir

    2015-01-01

    Full Text Available Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%, while only 18 (18.2% were females, both mainly with nerve injuries of the distal forearm - 75 (75.6%. Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis.

  15. Approximate median regression for complex survey data with skewed response.

    Science.gov (United States)

    Fraser, Raphael André; Lipsitz, Stuart R; Sinha, Debajyoti; Fitzmaurice, Garrett M; Pan, Yi

    2016-12-01

    The ready availability of public-use data from various large national complex surveys has immense potential for the assessment of population characteristics using regression models. Complex surveys can be used to identify risk factors for important diseases such as cancer. Existing statistical methods based on estimating equations and/or utilizing resampling methods are often not valid with survey data due to complex survey design features. That is, stratification, multistage sampling, and weighting. In this article, we accommodate these design features in the analysis of highly skewed response variables arising from large complex surveys. Specifically, we propose a double-transform-both-sides (DTBS)'based estimating equations approach to estimate the median regression parameters of the highly skewed response; the DTBS approach applies the same Box-Cox type transformation twice to both the outcome and regression function. The usual sandwich variance estimate can be used in our approach, whereas a resampling approach would be needed for a pseudo-likelihood based on minimizing absolute deviations (MAD). Furthermore, the approach is relatively robust to the true underlying distribution, and has much smaller mean square error than a MAD approach. The method is motivated by an analysis of laboratory data on urinary iodine (UI) concentration from the National Health and Nutrition Examination Survey. © 2016, The International Biometric Society.

  16. Does delay in diagnosing colorectal cancer in symptomatic patients affect tumor stage and survival? A population-based observational study

    Directory of Open Access Journals (Sweden)

    Visser Otto

    2010-06-01

    Full Text Available Abstract Background Diagnosing colorectal cancer (CRC at an early stage improves survival. To what extent any delay affects outcome once patients are symptomatic is still unclear. Our objectives were to evaluate the association between diagnostic delay and survival in symptomatic patients with early stage CRC and late stage CRC. Methods Prospective population-based observational study evaluating daily clinical practice in Northern Holland. Diagnostic delay was determined through questionnaire-interviews. Dukes' stage was classified into two groups: early stage (Dukes A or B and late stage (Dukes C or D cancer. Patients were followed up for 3.5 years after diagnosis. Results In total, 272 patients were available for analysis. Early stage CRC was present in 136 patients while 136 patients had late stage CRC. The mean total diagnostic delay (SE was 31 (1.5 weeks in all CRC patients. No significant difference was observed in the mean total diagnostic delay in early versus late stage CRC (p = 0.27. In early stage CRC, no difference in survival was observed between patients with total diagnostic delay shorter and longer than the median (Kaplan-Meier, log-rank p = 0.93. In late stage CRC, patients with a diagnostic delay shorter than the median had a shorter survival than patients with a diagnostic delay longer than the median (log-rank p = 0.01. In the multivariate Cox regression model with survival as dependent variable and median delay, age, open access endoscopy, number and type of symptoms as independent variables, the odd's ratio for survival in patients with long delay (>median versus short delay (≤median was 1.8 (95% confidence interval (CI 1.1 to 3.0; p = 0.01. Tumor-site was not associated with patient survival. When separating late stage CRC in Dukes C and Dukes D tumors, a shorter delay was associated with a shorter survival in Dukes D tumors only and not in Dukes C tumors. Conclusion In symptomatic CRC patients, a longer diagnostic and

  17. The frontotemporal syndrome of ALS is associated with poor survival.

    Science.gov (United States)

    Govaarts, Rosanne; Beeldman, Emma; Kampelmacher, Mike J; van Tol, Marie-Jose; van den Berg, Leonard H; van der Kooi, Anneke J; Wijkstra, Peter J; Zijnen-Suyker, Marianne; Cobben, Nicolle A M; Schmand, Ben A; de Haan, Rob J; de Visser, Marianne; Raaphorst, Joost

    2016-12-01

    Thirty percent of ALS patients have a frontotemporal syndrome (FS), defined as behavioral changes or cognitive impairment. Despite previous studies, there are no firm conclusions on the effect of the FS on survival and the use of non-invasive ventilation (NIV) in ALS. We examined the effect of the FS on survival and the start and duration of NIV in ALS. Behavioral changes were defined as >22 points on the ALS-Frontotemporal-Dementia-Questionnaire or ≥3 points on ≥2 items of the Neuropsychiatric Inventory. Cognitive impairment was defined as below the fifth percentile on ≥2 tests of executive function, memory or language. Classic ALS was defined as ALS without the frontotemporal syndrome. We performed survival analyses from symptom onset and time from NIV initiation, respectively, to death. The impact of the explanatory variables on survival and NIV initiation were examined using Cox proportional hazards models. We included 110 ALS patients (76 men) with a mean age of 62 years. Median survival time was 4.3 years (95 % CI 3.53-5.13). Forty-seven patients (43 %) had an FS. Factors associated with shorter survival were FS, bulbar onset, older age at onset, short time to diagnosis and a C9orf72 repeat expansion. The adjusted hazard ratio (HR) for the FS was 2.29 (95 % CI 1.44-3.65, p NIV initiation (adjusted HR 2.70, 95 % CI 1.04-4.67, p = 0.04). In conclusion, there is an association between the frontotemporal syndrome and poor survival in ALS, which remains present after initiation of NIV.

  18. Median sternotomy - gold standard incision for cardiac surgeons

    Directory of Open Access Journals (Sweden)

    Radu Matache

    2016-05-01

    Full Text Available Sternotomy is the gold standard incision for cardiac surgeons but it is also used in thoracic surgery especially for mediastinal, tracheal and main stem bronchus surgery. The surgical technique is well established and identification of the correct anatomic landmarks, midline tissue preparation, osteotomy and bleeding control are important steps of the procedure. Correct sternal closure is vital for avoiding short- and long-term morbidity and mortality. The two sternal halves have to be well approximated to facilitate healing of the bone and to avoid instability, which is a risk factor for wound infection. New suture materials and techniques would be expected to be developed to further improve the patients evolution, in respect to both immediate postoperative period and long-term morbidity and mortality

  19. The Investigation of Median Frequency Changes in Paraspinal Muscles Following Fatigue

    Directory of Open Access Journals (Sweden)

    Saeed Talebian

    2009-10-01

    Conclusion: Median frequency shift toward low values following fatigue in global and local paraspinal muscles was seen. However, median frequency values for the local stabilizer muscle were higher than median frequency values for the global muscles.

  20. Survival after stereotactic biopsy of malignant gliomas

    International Nuclear Information System (INIS)

    Coffey, R.J.; Lunsford, L.D.; Taylor, F.H.

    1988-01-01

    For many patients with malignant gliomas in inaccessible or functionally important locations, stereotactic biopsy followed by radiation therapy (RT) may be a more appropriate initial treatment than craniotomy and tumor resection. We studied the long term survival in 91 consecutive patients with malignant gliomas diagnosed by stereotactic biopsy: 64 had glioblastoma multiforme (GBM) and 27 had anaplastic astrocytoma (AA). Sixty-four per cent of the GBMs and 33% of the AAs involved deep or midline cerebral structures. The treatment prescribed after biopsy, the tumor location, the histological findings, and the patient's age at presentation (for AAs) were statistically important factors determining patient survival. If adequate RT (tumor dose of 5000 to 6000 cGy) was not prescribed, the median survival was less than or equal to 11 weeks regardless of tumor histology or location. The median survival for patients with deep or midline tumors who completed RT was similar in AA (19.4 weeks) and GBM (27 weeks) cases. Histology was an important predictor of survival only for patients with adequately treated lobar tumors. The median survival in lobar GBM patients who completed RT was 46.9 weeks, and that in lobar AA patients who completed RT was 129 weeks. Cytoreductive surgery had no statistically significant effect on survival. Among the clinical factors examined, age of less than 40 years at presentation was associated with prolonged survival only in AA patients. Constellations of clinical features, tumor location, histological diagnosis, and treatment prescribed were related to survival time

  1. Validation of a Predictive Model for Survival in Metastatic Cancer Patients Attending an Outpatient Palliative Radiotherapy Clinic

    International Nuclear Information System (INIS)

    Chow, Edward; Abdolell, Mohamed; Panzarella, Tony; Harris, Kristin; Bezjak, Andrea; Warde, Padraig; Tannock, Ian

    2009-01-01

    Purpose: To validate a predictive model for survival of patients attending a palliative radiotherapy clinic. Methods and Materials: We described previously a model that had good predictive value for survival of patients referred during 1999 (1). The six prognostic factors (primary cancer site, site of metastases, Karnofsky performance score, and the fatigue, appetite and shortness-of-breath items from the Edmonton Symptom Assessment Scale) identified in this training set were extracted from the prospective database for the year 2000. We generated a partial score whereby each prognostic factor was assigned a value proportional to its prognostic weight. The sum of the partial scores for each patient was used to construct a survival prediction score (SPS). Patients were also grouped according to the number of these risk factors (NRF) that they possessed. The probability of survival at 3, 6, and 12 months was generated. The models were evaluated for their ability to predict survival in this validation set with appropriate statistical tests. Results: The median survival and survival probabilities of the training and validation sets were similar when separated into three groups using both SPS and NRF methods. There was no statistical difference in the performance of the SPS and NRF methods in survival prediction. Conclusion: Both the SPS and NRF models for predicting survival in patients referred for palliative radiotherapy have been validated. The NRF model is preferred because it is simpler and avoids the need to remember the weightings among the prognostic factors

  2. Characterizing the continuously acquired cardiovascular time series during hemodialysis, using median hybrid filter preprocessing noise reduction

    Directory of Open Access Journals (Sweden)

    Wilson S

    2015-01-01

    Full Text Available Scott Wilson,1,2 Andrea Bowyer,3 Stephen B Harrap4 1Department of Renal Medicine, The Alfred Hospital, 2Baker IDI, Melbourne, 3Department of Anaesthesia, Royal Melbourne Hospital, 4University of Melbourne, Parkville, VIC, Australia Abstract: The clinical characterization of cardiovascular dynamics during hemodialysis (HD has important pathophysiological implications in terms of diagnostic, cardiovascular risk assessment, and treatment efficacy perspectives. Currently the diagnosis of significant intradialytic systolic blood pressure (SBP changes among HD patients is imprecise and opportunistic, reliant upon the presence of hypotensive symptoms in conjunction with coincident but isolated noninvasive brachial cuff blood pressure (NIBP readings. Considering hemodynamic variables as a time series makes a continuous recording approach more desirable than intermittent measures; however, in the clinical environment, the data signal is susceptible to corruption due to both impulsive and Gaussian-type noise. Signal preprocessing is an attractive solution to this problem. Prospectively collected continuous noninvasive SBP data over the short-break intradialytic period in ten patients was preprocessed using a novel median hybrid filter (MHF algorithm and compared with 50 time-coincident pairs of intradialytic NIBP measures from routine HD practice. The median hybrid preprocessing technique for continuously acquired cardiovascular data yielded a dynamic regression without significant noise and artifact, suitable for high-level profiling of time-dependent SBP behavior. Signal accuracy is highly comparable with standard NIBP measurement, with the added clinical benefit of dynamic real-time hemodynamic information. Keywords: continuous monitoring, blood pressure

  3. Characterizing the continuously acquired cardiovascular time series during hemodialysis, using median hybrid filter preprocessing noise reduction.

    Science.gov (United States)

    Wilson, Scott; Bowyer, Andrea; Harrap, Stephen B

    2015-01-01

    The clinical characterization of cardiovascular dynamics during hemodialysis (HD) has important pathophysiological implications in terms of diagnostic, cardiovascular risk assessment, and treatment efficacy perspectives. Currently the diagnosis of significant intradialytic systolic blood pressure (SBP) changes among HD patients is imprecise and opportunistic, reliant upon the presence of hypotensive symptoms in conjunction with coincident but isolated noninvasive brachial cuff blood pressure (NIBP) readings. Considering hemodynamic variables as a time series makes a continuous recording approach more desirable than intermittent measures; however, in the clinical environment, the data signal is susceptible to corruption due to both impulsive and Gaussian-type noise. Signal preprocessing is an attractive solution to this problem. Prospectively collected continuous noninvasive SBP data over the short-break intradialytic period in ten patients was preprocessed using a novel median hybrid filter (MHF) algorithm and compared with 50 time-coincident pairs of intradialytic NIBP measures from routine HD practice. The median hybrid preprocessing technique for continuously acquired cardiovascular data yielded a dynamic regression without significant noise and artifact, suitable for high-level profiling of time-dependent SBP behavior. Signal accuracy is highly comparable with standard NIBP measurement, with the added clinical benefit of dynamic real-time hemodynamic information.

  4. Effects of percutaneous endoscopic gastrostomy on survival of patients in a persistent vegetative state after stroke.

    Science.gov (United States)

    Wu, Kunpeng; Chen, Ying; Yan, Caihong; Huang, Zhijia; Wang, Deming; Gui, Peigen; Bao, Juan

    2017-10-01

    To assess the effect of percutaneous endoscopic gastrostomy on short- and long-term survival of patients in a persistent vegetative state after stroke and determine the relevant prognostic factors. Stroke may lead to a persistent vegetative state, and the effect of percutaneous endoscopic gastrostomy on survival of stroke patients in a persistent vegetative state remains unclear. Prospective study. A total of 97 stroke patients in a persistent vegetative state hospitalised from January 2009 to December 2011 at the Second Hospital, University of South China, were assessed in this study. Percutaneous endoscopic gastrostomy was performed in 55 patients, and mean follow-up time was 18 months. Survival rate and risk factors were analysed. Median survival in the 55 percutaneous endoscopic gastrostomy-treated patients was 17·6 months, higher compared with 8·2 months obtained for the remaining 42 patients without percutaneous endoscopic gastrostomy treatment. Univariate analyses revealed that age, hospitalisation time, percutaneous endoscopic gastrostomy treatment status, family financial situation, family care, pulmonary infection and nutrition were significantly associated with survival. Multivariate analysis indicated that older age, no gastrostomy, poor family care, pulmonary infection and poor nutritional status were independent risk factors affecting survival. Indeed, percutaneous endoscopic gastrostomy significantly improved the nutritional status and decreased pulmonary infection rate in patients with persistent vegetative state after stroke. Interestingly, median survival time was 20·3 months in patients with no or one independent risk factors of poor prognosis (n = 38), longer compared with 8·7 months found for patients with two or more independent risk factors (n = 59). Percutaneous endoscopic gastrostomy significantly improves long-term survival of stroke patients in a persistent vegetative state and is associated with improved nutritional status

  5. Short-course palliative radiotherapy for uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2013-12-15

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  6. Short-course palliative radiotherapy for uterine cervical cancer

    International Nuclear Information System (INIS)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won; Nam, Ji Ho; Jeon, Sang Ho

    2013-01-01

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  7. Implementation and evaluation of an ordered subsets reconstruction algorithm for transmission PET studies using median root prior and inter-update median filtering

    International Nuclear Information System (INIS)

    Bettinardi, V.; Gilardi, M.C.; Fazio, F.; Alenius, S.; Ruotsalainen, U.; Numminen, P.; Teraes, M.

    2003-01-01

    An ordered subsets (OS) reconstruction algorithm based on the median root prior (MRP) and inter-update median filtering was implemented for the reconstruction of low count statistics transmission (TR) scans. The OS-MRP-TR algorithm was evaluated using an experimental phantom, simulating positron emission tomography (PET) whole-body (WB) studies, as well as patient data. Various experimental conditions, in terms of TR scan time (from 1 h to 1 min), covering a wide range of TR count statistics were evaluated. The performance of the algorithm was assessed by comparing the mean value of the attenuation coefficient (MVAC) of known tissue types and the coefficient of variation (CV) for low-count TR images, reconstructed with the OS-MRP-TR algorithm, with reference values obtained from high-count TR images reconstructed with a filtered back-projection (FBP) algorithm. The reconstructed OS-MRP-TR images were then used for attenuation correction of the corresponding emission (EM) data. EM images reconstructed with attenuation correction generated by OS-MRP-TR images, of low count statistics, were compared with the EM images corrected for attenuation using reference (high statistics) TR data. In all the experimental situations considered, the OS-MRP-TR algorithm showed: (1) a tendency towards a stable solution in terms of MVAC; (2) a difference in the MVAC of within 5% for a TR scan of 1 min reconstructed with the OS-MRP-TR and a TR scan of 1 h reconstructed with the FBP algorithm; (3) effectiveness in noise reduction, particularly for low count statistics data [using a specific parameter configuration the TR images reconstructed with OS-MRP-TR(1 min) had a lower CV than the corresponding TR images of a 1-h scan reconstructed with the FBP algorithm]; (4) a difference of within 3% between the mean counts in the EM images attenuation corrected using the OS-MRP-TR images of 1 min and the mean counts in the EM images attenuation corrected using the OS-MRP-TR images of 1 h; (5

  8. 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.

  9. Polymorphisms of LIG4, BTBD2, HMGA2, and RTEL1 genes involved in the double-strand break repair pathway predict glioblastoma survival.

    Science.gov (United States)

    Liu, Yanhong; Shete, Sanjay; Etzel, Carol J; Scheurer, Michael; Alexiou, George; Armstrong, Georgina; Tsavachidis, Spyros; Liang, Fu-Wen; Gilbert, Mark; Aldape, Ken; Armstrong, Terri; Houlston, Richard; Hosking, Fay; Robertson, Lindsay; Xiao, Yuanyuan; Wiencke, John; Wrensch, Margaret; Andersson, Ulrika; Melin, Beatrice S; Bondy, Melissa

    2010-05-10

    Glioblastoma (GBM) is the most common and aggressive type of glioma and has the poorest survival. However, a small percentage of patients with GBM survive well beyond the established median. Therefore, identifying the genetic variants that influence this small number of unusually long-term survivors may provide important insight into tumor biology and treatment. Among 590 patients with primary GBM, we evaluated associations of survival with the 100 top-ranking glioma susceptibility single nucleotide polymorphisms from our previous genome-wide association study using Cox regression models. We also compared differences in genetic variation between short-term survivors (STS; or= 36 months), and explored classification and regression tree analysis for survival data. We tested results using two independent series totaling 543 GBMs. We identified LIG4 rs7325927 and BTBD2 rs11670188 as predictors of STS in GBM and CCDC26 rs10464870 and rs891835, HMGA2 rs1563834, and RTEL1 rs2297440 as predictors of LTS. Further survival tree analysis revealed that patients >or= 50 years old with LIG4 rs7325927 (V) had the worst survival (median survival time, 1.2 years) and exhibited the highest risk of death (hazard ratio, 17.53; 95% CI, 4.27 to 71.97) compared with younger patients with combined RTEL1 rs2297440 (V) and HMGA2 rs1563834 (V) genotypes (median survival time, 7.8 years). Polymorphisms in the LIG4, BTBD2, HMGA2, and RTEL1 genes, which are involved in the double-strand break repair pathway, are associated with GBM survival.

  10. Effect of integrated surgery + radiotherapy + chemotherapy treatment on survival status and serum indexes in patients with gallbladder carcinoma

    Directory of Open Access Journals (Sweden)

    Zhi-Li Wei

    2016-12-01

    Full Text Available Objective: To study the effect of integrated surgery + radiotherapy + chemotherapy treatment on the survival status and serum indexes in patients with gallbladder carcinoma. Methods: A total of 68 patients with gallbladder carcinoma were divided into observation group (received integrated surgery + radiotherapy + chemotherapy treatment and control group (received surgery + radiotherapy according to different treatments. Differences in the content of tumor markers, growth factors and adhesion molecules in serum as well as the median survival time and survival rate in 5 years of follow-up were compared between the two groups 1 month after treatment. Results: Tumor markers β2-MG, CA19-9, CA242, CA125, CA724, CEA and AFP content in serum of observation group after treatment were significantly lower than those of control group; growth factors VEGF, FGF, EGFR and HER2 content in serum were significantly lower than those of control group while IGFBP-2 and IGFBP-3 content were significantly higher than those of control group; adhesion molecules E-selectin, ICAM-1, VCAM-1 and sE-Cd content in serum were significantly lower than those of control group; the median survival time of 5-year follow-up as well as 1-, 3- and 5-year survival rate were significantly greater than those of control group. Conclusions: Integrated treatment of surgery + radiotherapy + chemotherapy can optimize the short-term and long-term curative effect in patients with gallbladder carcinoma.

  11. Short philtrum

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003302.htm Short philtrum To use the sharing features on this page, please enable JavaScript. A short philtrum is a shorter than normal distance between ...

  12. Cold intolerance following median and ulnar nerve injuries : prognosis and predictors

    NARCIS (Netherlands)

    Ruijs, A.C.J; Jaquet, J-B.; van Riel, W. G.; Daanen, H. A M; Hovius, S.E.R.

    This study describes the predictors for cold intolerance and the relationship to sensory recovery after median and ulnar nerve injuries. The study population consisted of 107 patients 2 to 10 years after median, ulnar or combined median and ulnar nerve injuries. Patients were asked to fill out the

  13. Cold intolerance following median and ulnar nerve injuries : prognosis and predictors

    NARCIS (Netherlands)

    Ruijs, A.C.J.; Jaquet, J.B.; Riel, W.G. van; Daanen, H.A.M.; Hovius, S.E.R.

    2007-01-01

    This study describes the predictors for cold intolerance and the relationship to sensory recovery after median and ulnar nerve injuries. The study population consisted of 107 patients 2 to 10 years after median, ulnar or combined median and ulnar nerve injuries. Patients were asked to fill out the

  14. Functional outcome and survival after radiotherapy of metastatic spinal cord compression in patients with cancer of unknown primary

    International Nuclear Information System (INIS)

    Rades, Dirk; Fehlauer, Fabian; Veninga, Theo; Stalpers, Lukas J.A.; Basic, Hiba; Hoskin, Peter J.; Rudat, Volker; Karstens, Johann H.; Schild, Steven E.; Dunst, Juergen

    2007-01-01

    Purpose: Patients with cancer of unknown primary (CUP) account for about 10% of patients with metastatic spinal cord compression (MSCC). This study aims to define the appropriate radiation regimen for these patients. Methods and Materials: Data of 143 CUP patients irradiated for MSCC were retrospectively evaluated. Short-course radiotherapy (RT) (1x8 Gy, 5x4 Gy, n = 68) and long-course RT (10x3 Gy, 15x2.5 Gy, 20x2 Gy, n = 75) plus 8 further potential prognostic factors (age, gender, performance status, visceral metastases, other bone metastases, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT) were compared for functional outcome and survival. Results: Improvement of motor function occurred in 10% of patients, no further progression of motor deficits in 57%, and deterioration in 33%. On multivariate analysis, functional outcome was positively associated with slower development of motor deficits (p < 0.001), absence of visceral metastases (p = 0.008) and other bone metastases (p = 0.027), and ambulatory status (p = 0.054), not with the radiation regimen (p = 0.74). Recurrence of MSCC in the irradiated region occurred in 7 patients after median 6 months. Median survival was 4 months. On multivariate analysis, better survival was significantly associated with absence of visceral metastases (p < 0.001), absence of other bone metastases (p = 0.005), ambulatory status (p = 0.001), and slower development of motor deficits (p = 0.030). Conclusions: For MSCC treatment in patients with CUP, no significant difference was observed between short-course and long-course RT regarding functional outcome and survival. Short-course RT appears preferable, at least for patients with a poor predicted survival, as it is more patient convenient and more cost-effective

  15. The survival time of chocolates on hospital wards: covert observational study.

    Science.gov (United States)

    Gajendragadkar, Parag R; Moualed, Daniel J; Nicolson, Phillip L R; Adjei, Felicia D; Cakebread, Holly E; Duehmke, Rudolf M; Martin, Claire A

    2013-12-14

    To quantify the consumption of chocolates in a hospital ward environment. Multicentre, prospective, covert observational study. Four wards at three hospitals (where the authors worked) within the United Kingdom. Boxes of Quality Street (Nestlé) and Roses (Cadbury) on the ward and anyone eating these chocolates. Observers covertly placed two 350 g boxes of Quality Street and Roses chocolates on each ward (eight boxes were used in the study containing a total of 258 individual chocolates). These boxes were kept under continuous covert surveillance, with the time recorded when each chocolate was eaten. Median survival time of a chocolate. 191 out of 258 (74%) chocolates were observed being eaten. The mean total observation period was 254 minutes (95% confidence interval 179 to 329). The median survival time of a chocolate was 51 minutes (39 to 63). The model of chocolate consumption was non-linear, with an initial rapid rate of consumption that slowed with time. An exponential decay model best fitted these findings (model R(2)=0.844, P<0.001), with a survival half life (time taken for 50% of the chocolates to be eaten) of 99 minutes. The mean time taken to open a box of chocolates from first appearance on the ward was 12 minutes (95% confidence interval 0 to 24). Quality Street chocolates survived longer than Roses chocolates (hazard ratio for survival of Roses v Quality Street 0.70, 95% confidence interval 0.53 to 0.93, P=0.014). The highest percentages of chocolates were consumed by healthcare assistants (28%) and nurses (28%), followed by doctors (15%). From our observational study, chocolate survival in a hospital ward was relatively short, and was modelled well by an exponential decay model. Roses chocolates were preferentially consumed to Quality Street chocolates in a ward setting. Chocolates were consumed primarily by healthcare assistants and nurses, followed by doctors. Further practical studies are needed.

  16. High BRAF Mutation Frequency and Marked Survival Differences in Subgroups According to KRAS/BRAF Mutation Status and Tumor Tissue Availability in a Prospective Population-Based Metastatic Colorectal Cancer Cohort

    DEFF Research Database (Denmark)

    Sorbye, Halfdan; Dragomir, Anca; Sundström, Magnus

    2015-01-01

    were analyzed in a prospectively collected unselected population-based cohort of 798 non-resectable mCRC patients. The cohort contained many patients with poor performance status (39% PS 2-4) and elderly (37% age>75), groups usually not included in clinical trials. Patients without available tissue...... patients. Median survival in this cohort varied from 1 month in BRAF mutated patients not given chemotherapy to 26 months in wildtype KRAS/BRAF patients availability, BRAF mutation and KRAS mutation were all independent prognostic factors for survival. The observed 21% BRAF......CRC patients. Survival in unselected metastatic colorectal cancer patients is extremely variable and subgroups have an extremely short survival compared to trial patients. Patients without available TMA had worse prognostic factors and shorter survival, which questions the total generalizability of present TMA...

  17. 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.

  18. Separate patient serum sodium medians from males and females provide independent information on analytical bias.

    Science.gov (United States)

    Hansen, Steen Ingemann; Petersen, Per Hyltoft; Lund, Flemming; Fraser, Callum G; Sölétormos, György

    2017-10-26

    During monitoring of monthly medians of results from patients undertaken to assess analytical stability in routine laboratory performance, the medians for serum sodium for male and female patients were found to be significantly related. Daily, weekly and monthly patient medians of serum sodium for both male and female patients were calculated from results obtained on samples from the population >18 years on three analysers in the hospital laboratory. The half-range of medians was applied as an estimate of the maximum bias. Further, the ratios between the two medians were calculated. The medians of both genders demonstrated dispersions over time, but they were closely connected in like patterns, which were confirmed by the half-range of the ratios of medians for males and females that varied from 0.36% for daily, 0.14% for weekly and 0.036% for monthly ratios over all instruments. The tight relationship between the gender medians for serum sodium is only possible when raw laboratory data are used for calculation. The two patient medians can be used to confirm both and are useful as independent estimates of analytical bias during constant calibration periods. In contrast to the gender combined median, the estimate of analytical bias can be confirmed further by calculation of the ratios of medians for males and females.

  19. Separate patient serum sodium medians from males and females provide independent information on analytical bias

    DEFF Research Database (Denmark)

    Hansen, Steen Ingemann; Petersen, Per Hyltoft; Lund, Flemming

    2017-01-01

    BACKGROUND: During monitoring of monthly medians of results from patients undertaken to assess analytical stability in routine laboratory performance, the medians for serum sodium for male and female patients were found to be significantly related. METHODS: Daily, weekly and monthly patient medians...... all instruments. CONCLUSIONS: The tight relationship between the gender medians for serum sodium is only possible when raw laboratory data are used for calculation. The two patient medians can be used to confirm both and are useful as independent estimates of analytical bias during constant...... calibration periods. In contrast to the gender combined median, the estimate of analytical bias can be confirmed further by calculation of the ratios of medians for males and females....

  20. Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

    Science.gov (United States)

    Lidsky, Michael E; Sun, Zhifei; Nussbaum, Daniel P; Adam, Mohamed A; Speicher, Paul J; Blazer, Dan G

    2017-08-01

    This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoretical advantages for undergoing surgery locally exist. The 1998 to 2012 National Cancer Data Base was queried for T1-3N0-1M0 pancreatic adenocarcinoma patients who underwent PD. Travel distances to treatment centers were calculated. Overlaying the upper and lower quartiles of travel distance with institutional volume established short travel/low-volume (ST/LV) and long travel/high-volume (LT/HV) cohorts. Overall survival was evaluated. Of 7086 patients, 773 ST/LV patients traveled ≤6.3 (median 3.2) miles to centers performing ≤3.3 PDs yearly, and 758 LT/HV patients traveled ≥45 (median 97.3) miles to centers performing ≥16 PDs yearly. LT/HV patients had higher stage disease (P travel to a high-volume center remained associated with reduced long-term mortality (hazard ratio 0.75, P travel burden, patients treated at high-volume centers had improved perioperative outcomes, short-term mortality, and overall survival. These data support ongoing efforts to centralize care for patients undergoing PD.

  1. Usefulness of ultrasound assessment of median nerve mobility in carpal tunnel syndrome.

    Science.gov (United States)

    Park, Gi-Young; Kwon, Dong Rak; Seok, Jung Im; Park, Dong-Soon; Cho, Hee Kyung

    2018-01-01

    Background Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy of the upper extremity. Recently, dynamic ultrasound (US) imaging has shown differences in median nerve mobility between the affected and unaffected sides in CTS. Purpose The present study was performed to compare the median nerve mobility between patients with CTS and healthy individuals, and to correlate median nerve mobility with the severity of CTS. Material and Methods A total of 101 patients (128 wrists) with CTS and 43 healthy individuals (70 wrists) were evaluated. Electrodiagnostic studies were initially conducted to determine the neurophysiological grading scale (NGS). The cross-sectional area (CSA) of the median nerve and the grade of median nerve mobility were measured using US. Results The mean grade of median nerve mobility in the CTS group (1.9) was significantly lower than that in the control group (2.6; P mobility and distal motor latency of the median nerve (r = -0.218, P = 0.015), NGS (r = -0.207, P = 0.020) and CSA of the median nerve (r = -0.196, P = 0.028). Conclusion The grade of median nerve mobility was negatively correlated with the severity of CTS. US assessment of median nerve mobility may be useful in diagnosing and determining the severity of CTS.

  2. Effects of in vitro conditions on the survival of Alaria alata mesocercariae.

    Science.gov (United States)

    González-Fuentes, Hiromi; Riehn, Katharina; Koethe, Martin; von Borell, Eberhard; Luecker, Ernst; Hamedy, Ahmad

    2014-08-01

    The aim of this study was to determine the effect of different concentrations of table salt (NaCl) and ethanol (v/v) solutions on the viability of Alaria alata mesocercariae. Furthermore, the survival of A. alata mesocercariae during simulated human gastric digestion was evaluated. For this purpose, A. alata mesocercariae migration technique (AMT) was used for the isolation of the parasite from high-positive A. alata mesocercariae meat from wild boar, raccoon, raccoon dog, and badger meat. In total, we have studied the behavior of 582 larvae under different conditions (NaCl, ethanol, and artificial gastric juice) in three independent in vitro experiments. The larvae survived at a NaCl concentration of up to 2.0% until day 21 with a median survival time of 11 days. At 3.0% NaCl concentration, the larvae lost their vitality after less than 24 h. In addition, it was found that ethanol concentrations from 8.0 to 70.0% were effective at reducing survival of A. alata mesocercariae within a short period of time (meat products recommended for human consumption because at lower NaCl concentration the parasite survived for a substantial period of time. Finally, the common concentrations of ethanol used for the disinfection of surfaces in household and/or laboratory, are sufficient for the inactivation of A. alata mesocercariae.

  3. [Determinants of survival in HIV patients receiving antiretroviral therapy in Goma, Democratic Republic of Congo].

    Science.gov (United States)

    Akilimali, P Z; Mutombo, P B; Kayembe, P K; Kaba, D K; Mapatano, M A

    2014-06-01

    The study aimed to identify factors associated with the survival of patients receiving antiretroviral therapy. A historic cohort of HIV patients from two major hospitals in Goma (Democratic Republic of Congo) was followed from 2004 to 2012. The Kaplan-Meier method was used to describe the probability of survival as a function of time since inclusion into the cohort. The log-rank test was used to compare survival curves based on determinants. The Cox regression model identified the determinants of survival since treatment induction. The median follow-up time was 3.56 years (IQR=2.22-5.39). The mortality rate was 40 deaths per 1000 person-years. Male gender (RR: 2.56; 95 %CI 1.66-4.83), advanced clinical stage (RR: 2.12; 95 %CI 1.15-3.90), low CD4 count (CD4 < 50) (RR: 2.05; 95 %CI : 1.22-3.45), anemia (RR: 3.95; 95 %CI 2.60-6.01), chemoprophylaxis with cotrimoxazole (RR: 4.29, 95 % CI 2.69-6.86) and period of treatment initiation (2010-2011) (RR: 3.34; 95 %CI 1.24-8.98) were statistically associated with short survival. Initiation of treatment at an early stage of the disease with use of less toxic molecules and an increased surveillance especially of male patients are recommended to reduce mortality. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Magnetic resonance spectroscopy metabolite profiles predict survival in paediatric brain tumours.

    Science.gov (United States)

    Wilson, Martin; Cummins, Carole L; Macpherson, Lesley; Sun, Yu; Natarajan, Kal; Grundy, Richard G; Arvanitis, Theodoros N; Kauppinen, Risto A; Peet, Andrew C

    2013-01-01

    Brain tumours cause the highest mortality and morbidity rate of all childhood tumour groups and new methods are required to improve clinical management. (1)H magnetic resonance spectroscopy (MRS) allows non-invasive concentration measurements of small molecules present in tumour tissue, providing clinically useful imaging biomarkers. The primary aim of this study was to investigate whether MRS detectable molecules can predict the survival of paediatric brain tumour patients. Short echo time (30ms) single voxel (1)H MRS was performed on children attending Birmingham Children's Hospital with a suspected brain tumour and 115 patients were included in the survival analysis. Patients were followed-up for a median period of 35 months and Cox-Regression was used to establish the prognostic value of individual MRS detectable molecules. A multivariate model of survival was also investigated to improve prognostic power. Lipids and scyllo-inositol predicted poor survival whilst glutamine and N-acetyl aspartate predicted improved survival (pmodel of survival based on three MRS biomarkers predicted survival with a similar accuracy to histologic grading (p5e-5). A negative correlation between lipids and glutamine was found, suggesting a functional link between these molecules. MRS detectable biomolecules have been identified that predict survival of paediatric brain tumour patients across a range of tumour types. The evaluation of these biomarkers in large prospective studies of specific tumour types should be undertaken. The correlation between lipids and glutamine provides new insight into paediatric brain tumour metabolism that may present novel targets for therapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Missense mutations located in structural p53 DNA-binding motifs are associated with extremely poor survival in chronic lymphocytic leukemia.

    Science.gov (United States)

    Trbusek, Martin; Smardova, Jana; Malcikova, Jitka; Sebejova, Ludmila; Dobes, Petr; Svitakova, Miluse; Vranova, Vladimira; Mraz, Marek; Francova, Hana Skuhrova; Doubek, Michael; Brychtova, Yvona; Kuglik, Petr; Pospisilova, Sarka; Mayer, Jiri

    2011-07-01

    There is a distinct connection between TP53 defects and poor prognosis in chronic lymphocytic leukemia (CLL). It remains unclear whether patients harboring TP53 mutations represent a homogenous prognostic group. We evaluated the survival of patients with CLL and p53 defects identified at our institution by p53 yeast functional assay and complementary interphase fluorescence in situ hybridization analysis detecting del(17p) from 2003 to 2010. A defect of the TP53 gene was identified in 100 of 550 patients. p53 mutations were strongly associated with the deletion of 17p and the unmutated IgVH locus (both P DBMs), structurally well-defined parts of the DNA-binding domain, manifested a clearly shorter median survival (12 months) compared with patients having missense mutations outside DBMs (41 months; P = .002) or nonmissense alterations (36 months; P = .005). The difference in survival was similar in the analysis limited to patients harboring mutation accompanied by del(17p) and was also confirmed in a subgroup harboring TP53 defect at diagnosis. The patients with p53 DBMs mutation (at diagnosis) also manifested a short median time to first therapy (TTFT; 1 month). The substantially worse survival and the short TTFT suggest a strong mutated p53 gain-of-function phenotype in patients with CLL with DBMs mutations. The impact of p53 DBMs mutations on prognosis and response to therapy should be analyzed in investigative clinical trials.

  6. Electroacupuncture and Acupuncture Promote the Rat’s Transected Median Nerve Regeneration

    OpenAIRE

    Ho, C. Y.; Yao, C. H.; Chen, W. C.; Shen, W. C.; Bau, D. T.

    2013-01-01

    Background. Acupuncture and electroacupuncture treatments of damaged nerves may aid nerve regeneration related to hindlimb function, but the effects on the forelimb-related median nerve were not known. Methods. A gap was made in the median nerve of each rat by suturing the stumps into silicone rubber tubes. The influences of acupuncture and electroacupuncture treatments on transected median nerve regeneration were evaluated from morphological, electrophysiological, and functional angles. Resu...

  7. Palliative Short-Course Radiation Therapy in Rectal Cancer: A Phase 2 Study

    Energy Technology Data Exchange (ETDEWEB)

    Picardi, Vincenzo; Deodato, Francesco [Department of Radiotherapy, Fondazione di Ricerca e Cura “Giovanni Paolo II,” Campobasso (Italy); Guido, Alessandra; Giaccherini, Lucia [Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna (Italy); Macchia, Gabriella, E-mail: gmacchia@rm.unicatt.it [Department of Radiotherapy, Fondazione di Ricerca e Cura “Giovanni Paolo II,” Campobasso (Italy); Frazzoni, Leonardo; Farioli, Andrea; Cuicchi, Dajana [Department of Medical and Surgical Sciences, University of Bologna, Bologna (Italy); Cilla, Savino [Department of Radiotherapy, Fondazione di Ricerca e Cura “Giovanni Paolo II,” Campobasso (Italy); Cellini, Francesco [Radiation Oncology Department, Policlinico Universitario Campus Bio-Medico, Rome (Italy); Uddin, A.F.M. Kamal [Department of Radiation Oncology, United Hospital Limited, Dhaka (Bangladesh); Gambacorta, Maria Antonietta [Department of Radiotherapy, Policlinico Universitario “A. Gemelli,” Università Cattolica del Sacro Cuore, Rome (Italy); Buwenge, Milly [Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna (Italy); Ardizzoni, Andrea [Medical Oncology Unit, Azienda Ospedaliera Universitaria, Policlinico S. Orsola-Malpighi, Bologna (Italy); Poggioli, Gilberto [Department of Medical and Surgical Sciences, University of Bologna, Bologna (Italy); Valentini, Vincenzo [Department of Radiotherapy, Policlinico Universitario “A. Gemelli,” Università Cattolica del Sacro Cuore, Rome (Italy); and others

    2016-07-15

    Purpose: The management of patients with symptomatic rectal cancer not amenable to curative treatment may be challenging. The aim of this phase 2 study was to evaluate the efficacy of short-course radiation therapy in patients with obstructing rectal cancer. Methods and Materials: Patients who were not candidates for surgical resection because of synchronous metastases, age, and/or comorbidities were considered eligible. The sample size was calculated based on the 2-stage design of Simon. Short-course radiation therapy was delivered with an isocentric 4-field box technique (total, 25 Gy; 5 fractions in 5 days). Chemotherapy was suspended during radiation treatment. Clinical outcome measures were symptomatic response rate, toxicity, colostomy-free survival, and overall survival. Results: From October 2003 to November 2012, 18 patients (median age, 77.5 years) were enrolled. The median follow-up was 11.5 months (range, 3-36 months). Four weeks after treatment, a complete response (ie, complete symptom resolution) was observed in 38.9% of patients and a partial response in 50.0% cases, whereas 11.1% had no response. The rates of reduction or resolution of pain and bleeding were 87.5% and 100%, respectively. The 1-, 2-, and 3-year colostomy-free survival rates were 100%, 71.4%, and 47.6%, respectively (median, 30 months). The 1-, 2-, and 3-year cumulative overall survival rates were 85.2%, 53%, and 39.8%, respectively (median, 25 months). No patients stopped treatment because of gastrointestinal or genitourinary toxicities: 38.9% of patients had grade 1 to 2 toxicity, and 16.7% had grade 3 toxicity. Only 1 patient had hematologic grade 2 toxicity, and 2 patients had grade 2 skin toxicity. Conclusions: Short-course radiation therapy may represent a safe and effective alternative treatment option in patients with obstructing rectal cancer not eligible for curative treatment, allowing colostomy to be avoided in a substantial proportion of patients.

  8. 网状减张缝合提高张力皮瓣存活率的实验研究%Experiment research on promoting survival rate of tension skin flap after meshed relaxing short incision suture

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To observe effects of meshed relaxing short incisions on the level of superoxide dismutase and malondialdehyde in rat tension skin flap, and to investigate the mechanism of meshed relaxing short incisions (MRSI) on wound healing process of tension skin flap. Method An experimental model was designed to investingate the changes of superoxide dismutase (SOD) and malondialdehyde (MDA) in rat skin flap tissue each period of wound healing (12h, 24h, 48h, 72h after suture). In the meantime, the biochemical reaction were employed. Results Our results showed that SOD content in rat skin flap tissue from MRSI group were significant higher than that of hypertension group (P≤ 0.05), while MDA content was significantly lower (P≤ 0.05). Conclusion The decrease of MDA contents may be one of the causes that MRSI improves microcirculation of skin flap, and reduces edema and facilitates healing of skin flap.

  9. Implantable cardioverter-defibrillators improve survival after coronary artery bypass grafting in patients with severely impaired left ventricular function

    Directory of Open Access Journals (Sweden)

    Pasque Michael K

    2007-01-01

    Full Text Available Abstract Objective Patients with severe left ventricular (LV dysfunction have a poor long term survival despite complete surgical revascularization. Recent data suggests that the use of Implantable Cardioverter-Defibrillator (ICD improves survival in patients with severe LV dysfunction. We compared the survival impact of ICD implantation in patients with severe LV dysfunction who underwent CABG. Methods Between January 1996 and August 2004, 305 patients with LV ejection fraction (EF ≤25% had CABG surgery at our institution. Demographics of patients who had received an ICD (ICD+ in the post -operative period was compared to those without ICD (ICD-. Survival was evaluated by the Kaplan-Meier method. Results Of the entire group, 35 (11.5% patients received an ICD with a median of 2 (+/-2 years after CABG. Indication for ICD implantation was clinical evidence of non sustained ventricular tachycardia (NSVT. There were no differences between the 2 groups with respect to age, gender, NYHA classification, number of bypasses, or other co-morbidities. Survival at 1, 3 and 5 years was 88%, 79%, and 67% for the ICD- group compared to 94%, 89% and 83% for the ICD+ group, respectively (figure, p Conclusion Implantation of ICD after CABG confers improved short and long term survival benefit to patients with severe LV dysfunction. Prophylactic ICD implantation in the setting of severe LV dysfunction and CABG surgery should be considered.

  10. Short communication

    African Journals Online (AJOL)

    abp

    2017-09-04

    Sep 4, 2017 ... Face-to-face interviews were conducted using a standardized ... Short communication. Open Access ... clinic during the time of the study and were invited to participate in the study. .... consume them. This is another ...

  11. SHORT COMMUNICATION

    African Journals Online (AJOL)

    PROF P.T. KAYE

    . SHORT COMMUNICATION. Formation and Structural Analysis of Novel Dibornyl Ethers. Perry T. Kaye*, Andrew R. Duggan, Joseph M. Matjila, Warner E. Molema, and. Swarnam S. Ravindran. Department of Chemistry, Rhodes University, Grahamstown, ...

  12. An investigation on the noise reduction performance of profiled rigid median barriers at highways

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Monazzam

    2012-01-01

    Full Text Available Median barriers as a portion of a divided highway are provided to minimize the cross-median crashes. Moreover, median barriers similar to roadside noise barriers could protect people from transportation noise. Thus, there is a need to investigate various median barrier models to identify changes of insertion loss over a simple rigid barrier. In order to estimate the acoustical influence of median barrier′s profile in the shadow zone, different median barrier models are presented and their insertion losses are calculated over a frequency range from 50 to 4000 Hz using a two-dimensional boundary element method. The present investigation has clearly revealed that among the profiled median barriers, T-shape, Y-shape, and L-shape provide better performance than that of the other shapes. It is also found that among inclined barriers, V-shape barrier significantly presents higher values of attenuation. Based on the calculation of different geometrics, it has been shown that a further 2 dB (A in efficiency could be obtained by a better design of the median barrier which is labeled model "L."

  13. 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... Headform-Basic, Reference, and Median Planes ER10MR98.002 ...

  14. Voimaa visuaalisuudesta : Narratiivinen kirjallisuuskatsaus visuaalisen sosiaalisen median vaikutuksista nuorten aikuisten hyvinvointiin

    OpenAIRE

    Viita, Shir

    2017-01-01

    Viita, Shir. Voimaa visuaalisuudesta – Narratiivinen kirjallisuuskatsaus visuaalisen sosiaalisen median vaikutuksista nuorten aikuisten hyvinvointiin. Kevät 2016. 52 s., 1 liite. Diakonia ammattikorkeakoulu. Sosiaalialan koulutusohjelma, sosionomin suuntautumisvaihtoehto. Sosionomi (AMK). Opinnäytetyön tavoitteena on tuottaa tietoa sosiaalialan ammattilaisille visuaalisen sosiaalisen median sivustojen Instagramin ja Snapchatin vaikutuksista nuorten aikuisten hyvinvointiin. Opinnäyte...

  15. 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...

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

    NARCIS (Netherlands)

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

    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

  17. Safety performance evaluation of cable median barriers on freeways in Florida.

    Science.gov (United States)

    Alluri, Priyanka; Haleem, Kirolos; Gan, Albert; Mauthner, John

    2016-07-03

    This article aims to evaluate the safety performance of cable median barriers on freeways in Florida. The safety performance evaluation was based on the percentages of barrier and median crossovers by vehicle type, crash severity, and cable median barrier type (Trinity Cable Safety System [CASS] and Gibraltar system). Twenty-three locations with cable median barriers totaling about 101 miles were identified. Police reports of 6,524 crashes from years 2005-2010 at these locations were reviewed to verify and obtain detailed crash information. A total of 549 crashes were determined to be barrier related (i.e., crashes involving vehicles hitting the cable median barrier) and were reviewed in further detail to identify crossover crashes and the manner in which the vehicles crossed the barriers; that is, by either overriding, underriding, or penetrating the barriers. Overall, 2.6% of vehicles that hit the cable median barrier crossed the median and traversed into the opposite travel lane. Overall, 98.1% of cars and 95.5% of light trucks that hit the barrier were prevented from crossing the median. In other words, 1.9% of cars and 4.5% of light trucks that hit the barrier had crossed the median and encroached on the opposite travel lanes. There is no significant difference in the performance of cable median barrier for cars versus light trucks in terms of crossover crashes. In terms of severity, overrides were more severe compared to underrides and penetrations. The statistics showed that the CASS and Gibraltar systems performed similarly in terms of crossover crashes. However, the Gibraltar system experienced a higher proportion of penetrations compared to the CASS system. The CASS system resulted in a slightly higher percentage of moderate and minor injury crashes compared to the Gibraltar system. Cable median barriers are successful in preventing median crossover crashes; 97.4% of the cable median barrier crashes were prevented from crossing over the median. Of all of

  18. Ultrahigh-frequency ultrasound of fascicles in the median nerve at the wrist.

    Science.gov (United States)

    Cartwright, Michael S; Baute, Vanessa; Caress, James B; Walker, Francis O

    2017-10-01

    An ultrahigh-frequency (70 MHZ) ultrasound device has recently been approved for human use. This study seeks to determine whether this device facilitates counting of fascicles within the median nerve at the wrist. Twenty healthy volunteers underwent imaging of the median nerve at the wrist bilaterally. The number of fascicles in each nerve was counted by two independent raters. The mean fascicle number was 22.68. Correlation was strong between the two raters (r = 0.68, P nerve area did not predict fascicle number. Those with bifid median nerves and persistent median arteries had lower fascicle density than those without anatomic anomalies (1.79 vs. 2.29; P = 0.01). Fascicles within the median nerve at the wrist can be readily imaged. Ultrahigh-frequency ultrasound technology may be informative in a variety of disorders affecting the peripheral nervous system. Muscle Nerve 56: 819-822, 2017. © 2017 Wiley Periodicals, Inc.

  19. 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...

  20. Short-term outcomes and safety of computed tomography-guided percutaneous microwave ablation of solitary adrenal metastasis from lung cancer: A multi-center retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Men, Min; Ye, Xin; Yang, Xia; Zheng, Aimin; Huang, Guang Hui; Wei, Zhigang [Dept. of Oncology, Shandong Provincial Hospital Affiliated with Shandong University, Jinan (China); Fan, Wei Jun [Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou (China); Zhang, Kaixian [Dept. of Oncology, Teng Zhou Central People' s Hospital Affiliated with Jining Medical College, Tengzhou (China); Bi, Jing Wang [Dept. of Oncology, Jinan Military General Hospital of Chinese People' s Liberation Army, Jinan (China)

    2016-11-15

    To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

  1. Infantile Short Bowel Syndrome: short and long term evaluation

    NARCIS (Netherlands)

    J.F. Olieman (Joanne)

    2009-01-01

    textabstractInfantile short bowel syndrome is a condition which is characterized by malabsorption of nutrients, as a result of congenital intestinal shortening or massive small bowel resection. Survival rates have improved over the years, but morbidity remains high and clinical management of these

  2. Short course of radiation therapy in elderly patients with multiform glioblastoma

    International Nuclear Information System (INIS)

    Idbaih, A.; Taillibert, S.; Simon, J.M.; Lopez, S.; Lang, P.; Toubiana, T.; Feuvret, L.; Mazeron, J.J.; Idbaih, A.; Taillibert, S.; Psimaras, D.; Delattre, J.Y.; Schneble, H.M.

    2008-01-01

    Purpose: The optimal schedule of irradiation in elderly patients suffering from glioblastoma multiform (G.B.M.) is unsettled. Materials and methods: This study reviewed the charts of 28 consecutive G.B.M. patients aged 70 years or more with a Karnofsky Performance Status (K.P.S.) greater than or equal to 70 who received a short course of radiotherapy (40 grays in 15 fractions over three weeks). Results: The median age at surgery was 74.6 years (range, 70.1 - 85.7). No patient received prior or concomitant chemotherapy. The median progression-free survival and overall survival were 21.6 weeks (95% CI, 17.0 - 39.9) and 50.6 weeks (95% CI, 26.3 - 62.0), respectively. Even within a narrow range (< 90 or = 90), K.P.S. remained a prognostic factor (p = 0.03). Tolerance appeared acceptable in terms of K.P.S. changes and corticosteroid use during radiation therapy. Conclusion: These results support the efficacy of short schedule radiotherapy for G.B.M. in elderly patients with a good K.P.S.. (authors)

  3. Short Stature

    DEFF Research Database (Denmark)

    Christesen, Henrik Boye Thybo; Pedersen, Birgitte Tønnes; Pournara, Effie

    2016-01-01

    -scale, non-interventional, multinational study. The patient cohort consisted of 5996 short pediatric patients diagnosed with growth hormone deficiency (GHD), Turner syndrome (TS) or born small for gestational age (SGA). The proportions of children with baseline height standard deviation score (SDS) below......The use of appropriate growth standards/references is of significant clinical importance in assessing the height of children with short stature as it may determine eligibility for appropriate therapy. The aim of this study was to determine the impact of using World Health Organization (WHO) instead...... of national growth standards/references on height assessment in short children. Data were collected from routine clinical practice (1998-2014) from nine European countries that have available national growth references and were enrolled in NordiNet® International Outcome Study (IOS) (NCT00960128), a large...

  4. Phase I study of short-time oxaliplatin, capecitabine and epirubicin (EXE) as first line therapy in patients with non-resectable gastric cancer

    DEFF Research Database (Denmark)

    Dupont, Jeanette; Jensen, Helle A; Jensen, Benny V

    2007-01-01

    A phase I trial of short-time oxaliplatin (E), capecitabine (X) and epirubicin (E) for patients with metastatic gastric cancer was initiated to establish the recommended dose for further therapy with short-time EXE. Patients received out-patient therapy with a fixed dose of epirubicin 50 mg/m2 day......-8), median survival was 9.2 months and median TTP was 7.5 months. A combination of epirubicin 50 mg/m2 day 1, capecitabine 1,000 mg/m2 continuously and oxaliplatin 130 mg/m2 day 1 each 3 weeks is an easily administered and well tolerated out-patient regimen for patients with non-resectable gastric cancer....

  5. 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.

  6. Nuorten sosiaalisen median käyttö seurustelusuhteissa : "Onksiul snappii, kikkii tai whatsappii?"

    OpenAIRE

    Pöllänen, Kati

    2016-01-01

    Tässä opinnäytetyössä tutkittiin nuorten sosiaalisen median käyttöä seurustelusuhteissa. Seurustelusuhteella tarkoitetaan kahden toisistaan pitävän ihmisen romanttista suhdetta. Työssä tarkasteltiin keskinuorten ja myöhäisnuorten käyttämiä sosiaalisen median sovelluksia, käyttömääriä ja –tapoja. Lisäksi selvitettiin, millainen rooli sosiaalisella medialla on seurustelusuhteen eri vaiheissa. Työssä tutustuttiin nuorten sosiaalisen median käyttöön kenttätutkimuksella, jossa nu...

  7. Survival benefit of primary deceased donor transplantation with high-KDPI kidneys.

    Science.gov (United States)

    Massie, A B; Luo, X; Chow, E K H; Alejo, J L; Desai, N M; Segev, D L

    2014-10-01

    The Kidney Donor Profile Index (KDPI) has been introduced as an aid to evaluating deceased donor kidney offers, but the relative benefit of high-KDPI kidney transplantation (KT) versus the clinical alternative (remaining on the waitlist until receipt of a lower KDPI kidney) remains unknown. Using time-dependent Cox regression, we evaluated the mortality risk associated with high-KDPI KT (KDPI 71-80, 81-90 or 91-100) versus a conservative, lower KDPI approach (remain on waitlist until receipt of KT with KDPI 0-70, 0-80 or 0-90) in first-time adult registrants, adjusting for candidate characteristics. High-KDPI KT was associated with increased short-term but decreased long-term mortality risk. Recipients of KDPI 71-80 KT, KDPI 81-90 KT and KDPI 91-100 KT reached a "break-even point" of cumulative survival at 7.7, 18.0 and 19.8 months post-KT, respectively, and had a survival benefit thereafter. Cumulative survival at 5 years was better in all three high-KDPI groups than the conservative approach (p 50 years and patients at centers with median wait time ≥33 months. Recipients of high-KDPI KT can enjoy better long-term survival; a high-KDPI score does not automatically constitute a reason to reject a deceased donor kidney. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  8. Factors predicting survival following noninvasive ventilation in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Peysson, S; Vandenberghe, N; Philit, F; Vial, C; Petitjean, T; Bouhour, F; Bayle, J Y; Broussolle, E

    2008-01-01

    The involvement of respiratory muscles is a major predicting factor for survival in amyotrophic lateral sclerosis (ALS). Recent studies show that noninvasive ventilation (NIV) can relieve symptoms of alveolar hypoventilation. However, factors predicting survival in ALS patients when treated with NIV need to be clarified. We conducted a retrospective study of 33 consecutive ALS patients receiving NIV. Ten patients had bulbar onset. We determined the median survivals from onset, diagnosis and initiation of NIV and factors predicting survival. Statistical analysis was performed using the Kaplan-Meier test and Cox proportional hazard models. The median initial and maximal total uses of NIV were 10 and 14 h/24h. The overall median survival from ALS onset was 34.2 months and worsened with increasing age and bulbar onset of the disease. The median survival from initiation of NIV was 8.4 months and was significantly poorer in patients with advanced age or with airway mucus accumulation. Survival from initiation of NIV was not influenced by respiratory parameters or bulbar symptoms. Advanced age at diagnosis and airway mucus accumulation represent poorer prognostic factors of ALS patients treated with NIV. NIV is a helpful treatment of sleep-disordered breathing, including patients with bulbar involvement. Copyright 2008 S. Karger AG, Basel.

  9. Statistical inference a short course

    CERN Document Server

    Panik, Michael J

    2012-01-01

    A concise, easily accessible introduction to descriptive and inferential techniques Statistical Inference: A Short Course offers a concise presentation of the essentials of basic statistics for readers seeking to acquire a working knowledge of statistical concepts, measures, and procedures. The author conducts tests on the assumption of randomness and normality, provides nonparametric methods when parametric approaches might not work. The book also explores how to determine a confidence interval for a population median while also providing coverage of ratio estimation, randomness, and causal

  10. Short Review

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Rühli, Frank

    2015-01-01

    modality in ancient mummy research. The aim of this short review is to address the advantages and pitfalls of this particular technique for such unique samples. We recommend that when results of X-ray examination of mummies are presented, the specific recording data should be listed, and any given finds...

  11. Short fusion

    CERN Multimedia

    2002-01-01

    French and UK researchers are perfecting a particle accelerator technique that could aid the quest for fusion energy or make X-rays that are safer and produce higher-resolution images. Led by Dr Victor Malka from the Ecole Nationale Superieure des Techniques Avancees in Paris, the team has developed a better way of accelerating electrons over short distances (1 page).

  12. Short communication

    African Journals Online (AJOL)

    UPuser

    Short communication. Polymorphisms of the CAST gene in the Meishan and five other pig populations in China. Q.S. Wang. 1. , Y.C. Pan. 1#. , L.B. Sun. 2 and H. Meng. 1. 1 Department of Animal Science, School of Agriculture and Biology, Shanghai Jiaotong University, Shanghai. 201101, P.R. China. 2 Shanghai Institute of ...

  13. SHORT COMMUNICATION

    African Journals Online (AJOL)

    a

    ______. *Corresponding author. E-mail: vani_chem@yahoo.com. SHORT COMMUNICATION. OXIDATION OF L-CYSTINE BY CHROMIUM(VI) - A KINETIC STUDY. Kalyan Kumar Adari, Annapurna Nowduri and Vani Parvataneni*. Department of Inorganic and Analytical Chemistry, School of Chemistry, Andhra University,.

  14. Short communication

    NARCIS (Netherlands)

    Pantophlet, Andre J.; Gilbert, M.S.; Gerrits, W.J.J.; Vonk, R.J.

    2017-01-01

    Heavy veal calves (4-6 mo old) often develop problems with insulin sensitivity. This could lead to metabolic disorders and impaired animal growth performance. Studies in various animal species have shown that the supplementation of short-chain fructo-oligosaccharides (scFOS) can improve insulin

  15. New England observed and predicted median July stream/river temperature points

    Data.gov (United States)

    U.S. Environmental Protection Agency — The shapefile contains points with associated observed and predicted median July stream/river temperatures in New England based on a spatial statistical network...

  16. 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...

  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. 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

  19. Tessier Number 30 Median Mandibular Cleft With Congenital Heart Anomalies in Qena, Egypt.

    Science.gov (United States)

    Ali, Ahmed Ali Abdelrahim

    2018-01-01

    Median cleft deformities of the lower lip and mandible are very rare congenital anomalies. Our patient had median cleft of the lower lip, mandible, and the chin with tongue duplication, ankyloglossia, and cleft strap muscles with 2 neck contracture bands. This anomaly was associated with congenital heart disease transposition of great vessels, large ventricular septal defect, and severe pulmonary stenosis. Early repair was done at 6 months to improve feeding.

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

    International Nuclear Information System (INIS)

    Yao, Lawrence; Gai, Neville

    2009-01-01

    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 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 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 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.)

  1. [Safety of repeat median sternotomy in the palliative treatment of patients with a univentricular heart].

    Science.gov (United States)

    Díliz-Nava, Héctor; Meléndez-Sagaón, Isis; Tamaríz-Cruz, Orlando; García-Benítez, Luis; Araujo-Martínez, Aric; Palacios-Macedo, Alexis

    To establish the morbidity and mortality of patients with univentricular hearts who underwent a repeat median sternotomy at the Instituto Nacional de Pediatría. A retrospective review was performed on the clinical charts of all patients who underwent a repeat median sternotomy from 2001 to 2016. Sixty-five patients underwent 76 surgeries by repeat median sternotomy. Fifty-nine patients had a first repeat median sternotomy, with a mean age of 36 months (range: 4-176 months) and a mean weight of 12.2 kg (range: 3.2-21.5 kg). Forty patients had a Glenn procedure, and 19 patients had a Fontan procedure. There were 17 patients with a second repeat median sternotomy, with a mean age of 89 months (range 48-156 months), and a mean weight of 22.7 kg (14.4-41 kg). A Fontan procedure was performed on all these 17 patients. A 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 subsequent death. This represents 3.9% of re-entry injuries. It is concluded 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.

  2. Variant palmaris profundus enclosed by an unusual loop of the median nerve

    Science.gov (United States)

    CHOU, HSIU-CHU; JENG, HELLEN; KO, TSUI-LING; PAI, MAN-HUI; CHANG, CHIU-YUN; WU, CHING-HSIANG

    2001-01-01

    According to the usual description in most anatomy texts, the median nerve in the forearm passes between the 2 heads of pronator teres. It continues distally between flexor digitorum superficialis and profundus almost to the retinaculum. Muscular branches leave the nerve near the elbow and supply all superficial muscles of the anterior part of the forearm except flexor carpi ulnaris. Many variations of the median nerve in the forearm have been reported (Urban & Krosman, 1992). The palmaris profundus is also a rare anomaly of the forearm (Dyreby & Engber, 1982). It originates from the radial side of the common flexor tendon in the proximal forearm and inserts into the undersurface of the palmar aponeurosis. The origin of palmaris profundus may be close to the median nerve and its branches, and may be involved in compressive neuropathy of the anterior interosseous nerve. Its tendon crossing through the carpal canal has been implicated in the carpal tunnel syndrome (reviewed by Lahey & Aulicino, 1986). In some cases, palmaris profundus was found enclosed in a common fascial sheath with the median nerve (Stark, 1992; Sahinoglu et al. 1994). To indicate its close association with the median nerve, the palmaris profundus was also named ‘musculus comitans nervi mediani’ (Sahinoglu et al. 1994). This article reports an unusual loop of the median nerve encircling an anomalous palmaris profundus in the forearm, which, to the best of our knowledge, has not been previously described. PMID:11693311

  3. Regularization of DT-MRI Using 3D Median Filtering Methods

    Directory of Open Access Journals (Sweden)

    Soondong Kwon

    2014-01-01

    Full Text Available DT-MRI (diffusion tensor magnetic resonance imaging tractography is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of the principal eigenvectors obtained from tensor matrix, which is different from the conventional isotropic MRI. Tractography based on DT-MRI is known to need many computations and is highly sensitive to noise. Hence, adequate regularization methods, such as image processing techniques, are in demand. Among many regularization methods we are interested in the median filtering method. In this paper, we extended two-dimensional median filters already developed to three-dimensional median filters. We compared four median filtering methods which are two-dimensional simple median method (SM2D, two-dimensional successive Fermat method (SF2D, three-dimensional simple median method (SM3D, and three-dimensional successive Fermat method (SF3D. Three kinds of synthetic data with different altitude angles from axial slices and one kind of human data from MR scanner are considered for numerical implementation by the four filtering methods.

  4. Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review.

    Science.gov (United States)

    Ding, Chao; Wang, Chunmao; Dong, Aiqiang; Kong, Minjian; Jiang, Daming; Tao, Kaiyu; Shen, Zhonghua

    2012-05-04

    Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case-control study in the published English Journal. 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI -0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI -3.05 to -0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI -2.71 to -0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI -0.81 to 0.04 days, p = 0.08). ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

  5. Prescription dose and fractionation predict improved survival after stereotactic radiotherapy for brainstem metastases

    Directory of Open Access Journals (Sweden)

    Leeman Jonathan E

    2012-07-01

    Full Text Available Abstract Background Brainstem metastases represent an uncommon clinical presentation that is associated with a poor prognosis. Treatment options are limited given the unacceptable risks associated with surgical resection in this location. However, without local control, symptoms including progressive cranial nerve dysfunction are frequently observed. The objective of this study was to determine the outcomes associated with linear accelerator-based stereotactic radiotherapy or radiosurgery (SRT/SRS of brainstem metastases. Methods We retrospectively reviewed 38 tumors in 36 patients treated with SRT/SRS between February 2003 and December 2011. Treatment was delivered with the Cyberknife™ or Trilogy™ radiosurgical systems. The median age of patients was 62 (range: 28–89. Primary pathologies included 14 lung, 7 breast, 4 colon and 11 others. Sixteen patients (44% had received whole brain radiation therapy (WBRT prior to SRT/SRS; ten had received prior SRT/SRS at a different site (28%. The median tumor volume was 0.94 cm3 (range: 0.01-4.2 with a median prescription dose of 17 Gy (range: 12–24 delivered in 1–5 fractions. Results Median follow-up for the cohort was 3.2 months (range: 0.4-20.6. Nineteen patients (52% had an MRI follow-up available for review. Of these, one patient experienced local failure corresponding to an actuarial 6-month local control of 93%. Fifteen of the patients with available follow-up imaging (79% experienced intracranial failure outside of the treatment volume. The median time to distant intracranial failure was 2.1 months. Six of the 15 patients with distant intracranial failure (40% had received previous WBRT. The actuarial overall survival rates at 6- and 12-months were 27% and 8%, respectively. Predictors of survival included Graded Prognostic Assessment (GPA score, greater number of treatment fractions, and higher prescription dose. Three patients experienced acute treatment-related toxicity consisting of

  6. Short Communication

    African Journals Online (AJOL)

    huis

    Short Communication. QTL analysis of production traits on SSC3 in a Large White×Meishan pig resource family. B. Zuo. 1. , Y.Z. Xiong. 1#. , Y.H. Su. 2. , C.Y. Deng. 1. , M.G. Lei. 1. , F.E. Li. 1. , R. Zheng. 1 and S.W. Jiang. 1. 1 Key Laboratory of Swine Genetics and Breeding, Ministry of Agriculture & Key Lab of Agricultural ...

  7. 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].

  8. Median nerve fascicular anatomy as a basis for distal neural prostheses.

    Science.gov (United States)

    Planitzer, Uwe; Steinke, Hanno; Meixensberger, Jürgen; Bechmann, Ingo; Hammer, Niels; Winkler, Dirk

    2014-05-01

    Functional electrical stimulation (FES) serves as a possible therapy to restore missing motor functions of peripheral nerves by means of cuff electrodes. FES is established for improving lower limb function. Transferring this method to the upper extremity is complex, due to a lack of anatomical data on the physiological configuration of nerve fascicles. Our study's aim was to provide an anatomical basis for FES of the median nerve in the distal forearm and hand. We investigated 21 distal median nerves from 12 body donors. The peripheral fascicles were traced back by removing the external and interfascicular epineurium and then assigned to 4 quadrants. A distinct motor and sensory distribution was observed. The fascicles innervating the thenar eminence and the first lumbrical muscle originated from the nerves' radial parts in 82%. The fascicle supplying the second lumbrical muscle originated from the ulnar side in 78%. No macroscopically visible plexus formation was observed for the distal median nerve in the forearm. The findings on the distribution of the motor branches of the median nerve and the missing plexus formation may likely serve as an anatomical basis for FES of the distal forearm. However, due to the considerable variability of the motor branches, cuff electrodes will need to be adapted individually in FES. Taking into account the sensory distribution of the median nerve, FES may also possibly be applied in the treatment of regional pain syndromes. Copyright © 2013 Elsevier GmbH. All rights reserved.

  9. Impact of keyboard typing on the morphological changes of the median nerve.

    Science.gov (United States)

    Yeap Loh, Ping; Liang Yeoh, Wen; Nakashima, Hiroki; Muraki, Satoshi

    2017-09-28

    The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (ptyping I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve.

  10. 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. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  11. Phase I and II trial on infusional 5-fluorouracil and gefitinib in combination with preoperative radiotherapy in rectal cancer: 10-years median follow-up

    Directory of Open Access Journals (Sweden)

    Maria Antonietta Gambacorta

    2018-03-01

    Full Text Available Purpose: The aim of this study is to evaluate the long term survival of the addition of gefitinib to chemoradiotherapy (CRT in locally advanced rectal cancer (LARC. Methods and materials: This previously published multicentre, open-label, phase I-II study, enrolled patients (pts with LARC to receive CRT with concurrent 5-fluorouracil continuous intravenous infusion and a dose escalation of orally administered gefitinib, followed 6–8 weeks later by surgery. An intra-operative radiotherapy boost of 10 Gy was planned. Adjuvant chemotherapy was administrated in ypN1-2 pts. After a median f/u of >10 years, we analyzed Local Control (LC, Metastasis Free Survival (MFS, Disease Free Survival (DFS, Disease Specific Survival (DSS and Overall Survival (OS. Predictive endpoints of clinical outcomes were tested by univariate and multivariate analysis. Variables analyzed included: age, gefitinib dose and interruptions, adjuvant CT, surgery type, ypT, ypN, and TRG grade. We have also analyzed late toxicity according to CTCAEv4. Results: Of the 41 initially enrolled pts, 39 were evaluable (27M, 12F. With a median f/u of 133 months, LC, MFS, DFS, OS and DSS at 5 years were 84%; 71%; 64%; 87% and 92%, respectively. The OS and DSS at 10 years were 61,5% and 76%, respectively. Grade 3-4 late toxicity occurred in 38% of pts: sexual (28,2% and gastrointestinal toxicities (10,2%. Conclusion: Long term outcomes and late toxicity were similar to previously reported series. The addition of gefitinib did not improve outcomes in LARC. Gefitinib is not recommended for rectal cancer patients who received 5-FU based preoperative CRT. Further studies may identify if gefitinib is beneficial in selected group of patients. Keywords: Rectal cancer, Gefitinib, Log term follow-up, Chemoradiotherapy

  12. Survival, safety, and prognostic factors for outcome with Regorafenib in patients with metastatic colorectal cancer refractory to standard therapies: results from a multicenter study (REBACCA) nested within a compassionate use program

    International Nuclear Information System (INIS)

    Adenis, Antoine; Fouchardiere, Christelle de la; Paule, Bernard; Burtin, Pascal; Tougeron, David; Wallet, Jennifer; Dourthe, Louis-Marie; Etienne, Pierre-Luc; Mineur, Laurent; Clisant, Stéphanie; Phelip, Jean-Marc; Kramar, Andrew; Andre, Thierry

    2016-01-01

    Randomized trials have shown a survival benefit for regorafenib over placebo in patients with metastatic colorectal cancer (mCRC) that progressed after standard therapies. We evaluated survival and safety outcomes in patients treated with regorafenib in a real-life setting. REBECCA is a cohort study nested within a compassionate use program designed to evaluate survival, safety, and potential prognostic factors for outcome associated with regorafenib in patients with mCRC refractory to standard therapies. Treatment effects according to various patient and tumour characteristics were evaluated using univariate and multivariate Cox proportional hazards regression models. Of 1178 patients in the compassionate use program, 654 were in the full analysis set. Median follow-up was 16.5 months. Median survival was 5.6 months. The 12-month survival rate was 22 %. Survival was independently and unfavourably affected by the following variables: poor performance status, short time from initial diagnosis of metastases to the start of regorafenib, low initial regorafenib dose, >3 metastatic sites, presence of liver metastases, and KRAS mutations. We identified prognostic groups of patients with low, intermediate, and high risk of death, with a median survival of 9.2, 5.2, and 2.5 months, respectively. Five-hundred-twenty-four patients (80 %) experienced at least one regorafenib-related adverse event, most commonly, fatigue, hand-foot skin reaction, diarrhea, anorexia, arterial hypertension, and mucositis. The safety and efficacy profile of regorafenib in REBECCA are similar to those in randomized trials. Our prognostic model identified subgroups of mCRC patients who derived a minimal and maximum benefit from regorafenib. Clinicaltrials.gov: NCT02310477

  13. A Randomized Trial (Irish Clinical Oncology Research Group 97-01) Comparing Short Versus Protracted Neoadjuvant Hormonal Therapy Before Radiotherapy for Localized Prostate Cancer.

    LENUS (Irish Health Repository)

    Armstrong, John G

    2010-08-24

    PURPOSE: To examine the long-term outcomes of a randomized trial comparing short (4 months; Arm 1) and long (8 months; Arm 2) neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer. METHODS AND MATERIALS: Between 1997 and 2001, 276 patients were enrolled and the data from 261 were analyzed. The stratification risk factors were prostate-specific antigen level >20 ng\\/mL, Gleason score >\\/=7, and Stage T3 or more. The intermediate-risk stratum had one factor and the high-risk stratum had two or more. Staging was done from the bone scan and computed tomography findings. The primary endpoint was biochemical failure-free survival. RESULTS: The median follow-up was 102 months. The overall survival, biochemical failure-free survival. and prostate cancer-specific survival did not differ significantly between the two treatment arms, overall or at 5 years. The cumulative probability of overall survival at 5 years was 90% (range, 87-92%) in Arm 1 and 83% (range, 80-86%) in Arm 2. The biochemical failure-free survival rate at 5 years was 66% (range, 62-71%) in Arm 1 and 63% (range, 58-67%) in Arm 2. CONCLUSION: No statistically significant difference was found in biochemical failure-free survival between 4 months and 8 months of neoadjuvant hormonal therapy before radiotherapy for localized prostate cancer.

  14. Effect of finger motion on transverse median nerve movement in the carpal tunnel.

    Science.gov (United States)

    Kang, Hyo Jung; Yoon, Joon Shik

    2016-10-01

    We used ultrasonography (US) to investigate the effects of finger motion on movement of the median nerve in patients with carpal tunnel syndrome (CTS) and the correlation between these US parameters and CTS severity. Ultrasonographic measures were performed in 23 control wrists and 22 CTS wrists in women. During first through third finger flexion and grip motion, median nerve movements were obtained using US and a tracing program. Nerve movements during third finger flexion in the dorsopalmar axis and grip motion in both axes, and during second finger flexion in the radioulnar axis, differed significantly between the control and CTS groups. US parameters correlated negatively with cross-sectional area. This study shows that transverse median nerve movements decreased during grip using US and correlated negatively with CTS severity. Muscle Nerve, 2016 Muscle Nerve 54: -, 2016 Muscle Nerve 54: 738-742, 2016. © 2016 Wiley Periodicals, Inc.

  15. PENERAPAN METODE LEAST MEDIAN SQUARE-MINIMUM COVARIANCE DETERMINANT (LMS-MCD DALAM REGRESI KOMPONEN UTAMA

    Directory of Open Access Journals (Sweden)

    I PUTU EKA IRAWAN

    2013-11-01

    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.

  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. PERBANDINGAN TRANSFORMASI BOX-COX DAN REGRESI KUANTIL MEDIAN DALAM MENGATASI HETEROSKEDASTISITAS

    Directory of Open Access Journals (Sweden)

    NI WAYAN YUNI CAHYANI

    2015-01-01

    Full Text Available Ordinary least square (OLS is a method that can be used to estimate the parameter in linear regression analysis. There are some assumption which should be satisfied on OLS, one of this assumption is homoscedasticity, that is the variance of error is constant. If variance of the error is unequal that so-called heteroscedasticity. The presence heteroscedasticity can cause estimation with OLS becomes inefficient. Therefore, heteroscedasticity shall be overcome. There are some method that can used to overcome heteroscedasticity, two among those are Box-Cox power transformation and median quantile regression. This research compared Box-Cox power transformation and median quantile regression to overcome heteroscedasticity. Applied Box-Cox power transformation on OLS result ????2point are greater, smaller RMSE point and confidencen interval more narrow, therefore can be concluded that applied of Box-Cox power transformation on OLS better of median quantile regression to overcome heteroscedasticity.

  18. PERBANDINGAN TRANSFORMASI BOX-COX DAN REGRESI KUANTIL MEDIAN DALAM MENGATASI HETEROSKEDASTISITAS

    Directory of Open Access Journals (Sweden)

    NI WAYAN YUNI CAHYANI

    2015-03-01

    Full Text Available Ordinary least square (OLS is a method that can be used to estimate the parameter in linear regression analysis. There are some assumption which should be satisfied on OLS, one of this assumption is homoscedasticity, that is the variance of error is constant. If variance of the error is unequal that so-called heteroscedasticity. The presence heteroscedasticity can cause estimation with OLS becomes inefficient. Therefore, heteroscedasticity shall be overcome. There are some method that can used to overcome heteroscedasticity, two among those are Box-Cox power transformation and median quantile regression. This research compared Box-Cox power transformation and median quantile regression to overcome heteroscedasticity. Applied Box-Cox power transformation on OLS result ????2point are greater, smaller RMSE point and confidencen interval more narrow, therefore can be concluded that applied of Box-Cox power transformation on OLS better of median quantile regression to overcome heteroscedasticity.

  19. 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.

  20. 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.

  1. Regularization of DT-MR images using a successive Fermat median filtering method.

    Science.gov (United States)

    Kwon, Kiwoon; Kim, Dongyoun; Kim, Sunghee; Park, Insung; Jeong, Jaewon; Kim, Taehwan; Hong, Cheolpyo; Han, Bongsoo

    2008-05-21

    Tractography using diffusion tensor magnetic resonance imaging (DT-MRI) is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of greatest diffusion in the white matter of the brain. To reduce the noise in DT-MRI measurements, a tensor-valued median filter, which is reported to be denoising and structure preserving in the tractography, is applied. In this paper, we proposed the successive Fermat (SF) method, successively using Fermat point theory for a triangle contained in the two-dimensional plane, as a median filtering method. We discussed the error analysis and numerical study about the SF method for phantom and experimental data. By considering the computing time and the image quality aspects of the numerical study simultaneously, we showed that the SF method is much more efficient than the simple median (SM) and gradient descents (GD) methods.

  2. Regularization of DT-MR images using a successive Fermat median filtering method

    International Nuclear Information System (INIS)

    Kwon, Kiwoon; Kim, Dongyoun; Kim, Sunghee; Park, Insung; Jeong, Jaewon; Kim, Taehwan; Hong, Cheolpyo; Han, Bongsoo

    2008-01-01

    Tractography using diffusion tensor magnetic resonance imaging (DT-MRI) is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of greatest diffusion in the white matter of the brain. To reduce the noise in DT-MRI measurements, a tensor-valued median filter, which is reported to be denoising and structure preserving in the tractography, is applied. In this paper, we proposed the successive Fermat (SF) method, successively using Fermat point theory for a triangle contained in the two-dimensional plane, as a median filtering method. We discussed the error analysis and numerical study about the SF method for phantom and experimental data. By considering the computing time and the image quality aspects of the numerical study simultaneously, we showed that the SF method is much more efficient than the simple median (SM) and gradient descents (GD) methods

  3. Regularization of DT-MR images using a successive Fermat median filtering method

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Kiwoon; Kim, Dongyoun; Kim, Sunghee; Park, Insung; Jeong, Jaewon; Kim, Taehwan [Department of Biomedical Engineering, Yonsei University, Wonju, 220-710 (Korea, Republic of); Hong, Cheolpyo; Han, Bongsoo [Department of Radiological Science, Yonsei University, Wonju, 220-710 (Korea, Republic of)], E-mail: bshan@yonsei.ac.kr

    2008-05-21

    Tractography using diffusion tensor magnetic resonance imaging (DT-MRI) is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of greatest diffusion in the white matter of the brain. To reduce the noise in DT-MRI measurements, a tensor-valued median filter, which is reported to be denoising and structure preserving in the tractography, is applied. In this paper, we proposed the successive Fermat (SF) method, successively using Fermat point theory for a triangle contained in the two-dimensional plane, as a median filtering method. We discussed the error analysis and numerical study about the SF method for phantom and experimental data. By considering the computing time and the image quality aspects of the numerical study simultaneously, we showed that the SF method is much more efficient than the simple median (SM) and gradient descents (GD) methods.

  4. Phase II Study of Short-Course Radiotherapy Plus Concomitant and Adjuvant Temozolomide in Elderly Patients With Glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Minniti, Giuseppe, E-mail: Giuseppe.Minniti@ospedalesantandrea.it [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Lanzetta, Gaetano [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Scaringi, Claudia [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Caporello, Paola [Department of Medical Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Salvati, Maurizio [Department of Neurosurgery, Umberto I Hospital, University ' La Sapienza,' Rome (Italy); Arcella, Antonella [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); De Sanctis, Vitaliana [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy); Giangaspero, Felice [Department of Neurological Sciences, Neuromed Institute, Pozzilli (Italy); Department of Pathology, Umberto I Hospital, University ' La Sapienza,' Rome (Italy); Enrici, Riccardo Maurizi [Department of Radiation Oncology, Sant' Andrea Hospital, University ' La Sapienza,' Rome (Italy)

    2012-05-01

    Purpose: Radiotherapy (RT) and chemotherapy may prolong survival in older patients (age {>=}70 years) with glioblastoma multiforme (GBM), although the survival benefits remain poor. This Phase II multicenter study was designed to evaluate the efficacy and safety of an abbreviated course of RT plus concomitant and adjuvant temozolomide (TMZ) in older patients with GBM. Patients and Methods: Seventy-one eligible patients 70 years of age or older with newly diagnosed GBM and a Karnofsky performance status {>=}60 were treated with a short course of RT (40 Gy in 15 fractions over 3 weeks) plus TMZ at the dosage of 75 mg/m{sup 2} per day followed by 12 cycles of adjuvant TMZ (150-200 mg/m{sup 2} for 5 days during each 28-day cycle). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival and toxicity. Results: The Median OS was 12.4 months, and the 1-year and 2-year OS rates were 58% and 20%, respectively. The median and 1-year rates of progression-free survival were 6 months and 20%, respectively. All patients completed the planned programme of RT. Grade 3 or 4 adverse events occurred in 16 patients (22%). Grade 3 and 4 neutropenia and/or thrombocytopenia occurred in 10 patients (15%), leading to the interruption of treatment in 6 patients (8%). Nonhematologic Grade 3 toxicity was rare, and included fatigue in 4 patients and cognitive disability in 1 patient. Conclusions: A combination of an abbreviated course of RT plus concomitant and adjuvant TMZ is well tolerated and may prolong survival in elderly patients with GBM. Future randomized studies need to evaluate the efficacy and toxicity of different schedules of RT in association with chemotherapy.

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

    International Nuclear Information System (INIS)

    Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli

    2014-01-01

    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.

  6. Sosiaalisen median kehittäminen pk-yrityksissä Töpseli-verkoston avulla

    OpenAIRE

    Palander, Laura

    2010-01-01

    Tämän opinnäytetyön tarkoituksena oli selvittää, minkälaisena mahdollisuutena pk-yrittäjät kokevat sosiaalisen median ja miten he ymmärtävät sen. Läntisellä Uudellamaalla toimivia yrityksiä on osallistunut Laurea-ammattikorkeakoulun Lohjan toimipisteen Töpseli-verkostoon. Verkoston tarkoituksena on vahvistaa länsi Uudellamaalla toimivien pk-yritysten kilpailukykyä, parantamalla yrittäjien ymmärrystä sosiaalisen median tarjoamista mahdollisuuksista. Työtä varten selvitettiin myös ammattikorkea...

  7. A GPU-Based Genetic Algorithm for the P-Median Problem

    OpenAIRE

    AlBdaiwi, Bader F.; AboElFotoh, Hosam M. F.

    2016-01-01

    The p-median problem is a well-known NP-hard problem. Many heuristics have been proposed in the literature for this problem. In this paper, we exploit a GPGPU parallel computing platform to present a new genetic algorithm implemented in Cuda and based on a Pseudo Boolean formulation of the p-median problem. We have tested the effectiveness of our algorithm using a Tesla K40 (2880 Cuda cores) on 290 different benchmark instances obtained from OR-Library, discrete location problems benchmark li...

  8. 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.

  9. 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.

  10. Multiple neoplasms, single primaries, and patient survival

    International Nuclear Information System (INIS)

    Amer, Magid H

    2014-01-01

    Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first) primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284), and three or more primaries (n=38). Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%), with a tendency to develop thrombosis (20.2%), had a strong family history of similar cancer (22.3%), and usually presented with earlier stage 0 through stage II disease (78.9%). When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001). Five-year survival rates were higher for metachronous cancers (95%) than for synchronous primaries (59%) and single primaries (59%). The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years) and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991). Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition

  11. 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.).

  12. Years Versus Days Between Successive Surgeries, After an Initial Outpatient Procedure, for the Median Patient Versus the Median Surgeon in the State of Iowa.

    Science.gov (United States)

    Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

    2018-03-01

    Previously, we studied the relative importance of different institutional interventions that the largest hospital in Iowa could take to grow the anesthesia department's outpatient surgical care. Most (>50%) patients having elective surgery had not previously had surgery at the hospital. Patient perioperative experience was unimportant for influencing total anesthesia workload and numbers of patients. More important was the availability of surgical clinic appointments within several days. These results would be generalizable if the median time from surgery to a patient's next surgical procedure was large (eg, >2 years), among all hospitals in Iowa with outpatient surgery, and without regard to the hospital where the next procedure was performed. There were 37,172 surgical cases at hospital outpatient departments of any of the 117 hospitals in Iowa from July 1, 2013, to September 30, 2013. Data extracted about each case included its intraoperative work relative value units. The 37,172 cases were matched to all inpatient and outpatient records for the next 2 years statewide using patient linkage identifiers; from these were determined whether the patient had surgery again within 2 years. Furthermore, the cases' 1820 surgeons were matched to the surgeon's next outpatient or inpatient case, both including and excluding other cases performed on the date of the original case. By patient, the median time to their next surgical case, either outpatient or inpatient, exceeded 2 years, tested with weighting by intraoperative relative value units and repeated when unweighted (both P 2 years for patients versus 1 day for surgeons. Thus, although patients' experiences are an important attribute of quality of care, surgeons' experiences are orders of magnitude more important from the vantage point of marketing and growth of an anesthesia practice.

  13. 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

  14. Overall Survival of Patients with Locally Advanced or Metastatic Esophageal Squamous Cell Carcinoma Treated with Nimotuzumab in the Real World.

    Science.gov (United States)

    Saumell, Yaimarelis; Sanchez, Lizet; González, Sandra; Ortiz, Ramón; Medina, Edadny; Galán, Yaima; Lage, Agustin

    2017-12-01

    Despite improvements in surgical techniques and treatments introduced into clinical practice, the overall survival of patients with esophageal squamous cell carcinoma remains low. Several epidermal growth factor receptor inhibitors are being evaluated in the context of clinical trials, but there is little evidence of effectiveness in real-world conditions. This study aimed at assessing the effectiveness of nimotuzumab combined with onco-specific treatment in Cuban real-life patients with locally advanced or metastatic esophageal squamous cell carcinoma. A comparative and retrospective effectiveness study was performed. The 93 patients treated with nimotuzumab were matched, with use of propensity score matching, with patients who received a diagnosis of locally advanced or metastatic squamous cell carcinoma of the esophagus in three Cuban provinces reported between 2011 and 2015 to the National Cancer Registry. The Kaplan-Meier method was used to estimate event-time distributions. Log-rank statistics were used for comparisons of overall survival between groups. A two-component mixture model assuming a Weibull distribution was fitted to assess the effect of nimotuzumab on short-term and long-term survival populations. There was an increase in median overall survival in patients treated with nimotuzumab (11.9 months versus 6.5 months without treatment) and an increase in the 1-year survival rate (54.0% versus 21.9% without treatment). The 2-year survival rates were 21.1% for patients treated with nimotuzumab and 0% in the untreated cohort. There were statistically significant differences in survival between groups treated and not treated with nimotuzumab, both in the short-term survival population (6.0 months vs 4.0 months, p = 0.009) and in the long-term survival population (18.0 months vs 11.0 months, p = 0.001). Our study shows that nimotuzumab treatment concurrent with chemoradiotherapy increases the survival of real-world patients with locally advanced

  15. Small median tumor diameter at cure threshold (lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation framework.

    Science.gov (United States)

    Goldwasser, Deborah L; Kimmel, Marek

    2013-01-01

    The effectiveness of population-wide lung cancer screening strategies depends on the underlying natural course of lung cancer. We evaluate the expected stage distribution in the Mayo CT screening study under an existing simulation model of non-small cell lung cancer (NSCLC) progression calibrated to the Mayo lung project (MLP). Within a likelihood framework, we evaluate whether the probability of 5-year NSCLC survival conditional on tumor diameter at detection depends significantly on screening detection modality, namely chest X-ray and computed tomography. We describe a novel simulation framework in which tumor progression depends on cellular proliferation and mutation within a stem cell compartment of the tumor. We fit this model to randomized trial data from the MLP and produce estimates of the median radiologic size at the cure threshold. We examine the goodness of model fit with respect to radiologic tumor size and 5-year NSCLC survival among incident cancers in both the MLP and Mayo CT studies. An existing model of NSCLC progression under-predicts the number of advanced-stage incident NSCLCs among males in the Mayo CT study (p-value = 0.004). The probability of 5-year NSCLC survival conditional on tumor diameter depends significantly on detection modality (p-value = 0.0312). In our new model, selected solution sets having a median tumor diameter of 16.2-22.1 mm at cure threshold among aggressive NSCLCs predict both MLP and Mayo CT outcomes. We conclude that the median lung tumor diameter at cure threshold among aggressive NSCLCs in male smokers may be small (<20 mm). Copyright © 2012 UICC.

  16. 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.

  17. Variability of pudendal and median nerve sensory perception thresholds in healthy persons.

    Science.gov (United States)

    Quaghebeur, Jörgen; Wyndaele, Jean-Jacques

    2015-04-01

    Normative current perception thresholds (CPTs) are used for the evaluation of sensory function in a variety of diseases. To evaluate the reproducibility of CPT measurements with sinusoidal current in healthy volunteers. Neuroselective CPT evaluations of the median and pudendal nerve in healthy volunteers were repeated with 1 week interval (T1 and T2). In the study group (N = 41) no difference between genders for age (MW-U: P = 0.91) and BMI (t-test: P = 0.18) were found. No significant difference between T1 and T2 was found (Paired t-test: all P-values > 0.05), although the intraclass correlation for each person was low. The variability of measures for the pudendal nerve was: ICC 2 kHz: 0.41; 250 Hz: 0.30; 5 Hz: 0.38, and for the median nerve respectively: 0.58; 0.46; 0.40. Normal CPTs were shown for the pudendal nerve: 2 kHz: 51%; 250 Hz: 76%; 5 Hz: 71%, and median nerve respectively: 78%; 98%; 80%. The pudendal nerve showed more deviating values compared to the median nerve. Both nerves showed deviating values. CPT values with sinusoidal current assessed with 1 week interval, showed a weak intraclass correlation. This finding limits the use of CPT values with this current for longitudinal studies. © 2014 Wiley Periodicals, Inc.

  18. Income Inequality, the Median Voter, and the Support for Public Education. NBER Working Paper No. 16097

    Science.gov (United States)

    Corcoran, Sean; Evans, William N.

    2010-01-01

    Using a panel of U.S. school districts spanning 1970-2000, we examine the relationship between income inequality and fiscal support for public education. In contrast with recent theoretical and empirical work suggesting a negative relationship between inequality and public spending, we find results consistent with a median voter model, in which…

  19. Endocrine and anatomical findings in a case of Solitary Median Maxillary Central Incisor Syndrome

    NARCIS (Netherlands)

    Szakszon, Katalin; Felszeghy, Enikő; Csízy, István; Józsa, Tamás; Káposzta, Rita; Balogh, Erzsébet; Oláh, Eva; Balogh, István; Berényi, Ervin; Knegt, Alida C.; Ilyés, István

    2012-01-01

    Solitary Median Maxillary Central Incisor Syndrome (SMMCI) is a rare malformation syndrome consisting of multiple, mainly midline defects. Some authors suggest that it is a mild manifestation of the wide spectrum of holoprosencephaly, others classify it rather as a distinct entity. Authors report a

  20. A median filter approach for correcting errors in a vector field

    Science.gov (United States)

    Schultz, H.

    1985-01-01

    Techniques are presented for detecting and correcting errors in a vector field. These methods employ median filters which are frequently used in image processing to enhance edges and remove noise. A detailed example is given for wind field maps produced by a spaceborne scatterometer. The error detection and replacement algorithm was tested with simulation data from the NASA Scatterometer (NSCAT) project.

  1. Experimental concrete coating application on the median barrier of I 65 in Louisville.

    Science.gov (United States)

    2008-06-01

    The objectives of this research were to evaluate the experimental protective coating that was applied to approximately 1,200 linear feet of concrete median barrier along the paving project on a section of I 65 between mile points 131.289 and 136.421 ...

  2. Application of median-equation approach for outlier detection in geodetic networks

    Directory of Open Access Journals (Sweden)

    Serif Hekimoglu

    Full Text Available In geodetic measurements some outliers may occur sometimes in data sets, depending on different reasons. There are two main approaches to detect outliers as Tests for outliers (Baarda's and Pope's Tests and robust methods (Danish method, Huber method etc.. These methods use the Least Squares Estimation (LSE. The outliers affect the LSE results, especially it smears the effects of the outliers on the good observations and sometimes wrong results may be obtained. To avoid these effects, a method that does not use LSE should be preferred. The median is a high breakdown point estimator and if it is applied for the outlier detection, reliable results can be obtained. In this study, a robust method which uses median with or as a treshould value on median residuals that are obtained from median equations is proposed. If the a priori variance of the observations is known, the reliability of the new approch is greater than the one in the case where the a priori variance is unknown.

  3. 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…

  4. A Comparison among Worker Types Using a Composites Approach and Median Splits

    Science.gov (United States)

    Aziz, Shahnaz; Wuensch, Karl L.; Brandon, Howard R.

    2010-01-01

    The current study examined Spence and Robbins' (1992) worker types in terms of correlates of workaholism (e.g., work-life imbalance, obsessive-compulsive behavior). A survey was administered to professionals, who were then classified into different worker types following the traditional median-split technique. The data were also analyzed with…

  5. 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

    2017-01-01

    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...

  6. 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.

  7. Speckle Reduction and Structure Enhancement by Multichannel Median Boosted Anisotropic Diffusion

    Directory of Open Access Journals (Sweden)

    Yang Zhi

    2004-01-01

    Full Text Available We propose a new approach to reduce speckle noise and enhance structures in speckle-corrupted images. It utilizes a median-anisotropic diffusion compound scheme. The median-filter-based reaction term acts as a guided energy source to boost the structures in the image being processed. In addition, it regularizes the diffusion equation to ensure the existence and uniqueness of a solution. We also introduce a decimation and back reconstruction scheme to further enhance the processing result. Before the iteration of the diffusion process, the image is decimated and a subpixel shifted image set is formed. This allows a multichannel parallel diffusion iteration, and more importantly, the speckle noise is broken into impulsive or salt-pepper noise, which is easy to remove by median filtering. The advantage of the proposed technique is clear when it is compared to other diffusion algorithms and the well-known adaptive weighted median filtering (AWMF scheme in both simulation and real medical ultrasound images.

  8. Median Growth Percentiles (MGPs): Assessment of Intertemporal Stability and Correlations with Observational Scores

    Science.gov (United States)

    Pivovarova, Margarita; Amrein-Beardsley, Audrey

    2018-01-01

    While states are no longer required to set up teacher evaluation systems based in significant part on student test scores, quite a few continue to use value-added (VAMs) or student growth percentile (SGP) models for that purpose. In this study, we analyzed three years of teacher data to illustrate the performance of teachers' median growth…

  9. Property Mix Heterogeneity and Market Cycles: How Much Can We Rely on Median-Price Indices?

    Directory of Open Access Journals (Sweden)

    Odilon Ricardo da Hora Gonçalves Fernandes Costa

    2017-05-01

    Full Text Available Objective. Understand in which types of location median-price indices could provide reasonable estimates of rent growth. As far as our research allows, the market-based measures developed througout this study are the first to emphasize office properties in Brazil using an hedonic framework.Methodology. Create appraisal-based indices of rent growth using median-price and hedonic-based techniques for two regions with different degrees of property mix heterogeneity and compare their behavior overtime.Findings. Volatility in median-price measures is larger than hedonic-based measures in market peaks and throughs due to different weighting of high and low-tier properties overtime. This result is stronger in the location with higher property mix heterogeneity and, consequently, exacerbates market cycles in this region.  Limitations. We do not find statistically significant differences between the measures considered. Nevertheless, we do not consider whether this similarity would hold when using transactional-based data.    Value. Our results suggest that researchers, policy makers and investors need to take into account the “undesired fluctuation” of median-price measures when interpreting such indices.  

  10. Usability testing of wireless broadband LAN in the MEDIAN user trials

    NARCIS (Netherlands)

    Dam, C. van; Vliet, P.J. van; Schuurman, K.; Maltha, S.R.; Leyten, A.J.M.; Dirks, M.W.S.

    1999-01-01

    The main objective of the ACTS MEDIAN project is to build a high speed WCPN/LAN demonstrator system for multimedia applications and demonstrate it in user trials. The demonstrator system, consisting of one base station and two portable stations, is capable of handling high speed (up to 150 Mbit/s)

  11. Case Report: A true median facial cleft (crano-facial dysraphia ...

    African Journals Online (AJOL)

    Case Report: A true median facial cleft (crano-facial dysraphia, atessier type O) in Bingham University Teaching Hospital, Jos. ... Patient had a multidisciplinary care by the obstetrician, Neonatologist, anesthesiologist and the plastic surgery team who scheduled a soft tissue repair of the upper lip defect, columella and ...

  12. Survival pathways under stress

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Survival pathways under stress. Bacteria survive by changing gene expression. pattern. Three important pathways will be discussed: Stringent response. Quorum sensing. Proteins performing function to control oxidative damage.

  13. Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves

    Directory of Open Access Journals (Sweden)

    Guyot Patricia

    2012-02-01

    Full Text Available Abstract Background The results of Randomized Controlled Trials (RCTs on time-to-event outcomes that are usually reported are median time to events and Cox Hazard Ratio. These do not constitute the sufficient statistics required for meta-analysis or cost-effectiveness analysis, and their use in secondary analyses requires strong assumptions that may not have been adequately tested. In order to enhance the quality of secondary data analyses, we propose a method which derives from the published Kaplan Meier survival curves a close approximation to the original individual patient time-to-event data from which they were generated. Methods We develop an algorithm that maps from digitised curves back to KM data by finding numerical solutions to the inverted KM equations, using where available information on number of events and numbers at risk. The reproducibility and accuracy of survival probabilities, median survival times and hazard ratios based on reconstructed KM data was assessed by comparing published statistics (survival probabilities, medians and hazard ratios with statistics based on repeated reconstructions by multiple observers. Results The validation exercise established there was no material systematic error and that there was a high degree of reproducibility for all statistics. Accuracy was excellent for survival probabilities and medians, for hazard ratios reasonable accuracy can only be obtained if at least numbers at risk or total number of events are reported. Conclusion The algorithm is a reliable tool for meta-analysis and cost-effectiveness analyses of RCTs reporting time-to-event data. It is recommended that all RCTs should report information on numbers at risk and total number of events alongside KM curves.

  14. Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves.

    Science.gov (United States)

    Guyot, Patricia; Ades, A E; Ouwens, Mario J N M; Welton, Nicky J

    2012-02-01

    The results of Randomized Controlled Trials (RCTs) on time-to-event outcomes that are usually reported are median time to events and Cox Hazard Ratio. These do not constitute the sufficient statistics required for meta-analysis or cost-effectiveness analysis, and their use in secondary analyses requires strong assumptions that may not have been adequately tested. In order to enhance the quality of secondary data analyses, we propose a method which derives from the published Kaplan Meier survival curves a close approximation to the original individual patient time-to-event data from which they were generated. We develop an algorithm that maps from digitised curves back to KM data by finding numerical solutions to the inverted KM equations, using where available information on number of events and numbers at risk. The reproducibility and accuracy of survival probabilities, median survival times and hazard ratios based on reconstructed KM data was assessed by comparing published statistics (survival probabilities, medians and hazard ratios) with statistics based on repeated reconstructions by multiple observers. The validation exercise established there was no material systematic error and that there was a high degree of reproducibility for all statistics. Accuracy was excellent for survival probabilities and medians, for hazard ratios reasonable accuracy can only be obtained if at least numbers at risk or total number of events are reported. The algorithm is a reliable tool for meta-analysis and cost-effectiveness analyses of RCTs reporting time-to-event data. It is recommended that all RCTs should report information on numbers at risk and total number of events alongside KM curves.

  15. Survival of patients with Ewing's sarcoma in Yazd-Iran.

    Science.gov (United States)

    Akhavan, Ali; Binesh, Fariba; Shamshiri, Hadi; Ghanadi, Fazllolah

    2014-01-01

    The Ewing's sarcoma family is a group of small round cell tumors which accounts for 10-15% of all primary bone neoplasms. The aim of this study was to evaluate the survival of Ewing's sarcoma patients in our province and to determine of influencing factors. All patients with documented Ewing's sarcoma/ primitive neuroectodermal tumor(PNET) family pathology were enrolled in this study during a period of eight years. For all of them local and systemic therapy were carried out. Overall and event free survival and prognostic factors were evaluated. Thirty two patients were enrolled in the study. The median age was 17.5 years. Twenty (65.2%) were male and 9 (28.1%) were aged 14 years or less. Mean disease free survival was 26.8 (95%CI; 13.8-39.9) months and five year disease free survival was 26%. Mean overall survival was 38.7 months (95%CI; 25.9-50.6) and median overall survival was 24 months. Five year overall survival was 25%. From the variables evaluated , only presence of metastatic disease at presentation (p value=0. 028) and complete response (p value =0. 006) had significant relations to overall survival. Survival of Ewing's sarcoma in our province is disappointing. It seems to be mostly due to less effective treatment. Administration of adequate chemotherapy dosage, resection of tumor with negative margins and precise assessment of irradiation volume may prove helpful.

  16. Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.

    Science.gov (United States)

    Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F

    2015-01-01

    Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], Ppatient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by

  17. Correlation between the median particle size of chewed frankfurter sausage and almonds during masticatory performance test.

    Science.gov (United States)

    Sumonsiri, P; Thongudomporn, U; Paphangkorakit, J

    2018-04-27

    The correlation between chewing and gastric function is best reflected when the same food type is used during both tests. We proposed frankfurter sausage as test food for masticatory performance as it can also be used in gastric emptying test. The suitability of frankfurter sausage to determine masticatory performance, however, has never been examined. To examine the correlations between the median particle size of frankfurter sausage and almonds (as standard test food) after different numbers of chewing cycles. Twenty-seven subjects performed masticatory performance tests by chewing 2 types of test foods, that is, a piece of almond or 5-g frankfurter sausage cubes placed in a sealed latex bag, for 5 and 15 chewing cycles. For each individual, right and left sides were tested separately. Chewed samples obtained from both sides were pooled. Median particle sizes were determined using a multiple sieving method. Spearman's rank correlation was used to examine any correlation between median particle sizes of the 2 test foods after 5 and 15 cycles. Median particle sizes after 5 and 15 cycles were 2.04 ± 0.87 and 0.95 ± 0.58 mm for almonds and 4.16 ± 0.19 and 3.73 ± 0.25 mm for frankfurter sausage, respectively. Significant correlations were observed between the median particle size of chewed frankfurter sausage after 15 cycles and that of chewed almonds after 5 and 15 cycles (r = .76, P < .01 and r = .52, P = .01, respectively). Frankfurter sausage chewed for 15 cycles may be suitable for the determination of masticatory performance in conjunction with gastric emptying test. © 2018 John Wiley & Sons Ltd.

  18. Clinical results and toxicity for short-course preoperative radiotherapy and total mesorectal excision in rectal cancer patients

    International Nuclear Information System (INIS)

    Sterzing, Florian; Jensen, Alexandra; Debus, Jürgen; Hoehle, Frieder; Ulrich, Alexis; Muenter, Marc

    2015-01-01

    Short-course preoperative radiotherapy (SCPRT) is an alternative method to chemoirradiation for patients with Stage II and III rectal cancer when no downsizing is needed, but there is still widespread reluctance to use this method because of fear of side effects from high-fraction doses. This paper reports on a single institution patient cohort of operated rectal cancer patients after SCPRT, evaluated for chronic adverse effects, local control, progression-free survival and overall survival. Altogether, 257 patients were treated with SCPRT and surgery including total mesorectal excision (92% total mesorectal excision = TME) between 2002 and 2009. Local control and survival were analyzed. Chronic adverse effects for 154 patients without local relapse were evaluated according to the NCI–CTCAE version 4.0 classification, with a median follow-up of 48 months. We found a 5-year disease-free survival (DFS) and overall survival (OS) of 71%. The 5-year estimated local control (LC) rate was 94%. A positive resection margin was found in 4% of the patients and was significantly correlated with decreased DFS, OS and LC. Chronic adverse effects were reported by 58% of the patients, of which 10% were Grade 3 toxicities. The most frequent Grade 2 toxicity was stool incontinence (13%). Sexual dysfunction was found in 36% of the patients (31% Grade 1 or 2, and only 5% Grade 3). SCPRT combined with TME produced excellent LC rates together with a low rate of high-grade chronic adverse effects. (author)

  19. The impact of chemotherapy and its timing on survival in malignant peritoneal mesothelioma treated with complete debulking.

    Science.gov (United States)

    Naffouje, Samer A; Tulla, Kiara A; Salti, George I

    2018-04-12

    The current standard of treatment for malignant peritoneal mesothelioma (MPM) is cytoreductive surgery when the disease distribution is favorable. The role of chemotherapy, as an adjunct to surgery, remains unclear. The national database of mesothelioma was used to identify MPM patients who were treated with curative intent. Patients were divided into treatment groups: (1) chemotherapy only, (2) surgery only, (3) neoadjuvant chemotherapy + surgery, and (4) surgery + adjuvant chemotherapy. A negative control group of patients who did not receive any treatment was added (group 0). Totally, 1740 patients were included. Mean age was 63.04 ± 14.58 and 60.7% were males. The patients' distribution into the treatment groups was 604, 684, 169, 55, and 228 patients in groups 0-4, respectively, with a median survival of 3.61 ± 0.37, 11.10 ± 0.73, 57.41 ± 11.91, 52.30 ± 7.20, and 55.00 ± 9.19 months. The addition of chemotherapy, in any setting, to surgery provided an improved survival at 1 year (p = 0.006). This survival benefit ceased at the 2-, 3-, and 5-year checkpoints. The multivariate analysis identified age, sarcomatoid/biphasic histologies, nodal and distant metastasis, and offering no treatment or chemotherapy only as poor prognostic factors for overall survival. No difference in overall survival was noted with the addition of chemotherapy to complete debulking regardless of the timing. Complete debulking remains the standard treatment for MPM. The addition of systemic chemotherapy provides a short-term survival improvement at 1 year only and was similar whether given in the neoadjuvant or adjuvant setting. Nevertheless, it did not add a survival benefit beyond the 1-year time point.

  20. Survival of Alzheimer's disease patients in Korea.

    Science.gov (United States)

    Go, Seok Min; Lee, Kang Soo; Seo, Sang Won; Chin, Juhee; Kang, Sue J; Moon, So Young; Na, Duk L; Cheong, Hae-Kwan

    2013-01-01

    The natural history of Alzheimer's disease (AD) has rarely been studied in the Korean population. Our study on survival analyses in Korean AD patients potentially provides a basis for cross-cultural comparisons. We studied 724 consecutive patients from a memory disorder clinic in a tertiary hospital in Seoul, who were diagnosed as having AD between April 1995 and December 2005. Deaths were identified by the Statistics Korea database. The Kaplan-Meier method was used for survival analysis, and a Cox proportional hazard model was used to assess factors related to patient survival. The overall median survival from the onset of first symptoms and from the time of diagnosis was 12.6 years (95% confidence interval 11.7-13.4) and 9.3 years (95% confidence interval 8.7-9.9), respectively. The age of onset, male gender, history of diabetes mellitus, lower Mini-Mental State Examination score, and higher Clinical Dementia Rating score were negatively associated with survival. There was a reversal of risk of AD between early-onset and later-onset AD, 9.1 years after onset. The results of our study show a different pattern of survival compared to those studies carried out with western AD populations. Mortality risk of early-onset AD varied depending on the duration of follow-up. Copyright © 2013 S. Karger AG, Basel.

  1. Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review

    Directory of Open Access Journals (Sweden)

    Ding Chao

    2012-05-01

    Full Text Available Abstract Background Anterolateral Minithoracotomy (ALMT for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal. Methods 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. Results ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04. Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI −0.15 to 4.91 min, p = 0.06. In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI −3.05 to −0.27 hrs, p = 0.02. Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI −2.71 to −0.33 days, p = 0.01. Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI −0.81 to 0.04 days, p = 0.08. Conclusion ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

  2. Network survivability performance

    Science.gov (United States)

    1993-11-01

    This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

  3. 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.

  4. 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.

  5. Characterization of the Small and Median Companies in the Textile Sector of the Ecuadorian Economy

    Directory of Open Access Journals (Sweden)

    Jenny Lilián Basantes–Avalos

    2015-12-01

    Full Text Available The small and median companies perform a fundamental role in the economy of latinoamerican countries, and Ecuador is not the exception, because of its incidence in the generation of employment and economic development. Historically, Ecuador has been a textile country by excellence, and with the years has been consolidated like one of the manufactured industries most importants of the country. However, the sector has to deal with adverse condition in the last decade. For such reason, the manufacturers have the challenge of improve the production techniques to promote a better quality offer and recognition, capable of competing with foreign products of similar characteristics. In this context, this paper has the intent to characterize the small and median companies of Ecuador in general and the textile sector as a particularity, its current situation, the importance of the Ecuadorian economy, such as their problems and opportunities. 

  6. Median nerve trauma in a rat model of work-related musculoskeletal disorder.

    Science.gov (United States)

    Clark, Brian D; Barr, Ann E; Safadi, Fayez F; Beitman, Lisa; Al-Shatti, Talal; Amin, Mamta; Gaughan, John P; Barbe, Mary F

    2003-07-01

    Anatomical and physiological changes were evaluated in the median nerves of rats trained to perform repetitive reaching. Motor degradation was evident after 4 weeks. ED1-immunoreactive macrophages were seen in the transcarpal region of the median nerve of both forelimbs by 5-6 weeks. Fibrosis, characterized by increased immunoexpression of collagen type I by 8 weeks and connective tissue growth factor by 12 weeks, was evident. The conduction velocity (NCV) within the carpal tunnel showed a modest but significant decline after 9-12 weeks. The lowest NCV values were found in animals that refused to participate in the task for the full time available. Thus, both anatomical and physiological signs of progressive tissue damage were present in this model. These results, together with other recent findings indicate that work-related carpal tunnel syndrome develops through mechanisms that include injury, inflammation, fibrosis and subsequent nerve compression.

  7. Additional Muscle Slip of Bicipital Aponeurosis and its Anomalous Relationship with the Median Cubital Vein

    Directory of Open Access Journals (Sweden)

    Nandini Bhat

    2017-03-01

    Full Text Available The cubital region of the arm is a common site for recording blood pressure, taking blood for analysis and administering intravenous therapy and blood transfusions. During the routine dissection of a 70-year-old male cadaver at the Kasturba Medical College, Manipal, Karnataka, India, in 2015, it was observed that the aponeurotic insertion of the biceps brachii muscle divided into two slips. The medial slip fused normally with the deep fascia of the forearm, while flexor carpi radialis muscle fibres originated from the lateral slip. There was also a single vein in the forearm, the cephalic vein, which bifurcated to form the median cubital vein and the cephalic vein proper. The median cubital vein, further reinforced by the radial vein, passed deep to the two slips of the bicipital aponeurosis and then continued as the basilic vein. During venepuncture, medical practitioners should be aware of potential cubital fossa variations which could lead to nerve entrapment syndromes.

  8. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm.

    Science.gov (United States)

    Atoni, Atoni Dogood; Oyinbo, Charles Aidemise

    2017-03-01

    Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  9. Anatomic Variation of the Median Nerve Associated with an Anomalous Muscle of the Forearm

    Directory of Open Access Journals (Sweden)

    Atoni Atoni Dogood

    2017-03-01

    Full Text Available Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.

  10. 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...

  11. Separation of simultaneous sources using a structural-oriented median filter in the flattened dimension

    Science.gov (United States)

    Gan, Shuwei; Wang, Shoudong; Chen, Yangkang; Chen, Xiaohong; Xiang, Kui

    2016-01-01

    Simultaneous-source shooting can help tremendously shorten the acquisition period and improve the quality of seismic data for better subsalt seismic imaging, but at the expense of introducing strong interference (blending noise) to the acquired seismic data. We propose to use a structural-oriented median filter to attenuate the blending noise along the structural direction of seismic profiles. The principle of the proposed approach is to first flatten the seismic record in local spatial windows and then to apply a traditional median filter (MF) to the third flattened dimension. The key component of the proposed approach is the estimation of the local slope, which can be calculated by first scanning the NMO velocity and then transferring the velocity to the local slope. Both synthetic and field data examples show that the proposed approach can successfully separate the simultaneous-source data into individual sources. We provide an open-source toy example to better demonstratethe proposed methodology.

  12. Asymmetric Bilateral Variations in the Musculocutaneous and Median Nerves with High Branching of Brachial Artery

    Directory of Open Access Journals (Sweden)

    Vandana Tomar

    2012-01-01

    Full Text Available Brachial Plexus is formed by the union of the anterior rami of cervical 5, 6, 7, 8 and thoracic 1 nerves. These nerves unite and divide to form the key nerves innervating the upper limb. Variations in the course of these nerves are clinically important to anesthetists, neurologists and orthopedicians. We report bilateral variations in the arterial and neural structures in the upper limb of a 65 year old cadaver. The muscles of the arm on one side were innervated by the median nerve with absence of musculocutaneous. While on the other side the musculocutaneous nerve contributed to the formation of the median nerve. There was a presence of high bifurcation of brachial artery on both sides. Knowledge of such variations in the innervations of muscles and the arterial supply of the limbs are important to remember before performing any reconstructive procedures or interventions on the limb.

  13. 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.

  14. Wound infections after median sternotomy treated by VAC therapy, summary of results, and risk factor analysis.

    Science.gov (United States)

    Hulman, M; Bezak, B; Artemiou, P; Cikrai, R

    2017-01-01

    The aim of this study is to summarize results and analyze risk factors for the development of wound infection in heart surgery patients after median sternotomy. In this retrospective analysis with assessment of multiple risk factors, we examined 143 patients with infection after median sternotomy treated with VAC therapy from total of 4,650 patients operated in our department from 2012 to 2015. Total of 143 patients developed significant SSI treated by VAC therapy following cardiac surgery. Of these, only 14 patients developed DSWI and one patient was diagnosed with suspected osteomyelitis. BMI, female gender, and use of BIMA proved to be statistically significant risk factors in our study (p infection (p infection proved to be a significant prognostic factor for patients' outcome (p infection (Tab. 3, Ref. 30).

  15. 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.

  16. Median and ulnar neuropathies in U.S. Army Medical Command Band members.

    Science.gov (United States)

    Shaffer, Scott W; Koreerat, Nicholas R; Gordon, Lindsay B; Santillo, Douglas R; Moore, Josef H; Greathouse, David G

    2013-12-01

    Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas. Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings. The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

  17. Application of subinterval area median contrast filtering method in the recognizing of geochemical anomalies

    International Nuclear Information System (INIS)

    Zhao Ningbo; Fu Jin; Zhang Chuan; Liu Huan

    2012-01-01

    Traditional geochemical processing method sometimes maybe loses some weak anomalies related to mineralization, the authors can avoid the influence of geology background and can solve the problem of recognizing weak anomalies in the low-background and high-background area with the subinterval area median contrast filtering method. In an area of Jiangxi Province, several new anomalies are identified by this method and uranium mineralized prospects are found among them. (authors)

  18. Evaluation of median nerve T2 signal changes in patients with surgically treated carpal tunnel syndrome.

    Science.gov (United States)

    Samanci, Yavuz; Karagöz, Yeşim; Yaman, Mehmet; Atçı, İbrahim Burak; Emre, Ufuk; Kılıçkesmez, Nuri Özgür; Çelik, Suat Erol

    2016-11-01

    To determine the accuracy of median nerve T2 evaluation and its relation with Boston Questionnaire (BQ) and nerve conduction studies (NCSs) in pre-operative and post-operative carpal tunnel syndrome (CTS) patients in comparison with healthy volunteers. Twenty-three CTS patients and 24 healthy volunteers underwent NCSs, median nerve T2 evaluation and self-administered BQ. Pre-operative and 1st year post-operative median nerve T2 values and cross-sectional areas (CSAs) were compared both within pre-operative and post-operative CTS groups, and with healthy volunteers. The relationship between MRI findings and BQ and NCSs was analyzed. The ROC curve analysis was used for determining the accuracy. The comparison of pre-operative and post-operative T2 values and CSAs revealed statistically significant improvements in the post-operative patient group (pT2 values at all levels and BQ values, and positive and negative correlations were also found regarding T2 values and NCS findings in CTS patients. The receiver operating characteristic curve analysis for defined cut-off levels of median nerve T2 values in hands with severe CTS yielded excellent accuracy at all levels. However, this accuracy could not be demonstrated in hands with mild CTS. This study is the first to analyze T2 values in both pre-operative and post-operative CTS patients. The presence of increased T2 values in CTS patients compared to controls and excellent accuracy in hands with severe CTS indicates T2 signal changes related to CTS pathophysiology and possible utilization of T2 signal evaluation in hands with severe CTS. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Short Term Survival after Admission for Heart Failure in Sweden

    DEFF Research Database (Denmark)

    Ghith, Nermin; Wagner, Philippe; Frølich, Anne

    2016-01-01

    of birth as well as hospitals and wards levels. Average mortality was higher in small wards and municipal hospitals but the POOR values were 15% and 16% respectively. CONCLUSIONS: Swedish wards and hospitals in general performed homogeneously well, resulting in a low 30-day mortality rate after HF. In our...... (PCV) and the proportion of ORs in the opposite direction (POOR). FINDINGS: Overall, the average 30-day mortality was 9%. Using only patient information on age and previous hospitalizations for different diseases we obtained an AUC = 0.727. This value was almost unchanged when adding sex, country...... study, knowledge on a patient's previous hospitalizations was the best predictor of 30-day mortality, and this information did not improve by knowing the sex and country of birth of the patient or where the patient was treated....

  20. A Phase 1/2 and Biomarker Study of Preoperative Short Course Chemoradiation With Proton Beam Therapy and Capecitabine Followed By Early Surgery for Resectable Pancreatic Ductal Adenocarcinoma

    International Nuclear Information System (INIS)

    Hong, Theodore S.; Ryan, David P.; Borger, Darrell R.; Blaszkowsky, Lawrence S.; Yeap, Beow Y.; Ancukiewicz, Marek; Deshpande, Vikram; Shinagare, Shweta; Wo, Jennifer Y.; Boucher, Yves; Wadlow, Raymond C.; Kwak, Eunice L.; Allen, Jill N.; Clark, Jeffrey W.; Zhu, Andrew X.; Ferrone, Cristina R.; Mamon, Harvey J.; Adams, Judith; Winrich, Barbara; Grillo, Tarin

    2014-01-01

    Purpose: To evaluate the safety, efficacy and biomarkers of short-course proton beam radiation and capecitabine, followed by pancreaticoduodenectomy in a phase 1/2 study in pancreatic ductal adenocarcinoma (PDAC) patients. Methods and Materials: Patients with radiographically resectable, biopsy-proven PDAC were treated with neoadjuvant short-course (2-week) proton-based radiation with capecitabine, followed by surgery and adjuvant gemcitabine. The primary objective was to demonstrate a rate of toxicity grade ≥3 of <20%. Exploratory biomarker studies were performed using surgical specimen tissues and peripheral blood. Results: The phase 2 dose was established at 5 daily doses of 5 GyE. Fifty patients were enrolled, of whom 35 patients were treated in the phase 2 portion. There were no grade 4 or 5 toxicities, and only 2 of 35 patients (4.1%) experienced a grade 3 toxicity event (chest wall pain grade 1, colitis grade 1). Of 48 patients eligible for analysis, 37 underwent pancreaticoduodenectomy. Thirty of 37 (81%) had positive nodes. Locoregional failure occurred in 6 of 37 resected patients (16.2%), and distant recurrence occurred in 35 of 48 patients (72.9%). With median follow-up of 38 months, the median progression-free survival for the entire group was 10 months, and overall survival was 17 months. Biomarker studies showed significant associations between worse survival outcomes and the KRAS point mutation change from glycine to aspartic acid at position 12, stromal CXCR7 expression, and circulating biomarkers CEA, CA19-9, and HGF (all, P<.05). Conclusions: This study met the primary endpoint by showing a rate of 4.1% grade 3 toxicity for neoadjuvant short-course proton-based chemoradiation. Treatment was associated with favorable local control. In exploratory analyses, KRAS G12D status and high CXCR7 expression and circulating CEA, CA19-9, and HGF levels were associated with poor survival

  1. Percentiles of the run-length distribution of the Exponentially Weighted Moving Average (EWMA) median chart

    Science.gov (United States)

    Tan, K. L.; Chong, Z. L.; Khoo, M. B. C.; Teoh, W. L.; Teh, S. Y.

    2017-09-01

    Quality control is crucial in a wide variety of fields, as it can help to satisfy customers’ needs and requirements by enhancing and improving the products and services to a superior quality level. The EWMA median chart was proposed as a useful alternative to the EWMA \\bar{X} chart because the median-type chart is robust against contamination, outliers or small deviation from the normality assumption compared to the traditional \\bar{X}-type chart. To provide a complete understanding of the run-length distribution, the percentiles of the run-length distribution should be investigated rather than depending solely on the average run length (ARL) performance measure. This is because interpretation depending on the ARL alone can be misleading, as the process mean shifts change according to the skewness and shape of the run-length distribution, varying from almost symmetric when the magnitude of the mean shift is large, to highly right-skewed when the process is in-control (IC) or slightly out-of-control (OOC). Before computing the percentiles of the run-length distribution, optimal parameters of the EWMA median chart will be obtained by minimizing the OOC ARL, while retaining the IC ARL at a desired value.

  2. Median Arcuate Ligament Syndrome: A Single-Center Experience with 23 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Nasr, Layla A. [American University of Beirut Medical Center, Division of Interventional Radiology, Department of Radiology (Lebanon); Faraj, Walid G. [American University of Beirut Medical Center, Department of Surgery (Lebanon); Al-Kutoubi, Aghiad [American University of Beirut Medical Center, Division of Interventional Radiology, Department of Radiology (Lebanon); Hamady, Mohamad [Imperial College-London Faculty of Medicine, Division of Interventional Radiology, Department of Radiology (United Kingdom); Khalifeh, Mohamad; Hallal, Ali; Halawani, Hamzeh M. [American University of Beirut Medical Center, Department of Surgery (Lebanon); Wazen, Joelle; Haydar, Ali A., E-mail: ah24@aub.edu.lb [American University of Beirut Medical Center, Division of Interventional Radiology, Department of Radiology (Lebanon)

    2017-05-15

    BackgroundMedian arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result.MethodsThis is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center. Computed tomographic (CT) scans, medical records, and patient follow-up were reviewed.ResultsThe number of patients included herein was 23. The median age was 56 years (17–83). Sixteen patients (69.6%) had a significant arterial collateral circulation. Eleven patients (47.8%) were found to have visceral artery aneurysms; 4 patients (36.4%) bled secondary to aneurysm rupture. All ruptured aneurysms were treated with endovascular approach. The severity of the hemodynamic changes appears to be greater with complete occlusion,ConclusionsMALS causes pathological hemodynamic changes within the abdominal vasculature. Follow-up is advised for patients who develop a collateral circulation. Resulting aneurysms should preferably be treated when the size ratio approaches three. Treatment of these aneurysms can be done via an endovascular approach coupled with possible celiac artery decompression to restore physiologic blood flow.

  3. 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.

  4. Relationship between median nerve somatosensory evoked potentials and spinal cord injury levels in patients with quadriplegia.

    Science.gov (United States)

    de Arruda Serra Gaspar, M I F; Cliquet, A; Fernandes Lima, V M; de Abreu, D C C

    2009-05-01

    Cross-sectional study. To observe if there is a relationship between the level of injury by the American Spinal Cord Injury Association (ASIA) and cortical somatosensory evoked potential (SSEP) recordings of the median nerve in patients with quadriplegia. Rehabilitation Outpatient Clinic at the university hospital in Brazil. Fourteen individuals with quadriplegia and 8 healthy individuals were evaluated. Electrophysiological assessment of the median nerve was performed by evoked potential equipment. The injury level was obtained by ASIA. N(9), N(13) and N(20) were analyzed based on the presence or absence of responses. The parameters used for analyzing these responses were the latency and the amplitude. Data were analyzed using mixed-effect models. N(9) responses were found in all patients with quadriplegia with a similar latency and amplitude observed in healthy individuals; N(13) responses were not found in any patients with quadriplegia. N(20) responses were not found in C5 patients with quadriplegia but it was present in C6 and C7 patients. Their latencies were similar to healthy individuals (P>0.05) but the amplitudes were decreased (P<0.05). This study suggests that the SSEP responses depend on the injury level, considering that the individuals with C6 and C7 injury levels, both complete and incomplete, presented SSEP recordings in the cortical area. It also showed a relationship between the level of spinal cord injury assessed by ASIA and the median nerve SSEP responses, through the latency and amplitude recordings.

  5. Association Between Pretransplant Cancer and Survival in Kidney Transplant Recipients.

    Science.gov (United States)

    Dahle, Dag Olav; Grotmol, Tom; Leivestad, Torbjørn; Hartmann, Anders; Midtvedt, Karsten; Reisæter, Anna V; Mjøen, Geir; Pihlstrøm, Hege K; Næss, Hege; Holdaas, Hallvard

    2017-10-01

    Kidney transplantation in recipients with a previous malignancy is often deferred 2 to 5 years after cancer treatment due to fear of cancer recurrence. In Norway, the required waiting period has been 1 year. We compared patient and graft survival of recipients with pretransplant cancer to the outcomes of matched recipients without such cancer (comparators) using Cox regression. From 1963 to 2010, 377 (6.4%) of 5867 recipients had a pretransplant cancer. During a median follow-up of 6.8 years, 256 recipients died, 35 (13.7%) from recurrent cancer and 27 (10.5%) from de novo cancer. Uncensored and death-censored graft loss occurred in 263 and 46 recipients, respectively. All-cause mortality was similar as in comparators (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.93-1.20]; P = 0.40), death-censored graft loss was lower (HR, 0.63; 95% CI, 0.47-0.84; P = 0.002), and uncensored graft loss was similar (HR, 0.99; 95% CI, 0.87-1.12; P = 0.87). Cancer mortality was higher than in comparators (HR, 1.97; 95% CI, 1.51-2.56; P cancer mortality or all-cause mortality (both P > 0.45). Results were similar within cancer subgroups, with most data in patients with a history of kidney cancer, prostate cancer, urothelial cancer, and skin squamous cell carcinoma. Kidney transplant recipients with a pretransplant cancer had a similar overall patient and graft survival as recipients without such cancer. Cancer mortality was increased, particularly during the first 5 years after transplantation. A short waiting period was not associated with mortality.

  6. Benign meningiomas: primary treatment selection affects survival

    International Nuclear Information System (INIS)

    Condra, Kellie S.; Buatti, John M.; Mendenhall, William M.; Friedman, William A.; Marcus, Robert B.; Rhoton, Albert L.

    1997-01-01

    Purpose: To examine the effect of primary treatment selection on outcomes for benign intracranial meningiomas at the University of Florida. Methods and Materials: For 262 patients, the impact of age, Karnofsky performance status, pathologic features, tumor size, tumor location, and treatment modality on local control and cause-specific survival was analyzed (minimum potential follow-up, 2 years; median follow-up, 8.2 years). Extent of surgery was classified by Simpson grade. Treatment groups: surgery alone (n = 229), surgery and postoperative radiotherapy (RT) (n = 21), RT alone (n = 7), radiosurgery alone (n = 5). Survival analysis: Kaplan-Meier method with univariate and multivariate analysis. Results: At 15 years, local control was 76% after total excision (TE) and 87% after subtotal excision plus RT (SE+RT), both significantly better (p = 0.0001) than after SE alone (30%). Cause-specific survival at 15 years was reduced after treatment with SE alone (51%), compared with TE (88%) or SE+RT (86%) (p = 0.0003). Recurrence after primary treatment portended decreased survival, independent of initial treatment group or salvage treatment selection (p = 0.001). Atypical pathologic features predicted reduced 15-year local control (54 vs. 71%) and cause-specific survival rates (57 vs. 86%). Multivariate analysis for cause-specific survival revealed treatment group (SE vs. others; p = 0.0001), pathologic features (atypical vs. typical; p = 0.0056), and Karnofsky performance status (≥80 vs. <80; p = 0.0153) as significant variables. Conclusion: Benign meningiomas are well managed by TE or SE+RT. SE alone is inadequate therapy and adversely affects cause-specific survival. Atypical pathologic features predict a poorer outcome, suggesting possible benefit from more aggressive treatment. Because local recurrence portends lower survival rates, primary treatment choice is important

  7. 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...

  8. Long-term survival and function after suspected gram-negative sepsis.

    Science.gov (United States)

    Perl, T M; Dvorak, L; Hwang, T; Wenzel, R P

    1995-07-26

    To determine the long-term (> 3 months) survival of septic patients, to develop mathematical models that predict patients likely to survive long-term, and to measure the health and functional status of surviving patients. A large tertiary care university hospital and an associated Veterans Affairs Medical Center. From December 1986 to December 1990, a total of 103 patients with suspected gram-negative sepsis entered a double-blind, placebo-controlled efficacy trial of monoclonal antiendotoxin antibody. Of these, we followed up 100 patients for 7667 patient-months. Beginning in May 1992, we reviewed hospital records and contacted all known survivors. We measured the health status of all surviving patients. The determinants of long-term survival (up to 6 years) were identified through two Cox proportional hazard regression models: one that included patient characteristics identified at the time of sepsis (bedside model) and another that included bedside, infection-related, and treatment characteristics (overall model). Of the 60 patients in the cohort who died at a median interval of 30.5 days after sepsis, 32 died within the first month of the septic episode, seven died within 3 months, and four more died within 6 months. In the bedside multivariate model constructed to predict long-term survival, large hazard ratios (HRs) were associated with severity of underlying illness as classified by McCabe and Jackson criteria (for rapidly fatal disease, HR = 30.4, P respiratory distress syndrome (HR = 2.3; P = .02) predicted patients most likely to die. The Acute Physiology and Chronic Health Evaluation II score was not a significant predictor of outcome when either model included the simpler McCabe and Jackson classification of underlying disease severity. We compared the health status scores with norms for the general population and found that patients with resolved sepsis reported more physical dysfunction (P bedridden), suggesting that the patients' physical function

  9. Concurrent Chemoradiotherapy Improves Survival in Patients With Hypopharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Paximadis, Peter, E-mail: ppaximad@med.wayne.edu [Department of Radiation Oncology, Wayne State University, Detroit, MI (United States); Yoo, George; Lin, Ho-Sheng; Jacobs, John [Department of Otolaryngology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Sukari, Ammar [Department of Medical Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Dyson, Greg [Department of Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI (United States); Christensen, Michael; Kim, Harold [Department of Radiation Oncology, Wayne State University, Detroit, MI (United States)

    2012-03-15

    Purpose: To retrospectively review our institutional experience with hypopharyngeal carcinoma with respect to treatment modality. Methods and Materials: A total of 70 patients with hypopharyngeal cancer treated between 1999 and 2009 were analyzed for functional and survival outcomes. The treatments included surgery alone (n = 5), surgery followed by radiotherapy (RT) (n = 3), surgery followed by chemoradiotherapy (CRT) (n = 13), RT alone (n = 2), CRT alone (n = 22), induction chemotherapy followed by RT (n = 3), and induction chemotherapy followed by CRT (n = 22). Results: The median follow-up was 18 months. The median overall survival and disease-free survival for all patients was 28.3 and 17.6 months, respectively. The 1- and 2-year local control rate for all patients was 87.1% and 80%. CRT, given either as primary therapy or in the adjuvant setting, improved overall survival and disease-free survival compared with patients not receiving CRT. The median overall survival and disease-free survival for patients treated with CRT was 36.7 and 17.6 months vs. 14.0 and 8.0 months, respectively (p < .01). Of the patients initially treated with an organ-preserving approach, 4 (8.2%) required salvage laryngectomy for local recurrence or persistent disease; 8 (16.3%) and 12 (24.5%) patients were dependent on a percutaneous gastrostomy and tracheostomy tube, respectively. The 2-year laryngoesophageal dysfunction-free survival rate for patients treated with an organ-preserving approach was estimated at 31.7%. Conclusions: Concurrent CRT improves survival in patients with hypopharyngeal cancer. CRT given with conventional radiation techniques yields poor functional outcomes, and future efforts should be directed at determining the feasibility of pharyngeal-sparing intensity-modulated radiotherapy in patients with hypopharyngeal tumors.

  10. Deep structure of Porcupine Basin and nature of the Porcupine Median Ridge from seismic refraction tomography

    Science.gov (United States)

    Watremez, L.; Chen, C.; Prada, M.; Minshull, T. A.; O'Reilly, B.; Reston, T. J.; Wagner, G.; Gaw, V.; Klaeschen, D.; Shannon, P.

    2015-12-01

    The Porcupine Basin is a narrow V-shaped failed rifted basin located offshore SW Ireland. It is of Permo-Triassic to Cenozoic age, with the main rifting phase in the Late Jurassic to Early Cretaceous. Porcupine Basin is a key study area to learn about the processes of continental extension and to understand the thermal history of this rifted basin. Previous studies show increasing stretching factors, from less than 1.5 to the North to more than 6 to the South. A ridge feature, the Porcupine Median Ridge, has been identified in the middle of the southernmost part of the basin. During the last three decades, this ridge has been successively interpreted as a volcanic structure, a diapir of partially serpentinized mantle, or a block of continental crust. Its nature still remains debated today. In this study, we use arrival times from refractions and wide-angle reflections in the sedimentary, crustal and mantle layers to image the crustal structure of the thinnest part of the basin, the geometry of the continental thinning from margin to margin, and the Porcupine Median Ridge. The final velocity model is then compared with coincident seismic reflection data. We show that (1) the basin is asymmetric, (2) P-wave velocities in the uppermost mantle are lower than expected for unaltered peridotites, implying upper-mantle serpentinisation, (3) the nature of Porcupine Median Ridge is probably volcanic, and (4) the amount of thinning is greater than shown in previous studies. We discuss the thermal implications of these results for the evolution of this rift system and the processes leading to the formation of failed rifts. This project is funded by the Irish Shelf Petroleum Studies Group (ISPSG) of the Irish Petroleum Infrastructure Programme Group 4.

  11. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Experience of thymectomy by median sternotomy in patients with myasthenia gravis

    International Nuclear Information System (INIS)

    Hussain, N.; Ahmed, S.W.; Ahmed, T.; Hafeez, A.B.; Baloch, R.; Ali, S.

    2010-01-01

    Objective: To determine the outcome of thymectomy in patients with myasthenia gravis and safety of median sternotomy approach. Methodology: An observational descriptive study was conducted in the department of thoracic surgery JPMC from February 2005 to January 2009. Twenty two patients having persistent generalized or ocular myasthenia gravis referred to our department by neurologists and general physicians, partially or not responding to medical treatment with or without thymoma, were included in the study. Those who were not fit for anaesthesia were excluded. Preoperatively 2 to 3 sessions of plasmaphaeresis were done and each patient was given anti myasthenia gravis treatment. Clinical staging was done by Modified Osserman classification. Median sternotomy approach was used. Outcome was assessed on the basis of remission of disease in different Osserman groups. All patients were followed for a minimum of 6 months. Results: Out of 22 patients, 16 (72.7%) were females and 6 (27.2%) males. Mean age at presentation was 35.2 +- 14.5 years. Mean duration of symptoms was 1.5 +- 1.2 years. A total of 4 (18.1%) patients with myasthenia gravis had thymoma and histopathology of 18 (81.9%) patients showed thymic hyperplasia. Remission was seen in most grades of Osserman. The best response was seen in Grade I where all patients achieved remission. Most patients in Grade II A and II B were benefited. The only patient in Grade III had no improvement of symptoms. No patient in Grade IV underwent thymectomy. Overall 86.3 % had a positive outcome on basis of remission and improvement. Conclusion: Thymectomy by median sternotomy is safe and effective with more favourable outcomes for patients of myasthenia gravis not responding to medical treatment. (author)

  13. Statistical properties of the deviations of f 0 F 2 from monthly medians

    Directory of Open Access Journals (Sweden)

    Y. Tulunay

    2002-06-01

    Full Text Available The deviations of hourly f 0 F 2 from monthly medians for 20 stations in Europe during the period 1958-1998 are studied. Spectral analysis is used to show that, both for original data (for each hour and for the deviations from monthly medians, the deterministic components are the harmonics of 11 years (solar cycle, 1 year and its harmonics, 27 days and 12 h 50.49 m (2nd harmonic of lunar rotation period L 2 periodicities. Using histograms for one year samples, it is shown that the deviations from monthly medians are nearly zero mean (mean < 0.5 and approximately Gaussian (relative difference range between %10 to %20 and their standard deviations are larger for daylight hours (in the range 5-7. It is shown that the amplitude distribution of the positive and negative deviations is nearly symmetrical at night hours, but asymmetrical for day hours. The positive and negative deviations are then studied separately and it is observed that the positive deviations are nearly independent of R12 except for high latitudes, but negative deviations are modulated by R12 . The 90% confidence interval for negative deviations for each station and each hour is computed as a linear model in terms of R12. After correction for local time, it is shown that for all hours the confidence intervals increase with latitude but decrease above 60N. Long-term trend analysis showed that there is an increase in the amplitude of positive deviations from monthly means irrespective of the solar conditions. Using spectral analysis it is also shown that the seasonal dependency of negative deviations is more accentuated than the seasonal dependency of positive deviations especially at low latitudes. In certain stations, it is also observed that the 4th harmonic of 1 year corresponding to a periodicity of 3 months, which is missing in f 0 F 2 data, appears in the spectra of negative variations.

  14. Altered brain morphometry in carpal tunnel syndrome is associated with median nerve pathology☆☆☆

    Science.gov (United States)

    Maeda, Yumi; Kettner, Norman; Sheehan, James; Kim, Jieun; Cina, Stephen; Malatesta, Cristina; Gerber, Jessica; McManus, Claire; Mezzacappa, Pia; Morse, Leslie R.; Audette, Joseph; Napadow, Vitaly

    2013-01-01

    Objective Carpal tunnel syndrome (CTS) is a common median nerve entrapment neuropathy characterized by pain, paresthesias, diminished peripheral nerve conduction velocity (NCV) and maladaptive functional brain neuroplasticity. We evaluated structural reorganization in brain gray matter (GM) and white matter (WM) and whether such plasticity is linked to altered median nerve function in CTS. Methods We performed NCV testing, T1-weighted structural MRI, and diffusion tensor imaging (DTI) in 28 CTS and 28 age-matched healthy controls (HC). Voxel-based morphometry (VBM) contrasted regional GM volume for CTS versus HC. Significant clusters were correlated with clinical metrics and served as seeds to define associated WM tracts using DTI data and probabilistic tractography. Within these WM tracts, fractional anisotropy (FA), axial (AD) and radial (RD) diffusivity were evaluated for group differences and correlations with clinical metrics. Results For CTS subjects, GM volume was significantly reduced in contralesional S1 (hand-area), pulvinar and frontal pole. GM volume in contralesional S1 correlated with median NCV. NCV was also correlated with RD and was negatively correlated with FA within U-fiber cortico-cortical association tracts identified from the contralesional S1 VBM seed. Conclusions Our study identified clear morphometric changes in the CTS brain. This central morphometric change is likely secondary to peripheral nerve pathology and altered somatosensory afference. Enhanced axonal coherence and myelination within cortico-cortical tracts connecting primary somatosensory and motor areas may accompany peripheral nerve deafferentation. As structural plasticity was correlated with NCV and not symptomatology, the former may be a better determinant of appropriate clinical intervention for CTS, including surgery. PMID:23799199

  15. A biological inspired fuzzy adaptive window median filter (FAWMF) for enhancing DNA signal processing.

    Science.gov (United States)

    Ahmad, Muneer; Jung, Low Tan; Bhuiyan, Al-Amin

    2017-10-01

    Digital signal processing techniques commonly employ fixed length window filters to process the signal contents. DNA signals differ in characteristics from common digital signals since they carry nucleotides as contents. The nucleotides own genetic code context and fuzzy behaviors due to their special structure and order in DNA strand. Employing conventional fixed length window filters for DNA signal processing produce spectral leakage and hence results in signal noise. A biological context aware adaptive window filter is required to process the DNA signals. This paper introduces a biological inspired fuzzy adaptive window median filter (FAWMF) which computes the fuzzy membership strength of nucleotides in each slide of window and filters nucleotides based on median filtering with a combination of s-shaped and z-shaped filters. Since coding regions cause 3-base periodicity by an unbalanced nucleotides' distribution producing a relatively high bias for nucleotides' usage, such fundamental characteristic of nucleotides has been exploited in FAWMF to suppress the signal noise. Along with adaptive response of FAWMF, a strong correlation between median nucleotides and the Π shaped filter was observed which produced enhanced discrimination between coding and non-coding regions contrary to fixed length conventional window filters. The proposed FAWMF attains a significant enhancement in coding regions identification i.e. 40% to 125% as compared to other conventional window filters tested over more than 250 benchmarked and randomly taken DNA datasets of different organisms. This study proves that conventional fixed length window filters applied to DNA signals do not achieve significant results since the nucleotides carry genetic code context. The proposed FAWMF algorithm is adaptive and outperforms significantly to process DNA signal contents. The algorithm applied to variety of DNA datasets produced noteworthy discrimination between coding and non-coding regions contrary

  16. Classical and anaplastic seminoma: Difference in survival

    International Nuclear Information System (INIS)

    Bobba, V.S.; Mittal, B.B.; Hoover, S.V.; Kepka, A.

    1987-01-01

    The authors undertook a retrospective study of seminoma patients treated with radiation therapy between 1961 and 1985. The classical group consisted of 66 patients, of whom 47 were stage I and 19 were stage II. The anaplastic group consisted of 21 patients, of whom 11 were stage I, nine were stage II, and one was stage III. The median follow-up was 66 months. The five-year crude survival rate for the entire group was 92%, for classical 96%, and for anaplastic 78% (P<.005). Similarly, there was a significant difference (P<.005) in actuarial relapse-free survival at 5 years between classical and anaplastic seminoma. For classical stage I, the relapse-free actuarial 5-year survival rate was 96; for classical stage II, 84%. For anaplastic stage I the relapse-free actuarial 5-year survival rate was 82%, and for stage II 75%. Six patients in the classical group (9%) failed treatment. In the anaplastic group, five patients or 24 failed treatment. Therefore, the authors' data suggest a difference in survival and failure rate between classical and anaplastic seminoma. Extratesticular seminoma with anaplastic histology has an even worse prognosis

  17. Illness perceptions predict survival in haemodialysis patients.

    Science.gov (United States)

    Chilcot, Joseph; Wellsted, David; Farrington, Ken

    2011-01-01

    Illness perceptions have been shown to be important determinants of functional and psychosocial outcomes, including quality of life and treatment adherence in end-stage renal disease patients. The aim of this prospective study was to determine whether haemodialysis patients' illness perceptions impact upon survival. Haemodialysis patients from a UK renal service completed the Revised Illness Perception Questionnaire. Over the study period (May 2007 to December 2010), all-cause mortality was recorded as the endpoint. 223 patients were followed up for a median of 15.9 months (min. 10 days, max. 42.7 months). The median dialysis vintage was 17.6 months (min. 4 days, max. 391.3 months). Treatment control perceptions demonstrated a significant association with mortality (HR = 0.91, 95% CI: 0.83-0.99, p = 0.03). After controlling for covariates, including age, albumin, extra renal comorbidity and depression scores, perception of treatment control remained a significant predictor of mortality (HR = 0.89, 95% CI: 0.80-0.99, p = 0.03). Patients' perceptions of treatment control (dialysis therapy) predict survival independently of survival risk factors, including comorbidity. Studies are required to test whether psychological interventions designed to modify maladaptive illness perceptions influence clinical outcomes in this patient setting. Copyright © 2011 S. Karger AG, Basel.

  18. Interfascicular suture with nerve autografts for median, ulnar and radial nerve lesions.

    Science.gov (United States)

    Pluchino, F; Luccarelli, G

    1981-05-01

    Interfascicular nerve suture with autografts is the operation of choice for repairing peripheral nerve injuries because it ensures more precise alignment of the fasciculi and so better chances of reinnervation of the sectioned nerve. The procedure as described by Millesi et al has been used at the Istituto Neurologico di Milano in 30 patients with traumatic lesions of the median, ulnar and radial nerves. All have been followed up for 2 to 7 years since operation. The results obtained are compared with those of other series obtained with interfascicular suture and with epineural suture. Microsurgery is essential. The best time to operate is discussed.

  19. Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala

    Directory of Open Access Journals (Sweden)

    Sadanandavalli Retnaswami Chandra

    2017-01-01

    for other causes not” contributing to the etiological diagnosis. Subjects and Methods: One hundred and forty-two upper limbs and 142 lower limbs in patients engaged in long years of coir work but having no symptoms were evaluated electrophysiologically with informed consent and financial compensation, appropriate inclusion and exclusion criteria were followed as described in the text. Results: There is electrophysiological evidence for median and common peroneal neuropathy in persons engaged in long years of coir work. Conclusions: Coir workers neuropathy appears to be a new occupational neuropathy which can be prevented by following simple preventive measures.

  20. CT morphology of benign median nerve tumors; Report of three cases and a review

    Energy Technology Data Exchange (ETDEWEB)

    Feyerabend, T; Schmitt, R; Lanz, U; Warmuth-Metz, M [Wuerzburg Univ. (Germany, F.R.). Abt. fuer Roentgendiagnostik Wuerzburg Univ. (Germany, F.R.). Abt. fuer Hand- und Mikrochirurgie

    1990-01-01

    Computed tomography (CT) was performed in 3 patients with benign tumors of the median nerve, histologically confirmed as neurilemmoma, fibrolipoma and hemangioma. The neurilemmoma showed a ring-shaped contrast enhancement. The fibrolipoma presented with areas of solid soft tissue and areas of fat. The hemangioma was a solid tumor with a lacunar, vascular contrast enhancement. According to our experience and to the previous literature CT gives useful information regarding the anatomic location, size, and relationship of peripheral nerve sheath tumors to surrounding structures, and may help to differentiate between various tumor types. (orig.).

  1. Entrapment of the Martin-Gruber branch of median nerve in the forearm

    Directory of Open Access Journals (Sweden)

    Anu Vinod Ranade

    2016-07-01

    Full Text Available We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comitantes. There was an acute angulation of the MGB here, suggesting entrapment at this site.

  2. Impulse Noise Cancellation of Medical Images Using Wavelet Networks and Median Filters

    Science.gov (United States)

    Sadri, Amir Reza; Zekri, Maryam; Sadri, Saeid; Gheissari, Niloofar

    2012-01-01

    This paper presents a new two-stage approach to impulse noise removal for medical images based on wavelet network (WN). The first step is noise detection, in which the so-called gray-level difference and average background difference are considered as the inputs of a WN. Wavelet Network is used as a preprocessing for the second stage. The second step is removing impulse noise with a median filter. The wavelet network presented here is a fixed one without learning. Experimental results show that our method acts on impulse noise effectively, and at the same time preserves chromaticity and image details very well. PMID:23493998

  3. Sosiaalisen median negatiiviset vaikutukset käyttäjälle

    OpenAIRE

    Vidgren, Lilli

    2018-01-01

    Tutkielma on kirjallisuuskatsauksena toteutettu kandidaatintutkielma, jonka tutkimusaihe ja -otsikko on sosiaalisen median negatiiviset vaikutukset käyttä- jälle. Negatiivisia vaikutuksia tutkittiin vapaa-ajan käytön näkökulmasta. Sosiaalinen media on tullut nopeasti tärkeäksi ja välttämättömäksi osaksi ihmisten jokapäiväistä elämää, ja sen jatkuva läsnäolo vaikuttaa sen käyttäjiin negatiivisella tavalla. Negatiivisten vaikutusten tutkimisella ihmiset tulisivat enemmän tieto...

  4. Speckle noise reduction in breast ultrasound images: SMU (srad median unsharp) approch

    International Nuclear Information System (INIS)

    Njeh, I.; Sassi, O. B.; Ben Hamida, A.; Chtourou, K.

    2011-01-01

    Image denoising has become a very essential for better information extraction from the image and mainly from so noised ones, such as ultrasound images. In certain cases, for instance in ultrasound images, the noise can restrain information which is valuable for the general practitioner. Consequently medical images are very inconsistent, and it is crucial to operate case to case. This paper presents a novel algorithm SMU (Srad Median Unsharp) for noise suppression in ultrasound breast images in order to realize a computer aided diagnosis (CAD) for breast cancer.

  5. Lightweight MAC-Spoof Detection Exploiting Received Signal Power and Median Filtering

    DEFF Research Database (Denmark)

    Papini, Davide

    2011-01-01

    this kind of attack based on signal power monitoring. The main contribution of our work is the introduction of a median l- ter that enables the detection of the attack by looking at the variance of the signal power. We take into account two types of references for the samples, time and number of frames......IEEE 802.11 networks are subject to MAC-spoof attacks. An attacker can easily steal the identity of a legitimate station, even Access Points, thus enabling him to take full control over network basic mech- anisms or even access restricted resources. In this paper we propose a method to detect...

  6. Sosiaalisen median strategian jalkauttaminen : Facebook Merikeskus Vellamon markkinointiviestinnän välineenä

    OpenAIRE

    Okulov, Jaana

    2013-01-01

    Tämä opinnäytetyö käsittelee museokeskus Merikeskus Vellamon sosiaalisen median strategian jalkauttamista ja Facebook-yhteisösovelluksen hyödyntämistä markkinointiviestinnässä. Facebook-yrityssivun perustaminen ja houkuttelevan kohderyhmäkohtaisen sisällöntuotannon oppiminen oli toimeksiantajan toiveesta operatiivisen suunnittelun pohjana tälle toiminnalliselle opinnäytetyölle. Teoriaosuudessa tutkittiin sosiaalista mediaa ilmiönä ja vuorovaikutteisena viestintäkanavana sekä Facebook-yh...

  7. 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.

  8. Multiple neoplasms, single primaries, and patient survival

    Directory of Open Access Journals (Sweden)

    Amer MH

    2014-03-01

    Full Text Available Magid H Amer Department of Medicine, St Rita's Medical Center, Lima, OH, USA Background: Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. Methods: This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Results: Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284, and three or more primaries (n=38. Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%, with a tendency to develop thrombosis (20.2%, had a strong family history of similar cancer (22.3%, and usually presented with earlier stage 0 through stage II disease (78.9%. When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001. Five-year survival rates were higher for metachronous cancers (95% than for synchronous primaries (59% and single primaries (59%. The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991. Conclusion: Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent

  9. ASURV: Astronomical SURVival Statistics

    Science.gov (United States)

    Feigelson, E. D.; Nelson, P. I.; Isobe, T.; LaValley, M.

    2014-06-01

    ASURV (Astronomical SURVival Statistics) provides astronomy survival analysis for right- and left-censored data including the maximum-likelihood Kaplan-Meier estimator and several univariate two-sample tests, bivariate correlation measures, and linear regressions. ASURV is written in FORTRAN 77, and is stand-alone and does not call any specialized libraries.

  10. Rotasi Varimax dan Median Hirarki Cluster Pada Program Raskin di Kabupaten Lombok Barat

    Directory of Open Access Journals (Sweden)

    Desy Komalasari

    2015-11-01

    Full Text Available The granting rice program for poor households (Raskin is one of the West Lombok regency government programs for village poverty. The effectiveness of the program relating to 14 criteria for the poor households Raskin recipients (RTS-PM. The 14 criteria have been grouped into several factors using varimax rotation factor analysis, while the RTS-PM have been grouped using hierarchical median cluster analysis. Four factors obtained based on the analysis. First factor was the house existence, the second factor was the financial ability, the third factor was the house existing facilities, and the four factor was the education of the household head and the purchasing power of clothing. The clustering results using hierarchical median cluster analysis formed 3 clusters. The first cluster contains the RTS-PM which have been grouped into first factor; the second cluster contains the RTS-PM which have been grouped into second and third factor; and the third cluster contains the RTS-PM which have been grouped into fourth factor.

  11. Rotasi Varimax dan Median Hirarki Cluster Pada Program Raskin di Kabupaten Lombok Barat

    Directory of Open Access Journals (Sweden)

    Desy Komalasari

    2015-06-01

    Full Text Available The granting rice program for poor households (Raskin is one of the West Lombok regency government programs for village poverty. The effectiveness of the program relating to 14 criteria for the poor households Raskin recipients (RTS-PM. The 14 criteria have been grouped into several factors using varimax rotation factor analysis, while the RTS-PM have been grouped using hierarchical median cluster analysis. Four factors obtained based on the analysis. First factor was the house existence, the second factor was the financial ability, the third factor was the house existing facilities, and the four factor was the education of the household head and the purchasing power of clothing. The clustering results using hierarchical median cluster analysis formed 3 clusters. The first cluster contains the RTS-PM which have been grouped into first factor; the second cluster contains the RTS-PM which have been grouped into second and third factor; and the third cluster contains the RTS-PM which have been grouped into fourth factor.

  12. Median of patient results as a tool for assessment of analytical stability.

    Science.gov (United States)

    Jørgensen, Lars Mønster; Hansen, Steen Ingemann; Petersen, Per Hyltoft; Sölétormos, György

    2015-06-15

    In spite of the well-established external quality assessment and proficiency testing surveys of analytical quality performance in laboratory medicine, a simple tool to monitor the long-term analytical stability as a supplement to the internal control procedures is often needed. Patient data from daily internal control schemes was used for monthly appraisal of the analytical stability. This was accomplished by using the monthly medians of patient results to disclose deviations from analytical stability, and by comparing divergences with the quality specifications for allowable analytical bias based on biological variation. Seventy five percent of the twenty analytes achieved on two COBASs INTEGRA 800 instruments performed in accordance with the optimum and with the desirable specifications for bias. Patient results applied in analytical quality performance control procedures are the most reliable sources of material as they represent the genuine substance of the measurements and therefore circumvent the problems associated with non-commutable materials in external assessment. Patient medians in the monthly monitoring of analytical stability in laboratory medicine are an inexpensive, simple and reliable tool to monitor the steadiness of the analytical practice. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala.

    Science.gov (United States)

    Chandra, Sadanandavalli Retnaswami; Anand, Biji; Issac, Thomas Gregor

    2017-01-01

    Coir work, in a large number of people involves mechanically rolling the coconut fibers into coir which is later subjected to various processes. The primary work is done as a cottage industry specially by women in the sitting posture for several hours. This study reports evidence of median and common peroneal neuropathy electrophysiologically in people who had been engaged in this job for several years. This study was initiated to establish the possible relationship between coir work and symptomatic neuropathies which was seen in that region with all investigations " for other causes not " contributing to the etiological diagnosis. One hundred and forty-two upper limbs and 142 lower limbs in patients engaged in long years of coir work but having no symptoms were evaluated electrophysiologically with informed consent and financial compensation, appropriate inclusion and exclusion criteria were followed as described in the text. There is electrophysiological evidence for median and common peroneal neuropathy in persons engaged in long years of coir work. Coir workers neuropathy appears to be a new occupational neuropathy which can be prevented by following simple preventive measures.

  14. Least median of squares filtering of locally optimal point matches for compressible flow image registration

    International Nuclear Information System (INIS)

    Castillo, Edward; Guerrero, Thomas; Castillo, Richard; White, Benjamin; Rojo, Javier

    2012-01-01

    Compressible flow based image registration operates under the assumption that the mass of the imaged material is conserved from one image to the next. Depending on how the mass conservation assumption is modeled, the performance of existing compressible flow methods is limited by factors such as image quality, noise, large magnitude voxel displacements, and computational requirements. The Least Median of Squares Filtered Compressible Flow (LFC) method introduced here is based on a localized, nonlinear least squares, compressible flow model that describes the displacement of a single voxel that lends itself to a simple grid search (block matching) optimization strategy. Spatially inaccurate grid search point matches, corresponding to erroneous local minimizers of the nonlinear compressible flow model, are removed by a novel filtering approach based on least median of squares fitting and the forward search outlier detection method. The spatial accuracy of the method is measured using ten thoracic CT image sets and large samples of expert determined landmarks (available at www.dir-lab.com). The LFC method produces an average error within the intra-observer error on eight of the ten cases, indicating that the method is capable of achieving a high spatial accuracy for thoracic CT registration. (paper)

  15. Characterization of melatonin binding sites in the Harderian gland and median eminence of the rat

    International Nuclear Information System (INIS)

    Lopez-Gonzalez, M.A.; Calvo, J.R.; Rubio, A.; Goberna, R.; Guerrero, J.M.

    1991-01-01

    The characterization of specific melatonin binding sites in the Harderian gland (HG) and median eminence (ME) of the rat was studied using [ 125 I]melatonin. Binding of melatonin to membrane crude preparations of both tissues was dependent on time and temperature. Thus, maximal binding was obtained at 37 degree C after 30-60 min incubation. Binding was also dependent on protein concentration. The specific binding of [ 125 I]melatonin was saturable, exhibiting only the class of binding sites in both tissues. The dissociation constants (Kd) were 170 and 190 pM for ME and HG, respectively. The concentration of the binding sites in ME was 8 fmol/mg protein, and in the HG 4 fmol/mg protein. In competition studies, binding of [ 125 I]melatonin to ME or HG was inhibited by increasing concentration of native melatonin; 50% inhibition was observed at about 702 and 422 nM for ME and HG, respectively. Additionally, the [ 125 I]melatonin binding to the crude membranes was not affected by the addition of different drugs such as norepinephrine, isoproterenol, phenylephrine, propranolol, or prazosin. The results confirm the presence of melatonin binding sites in median eminence and show, for the first time, the existence of melatonin binding sites in the Harderian gland

  16. Median and Ulnar Neuropathy Assessment in Parkinson’s Disease regarding Symptom Severity and Asymmetry

    Directory of Open Access Journals (Sweden)

    Nilgul Yardimci

    2016-01-01

    Full Text Available Background. While increasing evidence suggests comorbidity of peripheral neuropathy (PNP and Parkinson’s disease (PD, the pathogenesis of PNP in PD is still a debate. The aim of this article is to search the core PD symptoms such as rigidity and tremor as contributing factors to mononeuropathy development while emphasizing each individual patient’s asymmetric symptom severity. Methods. We studied 62 wrists and 62 elbows of 31 patients (mean age 66.48±10.67 and 64 wrists and 64 elbows of 32 age-gender matched healthy controls (mean age 62.03±10.40, p=0.145. The Hoehn and Yahr disability scale and Unified Parkinson’s Disease Rated Scale were used to determine the severity of the disease. Results. According to electrodiagnostic criteria, we confirmed median neuropathy in 16.12% (bilateral in two-thirds of the patients and ulnar neuropathy in 3.22% of the PD group. While mean age (p=0.003, age at PD onset (p=0.019, and H&Y scores (p=0.016 were significant, tremor and rigidity scores were not. The comparison of the mean indices of electrophysiologic parameters indicated subclinical median and ulnar nerve demyelination both at the wrist and at the elbow in the patient groups where a longer disease duration and mild tremor and rigidity scores are prominent, remarkably. Conclusion. A disease related peripheral neurodegeneration beyond symptom severity occurs in PD.

  17. 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.

  18. Hybrid (laparoscopy + stent) treatment of celiac trunk compression syndrome (Dunbar syndrome, median arcuate ligament syndrome (MALS)).

    Science.gov (United States)

    Michalik, Maciej; Dowgiałło-Wnukiewicz, Natalia; Lech, Paweł; Majda, Kaja; Gutowski, Piotr

    2016-01-01

    Celiac trunk (CT) compression syndrome caused by the median arcuate ligament (MAL) is a rarely diagnosed disease because of its nonspecific symptoms, which cause a delay in the correct diagnosis. Intestinal ischemia occurs, which causes symptoms of abdominal angina. One method of treatment for this disease is surgical release of the CT - the intersection of the MAL. Laparoscopy is the first step of the hybrid technique combined with percutaneous angioplasty and stenting of the CT. To demonstrate the usefulness and advantages of the laparoscopic approach in the treatment of Dunbar syndrome. Between 2013 and 2016 in the General and Minimally Invasive Surgery Department of the Medical Sciences Faculty of the University of Warmia and Mazury in Olsztyn, 6 laparoscopic procedures were performed because of median arcuate ligament syndrome. During the laparoscopy the MAL was cut with a harmonic scalpel. One month after laparoscopy 5 patients had Doppler percutaneous angioplasty of the CT with stent implantation in the Vascular Surgery Department in Pomeranian Medical University in Szczecin. In one case, there was a conversion of laparoscopic surgery to open due to unmanageable intraoperative bleeding. In one case, postoperative ultrasound examination of the abdominal cavity demonstrated the presence of a large hematoma in the retroperitoneal space. All patients reported relief of symptoms in the first days after the operation. The hybrid method, combining laparoscopy and angioplasty, seems to be a long-term solution, which increases the comfort of the patient, brings the opportunity for normal functioning and minimizes the risk of restenosis.

  19. Overall eller progression free survival, median og hazard ratio – forstår vi egentlig vores egne endemål i onkologien?

    DEFF Research Database (Denmark)

    Jensen, Lars Henrik; Dahl Steffensen, Karina; Hansen, Torben Frøstrup

    2018-01-01

    -15% flere i live i gruppen, der har fået kombinationsbehandling (gul kurve). Ved lange observationstider, hvor ”halen” af kurverne flader ud med en mere eller mindre konstant forskel, kan det være relevant at supplere med nogle milepæle. Det kan være en forskel i overlevelse ved ti år, som i ovenstående......;359:4530. 2. Grothey A, Van Cutsem E, Sobrero A, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013 Jan 26;381(9863):303-312. 3. Jensen LH, Trabjerg ND, Hansen TF, Jakobsen A...

  20. Endoscopic submucosal dissection of early colorectal neoplasms with a monopolar scissor-type knife: short- to long-term outcomes.

    Science.gov (United States)

    Kuwai, Toshio; Yamaguchi, Toshiki; Imagawa, Hiroki; Sumida, Yuki; Takasago, Takeshi; Miyasako, Yuki; Nishimura, Tomoyuki; Iio, Sumio; Yamaguchi, Atsushi; Kouno, Hirotaka; Kohno, Hiroshi; Ishaq, Sauid

    2017-09-01

    Background and study aims  Endoscopic submucosal dissection (ESD) for colorectal neoplasms remains challenging because of technical issues imposed by the complex anatomical features of the large intestine. We evaluated the feasibility, and the short- and long-term clinical outcomes of ESD for early colorectal neoplasms performed using the Stag-beetle Knife Jr. (SB Knife Jr.) Patients and methods  We retrospectively assessed 228 patients who underwent ESD for 247 colorectal lesions with the SB Knife Jr. Clinicopathological characteristics of the neoplasms, complications, and various short- and long-term outcomes were evaluated. Results  Mean tumor size was 34.3 mm and median procedure time was 76 minutes. The SB Knife Jr. achieved 98.4 % en bloc resection, 93.9 % complete resection, and 85.4 % curative resection. No perforations occurred during the procedure, and a delayed bleeding rate of 2.4 % was observed. Long-term outcomes were favorable with no distant recurrence, 1.1 % local recurrence, a 5-year overall survival rate of 94.1 % and 5-year tumor-specific survival rate of 98.6 % in patients with cancer. Conclusions  ESD using the SB Knife Jr. is technically efficient and safe in treating early colorectal neoplasms and is associated with favorable short- and long-term outcomes. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses.

    Science.gov (United States)

    Prescott, Hallie C; Chang, Virginia W

    2018-02-06

    Obesity has been associated with improved short-term mortality following common acute illness, but its relationship with longer-term mortality is unknown. Observational study of U.S. Health and Retirement Study (HRS) participants with federal health insurance (fee-for-service Medicare) coverage, hospitalized with congestive heart failure (N = 4287), pneumonia (N = 4182), or acute myocardial infarction (N = 2001), 1996-2012. Using cox proportional hazards models, we examined the association between overweight or obese BMI (BMI ≥ 25.0 kg/m 2 ) and mortality to 5 years after hospital admission, adjusted for potential confounders measured at the same time as BMI, including age, race, sex, education, partnership status, income, wealth, and smoking status. Body mass index (BMI) was calculated from self-reported height and weight collected at the HRS survey prior to hospitalization (a median 1.1 year prior to hospitalization). The referent group was patients with a normal BMI (18.5 to BMI was associated with lower mortality at 1 year after hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction-with adjusted hazard ratios of 0.68 (95% CI 0.59-0.79), 0.74 (95% CI: 0.64-0.84), and 0.65 (95%CI: 0.53-0.80), respectively. Among participants who lived to one year, however, subsequent survival was similar between patients with normal versus overweight/obese BMI. In older Americans, overweight or obese BMI was associated with improved survival following hospitalization for congestive heart failure, pneumonia, and acute myocardial infarction. This association, however, is limited to the shorter-term. Conditional on surviving to one year, we did not observe a survival advantage associated with excess weight.

  2. Gamma irradiation of isolated rat islets pretransplantation produces indefinite allograft survival in cyclosporine-treated recipients

    International Nuclear Information System (INIS)

    James, R.F.; Lake, S.P.; Chamberlain, J.; Thirdborough, S.; Bassett, P.D.; Mistry, N.; Bell, P.R.

    1989-01-01

    In this study we have examined the use of low-dose gamma-irradiation for the reduction of islet immunogenicity in the strong allogeneic combination of WAG rat islets transplanted into diabetic AUG recipients. First, we determined that gamma-irradiation reduced immunogenicity in vitro by use of a modified MLR with WAG islets as stimulators and AUG splenocytes as responders. We then determined the maximum dose of gamma-irradiation that could be used (250 rads) before islet function was affected. As 250 rads islet pretreatment alone was ineffective in prolonging allograft survival, we combined the pretreatment with a short course (days 0, 1, 2; 30 mg/kg) of cyclosporine. We found that CsA was only effective in significantly prolonging allograft survival when given subcutaneously in olive oil. The CsA treatment alone gave a significantly prolonged survival time for the islet allografts (median, 37 days vs. 6 days for controls), but when combined with the 250 rads islet pretreatment a synergistic effect was seen with 100% becoming long-term survivors (greater than 100 days). The long-term surviving AUG rats from both the CsA alone group and the CsA plus 250 rads pretreated islets group were challenged with WAG dendritic cells (DC). The islets from the 250 rads pretreated group were subsequently rejected (day 6) while the CsA alone group were not affected. The role of low dose gamma-irradiation when combined with CsA treatment of islet graft recipients in inducing specific unresponsiveness will be discussed

  3. Gamma irradiation of isolated rat islets pretransplantation produces indefinite allograft survival in cyclosporine-treated recipients

    Energy Technology Data Exchange (ETDEWEB)

    James, R.F.; Lake, S.P.; Chamberlain, J.; Thirdborough, S.; Bassett, P.D.; Mistry, N.; Bell, P.R.

    1989-06-01

    In this study we have examined the use of low-dose gamma-irradiation for the reduction of islet immunogenicity in the strong allogeneic combination of WAG rat islets transplanted into diabetic AUG recipients. First, we determined that gamma-irradiation reduced immunogenicity in vitro by use of a modified MLR with WAG islets as stimulators and AUG splenocytes as responders. We then determined the maximum dose of gamma-irradiation that could be used (250 rads) before islet function was affected. As 250 rads islet pretreatment alone was ineffective in prolonging allograft survival, we combined the pretreatment with a short course (days 0, 1, 2; 30 mg/kg) of cyclosporine. We found that CsA was only effective in significantly prolonging allograft survival when given subcutaneously in olive oil. The CsA treatment alone gave a significantly prolonged survival time for the islet allografts (median, 37 days vs. 6 days for controls), but when combined with the 250 rads islet pretreatment a synergistic effect was seen with 100% becoming long-term survivors (greater than 100 days). The long-term surviving AUG rats from both the CsA alone group and the CsA plus 250 rads pretreated islets group were challenged with WAG dendritic cells (DC). The islets from the 250 rads pretreated group were subsequently rejected (day 6) while the CsA alone group were not affected. The role of low dose gamma-irradiation when combined with CsA treatment of islet graft recipients in inducing specific unresponsiveness will be discussed.

  4. Lymphocyte-conditioned medium in combination with interleukin-2 effectively induces antitumour autoimmunity by adoptive transfer of short activated killer (SHAK) cells.

    Science.gov (United States)

    Buer, J; Hilse, R; Dallmann, I; Grosse, J; Kirchner, H; Zorn, U; Hänninen, E L; Franzke, A; Duensing, S; Poliwoda, H

    1995-03-01

    In this study, effective antitumour immunity was transferred by autologous short activated killer (SHAK) cells induced over four hours with lymphocyte conditioned medium (LCM) and recombinant interleukin-2 (rIL-2). Among eight patients with progressive metastatic renal cell carcinoma refractory to standard therapy, there were six objective tumour responses to SHAKs. Progression-free survival ranged from 0 to 8+ months, and overall survival ranged from 2 to 14+ months, with a median of 9+ months. Systemic toxicity of SHAKs was limited to flulike symptoms. Patient SHAKs provided a tumour-specific immunity, both cellular and humoral (expression and secretion of secondary cytokines, including IL-2, GM-CSF, INF-gamma and TNF-alpha), far superior to rIL-2 activated killer cells.

  5. Stereotactic Radiosurgery in the Management of Brain Metastases: An Institutional Retrospective Analysis of Survival

    International Nuclear Information System (INIS)

    Frazier, James L.; Batra, Sachin; Kapor, Sumit; Vellimana, Ananth; Gandhi, Rahul; Carson, Kathryn A.; Shokek, Ori; Lim, Michael; Kleinberg, Lawrence; Rigamonti, Daniele

    2010-01-01

    Purpose: The objective of this study was to report our experience with stereotactic radiosurgery performed with the Gamma Knife (GK) in the treatment of patients with brain metastases and to compare survival for those treated with radiosurgery alone with survival for those treated with radiosurgery and whole-brain radiotherapy. Methods and Materials: Prospectively collected demographic and clinical characteristics and treatment and survival data on 237 patients with intracranial metastases who underwent radiosurgery with the GK between 2003 and 2007 were reviewed. Kaplan-Meier and Cox proportional hazards regression analyses were used to compare survival by demographic and clinical characteristics and treatment. Results: The mean age of the patient population was 56 years. The most common tumor histologies were non-small-cell lung carcinoma (34.2%) and breast cancer (13.9%). The median overall survival time was 8.5 months from the time of treatment. The median survival times for patients with one, two/three, and four or more brain metastases were 8.5, 9.4, and 6.7 months, respectively. Patients aged 65 years or greater and those aged less than 65 years had median survival times of 7.8 and 9 months, respectively (p = 0.008). The Karnofsky Performance Score (KPS) at the time of treatment was a significant predictor of survival: those patients with a KPS of 70 or less had a median survival of 2.9 months compared with 10.3 months (p = 0.034) for those with a KPS of 80 or greater. There was no statistically significant difference in survival between patients treated with radiosurgery alone and those treated with radiosurgery plus whole-brain radiotherapy. Conclusions: Radiosurgery with the GK is an efficacious treatment modality for brain metastases. A KPS greater than 70, histology of breast cancer, smaller tumor volume, and age less than 65 years were associated with a longer median survival in our study.

  6. Median of patient results as a tool for assessment of analytical stability

    DEFF Research Database (Denmark)

    Jørgensen, Lars Mønster; Hansen, Steen Ingemann; Petersen, Per Hyltoft

    2015-01-01

    BACKGROUND: In spite of the well-established external quality assessment and proficiency testing surveys of analytical quality performance in laboratory medicine, a simple tool to monitor the long-term analytical stability as a supplement to the internal control procedures is often needed. METHOD......: Patient data from daily internal control schemes was used for monthly appraisal of the analytical stability. This was accomplished by using the monthly medians of patient results to disclose deviations from analytical stability, and by comparing divergences with the quality specifications for allowable...... analytical bias based on biological variation. RESULTS: Seventy five percent of the twenty analytes achieved on two COBASs INTEGRA 800 instruments performed in accordance with the optimum and with the desirable specifications for bias. DISCUSSION: Patient results applied in analytical quality performance...

  7. A molecular census of arcuate hypothalamus and median eminence cell types

    DEFF Research Database (Denmark)

    Campbell, John N; Macosko, Evan Z; Fenselau, Henning

    2017-01-01

    The hypothalamic arcuate-median eminence complex (Arc-ME) controls energy balance, fertility and growth through molecularly distinct cell types, many of which remain unknown. To catalog cell types in an unbiased way, we profiled gene expression in 20,921 individual cells in and around the adult...... mouse Arc-ME using Drop-seq. We identify 50 transcriptionally distinct Arc-ME cell populations, including a rare tanycyte population at the Arc-ME diffusion barrier, a new leptin-sensing neuron population, multiple agouti-related peptide (AgRP) and pro-opiomelanocortin (POMC) subtypes, and an orexigenic...... somatostatin neuron population. We extended Drop-seq to detect dynamic expression changes across relevant physiological perturbations, revealing cell type-specific responses to energy status, including distinct responses in AgRP and POMC neuron subtypes. Finally, integrating our data with human genome...

  8. Functional connectivity of the dorsal and median raphe nuclei at rest

    DEFF Research Database (Denmark)

    Beliveau, Vincent; Svarer, Claus; Frokjaer, Vibe G

    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 provide a compelling target for a seed-based probe of resting-state activity related to 5-HT. Here we...... implemented a novel multimodal neuroimaging approach for investigating resting-state functional connectivity (FC) between DR and MR and cortical, subcortical and cerebellar target areas. Using [(11)C]DASB positron emission tomography (PET) images of the brain serotonin transporter (5-HTT) combined...

  9. Estimation of mean and median pO2 values for a composite EPR spectrum.

    Science.gov (United States)

    Ahmad, Rizwan; Vikram, Deepti S; Potter, Lee C; Kuppusamy, Periannan

    2008-06-01

    Electron paramagnetic resonance (EPR)-based oximetry is capable of quantifying oxygen content in samples. However, for a heterogeneous environment with multiple pO2 values, peak-to-peak linewidth of the composite EPR lineshape does not provide a reliable estimate of the overall pO2 in the sample. The estimate, depending on the heterogeneity, can be severely biased towards narrow components. To address this issue, we suggest a postprocessing method to recover the linewidth histogram which can be used in estimating meaningful parameters, such as the mean and median pO2 values. This information, although not as comprehensive as obtained by EPR spectral-spatial imaging, goes beyond what can be generally achieved with conventional EPR spectroscopy. Substantially shorter acquisition times, in comparison to EPR imaging, may prompt its use in clinically relevant models. For validation, simulation and EPR experiment data are presented.

  10. A Divergence Median-based Geometric Detector with A Weighted Averaging Filter

    Science.gov (United States)

    Hua, Xiaoqiang; Cheng, Yongqiang; Li, Yubo; Wang, Hongqiang; Qin, Yuliang

    2018-01-01

    To overcome the performance degradation of the classical fast Fourier transform (FFT)-based constant false alarm rate detector with the limited sample data, a divergence median-based geometric detector on the Riemannian manifold of Heimitian positive definite matrices is proposed in this paper. In particular, an autocorrelation matrix is used to model the correlation of sample data. This method of the modeling can avoid the poor Doppler resolution as well as the energy spread of the Doppler filter banks result from the FFT. Moreover, a weighted averaging filter, conceived from the philosophy of the bilateral filtering in image denoising, is proposed and combined within the geometric detection framework. As the weighted averaging filter acts as the clutter suppression, the performance of the geometric detector is improved. Numerical experiments are given to validate the effectiveness of our proposed method.

  11. KEHONKUVA JA MEDIA : 9.-luokkalaisten tyttöjen kehonkuva ja median vaikutus siihen

    OpenAIRE

    Vainionpää, Charlotta; Koski, Riikka

    2016-01-01

    Tämän tutkimuksen aiheena oli kehonkuva ja media: 9.-luokkalaisten tyttöjen kehonkuva ja median vaikutus siihen. Tutkimuksen tarkoituksena oli selvittää minkälaisena tytöt kokevat oman kehonkuvansa, minkälaisia ulkonäköpaineita tytöillä on ja miten media vaikuttaa heidän kehonkuvaansa. Työn teoreettisessa viitekehyksessä pääkäsitteet olivat nuoruus, kehonkuva ja media. Nuoruus-osiossa käsiteltiin nuoruuden määrittelyn lisäksi murrosikää ja murrosiän fyysisiä sekä psyykkisiä muutoksia. Keh...

  12. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

    Science.gov (United States)

    Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

    2007-09-01

    Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

  13. Efficient Architecture and Implementation of Vector Median Filter in Co-Design Context

    Directory of Open Access Journals (Sweden)

    N. Masmoudi

    2007-09-01

    Full Text Available This work presents an efficient fast parallel architecture of the Vector Median Filter (VMF using combined hardware/software (HW/SW implementation. The hardware part of the system is implemented using VHDL language, whereas the software part is developed using C/C++ language. The software part of the embedded system uses the NIOS-II softcore processor and the operating system used is μClinux. The comparison between the software and HW/SW solutions shows that adding a hardware part in the design attempts to speed up the filtering process compared to the software solution. This efficient embedded system implementation can perform well in several image processing applications.

  14. Time course and predictors of median nerve conduction after carpal tunnel release.

    Science.gov (United States)

    Rotman, Mitchell B; Enkvetchakul, Bobby V; Megerian, J Thomas; Gozani, Shai N

    2004-05-01

    To identify predictors of outcome and of electrophysiologic recovery in patients with carpal tunnel syndrome (CTS) treated by endoscopic carpal tunnel release using a nerve conduction testing system (NC-Stat; NEUROMetrix, Inc, Waltham, MA). Validity of the automated nerve conduction testing system was shown by comparing presurgical distal motor latencies (DMLs) against a reference obtained by referral to an electromyography laboratory. The DML was evaluated in 48 patients with CTS. Measurements were obtained within 1 hour of surgery and at 2 weeks, 6 weeks, 3 months, and 6 months after carpal tunnel release. Presurgical and postsurgical DMLs were then compared and correlated with variables and possible predictors of outcome including age, body mass index, gender, and presurgical DMLs. The automated nerve conduction testing system DMLs matched those of reference electromyography/nerve conduction study values with high correlation. Sensitivity of the automated nerve conduction testing system when compared with a standardized CTS case definition was 89%, with a specificity of 95%. A significant correlation was found between the DML before release and the DML 1 hour after release. Moreover, maximal postsurgical DML improvement was highly dependent on the presurgical DML, with no improvement shown for the 6-ms group. Among the clinical variables of age, gender, and body mass index only age was mildly predictive of postrelease DML changes at 6 months. No other correlations between clinical variables and postsurgical DMLs were significant. In addition the predictive value of age was lost when combined with the presurgical DML in a multivariate analysis. Postsurgical changes in the median nerve DML were highly dependent on the prerelease latency. The sensitivity and specificity of a nerve conduction monitoring system in detecting and aiding in the diagnosis of CTS is useful in the long-term management of patients with CTS and can aid in determining the level of improvement

  15. Hybrid (laparoscopy + stent treatment of celiac trunk compression syndrome (Dunbar syndrome, median arcuate ligament syndrome (MALS

    Directory of Open Access Journals (Sweden)

    Maciej Michalik

    2016-12-01

    Full Text Available Introduction : Celiac trunk (CT compression syndrome caused by the median arcuate ligament (MAL is a rarely diagnosed disease because of its nonspecific symptoms, which cause a delay in the correct diagnosis. Intestinal ischemia occurs, which causes symptoms of abdominal angina. One method of treatment for this disease is surgical release of the CT – the intersection of the MAL. Laparoscopy is the first step of the hybrid technique combined with percutaneous angioplasty and stenting of the CT. Aim: To demonstrate the usefulness and advantages of the laparoscopic approach in the treatment of Dunbar syndrome. Material and methods : Between 2013 and 2016 in the General and Minimally Invasive Surgery Department of the Medical Sciences Faculty of the University of Warmia and Mazury in Olsztyn, 6 laparoscopic procedures were performed because of median arcuate ligament syndrome. During the laparoscopy the MAL was cut with a harmonic scalpel. One month after laparoscopy 5 patients had Doppler percutaneous angioplasty of the CT with stent implantation in the Vascular Surgery Department in Pomeranian Medical University in Szczecin. Results : In one case, there was a conversion of laparoscopic surgery to open due to unmanageable intraoperative bleeding. In one case, postoperative ultrasound examination of the abdominal cavity demonstrated the presence of a large hematoma in the retroperitoneal space. All patients reported relief of symptoms in the first days after the operation. Conclusions : The hybrid method, combining laparoscopy and angioplasty, seems to be a long-term solution, which increases the comfort of the patient, brings the opportunity for normal functioning and minimizes the risk of restenosis.

  16. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Haakma, Wieke [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Aarhus University, Department of Forensic Medicine and Comparative Medicine Lab, Aarhus (Denmark); Jongbloed, Bas A.; Goedee, H.S.; Berg, Leonard H. van den; Pol, W.L. van der [University Medical Center Utrecht, Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, Utrecht (Netherlands); Froeling, Martijn; Bos, Clemens; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Leemans, Alexander [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-05-15

    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. 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), mean (MD), axial (AD) and radial (RD) diffusivity. Cross-sectional areas (CSA) were measured on T2-weighted scans. Forty-five out of 60 arms were included in the analysis. AD was significantly lower in MMN patients (2.20 ± 0.12 x 10{sup -3} mm{sup 2}/s) compared to ALS patients (2.31 ± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05) and HCs (2.31± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05). Segmental analysis showed significant restriction of AD, RD and MD (p < 0.005) in the proximal third of the nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p < 0.01). Thickening of nerves is compatible with changes in the myelin sheath structure, whereas lowered AD values suggest axonal dysfunction. These findings suggest that myelin and axons are diffusely involved in MMN pathogenesis. (orig.)

  17. Variability and Reliability of Paired-Pulse Depression and Cortical Oscillation Induced by Median Nerve Stimulation.

    Science.gov (United States)

    Onishi, Hideaki; Otsuru, Naofumi; Kojima, Sho; Miyaguchi, Shota; Saito, Kei; Inukai, Yasuto; Yamashiro, Koya; Sato, Daisuke; Tamaki, Hiroyuki; Shirozu, Hiroshi; Kameyama, Shigeki

    2018-05-08

    Paired-pulse depression (PPD) has been widely used to investigate the functional profiles of somatosensory cortical inhibition. However, PPD induced by somatosensory stimulation is variable, and the reasons for between- and within-subject PPD variability remains unclear. Therefore, the purpose of this study was to clarify the factors influencing PPD variability induced by somatosensory stimulation. The study participants were 19 healthy volunteers. First, we investigated the relationship between the PPD ratio of each component (N20m, P35m, and P60m) of the somatosensory magnetic field, and the alpha, beta, and gamma band changes in power [event-related desynchronization (ERD) and event-related synchronization (ERS)] induced by median nerve stimulation. Second, because brain-derived neurotrophic factor (BDNF) gene polymorphisms reportedly influence the PPD ratio, we assessed whether BDNF genotype influences PPD ratio variability. Finally, we evaluated the test-retest reliability of PPD and the alpha, beta, and gamma ERD/ERS induced by somatosensory stimulation. Significant positive correlations were observed between the P60m_PPD ratio and beta power change, and the P60m_PPD ratio was significantly smaller for the beta ERD group than for the beta ERS group. P35m_PPD was found to be robust and highly reproducible; however, P60m_PPD reproducibility was poor. In addition, the ICC values for alpha, beta, and gamma ERD/ERS were 0.680, 0.760, and 0.552 respectively. These results suggest that the variability of PPD for the P60m deflection may be influenced by the ERD/ERS magnitude, which is induced by median nerve stimulation.

  18. Median Modified Wiener Filter for nonlinear adaptive spatial denoising of protein NMR multidimensional spectra

    KAUST Repository

    Cannistraci, Carlo Vittorio

    2015-01-26

    Denoising multidimensional NMR-spectra is a fundamental step in NMR protein structure determination. The state-of-the-art method uses wavelet-denoising, which may suffer when applied to non-stationary signals affected by Gaussian-white-noise mixed with strong impulsive artifacts, like those in multi-dimensional NMR-spectra. Regrettably, Wavelet\\'s performance depends on a combinatorial search of wavelet shapes and parameters; and multi-dimensional extension of wavelet-denoising is highly non-trivial, which hampers its application to multidimensional NMR-spectra. Here, we endorse a diverse philosophy of denoising NMR-spectra: less is more! We consider spatial filters that have only one parameter to tune: the window-size. We propose, for the first time, the 3D extension of the median-modified-Wiener-filter (MMWF), an adaptive variant of the median-filter, and also its novel variation named MMWF*. We test the proposed filters and the Wiener-filter, an adaptive variant of the mean-filter, on a benchmark set that contains 16 two-dimensional and three-dimensional NMR-spectra extracted from eight proteins. Our results demonstrate that the adaptive spatial filters significantly outperform their non-adaptive versions. The performance of the new MMWF* on 2D/3D-spectra is even better than wavelet-denoising. Noticeably, MMWF* produces stable high performance almost invariant for diverse window-size settings: this signifies a consistent advantage in the implementation of automatic pipelines for protein NMR-spectra analysis.

  19. Evaluation of a novel median power spectrogram for seizure detection by non-neurophysiologists.

    Science.gov (United States)

    Yan, Peter; Melman, Tamar; Yan, Sherry; Otgonsuren, Munkhzul; Grinspan, Zachary

    2017-08-01

    (1) To evaluate how well resident physicians use a novel EEG spectral analysis tool (the median power spectrogram; MPS) to detect seizures. (2) To assess the capability of the MPS to identify different seizure types. 120 EEG records from children with intractable seizures were converted to MPS by taking the median power across leads and using multi-taper spectral estimation. Twelve blinded neurology residents were trained to interpret the spectrogram with a five-minute video tutorial and post-test. Two residents independently assessed each set for presence of seizures. Their performance was compared to seizures identified using conventional EEG. Two blinded neurologists separately reviewed the EEGs and spectrograms to independently categorize the seizures. Their results were used to determine the spectrogram's capability to reveal seizures and visualize different seizure types for the user. Three key MPS features distinguished seizures from inter-ictal background: power difference relative to background, down-sloping resonance bands, and power in high frequencies. Using these features, residents identified seizures with 77% sensitivity and 72% specificity. 86% (51/59) of focal seizures and 81% (22/27) of generalized seizures were detected by at least one resident. Missed seizures included brief (seizures, tonic seizures, seizures with predominant delta (0-4Hz) activity, and seizures evident primarily in supplementary low temporal leads. The MPS is a novel qEEG modality that requires minimal training to interpret. It enables physicians without extensive neurophysiology training to identify seizures with sensitivity and specificity comparable to more complex multi-modal qEEG displays. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. Contemporary management of median arcuate ligament syndrome provides early symptom improvement

    Science.gov (United States)

    Columbo, Jesse A.; Trus, Thadeus; Nolan, Brian; Goodney, Philip; Rzucidlo, Eva; Powell, Richard; Walsh, Daniel; Stone, David

    2017-01-01

    Objective Optimal diagnosis and management of median arcuate ligament (MAL) syndrome (MALS) remains unclear in contemporary practice. The advent and evolution of laparoscopic and endovascular techniques has redirected management toward a less invasive therapeutic algorithm. This study examined our contemporary outcomes of patients treated for MALS. Methods All patients treated for MALS at Dartmouth-Hitchcock Medical Center from 2000 to 2013 were retrospectively reviewed. Demographics and comorbidities were recorded. Freedom from symptoms and freedom from reintervention were the primary end points. Return to work or school was assessed. Follow-up by clinic visits and telephone allowed quantitative comparisons among the patients. Results During the study interval, 21 patients (24% male), with a median age of 42 years, were treated for MALS. All patients complained of abdominal pain in the presence of a celiac stenosis, 16 (76%) also reported weight loss at the time of presentation, and 57% had a concomitant psychiatric history. Diagnostic imaging most commonly used included duplex ultrasound (81%), computed tomography angiography (66%), angiography (57%), and magnetic resonance angiography (5%). Fourteen patients (67%) underwent multiple diagnostic studies. All patients underwent initial laparoscopic MAL release. Seven patients (33%) underwent subsequent celiac stent placement in the setting of recurrent or unresolved symptoms with persistent celiac stenosis at a mean interval of 49 days. Two patients required surgical bypass after an endovascular intervention failed. The 6-month freedom from symptoms was 75% and freedom from reintervention was 64%. Eighteen patients (81%) reported early symptom improvement and weight gain, and 66% were able to return to work. Conclusions A multidisciplinary treatment approach using initial laparoscopic release and subsequent stent placement and bypass surgery provides symptom improvement in most patients treated for MALS. The

  1. Median Modified Wiener Filter for nonlinear adaptive spatial denoising of protein NMR multidimensional spectra

    KAUST Repository

    Cannistraci, Carlo Vittorio; Abbas, Ahmed; Gao, Xin

    2015-01-01

    Denoising multidimensional NMR-spectra is a fundamental step in NMR protein structure determination. The state-of-the-art method uses wavelet-denoising, which may suffer when applied to non-stationary signals affected by Gaussian-white-noise mixed with strong impulsive artifacts, like those in multi-dimensional NMR-spectra. Regrettably, Wavelet's performance depends on a combinatorial search of wavelet shapes and parameters; and multi-dimensional extension of wavelet-denoising is highly non-trivial, which hampers its application to multidimensional NMR-spectra. Here, we endorse a diverse philosophy of denoising NMR-spectra: less is more! We consider spatial filters that have only one parameter to tune: the window-size. We propose, for the first time, the 3D extension of the median-modified-Wiener-filter (MMWF), an adaptive variant of the median-filter, and also its novel variation named MMWF*. We test the proposed filters and the Wiener-filter, an adaptive variant of the mean-filter, on a benchmark set that contains 16 two-dimensional and three-dimensional NMR-spectra extracted from eight proteins. Our results demonstrate that the adaptive spatial filters significantly outperform their non-adaptive versions. The performance of the new MMWF* on 2D/3D-spectra is even better than wavelet-denoising. Noticeably, MMWF* produces stable high performance almost invariant for diverse window-size settings: this signifies a consistent advantage in the implementation of automatic pipelines for protein NMR-spectra analysis.

  2. Survival benefit of TIPS versus serial paracentesis in patients with refractory ascites: a single institution case-control propensity score analysis

    International Nuclear Information System (INIS)

    Gaba, R.C.; Parvinian, A.; Casadaban, L.C.; Couture, P.M.; Zivin, S.P.; Lakhoo, J.; Minocha, J.; Ray, C.E.; Knuttinen, M.G.; Bui, J.T.

    2015-01-01

    Aim: To compare the impact of covered stent-graft transjugular intrahepatic portosystemic shunt (TIPS) versus serial paracentesis on survival of patients with medically refractory ascites. Materials and methods: In this retrospective study, cirrhotic patients who underwent covered stent-graft TIPS for refractory ascites from 2003–2013 were compared with similar patients who underwent serial paracentesis during 2009–2013. Demographic and liver disease data, Model for End-Stage Liver Disease (MELD) scores, and survival outcomes were obtained from hospital electronic medical records and the social security death index. After propensity score weighting to match study group characteristics, survival outcomes were compared using Kaplan–Meier statistics with log-rank analysis. Results: Seventy TIPS (70% men, mean age 55.7 years, mean MELD 15.1) and 80 paracentesis (58% men, mean age 53.5 years, mean MELD 22.5) patients were compared. The TIPS haemodynamic success rate was 100% (mean portosystemic pressure gradient reduction 13 mmHg). Paracentesis patients underwent a mean of 7.9 procedures. After propensity score weighting to balance group features, TIPS patients showed a trend toward enhanced survival compared with paracentesis patients (median survival 1037 versus 262 days, p = 0.074). TIPS conferred a significant increase or trend toward improved survival compared with paracentesis at 1 (66% versus 44%, p = 0.018), 2 (56% versus 38%, p = 0.057), and 3 year (49% versus 32%, p = 0.077) time points. Thirty and 90 day mortality rates were not statistically increased by TIPS. Conclusion: Covered stent-graft TIPS improves intermediate- to long-term survival without significantly increasing short-term mortality of ascites patients, and suggests a greater potential role for TIPS in properly selected ascitic patients when medical management fails. - Highlights: • The survival benefit of TIPS for patients with refractory ascites remains unproven. • A case

  3. Biochemical disease-free survival following I-125 prostate implantation

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, David C; Priestley, Joseph B

    1995-07-01

    Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p < 0.0001). Patients with a normal pretreatment PSA enjoyed 93% BDFS, while those presenting with PSA > 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with

  4. Biochemical disease-free survival following I-125 prostate implantation

    International Nuclear Information System (INIS)

    Beyer, David C.; Priestley, Joseph B.

    1995-01-01

    Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with early stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and

  5. Multiple Weather Factors Affect Apparent Survival of European Passerine Birds

    Science.gov (United States)

    Salewski, Volker; Hochachka, Wesley M.; Fiedler, Wolfgang

    2013-01-01

    Weather affects the demography of animals and thus climate change will cause local changes in demographic rates. In birds numerous studies have correlated demographic factors with weather but few of those examined variation in the impacts of weather in different seasons and, in the case of migrants, in different regions. Using capture-recapture models we correlated weather with apparent survival of seven passerine bird species with different migration strategies to assess the importance of selected facets of weather throughout the year on apparent survival. Contrary to our expectations weather experienced during the breeding season did not affect apparent survival of the target species. However, measures for winter severity were associated with apparent survival of a resident species, two short-distance/partial migrants and a long-distance migrant. Apparent survival of two short distance migrants as well as two long-distance migrants was further correlated with conditions experienced during the non-breeding season in Spain. Conditions in Africa had statistically significant but relatively minor effects on the apparent survival of the two long-distance migrants but also of a presumably short-distance migrant and a short-distance/partial migrant. In general several weather effects independently explained similar amounts of variation in apparent survival for the majority of species and single factors explained only relatively low amounts of temporal variation of apparent survival. Although the directions of the effects on apparent survival mostly met our expectations and there are clear predictions for effects of future climate we caution against simple extrapolations of present conditions to predict future population dynamics. Not only did weather explains limited amounts of variation in apparent survival, but future demographics will likely be affected by changing interspecific interactions, opposing effects of weather in different seasons, and the potential for

  6. New graphic AUC-based method to estimate overall survival benefit: pomalidomide reanalysis.

    Science.gov (United States)

    Fenix-Caballero, S; Diaz-Navarro, J; Prieto-Callejero, B; Rios-Sanchez, E; Alegre-del Rey, E J; Borrero-Rubio, J M

    2016-02-01

    Difference in median survival is an erratic measure and sometimes does not provide a good assessment of survival benefit. The aim of this study was to reanalyse the overall survival benefit of pomalidomide from pivotal clinical trial using a new area under curve (AUC)-based method. In the pivotal trial, pomalidomide plus low-dose dexamethasone showed a significant survival benefit over high-dose dexamethasone, with a difference between medians of 4.6 months. The new AUC method applied to the survival curves, obtained an overall survival benefit of 2.6 months for the pomalidomide treatment. This average difference in OS was calculated for the 61.5% of patients for whom the time to event is reliable enough. This 2-month differential would have major clinical and pharmacoeconomic implications, on both cost-effectiveness studies and on the willingness of the healthcare systems to pay for this treatment. © 2015 John Wiley & Sons Ltd.

  7. Network ties and survival

    DEFF Research Database (Denmark)

    Acheampong, George; Narteh, Bedman; Rand, John

    2017-01-01

    Poultry farming has been touted as one of the major ways by which poverty can be reduced in low-income economies like Ghana. Yet, anecdotally there is a high failure rate among these poultry farms. This current study seeks to understand the relationship between network ties and survival chances...... of small commercial poultry farms (SCPFs). We utilize data from a 2-year network survey of SCPFs in rural Ghana. The survival of these poultry farms are modelled using a lagged probit model of farms that persisted from 2014 into 2015. We find that network ties are important to the survival chances...... but this probability reduces as the number of industry ties increases but moderation with dynamic capability of the firm reverses this trend. Our findings show that not all network ties aid survival and therefore small commercial poultry farmers need to be circumspect in the network ties they cultivate and develop....

  8. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  9. Survivability and Hope

    Science.gov (United States)

    ... Current Issue Past Issues Special Section Survivability and Hope Past Issues / Spring 2007 Table of Contents For ... cure or long-term survivorship." This message of hope is a hallmark of the latest advances in ...

  10. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  11. Determinants of IPO survival on the Johannesburg securities exchange

    Directory of Open Access Journals (Sweden)

    Brownhilder Ngek Neneh

    2014-10-01

    Full Text Available The purpose of this paper was to establish the determinants of IPO survival on the Johannesburg Securities Exchange (JSE. Using the Kaplan-Meier test, this study established that firms less than five years prior to listing on the JSE have a significant smaller mean survival time; firms with a gross proceed less than the median have a significant shorter mean survival time; overpriced IPOs have a significant higher survival time; IPOs listed during the hot market period on the JSE have a significant smaller mean survival time and IPOs with return on asset, operating profit margin, and return on equity less than or equal to zero have a low mean survival time. Also, being in the internet industry significantly shortens the mean survival time of an IPO. Moreover, based on the Cox Proportional Hazard model, it was established that the determinants of IPO survivability on the JSE are the firms’ age, size, market period, return on equity and operating profit margin are. These findings provide investors and companies in the JSE with empirical evidence of the determinants of IPO survivability of the JSE. As such, investors are advised to consider these factors when selecting their portfolios

  12. Direct-acting Antivirals in Kidney Transplant Patients: Successful Hepatitis C Treatment and Short Term Reduction in Urinary Protein/Creatinine Ratios

    Directory of Open Access Journals (Sweden)

    Michael R. Goetsch

    2017-09-01

    Full Text Available Introduction: The role of Hepatitis C Virus (HCV clearance in long-term kidney graft survival is unknown. In this study, we examined short-term trends of urinary protein/creatinine (P/C ratios in a cohort of HCV-infected kidney transplant recipients with stable graft function and treated with direct-acting antivirals (DAAs. Methods: We conducted a retrospective study of 19 kidney transplant patients with chronic HCV infection treated with DAAs at the University of Alabama at Birmingham 1917 Viral Hepatitis Clinic between January 2013 and June 2016. Markers of glomerular damage were assessed using average protein/creatinine (P/C ratios measured pre- and post-treatment. We also described treatment efficacy using sustained virologic response at 12 weeks post-HCV treatment (SVR12. Results: The median age of the 19 patients included was 59 years (Q1=58, Q3=64 at completion of treatment. Of these patients, 68% were African American, 32% were White and 63% were male. The median time between kidney transplant and initiation of DAA therapy was 2.25 years (Q1=0.79, Q3=3.79. Post-treatment P/C ratios (median=0.127, Q1=0.090, Q3=0.220 were significantly lower (p=0.01 than pre-treatment ratios (median=0.168, Q1=0.118, Q3=0.385. P/C ratios decreased in 14 of 19 patients (74% with median change of -0.072 (median percent change= -40%. Post-treatment eGFRs (median=58.9, Q1=48.9, Q3=72.3 were not significantly different (p=0.82 than the pre-treatment values (median=57.0, Q1=48.8, Q3=67.8. Conclusions: In this preliminary study, there was a statistically significant decrease in P/C ratios associated with HCV clearance, suggesting a potential role for DAAs in improving kidney graft survival. Larger cohort studies will be needed to assess the clinical and long-term benefits of DAAs in this special population of HCV infected patients.

  13. Natural short sleeper

    Science.gov (United States)

    Sleep - natural short sleeper ... 7 to 9 hours of sleep each night. Short sleepers sleep less than 75% of what is normal for their age. Natural short sleepers are different from people who chronically do ...

  14. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial.

    Science.gov (United States)

    Bourke, Stephen C; Tomlinson, Mark; Williams, Tim L; Bullock, Robert E; Shaw, Pamela J; Gibson, G John

    2006-02-01

    Few patients with amyotrophic lateral sclerosis currently receive non-invasive ventilation (NIV), reflecting clinical uncertainty about the role of this intervention. We aimed to assess the effect of NIV on quality of life and survival in amyotrophic lateral sclerosis in a randomised controlled trial. 92 of 102 eligible patients participated. They were assessed every 2 months and randomly assigned to NIV (n=22) or standard care (n=19) when they developed either orthopnoea with maximum inspiratory pressure less than 60% of that predicted or symptomatic hypercapnia. Primary validated quality-of-life outcome measures were the short form 36 mental component summary (MCS) and the sleep apnoea quality-of-life index symptoms domain (sym). Both time maintained above 75% of baseline (T(i)MCS and T(i)sym) and mean improvement (microMCS and microsym) were measured. NIV improved T(i)MCS, T(i)sym, microMCS, microsym, and survival in all patients and in the subgroup with better bulbar function (n=20). This subgroup showed improvement in several measures of quality of life and a median survival benefit of 205 days (p=0.006) with maintained quality of life for most of this period. NIV improved some quality-of-life indices in those with poor bulbar function, including microsym (p=0.018), but conferred no survival benefit. In patients with amyotrophic lateral sclerosis without severe bulbar dysfunction, NIV improves survival with maintenance of, and improvement in, quality of life. The survival benefit from NIV in this group is much greater than that from currently available neuroprotective therapy. In patients with severe bulbar impairment, NIV improves sleep-related symptoms, but is unlikely to confer a large survival advantage.

  15. Evaluation of a non-proprietary, high-tension, four-cable median barrier on level terrain.

    Science.gov (United States)

    2012-11-01

    During the last decade, the use of cable median barriers has risen dramatically. Cable barriers are often utilized in depressed medians : with widths ranging from 30 to 50 ft (9.1 to 15.2 m) and with fill slopes as steep as 4H:1V. A careful review of...

  16. Validation of Progression‐Free Survival as a Surrogate Endpoint for Overall Survival in Malignant Mesothelioma: Analysis of Cancer and Leukemia Group B and North Central Cancer Treatment Group (Alliance) Trials

    Science.gov (United States)

    Wang, Xiaoyi; Hodgson, Lydia; George, Stephen L.; Sargent, Daniel J.; Foster, Nate R.; Ganti, Apar Kishor; Stinchcombe, Thomas E.; Crawford, Jeffrey; Kratzke, Robert; Adjei, Alex A.; Kindler, Hedy L.; Vokes, Everett E.; Pang, Herbert

    2017-01-01

    Abstract Purpose. The aim of this study was to investigate whether progression‐free survival (PFS) can be considered a surrogate endpoint for overall survival (OS) in malignant mesothelioma. Materials and Methods. Individual data were collected from 15 Cancer and Leukemia Group B (615 patients) and 2 North Central Cancer Treatment Group (101 patients) phase II trials. The effects of 5 risk factors for OS and PFS, including age, histology, performance status (PS), white blood cell count, and European Organisation for Research and Treatment of Cancer (EORTC) risk score, were used in the analysis. Individual‐level surrogacy was assessed by Kendall's tau through a Clayton bivariate Copula survival (CBCS) model. Summary‐level surrogacy was evaluated via the association between logarithms of the hazard ratio (log HR)—log HROS and log HRPFS—measured in R2 from a weighted least‐square (WLS) regression model and the CBCS model. Results. The median PFS for all patients was 3.0 months (95% confidence interval [CI], 2.8–3.5 months) and the median OS was 7.2 months (95% CI, 6.5–8.0 months). Moderate correlations between PFS and OS were observed across all risk factors at the individual level, with Kendall's tau ranging from 0.46 to 0.47. The summary‐level surrogacy varied among risk factors. The Copula R2 ranged from 0.51 for PS to 0.78 for histology. The WLS R2 ranged from 0.26 for EORTC and PS to 0.67 for age. Conclusions. The analyses demonstrated low to moderate individual‐level surrogacy between PFS and OS. At the summary level, the surrogacy between PFS and OS varied significantly across different risk factors. With a short postprogression survival and a moderate correlation between PFS and OS, there is no evidence that PFS is a valid surrogate endpoint for OS in malignant mesothelioma. Implications for Practice. For better disease management and for more efficient clinical trial designs, it is important to know if progression‐free survival (PFS) is

  17. Early Cretaceous dextral transpressional deformation within the Median Batholith, Stewart Island, New Zealand

    International Nuclear Information System (INIS)

    Allibone, A.H.; Tulloch, A.J.

    2008-01-01

    The character, timing, and significance of deformation within the Median Batholith has been debated since at least 1967, with allochthonous and autochthonous models proposed to account for internal variations in the character of the batholith. Stewart Island provides excellent exposures of intrabatholithic structures, allowing many aspects of the deformation history within the batholith to be analysed, far removed from the effects of later deformation related to the current plate boundary. Median Batholith rocks in northern and central Stewart Island are deformed by three major structures: the Freshwater Fault System, Escarpment Fault, and Gutter Shear Zone. Lineation orientations, Al in hornblende geobarometry, and Ar-Ar thermochronology indicate up to c. 7 km of NNE-directed uplift of the hanging wall of the Escarpment Fault between c. 110 and 105 Ma. Unlike the Escarpment Fault, a wide range of mineral elongation lineation orientations, including many oblique to the strike and dip of related foliations, characterise both the Gutter Shear Zone and Freshwater Fault System. Lineation and limited sense of shear data indicate dextral-reverse movement on both structures during development of their dominant ductile fabrics. Crosscutting and intrusive relationships indicate movement on the Freshwater Fault System after c. 130 Ma and on the Gutter Shear Zone between 120 and 112 Ma. The amount of movement on the Freshwater Fault System and Gutter Shear Zone remains largely unconstrained. However, the 342 ± 24 Ma age of a granite clast in a Paterson Group lithic tuff horizon at Abrahams Bay overlaps that of Carboniferous plutons in the block immediately south of the Freshwater Fault System, implying that the Paterson Group is little displaced from the basement rocks through which it was erupted. The three structures mapped on Stewart Island form part of a narrow transpressional mobile belt active within the Jurassic-Cretaceous arc on the outboard margin of the Western

  18. Survival of civilian and prisoner drug-sensitive, multi- and extensive drug- resistant tuberculosis cohorts prospectively followed in Russia.

    Directory of Open Access Journals (Sweden)

    Yanina Balabanova

    Full Text Available OBJECTIVE AND METHODS: A long-term observational study was conducted in Samara, Russia to assess the survival and risk factors for death of a cohort of non-multidrug resistant tuberculosis (non-MDRTB and multidrug resistant tuberculosis (MDRTB civilian and prison patients and a civilian extensive drug-resistant tuberculosis (XDRTB cohort. RESULTS: MDRTB and XDRTB rates of 54.8% and 11.1% were identified in the region. Half (50% of MDRTB patients and the majority of non-MDRTB patients (71% were still alive at 5 years. Over half (58% of the patients died within two years of establishing a diagnosis of XDRTB. In the multivariate analysis, retreatment (HR = 1.61, 95%CI 1.04, 2.49 and MDRTB (HR = 1.67, 95%CI 1.17, 2.39 were significantly associated with death within the non-MDR/MDRTB cohort. The effect of age on survival was relatively small (HR = 1.01, 95%CI 1.00, 1.02. No specific factor affected survival of XDRTB patients although median survival time for HIV-infected versus HIV-negative patients from this group was shorter (185 versus 496 days. The majority of MDRTB and XDRTB strains (84% and 92% respectively strains belonged to the Beijing family. Mutations in the rpoB (codon 531 in 81/92; 88.8%, katG (mutation S315T in 91/92, 98.9% and inhA genes accounted for most rifampin and isoniazid resistance respectively, mutations in the QRDR region of gyrA for most fluroquinolone resistance (68/92; 73.5%. CONCLUSIONS: Alarmingly high rates of XDRTB exist. Previous TB treatment cycles and MDR were significant risk factors for mortality. XDRTB patients' survival is short especially for HIV-infected patients. Beijing family strains comprise the majority of drug-resistant strains.

  19. Ultrasound-guided hydrodissection decreases gliding resistance of the median nerve within the carpal tunnel.

    Science.gov (United States)

    Evers, Stefanie; Thoreson, Andrew R; Smith, Jay; Zhao, Chunfeng; Geske, Jennifer R; Amadio, Peter C

    2018-01-01

    The aim of this study was to assess alterations in median nerve (MN) biomechanics within the carpal tunnel resulting from ultrasound-guided hydrodissection in a cadaveric model. Twelve fresh frozen human cadaver hands were used. MN gliding resistance was measured at baseline and posthydrodissection, by pulling the nerve proximally and then returning it to the origin. Six specimens were treated with hydrodissection, and 6 were used as controls. In the hydrodissection group there was a significant reduction in mean peak gliding resistance of 92.9 ± 34.8 mN between baseline and immediately posthydrodissection (21.4% ± 10.5%; P = 0.001). No significant reduction between baseline and the second cycle occurred in the control group: 9.6 ± 29.8 mN (0.4% ± 5.3%; P = 0.467). Hydrodissection can decrease the gliding resistance of the MN within the carpal tunnel, at least in wrists unaffected by carpal tunnel syndrome. A clinical trial of hydrodissection seems justified. Muscle Nerve 57: 25-32, 2018. © 2017 Wiley Periodicals, Inc.

  20. Pinhole single-photon emission tomography reconstruction based on median root prior

    International Nuclear Information System (INIS)

    Sohlberg, Antti; Kuikka, Jyrki T.; Ruotsalainen, Ulla

    2003-01-01

    The maximum likelihood expectation maximisation (ML-EM) algorithm can be used to reduce reconstruction artefacts produced by filtered backprojection (FBP) methods in pinhole single-photon emission tomography (SPET). However, ML-EM suffers from noise propagation along iterations, which leads to quantitatively unpleasant reconstruction results. To avoid this increase in noise, the median root prior (MRP) algorithm for pinhole SPET was implemented. Projection data of a line source and Picker's thyroid phantom were collected using a single-head gamma camera with a pinhole collimator. MRP was added to existing pinhole ML-EM reconstruction algorithm and the phantom studies were reconstructed using MRP, ML-EM and FBP for comparison. Coefficients of variation, contrasts and full-widths at half-maximum were calculated and showed a clear reduction in noise without significant loss of resolution or decrease in contrast when MRP was applied. MRP also produced visually pleasing images even with high iteration numbers, free of the checkerboard-type noise patterns which are typical of ML-EM images. (orig.)

  1. Median effective dose of isoflurane, sevoflurane, and desflurane in green iguanas.

    Science.gov (United States)

    Barter, Linda S; Hawkins, Michelle G; Brosnan, Robert J; Antognini, Joseph F; Pypendop, Bruno H

    2006-03-01

    To determine the median effective dose (ED(50); equivalent to the minimum alveolar concentration [MAC]) of isoflurane, sevoflurane, and desflurane for anesthesia in iguanas. 6 healthy adult green iguanas. In unmedicated iguanas, anesthesia was induced and maintained with each of the 3 volatile drugs administered on separate days according to a Latin square design. Iguanas were endotracheally intubated, mechanically ventilated, and instrumented for cardiovascular and respiratory measurements. During each period of anesthesia, MAC was determined in triplicate. The mean value of 2 consecutive expired anesthetic concentrations, 1 that just permitted and 1 that just prevented gross purposeful movement in response to supramaximal electrical stimulus, and that were not different by more than 15%, was deemed the MAC. Mean +/- SD values for the third MAC determination for isoflurane, sevoflurane, and desflurane were 1.8 +/- 0.3%, 3.1 +/- 1.0%, and 8.9 +/- 2.1% of atmospheric pressure, respectively. The MAC for all inhaled agents was, on average, 22% greater for the first measurement than for the third measurement. Over time, MACs decreased for all 3 agents. Final MAC measurements were similar to values reported for other species. The decrease in MACs over time may be at least partly explained by limitations of anesthetic uptake and distribution imposed by the reptilian cardiorespiratory system. Hence, for a constant end-tidal anesthetic concentration in an iguana, the plane of anesthesia may deepen over time, which could contribute to increased morbidity during prolonged procedures.

  2. Presentation and management of keloid scarring following median sternotomy: a case study

    Directory of Open Access Journals (Sweden)

    Javangula Kalyana C

    2010-12-01

    Full Text Available Abstract Introduction Keloid scars following median sternotomy are rare and occur more frequently in pigmented skin. Different management strategies have been described with variable success. We present a case of keloid scar formation following cardiac surgery including our management and the final aesthetic result. Case description A 64 year old female of fair complexion underwent mitral valve replacement. The procedure and postoperative recovery were uncomplicated, however, during the following year, thick keloid scars formed over the incision sites. Initial non surgical measures failed to relieve pain and did not offer any tangible aesthetic benefit. Eventually surgical excision was attempted. She presented to our clinic for nine months follow up with significant improvement in pain and aesthetic result. Discussion and Evaluation Several theories have attempted to explore the pathophysiology of keloid scar formation. A number of predisposing factors have been documented however none existed in this case. A variety of invasive and non invasive approaches have been described but significant differences in success rates and methodology of investigations still precludes a standardized management protocol. Conclusions In this case study a rare presentation of keloid scar has been presented. The variety of methods used to improve pain and aesthetic result demonstrates the propensity of keloid scars to recur and the therapeutic challenges that surgeons have to face in their quest for a satisfactory patient outcome.

  3. Clinical importance of median mandibular flexure in oral rehabilitation: a review.

    Science.gov (United States)

    Sivaraman, K; Chopra, A; Venkatesh, S B

    2016-03-01

    The mandible has a property to flex inwards around the mandibular symphysis with change in shape and decrease in mandibular arch width during opening and protrusion of the mandible. The mandibular deformation may range from a few micrometres to more than 1 mm. The movement occurs because of the contraction of lateral pterygoid muscles that pulls mandibular condyles medially and causes a sagittal movement of the posterior segments. This movement of mandible can have a profound influence on prognosis and treatment outcome for various restorative, endodontics, fixed, removable and implant-related prosthesis. The review unfolds the causes, importance and clinical implications of median mandibular flexure in oral rehabilitation. This review also highlights the appropriate preventive measures and techniques that should be adopted by clinicians to minimise the effect of flexural movement of the jaw during oral rehabilitation. This would not only help clinicians to achieve a good prosthesis with accurate fit and longevity but also maintain the health of the surrounding periodontal or periimplant gingival tissues and bone. © 2015 John Wiley & Sons Ltd.

  4. Filtering with the Centered Moving Median to Effectively Monitor Solution Processes for Safeguard Purposes

    Energy Technology Data Exchange (ETDEWEB)

    Richir, Patrice; Dzbikowicz, Zdzislaw [Institute for Transuranium Elements (ITU), Joint Research Centre (JRC), European Commission, Ispra, Varese (Italy)

    2012-06-15

    Reprocessing plants require continuous and integrated safeguards activities by inspectors of the IAEA and Euratom because of their proliferation-sensitivity as complex facilities handling large quantities of direct use nuclear material. In support of both organizations, the JRC has developed a solution monitoring software package (DAI, Data Analysis and Interpretation) which has been implemented in the main commercial European reprocessing plants and which allows enhanced monitoring of nuclear materials in the processed solutions. This tool treats data acquired from different sensor types (e.g. from pressure transducers monitoring the solution levels in tanks). Collected signals are often noisy because of the instrumentation itself and/or because of ambient and operational conditions (e.g. pumps, ventilation systems or electromagnetic interferences) and therefore require filtering. Filtering means reduction of information and has to be applied correctly to avoid misinterpretation of the process steps. This paper describes the study of some filters one of which is the centered moving median which has been revealed as a powerful tool for solution monitoring.

  5. Accelerated median root prior reconstruction for pinhole single-photon emission tomography (SPET)

    Energy Technology Data Exchange (ETDEWEB)

    Sohlberg, Antti [Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 1777 FIN-70211, Kuopio (Finland); Ruotsalainen, Ulla [Institute of Signal Processing, DMI, Tampere University of Technology, PO Box 553 FIN-33101, Tampere (Finland); Watabe, Hiroshi [National Cardiovascular Center Research Institute, 5-7-1 Fujisihro-dai, Suita City, Osaka 565-8565 (Japan); Iida, Hidehiro [National Cardiovascular Center Research Institute, 5-7-1 Fujisihro-dai, Suita City, Osaka 565-8565 (Japan); Kuikka, Jyrki T [Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 1777 FIN-70211, Kuopio (Finland)

    2003-07-07

    Pinhole collimation can be used to improve spatial resolution in SPET. However, the resolution improvement is achieved at the cost of reduced sensitivity, which leads to projection images with poor statistics. Images reconstructed from these projections using the maximum likelihood expectation maximization (ML-EM) algorithms, which have been used to reduce the artefacts generated by the filtered backprojection (FBP) based reconstruction, suffer from noise/bias trade-off: noise contaminates the images at high iteration numbers, whereas early abortion of the algorithm produces images that are excessively smooth and biased towards the initial estimate of the algorithm. To limit the noise accumulation we propose the use of the pinhole median root prior (PH-MRP) reconstruction algorithm. MRP is a Bayesian reconstruction method that has already been used in PET imaging and shown to possess good noise reduction and edge preservation properties. In this study the PH-MRP algorithm was accelerated with the ordered subsets (OS) procedure and compared to the FBP, OS-EM and conventional Bayesian reconstruction methods in terms of noise reduction, quantitative accuracy, edge preservation and visual quality. The results showed that the accelerated PH-MRP algorithm was very robust. It provided visually pleasing images with lower noise level than the FBP or OS-EM and with smaller bias and sharper edges than the conventional Bayesian methods.

  6. Low Median Nerve Palsy as Initial Manifestation of Churg-Strauss Syndrome.

    Science.gov (United States)

    Roh, Young Hak; Koh, Young Do; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

    2017-06-01

    Anterior interosseous nerve (AIN) syndrome is typically characterized by forearm pain and partial or complete dysfunction of the AIN-innervated muscles. Although the exact etiology and pathophysiology of the disorder remain unclear, AIN syndrome is increasingly thought to be an inflammatory condition of the nerve rather than a compressive neuropathy because the symptoms often resolve spontaneously following prolonged observation. However, peripheral neuropathy can be 1 of the first symptoms of systemic vasculitis that needs early systemic immunotherapy to prevent extensive nerve damage. Churg-Strauss syndrome (CSS; eosinophilic granulomatosis with polyangiitis) is 1 type of primary systemic vasculitis that frequently damages the peripheral nervous system. CSS-associated neuropathy usually involves nerves of the lower limb, and few studies have reported on the involvement of the upper limb alone. We report on a rare case of low median nerve palsy as the initial manifestation of CSS. The patient recovered well with early steroid treatment for primary systemic vasculitis. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Anatomy of the palmar cutaneous branch of the median nerve: clinical significance.

    Science.gov (United States)

    DaSilva, M F; Moore, D C; Weiss, A P; Akelman, E; Sikirica, M

    1996-07-01

    A detailed anatomic, histologic, and immunohistochemical study of the palmar cutaneous branch of the median nerve (PCBMN) and its distal arborization was undertaken on 12 fresh human cadaveric hands. Small unmyelinated fibers terminated in the superficial loose connective tissue of the transverse carpal ligament. There were no nerve fibers detected in the deep, dense collagen aspect of the ligament. Based on these findings, during open carpal tunnel release, the skin incision should be placed along the axis of the ring finger to avoid injury to the superficial branches of the PCBMN. When open release is used, the very small terminal branches in the loose tissue of the ligament will be transected; this may in part be responsible for postoperative soft tissue pain. For endoscopic releases, some risk for transection of the main trunk of the PCBMN at the proximal incision exists. Repeated passes of the endoscopic knife should be avoided in an attempt to limit damage to the small fibers in the superficial aspect of the ligament.

  8. Pediatric Chronic Abdominal Pain and Median Arcuate Ligament Syndrome: A Review and Psychosocial Comparison.

    Science.gov (United States)

    Mak, Grace Zee; Lucchetti, Amanda R; Drossos, Tina; Fitzsimmons-Craft, Ellen E; Accurso, Erin C; Stiles-Shields, Colleen; Newman, Erika A; Skelly, Christopher L

    2016-07-01

    Chronic abdominal pain (CAP) occurs in children and adolescents with a reported prevalence of 4% to 41% with significant direct and indirect costs to the child, family, and society. Median arcuate ligament syndrome (MALS) is a vascular compression syndrome of the celiac artery that may cause symptoms of epigastric pain and weight loss and is a frequently overlooked cause of CAP in the pediatric population. We have observed that the psychosocial presentation of patients with MALS is notable for various psychiatric comorbidities. In this article, we review MALS as well as our study results of the psychosocial profile of 30 MALS patients. Our data suggest that children and adolescents with MALS have similar psychosocial profiles to children with other gastrointestinal disorders resulting in CAP. The overlap of physical and psychosocial symptoms of patients who have MALS with other CAP disorders leads us to recommend that patients with CAP should be evaluated for MALS. [Pediatr Ann. 2016;45(7):e257-e264.]. Copyright 2016, SLACK Incorporated.

  9. A center-median filtering method for detection of temporal variation in coronal images

    Directory of Open Access Journals (Sweden)

    Plowman Joseph

    2016-01-01

    Full Text Available Events in the solar corona are often widely separated in their timescales, which can allow them to be identified when they would otherwise be confused with emission from other sources in the corona. Methods for cleanly separating such events based on their timescales are thus desirable for research in the field. This paper develops a technique for identifying time-varying signals in solar coronal image sequences which is based on a per-pixel running median filter and an understanding of photon-counting statistics. Example applications to “EIT waves” (named after EIT, the EUV Imaging Telescope on the Solar and Heliospheric Observatory and small-scale dynamics are shown, both using 193 Å data from the Atmospheric Imaging Assembly (AIA on the Solar Dynamics Observatory. The technique is found to discriminate EIT waves more cleanly than the running and base difference techniques most commonly used. It is also demonstrated that there is more signal in the data than is commonly appreciated, finding that the waves can be traced to the edge of the AIA field of view when the data are rebinned to increase the signal-to-noise ratio.

  10. Incidence and survival in non-hereditary amyloidosis in Sweden

    Directory of Open Access Journals (Sweden)

    Hemminki Kari

    2012-11-01

    Full Text Available Abstract Background Amyloidosis is a heterogeneous disease caused by deposition of amyloid fibrils in organs and thereby interfering with physiological functions. Hardly any incidence data are available and most survival data are limited to specialist clinics. Methods Amyloidosis patients were identified from the Swedish Hospital Discharge and Outpatients Registers from years 2001 through 2008. Results The incidence of non-hereditary amyloidosis in 949 patients was 8.29 per million person-years and the diagnostic age with the highest incidence was over 65 years. Secondary systemic amyloidosis showed an incidence of 1 per million and a female excess and the largest number of subsequent rheumatoid arthritis deaths; the median survival was 4 years. However, as rheumatoid arthritis deaths also occurred in other diagnostic subtypes, the incidence of secondary systemic amyloidosis was likely to be about 2.0 per million. The median survival of patients with organ-limited amyloidosis was 6 years. Most myeloma deaths occurred in patients diagnosed with unspecified or ‘other’ amyloidosis. These subtypes probably accounted for most of immunoglobulin light chain (AL amyloidosis cases; the median survival time was 3 years. Conclusions The present diagnostic categorization cannot single out AL amyloidosis in the Swedish discharge data but, by extrapolation from myeloma cases, an incidence of 3.2 per million could be ascribed to AL amyloidosis. Similarly, based on rheumatoid arthritis death rates, an incidence of 2.0 could be ascribed to secondary systemic amyloidosis.

  11. Starvation-Survival in Haloarchaea.

    Science.gov (United States)

    Winters, Yaicha D; Lowenstein, Tim K; Timofeeff, Michael N

    2015-11-12

    experienced size reductions and shape transitions from rods to cocci. In the short-term, these trends more closely resembled the response of these organisms to starvation conditions than to nutrient-rich media. Results from this experiment reproduced the physical state of cells (small cocci) in ancient halite where prokaryotes co-exist with single-celled algae. We conclude that glycerol is not the limiting factor in the survival of haloarchaea for thousands of years in fluid inclusions in halite.

  12. Starvation-Survival in Haloarchaea

    Directory of Open Access Journals (Sweden)

    Yaicha D. Winters

    2015-11-01

    and DV582A-1 experienced size reductions and shape transitions from rods to cocci. In the short-term, these trends more closely resembled the response of these organisms to starvation conditions than to nutrient-rich media. Results from this experiment reproduced the physical state of cells (small cocci in ancient halite where prokaryotes co-exist with single-celled algae. We conclude that glycerol is not the limiting factor in the survival of haloarchaea for thousands of years in fluid inclusions in halite.

  13. Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer.

    Science.gov (United States)

    Prasongsook, Naiyarat; Kumar, Aditi; Chintakuntlawar, Ashish V; Foote, Robert L; Kasperbauer, Jan; Molina, Julian; Garces, Yolanda; Ma, Daniel; Wittich, Michelle A Neben; Rubin, Joseph; Richardson, Ronald; Morris, John; Hay, Ian; Fatourechi, Vahab; McIver, Bryan; Ryder, Mabel; Thompson, Geoffrey; Grant, Clive; Richards, Melanie; Sebo, Thomas J; Rivera, Michael; Suman, Vera; Jenkins, Sarah M; Smallridge, Robert C; Bible, Keith C

    2017-12-01

    Historical outcomes in anaplastic thyroid cancer (ATC) have been dismal. To determine whether an initial intensive multimodal therapy (MMT) is associated with improved ATC survival. MMT was offered to all patients with newly diagnosed ATC treated at the Mayo Clinic from 2003 through 2015; MMT vs care with palliative intent (PI) was individualized considering clinical status and patient preferences. Outcomes were retrospectively analyzed by American Joint Committee on Cancer stage and treatments compared with patient cohort data from 1949 through 1999. Forty-eight patients (60% male; median age, 62 years); 18 treated with PI, 30 with MMT. Overall survival (OS) and progression-free survival determined by Kaplan-Meier method. Median OS and 1-year survival for the later cohort were 9 months [95% confidence interval (CI), 4 to 22 months] and 42% (95% CI, 28% to 56%) vs 3 months and 10% for the earlier cohort. Median OS was 21 months compared with 3.9 months in the pooled MMT vs PI groups for the later cohort [hazard ratio (HR), 0.32; P = 0.0006]. Among only patients in the later cohort who had stage IVB disease, median OS was 22.4 vs 4 months (HR, 0.12; 95% CI, 0.03 to 0.44; P = 0.0001), with 68% vs 0% alive at 1 year (MMT vs PI). Among patients with stage IVC cancer, OS did not differ by therapy. MMT appears to convey longer survival in ATC among patients with stage IVA/B disease. Copyright © 2017 Endocrine Society

  14. Gender-partitioned patient medians of serum albumin requested by general practitioners for the assessment of analytical stability.

    Science.gov (United States)

    Hansen, Steen Ingemann; Petersen, Per Hyltoft; Lund, Flemming; Fraser, Callum G; Sölétormos, György

    2018-04-25

    Recently, the use of separate gender-partitioned patient medians of serum sodium has revealed potential for monitoring analytical stability within the optimum analytical performance specifications for laboratory medicine. The serum albumin concentration depends on whether a patient is sitting or recumbent during phlebotomy. We therefore investigated only examinations requested by general practitioners (GPs) to provide data from sitting patients. Weekly and monthly patient medians of serum albumin requested by GP for both male and female patients were calculated from the raw data obtained from three analysers in the hospital laboratory on examination of samples from those >18 years. The half-range of medians were applied as an estimate of the maximum bias. Further, the ratios between the two medians were calculated (females/males). The medians for male and female patients were closely related despite considerable variation due to the current analytical variation. This relationship was confirmed by the calculated half-range for the monthly ratio between the genders of 0.44%, which surpasses the optimum analytical performance specification for bias of serum albumin (0.72%). The weekly ratio had a half-range of 1.83%, which surpasses the minimum analytical performance specifications of 2.15%. Monthly gender-partitioned patient medians of serum albumin are useful for monitoring of long-term analytical stability, where the gender medians are two independent estimates of changes in (delta) bias: only results requested by GP are of value in this application to ensure that all patients are sitting during phlebotomy.

  15. Standard (60 Gy) or Short-Course (40 Gy) Irradiation Plus Concomitant and Adjuvant Temozolomide for Elderly Patients With Glioblastoma: A Propensity-Matched Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Minniti, Giuseppe, E-mail: gminniti@ospedalesantandrea.it [Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy); Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli (Italy); Scaringi, Claudia [Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy); Lanzetta, Gaetano [Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli (Italy); Terrenato, Irene [Biostatistic Unit, Regina Elena National Cancer Institute, Rome (Italy); Esposito, Vincenzo; Arcella, Antonella [Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli (Italy); Pace, Andrea [Neurology Unit, Regina Elena National Cancer Institute, Rome (Italy); Giangaspero, Felice [Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Neuromed, Pozzilli (Italy); Bozzao, Alessandro [Neuroradiology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy); Enrici, Riccardo Maurizi [Radiation Oncology Unit, Sant' Andrea Hospital, University Sapienza, Rome (Italy)

    2015-01-01

    Purpose: To evaluate 2 specific radiation schedules, each combined with temozolomide (TMZ), assessing their efficacy and safety in patients aged ≥65 years with newly diagnosed glioblastoma (GBM). Methods and Materials: Patients aged ≥65 years with Karnofsky performance status (KPS) ≥60 who received either standard (60 Gy) or short-course (40 Gy) radiation therapy (RT) with concomitant and adjuvant TMZ between June 2004 and October 2013 were retrospectively analyzed. A propensity score analysis was executed for a balanced comparison of treatment outcomes. Results: A total of 127 patients received standard RT-TMZ, whereas 116 patients underwent short-course RT-TMZ. Median overall survival and progression-free survival times were similar: 12 months and 5.6 months for the standard RT-TMZ group and 12.5 months and 6.7 months for the short-course RT-TMZ group, respectively. Radiation schedule was associated with similar survival outcomes in either unadjusted or adjusted analysis. O{sup 6}-methylguanine-DNA methyltransferase promoter methylation was the most favorable prognostic factor (P=.0001). Standard RT-TMZ therapy was associated with a significant rise in grade 2 and 3 neurologic toxicity (P=.01), lowering of KPS scores during the study (P=.01), and higher posttreatment dosing of corticosteroid (P=.02). Conclusions: In older adults with GBM, survival outcomes of standard and short-course RT-TMZ were similar. An abbreviated course of RT plus TMZ may represent a reasonable therapeutic approach for these patients, without loss of survival benefit and acceptable toxicity.

  16. Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm

    Energy Technology Data Exchange (ETDEWEB)

    Bao, Hongjing; Wang, Shanshan; Wang, Guangbin; Hasan, Mansoor-ul; Yao, Bin; Wu, Chao; Wu, Lebin [Shandong University, Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, Shandong (China); Yang, Li [Fudan University, Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Shanghai (China); Zhang, Xu [Shandong Chest Hospital, Department of Radiology, Jinan, Shandong (China); Chen, Weibo; Chan, Queenie [Philips Healthcare, Shanghai (China); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-06-15

    To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm. Thirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI). In volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P < 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842). DW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging. (orig.)

  17. Bayesian image reconstruction for emission tomography based on median root prior

    International Nuclear Information System (INIS)

    Alenius, S.

    1997-01-01

    The aim of the present study was to investigate a new type of Bayesian one-step late reconstruction method which utilizes a median root prior (MRP). The method favours images which have locally monotonous radioactivity concentrations. The new reconstruction algorithm was applied to ideal simulated data, phantom data and some patient examinations with PET. The same projection data were reconstructed with filtered back-projection (FBP) and maximum likelihood-expectation maximization (ML-EM) methods for comparison. The MRP method provided good-quality images with a similar resolution to the FBP method with a ramp filter, and at the same time the noise properties were as good as with Hann-filtered FBP images. The typical artefacts seen in FBP reconstructed images outside of the object were completely removed, as was the grainy noise inside the object. Quantitativley, the resulting average regional radioactivity concentrations in a large region of interest in images produced by the MRP method corresponded to the FBP and ML-EM results but at the pixel by pixel level the MRP method proved to be the most accurate of the tested methods. In contrast to other iterative reconstruction methods, e.g. ML-EM, the MRP method was not sensitive to the number of iterations nor to the adjustment of reconstruction parameters. Only the Bayesian parameter β had to be set. The proposed MRP method is much more simple to calculate than the methods described previously, both with regard to the parameter settings and in terms of general use. The new MRP reconstruction method was shown to produce high-quality quantitative emission images with only one parameter setting in addition to the number of iterations. (orig.)

  18. Serial recording of median nerve stimulated subcortical somatosensory evoked potentials (SEPs) in developing brain death.

    Science.gov (United States)

    Buchner, H; Ferbert, A; Hacke, W

    1988-01-01

    Subcortical somatosensory evoked potentials (SEPs) to median nerve stimulation were recorded serially in 35 patients during the evolution towards brain death and in brain death. Neuropathological alterations of the central nervous system down to the C1/C2 spinal cord segment in brain death are well known. SEP components supposed to be generated above this level should be lost in brain death, while components generated below should not be altered. Erb's point, scalp and neck potentials were recorded at C3/4, or over the spinous process C7, using an Fz reference. In 10 patients additional montages, including spinous process C2-Fz, a non-cephalic reference (Fz-contralateral shoulder) and a posterior to anterior neck montage (spinous process C7-jugulum) were used. The cephalic referenced N9 and N11 peaks remained unchanged until brain death. N9 and N11 decreased in parallel in amplitude and increased in latency after systemic effects like hypoxia or hypothermia occurred. The cephalic referenced 'N14' decreased in amplitude and increased in latency after the clinical brain death syndrome was observed, while N13 in the posterior to anterior neck montage remained unchanged. The alteration of 'N14' went parallel to the decrease of the P14 amplitude. The subcortical SEPs in the cephalic referenced lead are supposed to be a peak composed by a horizontally orientated dorsal horn generated N13 and a rostrally orientated P14 arising at the level of the foramen magnum. The deterioration of the non-cephalic referenced P14 and of its cephalic referenced reflection 'N14' seems to provide an additional objective criterion for the diagnosis of brain death.

  19. Adaptive partial median filter for early CT signs of acute cerebral infarction

    International Nuclear Information System (INIS)

    Lee, Yongbum; Tsai, Du-Yih; Takahashi, Noriyuki; Ishii, Kiyoshi

    2007-01-01

    Purpose: Detection of early CT signs of infarct in non- enhanced CT image is mandatory in patients with acute ischemic stroke. Loss of the gray-white matter interface at the lentiform nucleus or the insular ribbon has been an important early CT sign of acute cerebral infarction, which affects decisions on thrombolytic therapy. However, its detection is difficult, since the principal early CT sign is subtle hypoattenuation. An image processing method to reduce local noise with edges preserved was developed to improve infarct detection. Rationale: An adaptive partial median filter (APMF) was selected for this application, since the APMF can markedly improve the visibility of the normal gray-white matter interface. APMF should enhance the conspicuity of gray-white matter interface changes due to hypoattenuation that accompanies cerebral infarction. Method: In a criterion referenced performance study using simulated CT images with gray-white matter interfaces, a total of 14 conventional smoothing filters were also used for comparison to validate the usefulness of the proposed APMF. The APMF indicated the highest performance among the compared methods. Then, observer performance study by receiver operator characteristic (ROC) analysis was performed with 4 radiologist observers using a database with 18 abnormal and 33 normal head CT images. The average A z values of ROC curves for all radiologists increased from 0.876 without the APMF images to 0.926 with the APMF images, and this difference was statistically significant (P = 0.04). The results from the two observer performance studies demonstrated that APMF has significant potential to improve the diagnosis of acute cerebral infarction using non-enhanced CT images. (orig.)

  20. Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm

    International Nuclear Information System (INIS)

    Bao, Hongjing; Wang, Shanshan; Wang, Guangbin; Hasan, Mansoor-ul; Yao, Bin; Wu, Chao; Wu, Lebin; Yang, Li; Zhang, Xu; Chen, Weibo; Chan, Queenie; Chhabra, Avneesh

    2017-01-01

    To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm. Thirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI). In volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P < 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842). DW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging. (orig.)

  1. Variations in survival after cardiac arrest among academic medical center-affiliated hospitals.

    Directory of Open Access Journals (Sweden)

    Michael Christopher Kurz

    Full Text Available Variation exists in cardiac arrest (CA survival among institutions. We sought to determine institutional-level characteristics of academic medical centers (AMCs associated with CA survival.We examined discharge data from AMCs participating with Vizient clinical database-resource manager. We identified cases using ICD-9 diagnosis code 427.5 (CA or procedure code 99.60 (CPR. We estimated hospital-specific risk-standardized survival rates (RSSRs using mixed effects logistic regression, adjusting for individual mortality risk. Institutional and community characteristics of AMCs with higher than average survival were compared with those with lower survival.We analyzed data on 3,686,296 discharges in 2012, of which 33,700 (0.91% included a CA diagnosis. Overall survival was 42.3% (95% CI 41.8-42.9 with median institutional RSSR of 42.6% (IQR 35.7-51.0; Min-Max 19.4-101.6. We identified 28 AMCs with above average survival (median RSSR 61.8% and 20 AMCs with below average survival (median RSSR 26.8%. Compared to AMCs with below average survival, those with high CA survival had higher CA volume (median 262 vs.119 discharges, p = 0.002, total beds (722 vs. 452, p = 0.02, and annual surgical volume (24,939 vs. 13,109, p<0.001, more likely to offer cardiac catheterization (100% vs. 72%, p = 0.007 or cardiac surgery (93% vs. 61%, p = 0.02 and cared for catchment areas with higher household income ($61,922 vs. $49,104, p = 0.004 and lower poverty rates (14.6% vs. 17.3%, p = 0.03.Using discharge data from Vizient, we showed AMCs with higher CA and surgical case volume, cardiac catheterization and cardiac surgery facilities, and catchment areas with higher socioeconomic status had higher risk-standardized CA survival.

  2. Zoledronic acid enhances the effect of radiotherapy for bone metastases from renal cell carcinomas. More than a 24-month median follow-up

    International Nuclear Information System (INIS)

    Takeda, Naoki; Isu, Kazuo; Hiraga, Hiroaki; Shinohara, Nobuo; Minami, Akio; Kamata, Hajime

    2012-01-01

    Renal cell carcinoma (RCC) is thought to respond unreliably to radiotherapy (RT). Zoledronic acid significantly reduces the risk of skeletal complications. This study investigated whether RT with zoledronic acid prolonged the time to bone-lesion progression in comparison with RT alone. Twenty-seven patients (34 lesions) with bone metastases secondary to RCC undergoing treatment with RT with or without zoledronic acid were retrospectively evaluated at two institutions between 1999 and 2009. Twelve patients were treated with RT alone from 1999 to 2008 (RT group). Fifteen patients were treated with RT and zoledronic acid from 2006 to 2009 (RT+Z group). The time to skeletal-related events and pain progression were assessed from patients' medical records. The median (range) follow-up was 26 (3-75) and 24 (3-55) months in the RT and RT+Z groups, respectively. Three patients (three lesions) in the RT+Z group had skeletal-related events (SREs). In contrast, six patients (eight lesions) in the RT group had SREs. SREs comprised pathological fractures in five, additional surgeries in three, spinal cord or cauda equine compression in two, and repeat RT in one. There was a significant difference in SRE-free survival time and duration of site-specific pain response between groups. RT combined with zoledronic acid significantly prolonged SRE-free survival and duration of pain response compared with RT alone in the treatment of osseous metastases from RCC. (author)

  3. Prognostic Factors for Survival in Patients with Gastric Cancer using a Random Survival Forest

    Science.gov (United States)

    Adham, Davoud; Abbasgholizadeh, Nategh; Abazari, Malek

    2017-01-01

    Background: Gastric cancer is the fifth most common cancer and the third top cause of cancer related death with about 1 million new cases and 700,000 deaths in 2012. The aim of this investigation was to identify important factors for outcome using a random survival forest (RSF) approach. Materials and Methods: Data were collected from 128 gastric cancer patients through a historical cohort study in Hamedan-Iran from 2007 to 2013. The event under consideration was death due to gastric cancer. The random survival forest model in R software was applied to determine the key factors affecting survival. Four split criteria were used to determine importance of the variables in the model including log-rank, conversation?? of events, log-rank score, and randomization. Efficiency of the model was confirmed in terms of Harrell’s concordance index. Results: The mean age of diagnosis was 63 ±12.57 and mean and median survival times were 15.2 (95%CI: 13.3, 17.0) and 12.3 (95%CI: 11.0, 13.4) months, respectively. The one-year, two-year, and three-year rates for survival were 51%, 13%, and 5%, respectively. Each RSF approach showed a slightly different ranking order. Very important covariates in nearly all the 4 RSF approaches were metastatic status, age at diagnosis and tumor size. The performance of each RSF approach was in the range of 0.29-0.32 and the best error rate was obtained by the log-rank splitting rule; second, third, and fourth ranks were log-rank score, conservation of events, and the random splitting rule, respectively. Conclusion: Low survival rate of gastric cancer patients is an indication of absence of a screening program for early diagnosis of the disease. Timely diagnosis in early phases increases survival and decreases mortality. Creative Commons Attribution License

  4. Heterogeneity in Short Gamma-Ray Bursts

    Science.gov (United States)

    Norris, Jay P.; Gehrels Neil; Scargle, Jeffrey D.

    2011-01-01

    We analyze the Swift/BAT sample of short gamma-ray bursts, using an objective Bayesian Block procedure to extract temporal descriptors of the bursts' initial pulse complexes (IPCs). The sample comprises 12 and 41 bursts with and without extended emission (EE) components, respectively. IPCs of non-EE bursts are dominated by single pulse structures, while EE bursts tend to have two or more pulse structures. The medians of characteristic timescales - durations, pulse structure widths, and peak intervals - for EE bursts are factors of approx 2-3 longer than for non-EE bursts. A trend previously reported by Hakkila and colleagues unifying long and short bursts - the anti-correlation of pulse intensity and width - continues in the two short burst groups, with non-EE bursts extending to more intense, narrower pulses. In addition we find that preceding and succeeding pulse intensities are anti-correlated with pulse interval. We also examine the short burst X-ray afterglows as observed by the Swift/XRT. The median flux of the initial XRT detections for EE bursts (approx 6 X 10(exp -10) erg / sq cm/ s) is approx > 20 x brighter than for non-EE bursts, and the median X-ray afterglow duration for EE bursts (approx 60,000 s) is approx 30 x longer than for non-EE bursts. The tendency for EE bursts toward longer prompt-emission timescales and higher initial X-ray afterglow fluxes implies larger energy injections powering the afterglows. The longer-lasting X-ray afterglows of EE bursts may suggest that a significant fraction explode into more dense environments than non-EE bursts, or that the sometimes-dominant EE component efficiently p()wers the afterglow. Combined, these results favor different progenitors for EE and non-EE short bursts.

  5. HETEROGENEITY IN SHORT GAMMA-RAY BURSTS

    International Nuclear Information System (INIS)

    Norris, Jay P.; Gehrels, Neil; Scargle, Jeffrey D.

    2011-01-01

    We analyze the Swift/BAT sample of short gamma-ray bursts, using an objective Bayesian Block procedure to extract temporal descriptors of the bursts' initial pulse complexes (IPCs). The sample is comprised of 12 and 41 bursts with and without extended emission (EE) components, respectively. IPCs of non-EE bursts are dominated by single pulse structures, while EE bursts tend to have two or more pulse structures. The medians of characteristic timescales-durations, pulse structure widths, and peak intervals-for EE bursts are factors of ∼2-3 longer than for non-EE bursts. A trend previously reported by Hakkila and colleagues unifying long and short bursts-the anti-correlation of pulse intensity and width-continues in the two short burst groups, with non-EE bursts extending to more intense, narrower pulses. In addition, we find that preceding and succeeding pulse intensities are anti-correlated with pulse interval. We also examine the short burst X-ray afterglows as observed by the Swift/X-Ray Telescope (XRT). The median flux of the initial XRT detections for EE bursts (∼6x10 -10 erg cm -2 s -1 ) is ∼>20x brighter than for non-EE bursts, and the median X-ray afterglow duration for EE bursts (∼60,000 s) is ∼30x longer than for non-EE bursts. The tendency for EE bursts toward longer prompt-emission timescales and higher initial X-ray afterglow fluxes implies larger energy injections powering the afterglows. The longer-lasting X-ray afterglows of EE bursts may suggest that a significant fraction explode into denser environments than non-EE bursts, or that the sometimes-dominant EE component efficiently powers the afterglow. Combined, these results favor different progenitors for EE and non-EE short bursts.

  6. Platelet-rich plasma limits the nerve injury caused by 10% dextrose in the rabbit median nerve.

    Science.gov (United States)

    Park, Gi-Young; Kwon, Dong Rak

    2014-01-01

    We evaluated the effect of platelet-rich plasma (PRP) injection in a rabbit model of dextrose-induced median nerve injury. New Zealand white rabbits (n = 15) were divided randomly into 3 groups. Three different regimens (group 1: 0.1 ml saline; group 2: 10% dextrose with PRP; group 3: 10% dextrose with saline) were injected within the carpal tunnel. Electrophysiological and histological findings were evaluated 12 weeks after the injection. The mean median motor latency in group 3 was significantly longer than that in groups 1 and 2. The cross-sectional area of the median nerve and subsynovial connective tissue thickness in group 3 were significantly larger than those in groups 1 and 2. PRP injection may be effective in controlling median nerve injury, as demonstrated by improvement in electrophysiological and histological findings 12 weeks after dextrose injection. Copyright © 2013 Wiley Periodicals, Inc.

  7. Manual therapy intervention in the treatment of patients with carpal tunnel syndrome: median nerve mobilization versus medical treatment

    Directory of Open Access Journals (Sweden)

    Faten I Mohamed

    2016-01-01

    Conclusion CTS improves after median nerve mobilization, which is better than conventional medical treatment. It provides support for the use of manual therapy in conservative management of CTS with satisfactory Results .

  8. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

    Directory of Open Access Journals (Sweden)

    Hafize Yaliniz

    2015-10-01

    Conclusion: Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.

  9. Craniotomy and Survival for Primary Central Nervous System Lymphoma.

    Science.gov (United States)

    Rae, Ali I; Mehta, Amol; Cloney, Michael; Kinslow, Connor J; Wang, Tony J C; Bhagat, Govind; Canoll, Peter D; Zanazzi, George J; Sisti, Michael B; Sheth, Sameer A; Connolly, E Sander; McKhann, Guy M; Bruce, Jeffrey N; Iwamoto, Fabio M; Sonabend, Adam M

    2018-04-04

    Cytoreductive surgery is considered controversial for primary central nervous system lymphoma (PCNSL). To investigate survival following craniotomy or biopsy for PCNSL. The National Cancer Database-Participant User File (NCDB, n = 8936), Surveillance, Epidemiology, and End Results Program (SEER, n = 4636), and an institutional series (IS, n = 132) were used. We retrospectively investigated the relationship between craniotomy, prognostic factors, and survival for PCNSL using case-control design.  In NCDB, craniotomy was associated with increased median survival over biopsy (19.5 vs 11.0 mo), independent of subsequent radiation and chemotherapy (hazard ratio [HR] 0.80, P < .001). We found a similar trend with survival for craniotomy vs biopsy in the IS (HR 0.68, P = .15). In SEER, gross total resection was associated with increased median survival over biopsy (29 vs 10 mo, HR 0.68, P < .001). The survival benefit associated with craniotomy was greater within recursive partitioning analysis (RPA) class 1 group in NCDB (95.1 vs 29.1 mo, HR 0.66, P < .001), but was smaller for RPA 2-3 (14.9 vs 10.0 mo, HR 0.86, P < .001). A surgical risk category (RC) considering lesion location and number, age, and frailty was developed. Craniotomy was associated with increased survival vs biopsy for patients with low RC (133.4 vs 41.0 mo, HR 0.33, P = .01), but not high RC in the IS. Craniotomy is associated with increased survival over biopsy for PCNSL in 3 retrospective datasets. Prospective studies are necessary to adequately evaluate this relationship. Such studies should evaluate patients most likely to benefit from cytoreductive surgery, ie, those with favorable RPA and RC.

  10. Heterogeneous chloride homeostasis and GABA responses in the median preoptic nucleus of the rat

    Science.gov (United States)

    Grob, Magali; Mouginot, Didier

    2005-01-01

    The median preoptic nucleus (MnPO) is an integrative structure of the hypothalamus receiving periphery-derived information pertinent to hydromineral and cardiovascular homeostasis. In this context, excitability of MnPO neurones is controlled by fast GABAergic, glutamatergic and angiotensinergic projection from the subfornical organ (SFO). Taking advantage of a brain slice preparation preserving synaptic connection between the SFO and the MnPO, and appropriate bicarbonate-free artificial cerebrospinal fluid (CSF), we investigated a possible implication of an active outward Cl− transport in regulating efficacy of the GABAA receptor-mediated inhibitory response at the SFO–MnPO synapse. When somata of the MnPO neurones was loaded with 18 mm chloride, stimulation of the SFO evoked outward inhibitory postsynaptic currents (IPSCs) in 81% of the MnPO neurones held at −60 mV. Accordingly, EIPSC was found 25 mV hyperpolarized from the theoretical value calculated from the Nernst equation, indicating that IPSC polarity and amplitude were driven by an active Cl− extrusion system in these neurones. EIPSC estimated with gramicidin-based perforated-patch recordings amounted −89.2 ± 4.3 mV. Furosemide (100 μm), a pharmacological compound known to block the activity of the neurone-specific K+–Cl− cotransporter, KCC2, reversed IPSC polarity and shifted EIPSC towards its theoretical value. Presence of the KCC2 protein in the MnPO was further detected with immunohistochemistry, revealing a dense network of KCC2-positive intermingled fibres. In the presence of a GABAB receptor antagonist, high-frequency stimulation (5 Hz) of the SFO evoked a train of IPSCs or inhibitory postsynaptic potentials (IPSPs), whose amplitude was maintained throughout the sustained stimulation. Contrastingly, similar 5 Hz stimulation carried out in the presence of furosemide (50 μm) evoked IPSCs/IPSPs, whose amplitude collapsed during the high-frequency stimulation. Similar reduction in

  11. Distinct Contributions of Median Raphe Nucleus to Contextual Fear Conditioning and Fear-Potentiated Startle

    Science.gov (United States)

    Silva, R. C. B.; Cruz, A. P. M.; Avanzi, V.; Landeira-Fernandez, J.; Brandão, M. L.

    2002-01-01

    Ascending 5-HT projections from the median raphe nucleus (MRN), probably to the hippocampus, are implicated in the acquisition of contextual fear (background stimuli), as assessed by freezing behavior. Foreground cues like light, used as a conditioned stimulus (CS) in classical fear conditioning, also cause freezing through thalamic transmission to the amygdala. As the MRN projects to the hippocampus and amygdala, the role of this raphe nucleus in fear conditioning to explicit cues remains to be explained. Here we analyzed the behavior of rats with MRN electrolytic lesions in a contextual conditioning situation and in a fear-potentiated startle procedure. The animals received MRN electrolytic lesions either before or on the day after two consecutive training sessions in which they were submitted to 10 conditioning trials, each in an experimental chamber (same context) where they. received foot-shocks (0.6 mA, 1 sec) paired to a 4-sec light CS. Seven to ten days later, the animals were submitted to testing sessions for assessing conditioned fear when they were placed for five shocks, and the duration of contextual freezing was recorded. The animals were then submitted to a fear-potentiated startle in response to a 4-sec light-CS, followed by white noise (100 dB, 50 ms). Control rats (sham) tested in the same context showed more freezing than did rats with pre- or post-training MRN lesions. Startle was clearly potentiated in the presence of light CS in the sham-lesioned animals. Whereas pretraining lesions reduced both freezing and fear-potentiated startle, the post-training lesions reduced only freezing to context, without changing the fear-potentiated startle. In a second experiment, neurotoxic lesions of the MRN with local injections of N-methyl-D-aspartate or the activation of 5-HT1A somatodendritic auto-receptors of the MRN by microinjections of the 5-HT1A receptor agonist 8-hydroxy- 2-(di-n-propylamino)tetralin (8-OH-DPAT) before the training sessions also

  12. Isotopic ages of rocks along the Median Tectonic Line in the Yoshino area, Nara Prefecture

    International Nuclear Information System (INIS)

    Shibata, Ken; Sugiyama, Yuichi; Uchiumi, Shigeru; Takagi, Hideo.

    1988-01-01

    K-Ar, Rb-Sr and fission-track age determinations were carried out on rocks along the Median Tectonic Line (MTL) in the Yoshino area, Nara Prefecture. K-Ar ages on th Ryoke granitic rocks range from 35.3 to 75.9 Ma. Within about 1000 m of MTL the ages decrease toward MTL, probably caused by the hydrothermal alteration associated with cataclasis. The Takamiyama acidic rocks give a K-Ar age of 12.8 Ma. The cooling rate of the granitic rocks, calculated from K-Ar ages and closure temperatures of minerals, is 23 - 27degC/Ma. K-Ar ages for muscovites from pelitic schists in the Sambagawa belt are 62.3 - 69.4 Ma, whereas K-Ar whole-rock ages for phyllites in the Shimanto belt are 57.1 - 76.7 Ma; decrease in age is not observed even near MTL. Rb-Sr ages for muscovites from the schists are 70.4 and 72.5 Ma, which are assumed to indicate the time of metamorphism. The phyllites give a Rb-Sr whole-rock isochron age of 77.1±6.1 Ma, which is interpreted to represent the time of diagenesis or weak metamorphism. Fission-track ages for zircons from the Ryoke granitic rocks range from 37.0 to 68.2 Ma and decrease toward MTL. Fission-track ages of zircon are generally close to K-Ar ages of K-feldspar for the same rocks. From this fact the closure temperature for zircon is estimated to be lower than 200degC. The fine fractions (<2μm) separated from MTL fault gouges at Michaya and Takamiyama give K-Ar ages of 36.7 and 18.3 Ma, respectively. These ages probably represent the time of hydrothermal alteration following the major fault movement of MTL associated with cataclasis. (author)

  13. Scissoring Fault Rupture Properties along the Median Tectonic Line Fault Zone, Southwest Japan

    Science.gov (United States)

    Ikeda, M.; Nishizaka, N.; Onishi, K.; Sakamoto, J.; Takahashi, K.

    2017-12-01

    The Median Tectonic Line fault zone (hereinafter MTLFZ) is the longest and most active fault zone in Japan. The MTLFZ is a 400-km-long trench parallel right-lateral strike-slip fault accommodating lateral slip components of the Philippine Sea plate oblique subduction beneath the Eurasian plate [Fitch, 1972; Yeats, 1996]. Complex fault geometry evolves along the MTLFZ. The geomorphic and geological characteristics show a remarkable change through the MTLFZ. Extensional step-overs and pull-apart basins and a pop-up structure develop in western and eastern parts of the MTLFZ, respectively. It is like a "scissoring fault properties". We can point out two main factors to form scissoring fault properties along the MTLFZ. One is a regional stress condition, and another is a preexisting fault. The direction of σ1 anticlockwise rotate from N170°E [Famin et al., 2014] in the eastern Shikoku to Kinki areas and N100°E [Research Group for Crustral Stress in Western Japan, 1980] in central Shikoku to N85°E [Onishi et al., 2016] in western Shikoku. According to the rotation of principal stress directions, the western and eastern parts of the MTLFZ are to be a transtension and compression regime, respectively. The MTLFZ formed as a terrain boundary at Cretaceous, and has evolved with a long active history. The fault style has changed variously, such as left-lateral, thrust, normal and right-lateral. Under the structural condition of a preexisting fault being, the rupture does not completely conform to Anderson's theory for a newly formed fault, as the theory would require either purely dip-slip motion on the 45° dipping fault or strike-slip motion on a vertical fault. The fault rupture of the 2013 Barochistan earthquake in Pakistan is a rare example of large strike-slip reactivation on a relatively low angle dipping fault (thrust fault), though many strike-slip faults have vertical plane generally [Avouac et al., 2014]. In this presentation, we, firstly, show deep subsurface

  14. Growth and survival of Apache Trout under static and fluctuating temperature regimes

    Science.gov (United States)

    Recsetar, Matthew S.; Bonar, Scott A.; Feuerbacher, Olin

    2014-01-01

    Increasing stream temperatures have important implications for arid-region fishes. Little is known about effects of high water temperatures that fluctuate over extended periods on Apache Trout Oncorhynchus gilae apache, a federally threatened species of southwestern USA streams. We compared survival and growth of juvenile Apache Trout held for 30 d in static temperatures (16, 19, 22, 25, and 28°C) and fluctuating diel temperatures (±3°C from 16, 19, 22 and 25°C midpoints and ±6°C from 19°C and 22°C midpoints). Lethal temperature for 50% (LT50) of the Apache Trout under static temperatures (mean [SD] = 22.8 [0.6]°C) was similar to that of ±3°C diel temperature fluctuations (23.1 [0.1]°C). Mean LT50 for the midpoint of the ±6°C fluctuations could not be calculated because survival in the two treatments (19 ± 6°C and 22 ± 6°C) was not below 50%; however, it probably was also between 22°C and 25°C because the upper limb of a ±6°C fluctuation on a 25°C midpoint is above critical thermal maximum for Apache Trout (28.5–30.4°C). Growth decreased as temperatures approached the LT50. Apache Trout can survive short-term exposure to water temperatures with daily maxima that remain below 25°C and midpoint diel temperatures below 22°C. However, median summer stream temperatures must remain below 19°C for best growth and even lower if daily fluctuations are high (≥12°C).

  15. Surviving After Suicide

    Science.gov (United States)

    ... fewer tools for communicating their feelings. Surviving After Suicide Fact Sheet 3 Children are especially vulnerable to feelings of guilt and ... to take care of them. Secrecy about the suicide in the hopes of protecting children may cause further complications. Explain the situation and ...

  16. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  17. Education for Survival.

    Science.gov (United States)

    Allen, James E., Jr.

    In this address, James E. Allen, Jr., Assistant Secretary for Education and U.S. Commissioner of Education, discusses the relationship of education to the problem of ecological destruction. He states that the solutions to the problems of air, water, and soil pollution may be found in redirected education. This "education for survival" can serve to…

  18. Artists’ Survival Rate

    DEFF Research Database (Denmark)

    Bille, Trine; Jensen, Søren

    2017-01-01

    The literature of cultural economics generally finds that an artistic education has no significant impact on artists’ income and careers in the arts. In our research, we have readdressed this question by looking at the artists’ survival in the arts occupations. The results show that an artistic...... education has a significant impact on artists’ careers in the arts and we find important industry differences....

  19. Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature.

    Science.gov (United States)

    Aragão, José Aderval; da Silva, Ana Caroline Ferreira; Anunciação, Caio Barretto; Reis, Francisco Prado

    2017-01-01

    A persistent median artery is a rare anomaly. It accompanies the median nerve along its course in the forearm and is of variable origin. It is associated with other local anatomical variations and may contribute significantly towards formation of the superficial palmar arch. In embryos, it is responsible mainly for the blood supply to the hand. The objective of this study was to research the frequency, type (forearm or palmar) and origin of the median artery in fetuses, correlating its presence with sex and body side. Red-colored latex was injected into 32 brachial arteries of human fetuses until its arrival in the hand could be seen. Twenty-four hours after the injection, the median arteries were dissected without the aid of optical instruments. Among the 32 forearms dissected, the median artery was present in 81.25 % (26) of the cases, and it was found more frequently in females and on the left side. Regarding origin, most of the median arteries originated in the common interosseous artery (38.5 %) and anterior interosseous artery (34.6 %). The mean length of the median arteries was 21.1 mm for the palmar type and 19.8 mm for the forearm type. The median artery has a high rate of persistence. It is important to be aware of this anatomical variation, since its presence may give rise to difficulties during routine surgical procedures on the wrist. Its presence may cause serious functional complications in the carpal tunnel, anterior interosseous nerve, round pronator syndromes, and ischemia of the hand.

  20. Akıllı telefon kullanımının median sinir üzerine etkisi

    OpenAIRE

    İlik, Faik; Büyükgöl, Huseyin; Eren, Fatma A.; İlik, Mustafa K.; Kayhan, Fatih; Köse, Hatice

    2018-01-01

    Purpose: The aim of this study was to examine the effects of smartphone use on the median nerve. Materials and Methods: Participants were classified into three groups according to their smartphone use frequencies; high smartphone users (with Smartphone addiction scale (SAS) score of higher than 71), low smartphone users (SAS score less than 71) and classical type mobile phones users. The Visual analogue scale (VAS), quick-disabilities of arm, shoulder, hand (qDASH) and median nerve conduction...

  1. Survival of patients with multiple sclerosis in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Koch-Henriksen, Nils; Hyllested, K

    1994-01-01

    We estimated survival probability and excess death rates for patients with MS on the basis of data from the Danish Multiple Sclerosis Registry, which includes virtually all patients diagnosed with MS in Denmark (population, five million) since 1948. We reviewed and reclassified all case records...... in women (versus 46 years). The median survival time from diagnosis was 22 years in men (versus 37 years) and 28 years in women (versus 42 years). The excess death rate between onset and follow-up (observed deaths per 1,000 person-years minus the expected number of deaths in a matched general population...

  2. Determination of the Median Lethal Dose and Electrophoretic Pattern of Hottentotta saulcyi (Scorpiones, Buthidae Scorpion Venom

    Directory of Open Access Journals (Sweden)

    ErsenAydın Yağmur

    2015-10-01

    Full Text Available Background: In this study, we investigated the lethal potency, electrophoretic protein pattern and in vivo effects of Hottentotta saulcyi scorpion venom in mice.Methods: Scorpions were collected at night, by using a UV lamp from Mardin Province, Turkey. Venom was obtained from mature H. saulcyi scorpions by electrical stimulation of the telson. The lethality of the venom was determined by i.v. injections using Swiss mice. In vivo effects of the venom were assessed by using the intraperitoneal route (ip injections into mice (20±1g and monitored for 24 h. The protein profiles of the scorpion venom were analyzed by NuPAGE® Novex® 4–12 % gradient Bis-Tris gel followed by Coomassie blue staining.Results: The lethal assay of the venom was 0.73 mg/kg in mice. We determined the electrophoretic protein pattern of this scorpion venom to be 4, 6, 9, 31, 35, 40, 46 and 69 kDa by SDS-PAGE. Analysis of electrophoresis indicated that H. saulcyi scorpion intoxicated mice exhibited autonomic nervous system symptoms (tachypnea, restlessness, hyperexcitability, convulsions, salivation, lacrimation, weakness.Conclusions: Hottentotta saulcyi scorpion venom includes short-chain neurotoxins and long-chain neurotoxins according to the electrophoretic protein patterns. The stings of H. saulcyi scorpion must be considered of risk for humans in the southeastern region, Turkey.

  3. Survival chance in papillary thyroid cancer in Hungary: individual survival probability estimation using the Markov method

    International Nuclear Information System (INIS)

    Esik, Olga; Tusnady, Gabor; Daubner, Kornel; Nemeth, Gyoergy; Fuezy, Marton; Szentirmay, Zoltan

    1997-01-01

    Purpose: The typically benign, but occasionally rapidly fatal clinical course of papillary thyroid cancer has raised the need for individual survival probability estimation, to tailor the treatment strategy exclusively to a given patient. Materials and methods: A retrospective study was performed on 400 papillary thyroid cancer patients with a median follow-up time of 7.1 years to establish a clinical database for uni- and multivariate analysis of the prognostic factors related to survival (Kaplan-Meier product limit method and Cox regression). For a more precise prognosis estimation, the effect of the most important clinical events were then investigated on the basis of a Markov renewal model. The basic concept of this approach is that each patient has an individual disease course which (besides the initial clinical categories) is affected by special events, e.g. internal covariates (local/regional/distant relapses). On the supposition that these events and the cause-specific death are influenced by the same biological processes, the parameters of transient survival probability characterizing the speed of the course of the disease for each clinical event and their sequence were determined. The individual survival curves for each patient were calculated by using these parameters and the independent significant clinical variables selected from multivariate studies, summation of which resulted in a mean cause-specific survival function valid for the entire group. On the basis of this Markov model, prediction of the cause-specific survival probability is possible for extrastudy cases, if it is supposed that the clinical events occur within new patients in the same manner and with the similar probability as within the study population. Results: The patient's age, a distant metastasis at presentation, the extent of the surgical intervention, the primary tumor size and extent (pT), the external irradiation dosage and the degree of TSH suppression proved to be

  4. Aplicação do escore MELD em pacientes submetidos a transplante de fígado: análise retrospectiva da sobrevida e dos fatores preditivos a curto e longo prazo The application of MELD score in patients submitted to liver transplantation: a retrospective analysis of survival and the predictive factors in the short and long term

    Directory of Open Access Journals (Sweden)

    Ilka de Fátima Santana Ferreira Boin

    2008-12-01

    (65,16% vs 44,44%. A sobrevida aos 5 e 10 anos também seguiu o mesmo padrão. O uso de doadores limítrofes não alterou a sobrevida, mas quando se utilizou o índice de risco do doador observou-se que a sobrevida foi maior para pacientes com índice de risco do doador menor que 1,7 (63,62% vs 53,70%. A associação deste índice com o escore MELD não mostrou diferença estatística em relação à sobrevida. Observou-se que a falência e disfunção do enxerto foram associadas ao número crescente de critérios expandidos do doador. Os receptores de doadores maiores de 50 anos tiveram menor sobrevida (65,58% vs 38,40% e o escore delta-MELD não discriminou a sobrevida. CONCLUSÃO: A sobrevida dos receptores a curto e longo prazo é associada a escores MELD acima de 25, ao volume de sangue transfundido, à disfunção do enxerto, à hiponatremia, à idade do doador acima de 50 anos e àqueles doadores com índice de risco do doador acima de 1,7.BACKGROUND: The model for end-stage liver disease (MELD was developed to predict short-term mortality in patients with cirrhosis. There are few reports studying the correlation between MELD and long-term posttransplantation survival. AIM: To assess the value of pretransplant MELD in the prediction of posttransplant survival. METHODS: The adult patients (age >18 years who underwent liver transplantation were examined in a retrospective longitudinal cohort of patients, through the prospective data base. We excluded acute liver failure, retransplantation and reduced or split-livers. The liver donors were evaluated according to: age, sex, weight, creatinine, bilirubin, sodium, aspartate aminotransferase, personal antecedents, brain death cause, steatosis, expanded criteria donor number and index donor risk. The recipients' data were: sex, age, weight, chronic hepatic disease, Child-Turcotte-Pugh points, pretransplant and initial MELD score, pretransplant creatinine clearance, sodium, cold and warm ischemia times, hospital length

  5. Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital.

    Science.gov (United States)

    Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

    2017-05-18

    Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814

  6. [Effect of nutritional support on survival in patients with amyotrophic lateral sclerosis].

    Science.gov (United States)

    López Gómez, J J; Ballesteros Pomar, Ma D; Vázquez Sánchez, F; Vidal Casariego, A; Calleja Fernández, A; Cano Rodríguez, I

    2011-01-01

    Malnutrition affects morbidity and mortality of patients with ALS. The nutrition unit should evaluate these patients early and regularly providing the necessary steps in the evolution of the disease. A retrospective cohort study in which we analyzed 46 patients diagnosed with ALS, 21 of them received nutritional therapy. We studied age, mode of onset, date of entry into a nutritional protocol, placement of PEG and survival. We performed a test of Breslow comparing patients who were at nutritional protocol with those not receiving nutritional support, and those who received early nutritional therapy with those with delayed nutrition. There was an increase in median survival for patients in nutritional therapy in bulbar ALS (452 vs 55 days) and in spinal ALS (1,798 vs 357 days) (p = 0.002). The median delay in the initiation of nutritional therapy in spinal ALS was 557 days while in bulbar ALS was 230 days. The survival in the spinal ALS of those who entered into nutritional protocol before the median survival was 325 days to 181 days (p = 0.09) while in bulbar ALS those who entered before had a median survival of 435 days to 177 days (p = 0.38). The entry of patients with ALS in a nutritional protocol increases survival. There is an advantage in the evolution of patients with early nutritional treatment.

  7. A Comparison of Ultrasound and MRI Measurements of the Cross-Sectional Area of the Median Nerve at the Wrist.

    Science.gov (United States)

    Hersh, Beverly; D'Auria, Jennifer; Scott, Michael; Fowler, John R

    2018-05-01

    Ultrasound (US) measurement of cross-sectional area (CSA) of the median nerve has emerged as a viable alternative to electromyography/nerve conduction studies (EMG/NCS) for diagnosis of carpal tunnel syndrome (CTS). The purpose of this study is to compare CSA of the median nerve between US and MRI using current MRI and US technology. The null hypothesis is there is no difference between US and MRI CSA measurements. The study design was an observational cohort, enrolling patients presenting to clinic with MRI of the wrist. Participants with clinical signs and symptoms of CTS were excluded. The CSA measurements of the median nerve on MRI T1-weighted axial images were performed by a hand fellow blinded to results of US measurements, and US measurement of median nerve CSA was performed by a hand fellowship trained surgeon blinded to results of the MRI measurements. Results were analyzed via percent error, Pearson correlation, and t tests. Twenty participants were enrolled with mean age of 29.4 years. Four left wrists and 16 right wrists were measured. The US mean CSA of the median nerve was 6.8 mm 2 (±2.330 mm 2 ). The MRI mean CSA of the median nerve was 6.8 mm 2 (±2.153 mm 2 ), P = .442. Pearson correlation between modalities was 0.93, suggesting near-perfect correlation. Mean percent error was 8.8%. Results of this study suggest that US is an accurate method to measure CSA of the median nerve at the carpal tunnel inlet. The mean difference between US and MRI was unlikely to be clinically significant.

  8. Shortness of Breath

    Science.gov (United States)

    ... filled with air (called pneumotho- rax), it will hinder expansion of the lung, resulting in shortness of ... of Chest Physi- cians. Shortness of Breath: Patient Education. http: / / www. onebreath. org/ document. doc? id= 113. ...

  9. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy (‘SMART’ Trial: a randomised trial

    Directory of Open Access Journals (Sweden)

    Md Ali Katijjahbe

    2018-04-01

    Full Text Available Question: In people who have undergone cardiac surgery via median sternotomy, does modifying usual sternal precautions to make them less restrictive improve physical function, pain, kinesiophobia and health-related quality of life? Design: Two-centre, randomised, controlled trial with concealed allocation, blinded assessors and intention-to-treat analysis. Participants: Seventy-two adults who had undergone cardiac surgery via a median sternotomy were included. Intervention: Participants were randomly allocated to one of two groups at 4 (SD 1 days after surgery. The control group received the usual advice to restrict their upper limb use for 4 to 6 weeks (ie, restrictive sternal precautions. The experimental group received advice to use pain and discomfort as the safe limits for their upper limb use during daily activities (ie, less restrictive precautions for the same period. Both groups received postoperative individualised education in hospital and via weekly telephone calls for 6 weeks. Outcome measures: The primary outcome was physical function assessed by the Short Physical Performance Battery. Secondary outcomes included upper limb function, pain, kinesophobia, and health-related quality of life. Outcomes were measured before hospital discharge and at 4 and 12 weeks postoperatively. Adherence to sternal precautions was recorded. Results: There were no statistically significant differences in physical function between the groups at 4 weeks (MD 1.0, 95% CI –0.2 to 2.3 and 12 weeks (MD 0.4, 95% CI –0.9 to 1.6 postoperatively. There were no statistically significant between-group differences in secondary outcomes. Conclusion: Modified (ie, less restrictive sternal precautions for people following cardiac surgery had similar effects on physical recovery, pain and health-related quality of life as usual restrictive sternal precautions. Similar outcomes can be anticipated regardless of whether people following cardiac surgery are managed with

  10. Radiobilogical cell survival models

    International Nuclear Information System (INIS)

    Zackrisson, B.

    1992-01-01

    A central issue in clinical radiobiological research is the prediction of responses to different radiation qualities. The choice of cell survival and dose-response model greatly influences the results. In this context the relationship between theory and model is emphasized. Generally, the interpretations of experimental data depend on the model. Cell survival models are systematized with respect to their relations to radiobiological theories of cell kill. The growing knowlegde of biological, physical, and chemical mechanisms is reflected in the formulation of new models. The present overview shows that recent modelling has been more oriented towards the stochastic fluctuations connected to radiation energy deposition. This implies that the traditional cell surivival models ought to be complemented by models of stochastic energy deposition processes and repair processes at the intracellular level. (orig.)

  11. Carbonaceous Survivability on Impact

    Science.gov (United States)

    Bunch, T. E.; Becker, Luann; Morrison, David (Technical Monitor)

    1994-01-01

    In order to gain knowledge about the potential contributions of comets and cosmic dust to the origin of life on Earth, we need to explore the survivability of their potential organic compounds on impact and the formation of secondary products that may have arisen from the chaotic events sustained by the carriers as they fell to Earth. We have performed a series of hypervelocity impact experiments using carbon-bearing impactors (diamond, graphite, kerogens, PAH crystals, and Murchison and Nogoya meteorites) into Al plate targets at velocities - 6 km/s. Estimated peak shock pressures probably did not exceed 120 GPa and peak shock temperatures were probably less than 4000 K for times of nano- to microsecs. Nominal crater dia. are less than one mm. The most significant results of these experiments are the preservation of the higher mass PAHs (e. g., pyrene relative to napthalene) and the formation of additional alkylated PAHs. We have also examined the residues of polystyrene projectiles impacted by a microparticle accelerator into targets at velocities up to 15 km/s. This talk will discuss the results of these experiments and their implications with respect to the survival of carbonaceous deliverables to early Earth. The prospects of survivability of organic molecules on "intact" capture of cosmic dust in space via soft: and hard cosmic dust collectors will also be discussed.

  12. [Short-term outcomes of lung transplant recipients using organs from brain death donors].

    Science.gov (United States)

    He, W X; Jiang, C; Liu, X G; Huang, W; Chen, C; Jiang, L; Yang, B; Wu, K; Chen, Q K; Yang, Y; Yu, Y M; Jiang, G N

    2016-12-01

    Objective: To assess short-term outcomes after lung transplantation with organs procured following brain death. Methods: Between April 2015 and July 2016, all 17 recipients after lung transplantation using organs from brain death donors (DBD) at Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine were enrolled in this study. All patients were male, aging (60±7) years, including 11 chronic obstructive pulmonary disease, 5 idiopathic pulmonary fibrosis, 1 silicosis. Seventeen donors were 16 males and 1 female, with 10 traumatic brain injury, 5 cerebrovascular accident and 2 sudden cardiac death. Of 17 recipients receiving DBD lung transplant, 16 were single lung transplant. Data were collected including intubation duration of mechanical ventilation, hospital length of stay, incidence of pulmonary infection bronchus anastomosis complications, primary graft dysfunction (PGD), and acute rejection, bronchiolitis obliterans syndrome (BOS) as well as mortality of 90-day after lung transplantation. Results: Median duration of intubation were 2 (2) days ( M ( Q R )) in recipients after lung transplantation. The incidence of pulmonary infection and bronchus anastomosis complications were 15/17 and 5/17, respectively. Median length of stay in hospital were 56 (19) days. The ratio of readmission 1 month after discharge were 10/17. Mortality of 90-day post-transplant were 2/17. The incidence of PGD and BOS were 1/17 and 2/17, respectively. Conclusion: Recipients with DBD lung transplantation have an acceptable survival during short-term follow-up, but with higher incidences of complications related to infection post-transplantation.

  13. Older age impacts on survival outcome in patients receiving curative surgery for solid cancer

    Directory of Open Access Journals (Sweden)

    Chang-Hsien Lu

    2018-07-01

    Full Text Available Summary: Background: Given the global increase in aging populations and cancer incidence, understanding the influence of age on postoperative outcome after cancer surgery is imperative. This study aimed to evaluate the impact of age on survival outcome in solid cancer patients receiving curative surgery. Methods: A total of 37,288 patients receiving curative surgeries for solid cancers between 2007 and 2012 at four affiliated Chang Gung Memorial Hospital were included in the study. All patients were categorized into age groups by decades for survival analysis. Results: The percentages of patient populations aged <40 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and ≥80 years were 9.7%, 17.7%, 27.8%, 22.1%, 16.9%, and 5.7%, respectively. The median follow-up period was 38.9 months (range, 22.8–60.4 months and the overall, cancer-specific, and noncancer-specific mortality rates were 26.0%, 17.6%, and 8.5%, respectively. The overall mortality rate of patients in different age groups were 18.5%, 21.1%, 22.0%, 25.3%, 35.3%, and 49.0%, respectively. Compared to patients aged <40 years, more significant decrease in long-term survival were observed in aging patients. Multivariate analysis showed higher postoperative short-term mortality rates in patients older than 70 years, and the adjusted odds ratio of mortality risk ranged from 1.47 to 1.74 and 2.26 to 3.03 in patients aged 70–79 years and ≥80 years, respectively, compared to those aged <40 years. Conclusion: Aging was a negative prognostic factor of survival outcome in solid cancer patients receiving curative surgery. After adjustment of other clinicopathologic factors, the influence of age on survival outcome was less apparent in the elderly. Keywords: Age, Solid cancer, Surgical resection, Prognosis

  14. Short Implants: New Horizon in Implant Dentistry.

    Science.gov (United States)

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

  15. Short-circuit logic

    NARCIS (Netherlands)

    Bergstra, J.A.; Ponse, A.

    2010-01-01

    Short-circuit evaluation denotes the semantics of propositional connectives in which the second argument is only evaluated if the first argument does not suffice to determine the value of the expression. In programming, short-circuit evaluation is widely used. A short-circuit logic is a variant of

  16. The effect of metabolic control on hemodynamics in short-term insulin-dependent diabetic patients

    DEFF Research Database (Denmark)

    Mathiesen, E R; Hilsted, J; Feldt-Rasmussen, B

    1985-01-01

    Hemodynamics variables (heart rate, arterial blood pressure, cardiac output, hepato-splanchnic blood flow, forearm blood flow, and plasma catecholamines) were measured during good (median blood glucose 4.7 mmol/L) and poor (median blood glucose 16.3 mmol/L) metabolic control in eight young, short...

  17. Tracking plasma cell differentiation and survival.

    Science.gov (United States)

    Roth, Katrin; Oehme, Laura; Zehentmeier, Sandra; Zhang, Yang; Niesner, Raluca; Hauser, Anja E

    2014-01-01

    Plasma cells play a crucial role for the humoral immune response as they represent the body's factories for antibody production. The differentiation from a B cell into a plasma cell is controlled by a complex transcriptional network and happens within secondary lymphoid organs. Based on their lifetime, two types of antibody secreting cells can be distinguished: Short-lived plasma cells are located in extrafollicular sites of secondary lymphoid organs such as lymph node medullary cords and the splenic red pulp. A fraction of plasmablasts migrate from secondary lymphoid organs to the bone marrow where they can become long-lived plasma cells. Bone marrow plasma cells reside in special microanatomical environments termed survival niches, which provide factors promoting their longevity. Reticular stromal cells producing the chemokine CXCL12, which is known to attract plasmablasts to the bone marrow but also to promote plasma cell survival, play a crucial role in the maintenance of these niches. In addition, hematopoietic cells are contributing to the niches by providing other soluble survival factors. Here, we review the current knowledge on the factors involved in plasma cell differentiation, their localization and migration. We also give an overview on what is known regarding the maintenance of long lived plasma cells in survival niches of the bone marrow. © 2013 International Society for Advancement of Cytometry.

  18. Survival and clinical outcome of dogs with ischaemic stroke.

    Science.gov (United States)

    Gredal, H; Toft, N; Westrup, U; Motta, L; Gideon, P; Arlien-Søborg, P; Skerritt, G C; Berendt, M

    2013-06-01

    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 excellent in seven of 17 (41%) 30-day survivors. Another seven 30-day survivors experienced new acute neurological signs within 6-17months of the initial stroke event; in two of those cases a new ischaemic stroke was confirmed by MRI. In conclusion, dogs with ischaemic stroke have a fair to good prognosis in terms of survival and clinical outcome. However, owners should be informed of the risk of acute death within 30days and of the possibility of new neurological events in survivors. Mortality was increased in dogs with right-sided lesions in this study. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Survival analysis models and applications

    CERN Document Server

    Liu, Xian

    2012-01-01

    Survival analysis concerns sequential occurrences of events governed by probabilistic laws.  Recent decades have witnessed many applications of survival analysis in various disciplines. This book introduces both classic survival models and theories along with newly developed techniques. Readers will learn how to perform analysis of survival data by following numerous empirical illustrations in SAS. Survival Analysis: Models and Applications: Presents basic techniques before leading onto some of the most advanced topics in survival analysis.Assumes only a minimal knowledge of SAS whilst enablin

  20. Determinants of survival after liver resection for metastatic colorectal carcinoma.

    Science.gov (United States)

    Parau, Angela; Todor, Nicolae; Vlad, Liviu

    2015-01-01

    Prognostic factors for survival after liver resection for metastatic colorectal cancer identified up to date are quite inconsistent with a great inter-study variability. In this study we aimed to identify predictors of outcome in our patient population. A series of 70 consecutive patients from the oncological hepatobiliary database, who had undergone curative hepatic surgical resection for hepatic metastases of colorectal origin, operated between 2006 and 2011, were identified. At 44.6 months (range 13.7-73), 30 of 70 patients (42.85%) were alive. Patient demographics, primary tumor and liver tumor factors, operative factors, pathologic findings, recurrence patterns, disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) were analyzed. Clinicopathologic variables were tested using univariate and multivariate analyses. The 3-year CSS after first hepatic resection was 54%. Median CSS survival after first hepatic resection was 40.2 months. Median CSS after second hepatic resection was 24.2 months. The 3-year DFS after first hepatic resection was 14%. Median disease free survival after first hepatic resection was 18 months. The 3-year DFS after second hepatic resection was 27% and median DFS after second hepatic resection 12 months. The 30-day mortality and morbidity rate after first hepatic resection was 5.71% and 12.78%, respectively. In univariate analysis CSS was significantly reduced for the following factors: age >53 years, advanced T stage of primary tumor, moderately- poorly differentiated tumor, positive and narrow resection margin, preoperative CEA level >30 ng/ml, DFS <18 months. Perioperative chemotherapy related to metastasectomy showed a trend in improving CSS (p=0.07). Perioperative chemotherapy improved DFS in a statistically significant way (p=0.03). Perioperative chemotherapy and achievement of resection margins beyond 1 mm were the major determinants of both CSS and DFS after first liver resection in multivariate

  1. Socioeconomic position and survival after lung cancer

    DEFF Research Database (Denmark)

    Dalton, Susanne O; Steding-Jessen, Marianne; Jakobsen, Erik

    2015-01-01

    BACKGROUND: To address social inequality in survival after lung cancer, it is important to consider how socioeconomic position (SEP) influences prognosis. We investigated whether SEP influenced receipt of first-line treatment and whether socioeconomic differences in survival could be explained...... by differences in stage, treatment and comorbidity. MATERIAL AND METHODS: In the Danish Lung Cancer Register, we identified 13 045 patients with lung cancer diagnosed in 2004-2010, with information on stage, histology, performance status and first-line treatment. We obtained age, gender, vital status, comorbid...... with stepwise inclusion of possible mediators. RESULTS: For both low- and high-stage lung cancer, adjusted ORs for first-line treatment were reduced in patients with short education and low income, although the OR for education did not reach statistical significance in men with high-stage disease. Patients...

  2. Particle production and survival in muon acceleration

    Energy Technology Data Exchange (ETDEWEB)

    Noble, R.J.

    1992-06-01

    Because of the relative immunity of muons to synchrotron radiation, the idea of using them instead of electrons as probes in high-energy physics experiments has existed for some time, but applications were limited by the short muon lifetime. The production and survival of an adequate supply of low-emittance muons will determine the available luminosity in a high-energy physics collider. In this paper the production of pions by protons, their decay to muons and the survival of muons during acceleration are studied. Based on a combination of the various efficiencies, the number of protons needed at the pion source for every muon required in the final high-energy collider is estimated.

  3. Deriving stable multi-parametric MRI radiomic signatures in the presence of inter-scanner variations: survival prediction of glioblastoma via imaging pattern analysis and machine learning techniques

    Science.gov (United States)

    Rathore, Saima; Bakas, Spyridon; Akbari, Hamed; Shukla, Gaurav; Rozycki, Martin; Davatzikos, Christos

    2018-02-01

    There is mounting evidence that assessment of multi-parametric magnetic resonance imaging (mpMRI) profiles can noninvasively predict survival in many cancers, including glioblastoma. The clinical adoption of mpMRI as a prognostic biomarker, however, depends on its applicability in a multicenter setting, which is hampered by inter-scanner variations. This concept has not been addressed in existing studies. We developed a comprehensive set of within-patient normalized tumor features such as intensity profile, shape, volume, and tumor location, extracted from multicenter mpMRI of two large (npatients=353) cohorts, comprising the Hospital of the University of Pennsylvania (HUP, npatients=252, nscanners=3) and The Cancer Imaging Archive (TCIA, npatients=101, nscanners=8). Inter-scanner harmonization was conducted by normalizing the tumor intensity profile, with that of the contralateral healthy tissue. The extracted features were integrated by support vector machines to derive survival predictors. The predictors' generalizability was evaluated within each cohort, by two cross-validation configurations: i) pooled/scanner-agnostic, and ii) across scanners (training in multiple scanners and testing in one). The median survival in each configuration was used as a cut-off to divide patients in long- and short-survivors. Accuracy (ACC) for predicting long- versus short-survivors, for these configurations was ACCpooled=79.06% and ACCpooled=84.7%, ACCacross=73.55% and ACCacross=74.76%, in HUP and TCIA datasets, respectively. The hazard ratio at 95% confidence interval was 3.87 (2.87-5.20, P<0.001) and 6.65 (3.57-12.36, P<0.001) for HUP and TCIA datasets, respectively. Our findings suggest that adequate data normalization coupled with machine learning classification allows robust prediction of survival estimates on mpMRI acquired by multiple scanners.

  4. Gender-partitioned patient medians of serum albumin requested by general practitioners for the assessment of analytical stability

    DEFF Research Database (Denmark)

    Hansen, Steen Ingemann; Petersen, Per Hyltoft; Lund, Flemming

    2017-01-01

    BACKGROUND: Recently, the use of separate gender-partitioned patient medians of serum sodium has revealed potential for monitoring analytical stability within the optimum analytical performance specifications for laboratory medicine. The serum albumin concentration depends on whether a patient...... patients were closely related despite considerable variation due to the current analytical variation. This relationship was confirmed by the calculated half-range for the monthly ratio between the genders of 0.44%, which surpasses the optimum analytical performance specification for bias of serum albumin...... (0.72%). The weekly ratio had a half-range of 1.83%, which surpasses the minimum analytical performance specifications of 2.15%. CONCLUSIONS: Monthly gender-partitioned patient medians of serum albumin are useful for monitoring of long-term analytical stability, where the gender medians are two...

  5. Estudio del comportamiento de zapatas de medianería con viga centradora mediante modelos de elementos finitos

    OpenAIRE

    Galletero Montero, Pablo; Fernandez Gomez, Jaime Antonio; Perepérez Ventura, Bernardo

    2014-01-01

    Investigación sobre el cálculo de zapatas de medianería utilizando métodos no convencionales. Las dos soluciones más empleadas en edificación para el problema de las cimentaciones de medianería son la utilización de una viga centradora que conecta la zapata de medianería con la zapata del pilar interior más próximo y la colaboración de la viga de la primera planta trabajando como tirante. Los modelos convencionales existentes para el cálculo de este tipo de cimentaciones presentan una serie d...

  6. Association of a Locus in the CAMTA1 Gene With Survival in Patients With Sporadic Amyotrophic Lateral Sclerosis

    NARCIS (Netherlands)

    Fogh, Isabella; Lin, Kuang; Tiloca, Cinzia; Rooney, James; Gellera, Cinzia; Diekstra, Frank P; Ratti, Antonia; Shatunov, Aleksey; van Es, Michael A; Proitsi, Petroula; Jones, Ashley; Sproviero, William; Chiò, Adriano; McLaughlin, Russell Lewis; Sorarù, Gianni; Corrado, Lucia; Stahl, Daniel; Del Bo, Roberto; Cereda, Cristina; Castellotti, Barbara; Glass, Jonathan D; Newhouse, Steven; Dobson, Richard; Smith, Bradley N; Topp, Simon; van Rheenen, Wouter; Meininger, Vincent; Melki, Judith; Morrison, Karen E; Shaw, Pamela J; Leigh, P Nigel; Andersen, Peter M; Comi, Giacomo P; Ticozzi, Nicola; Mazzini, Letizia; D'Alfonso, Sandra; Traynor, Bryan J; Van Damme, Philip; Robberecht, Wim; Brown, Robert H; Landers, John E; Hardiman, Orla; Lewis, Cathryn M; van den Berg, Leonard H; Shaw, Christopher E; Veldink, Jan H; Silani, Vincenzo; Al-Chalabi, Ammar; Powell, John

    Importance: Amyotrophic lateral sclerosis (ALS) is a devastating adult-onset neurodegenerative disorder with a poor prognosis and a median survival of 3 years. However, a significant proportion of patients survive more than 10 years from symptom onset. Objective: To identify gene variants

  7. Survival in patients with brain metastases treated with radiotherapy holoencefalica at the National Institute of Cancerology

    International Nuclear Information System (INIS)

    Ospino, Rosalba; Cendales, Ricardo; Tria, Jaime

    2009-01-01

    Objective: To describe the overall survival among patients with brain metastases treated with whole brain radiation therapy at the Instituto Nacional de Cancerologia (INC) during 2004-2006. Methods: A survival study was conducted. All patients with brain metastases treated with whole brain radiotherapy were included. Frequencies, central tendency, and dispersion measures were used to describe discrete and continuous variables. Survival analysis was performed by the Kaplan-Meyer method. Results: 109 patients were included and the vital status was updated in 85 patients (80%). The median follow-up time was 2.76 months. 78 deaths were observed; the median survival time was 5.2 months and the cumulated one-year overall survival 25.5%. Karnofsky index, extra-cranial metastases, type of lesion, and recursive partitioning analysis (RPA) were significant prognostic factors. The overall median survival for recursive partitioning analysis class I was 7.2 months; class II 6.9 months; class III 1.8 months. Conclusion: Overall survival INC are similar than previous international series for RPA class I and III, while it was better in RPA class II.

  8. Statin use and survival following glioblastoma multiforme

    DEFF Research Database (Denmark)

    Gaist, David; Hallas, Jesper; Friis, Søren

    2014-01-01

    with glioblastoma multiforme (GBM). METHODS: We identified 1562 patients diagnosed with GBM during 2000-2009 from the Danish Cancer Registry and linked this cohort to Danish nationwide demographic and health registries. Within the GBM cohort, each patient recorded as using statins prior to diagnosis (defined as ≥2......-cause death associated with prediagnostic statin use. RESULTS: A total of 339 GBM patients were included in the analyses. Of these, 325 died during median follow-up of 6.9 months (interquartile range: 3.8-13.4 months). Prediagnostic statin use was associated with a reduced HR of death (0.79; 95% CI: 0......: 0.63-1.01). CONCLUSION: Long-term prediagnostic statin use may improve survival following GBM....

  9. Hotellin ravitsemispalveluiden markkinointiviestinnän kehittäminen sosiaalisen median keinoin, esimerkkinä case: Digihotelli

    OpenAIRE

    Ruokolainen, Anita

    2014-01-01

    Opinnäytetyössä kehitetään hotellin ravitsemispalveluiden markkinointiviestintää sosiaalisen median tarjoamin keinoin. Työn toimeksiantaja on majoitus- ja ravitsemispalveluita tarjoava yritys. Työn tavoitteena on laatia konkreettisia kehitysideoita markkinointiviestintää varten. Lisäksi tavoitteena on kehittää uusia tapoja hyödyntää sosiaalista mediaa yrityksen markkinointiviestinnässä. Työssä perehdytään myös sosiaalisen median uusiin trendeihin ja kehityssuuntiin. Työn teoreettinen vii...

  10. Applied survival analysis using R

    CERN Document Server

    Moore, Dirk F

    2016-01-01

    Applied Survival Analysis Using R covers the main principles of survival analysis, gives examples of how it is applied, and teaches how to put those principles to use to analyze data using R as a vehicle. Survival data, where the primary outcome is time to a specific event, arise in many areas of biomedical research, including clinical trials, epidemiological studies, and studies of animals. Many survival methods are extensions of techniques used in linear regression and categorical data, while other aspects of this field are unique to survival data. This text employs numerous actual examples to illustrate survival curve estimation, comparison of survivals of different groups, proper accounting for censoring and truncation, model variable selection, and residual analysis. Because explaining survival analysis requires more advanced mathematics than many other statistical topics, this book is organized with basic concepts and most frequently used procedures covered in earlier chapters, with more advanced topics...

  11. IGF-1 and Survival in ESRD

    Science.gov (United States)

    Jia, Ting; Gama Axelsson, Thiane; Heimbürger, Olof; Bárány, Peter; Stenvinkel, Peter; Qureshi, Abdul Rashid

    2014-01-01

    Summary Background and objectives IGF-1 deficiency links to malnutrition in CKD patients; however, it is not clear to what extent it associates with survival among these patients. Design, setting, participants, & measurements Serum IGF-1 and other biochemical, clinical (subjective global assessment), and densitometric (dual energy x-ray absorptiometry) markers of nutritional status and mineral and bone metabolism were measured in a cohort of 365 Swedish clinically stable CKD stage 5 patients (median age of 53 years) initiating dialysis between 1994 and 2009; in 207 patients, measurements were also taken after 1 year of dialysis. Deaths were registered during a median follow-up of 5 years. Associations of mortality with baseline IGF-1 and changes of IGF-1 after 1 year of dialysis were evaluated by Cox models. Results At baseline, IGF-1 concentrations associated negatively with age, diabetes mellitus, cardiovascular disease, poor nutritional status, IL-6, and osteoprotegerin and positively with body fat mass, bone mineral density, serum phosphate, calcium, and fibroblast growth factor-23. At 1 year, IGF-1 had increased by 33%. In multivariate regression, low age, diabetes mellitus, and high serum phosphate and calcium associated with IGF-1 at baseline, and in a mixed model, these factors, together with high fat body mass, associated with changes of IGF-1 during the first 1 year of dialysis. Adjusting for calendar year of inclusion, age, sex, diabetes mellitus, cardiovascular disease, IL-6, and poor nutritional status, a 1 SD higher level of IGF-1 at baseline associated with lower mortality risk (hazard ratio, 0.57; 95% confidence interval, 0.32 to 0.98). Persistently low or decreasing IGF-1 levels during the first 1 year on dialysis predicted worse survival (adjusted hazard ratio, 2.19; 95% confidence interval, 1.06 to 4.50). Conclusion In incident dialysis patients, low serum IGF-1 associates with body composition and markers of mineral and bone metabolism, and it

  12. Epidermal Growth Factor Receptor Is Related to Poor Survival in Glioblastomas: Single-Institution Experience

    Science.gov (United States)

    Choi, Youngmin; Lee, Hyung-Sik; Hur, Won-Joo; Sung, Ki-Han; Kim, Ki-Uk; Choi, Sun-Seob; Kim, Su-Jin; Kim, Dae-Cheol

    2013-01-01

    Purpose There are conflicting results surrounding the prognostic significance of epidermal growth factor receptor (EGFR) status in glioblastoma (GBM) patients. Accordingly, we attempted to assess the influence of EGFR expression on the survival of GBM patients receiving postoperative radiotherapy. Materials and Methods Thirty three GBM patients who had received surgery and postoperative radiotherapy at our institute, between March 1997 and February 2006, were included. The evaluation of EGFR expression with immunohistochemistry was available for 30 patients. Kaplan-Meier survival analysis and Cox regression were used for statistical analysis. Results EGFR was expressed in 23 patients (76.7%), and not expressed in seven (23.3%). Survival in EGFR expressing GBM patients was significantly less than that in non-expressing patients (median survival: 12.5 versus 17.5 months, p=0.013). Patients who received more than 60 Gy showed improved survival over those who received up to 60 Gy (median survival: 17.0 versus 9.0 months, p=0.000). Negative EGFR expression and a higher radiation dose were significantly correlated with improved survival on multivariate analysis. Survival rates showed no differences according to age, sex, and surgical extent. Conclusion The expression of EGFR demonstrated a significantly deleterious effect on the survival of GBM patients. Therefore, approaches targeting EGFR should be considered in potential treatment methods for GBM patients, in addition to current management strategies. PMID:23225805

  13. Nuclear War Survival Skills

    Energy Technology Data Exchange (ETDEWEB)

    Kearny, C.H.

    2002-06-24

    The purpose of this book is to provide Americans with information and instructions that will significantly increase their chances of surviving a possible nuclear attack. It brings together field-tested instructions that, if followed by a large fraction of Americans during a crisis that preceded an attack, could save millions of lives. The author is convinced that the vulnerability of our country to nuclear threat or attack must be reduced and that the wide dissemination of the information contained in this book would help achieve that objective of our overall defense strategy.

  14. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus

    2008-01-01

    of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... the SMR remained significantly 1.3-fold increased. CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion-transmitted disease...... as well as for cost-benefit estimation of new blood safety interventions....

  15. Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer-Specific Mortality or Disease-Free Survival.

    Science.gov (United States)

    White, Michael G; Cipriani, Nicole A; Abdulrasool, Layth; Kaplan, Sharone; Aschebrook-Kilfoy, Briseis; Angelos, Peter; Kaplan, Edwin L; Grogan, Raymon H; Onel, Kenan

    2016-08-01

    Radiation is a well-described risk factor for differentiated thyroid carcinoma (DTC). Although the natural history of DTC following nuclear disasters and in healthcare workers with chronic radiation exposure (RE) has been described, little is known about DTC following short-term exposure to therapeutic medical radiation for benign disease. This study compares DTC morphology and outcomes in patients with and without a prior history of therapeutic external RE. A retrospective review was performed of patients with DTC treated at The University of Chicago between 1951 and 1987, with a median follow-up of 27 years (range 0.3-60 years). Patients were classified as either having (RE+) or not having (RE-) a history of therapeutic RE. Variables examined included sex, age at RE, dose of RE, indication for RE, DTC histology, and outcome. Morphology was determined by blinded retrospective review of all available histologic slides. Outcomes were assessed using Cox proportional hazards model and Kaplan-Meier curves. Of 257 DTC patients, 165 (64%) were RE- and 92 (36%) were RE+, with males comprising a greater proportion of the RE+ group (43.5% vs. 27.3%; p = 0.01). A total of 94.2% of DTC cases were classic papillary cancers; histology did not differ between RE+ and RE- cohorts (p = 0.73). RE was associated with an increased median overall survival (OS; 43 years vs. 38 years; hazard ratio [HR] = 0.55 [confidence interval (CI) 0.34-0.89]; p = 0.01). Survival for males in the RE- group was significantly worse than it was for RE- females (HR = 1.78 [CI 1.05-3.03]; p = 0.03) or RE+ males (HR = 2.98 [CI 1.39-6.38]; p = 0.01). Recurrence did not differ between the RE+ and RE- groups (HR = 0.85 [CI 0.52-1.41]; p = 0.54), nor did DTC-specific mortality (HR = 0.54 [CI 0.21-1.37]; p = 0.20). While DTC following RE has historically been considered a more aggressive variant than DTC in the absence of RE, the present data indicate that RE+ DTC

  16. Survival curves for irradiated cells

    International Nuclear Information System (INIS)

    Gibson, D.K.

    1975-01-01

    The subject of the lecture is the probability of survival of biological cells which have been subjected to ionising radiation. The basic mathematical theories of cell survival as a function of radiation dose are developed. A brief comparison with observed survival curves is made. (author)

  17. Short-course radiotherapy, with elective delay prior to surgery, in patients with unresectable rectal cancer who have poor performance status or significant co-morbidity

    International Nuclear Information System (INIS)

    Hatfield, Paul; Hingorani, Mohan; Radhakrishna, Ganesh; Cooper, Rachel; Melcher, Alan; Crellin, Adrian; Kwok-Williams, Michelle; Sebag-Montefiore, David

    2009-01-01

    Background and purpose: Standard treatment for rectal cancer which threatens the expected plane of resection on MRI imaging is long-course, pre-operative chemoradiotherapy (1.8-2 Gy, 25-28 fractions). Not all patients are suitable for this because of age, poor performance status or co-morbidities. We describe our experience of short-course (5 x 5 Gy) pre-operative radiotherapy with planned, delayed surgery (SCPRT-delay) in this patient group. Materials and methods: Between April 2001 and October 2007, 43 patients were selected for SCPRT-delay. The clinical records were retrospectively evaluated. Results: Median age was 82 (range 58-87). Forty-one patients had radiotherapy of which 26 (61%) were subsequently able to have surgery. Of these, R0, R1 and R2 resections were performed in 22, 2 and 2 patients, respectively. Treatment was well tolerated, although two patients required hospital admission for management of diarrhoea and one developed significant late small bowel toxicity, attributable to radiotherapy. In those undergoing R0 or R1 resection there have been no local recurrences (median follow-up 18 months). Median survival for the whole group was 23 months, although this was 44 months in those undergoing surgery. Conclusions: SCPRT-delay appears to be a useful alternative to long-course pre-operative chemoradiotherapy in this high-risk group of patients.

  18. SubID, a non-median dichotomization tool for heterogeneous populations, reveals the pan-cancer significance of INPP4B and its regulation by EVI1 in AML.

    Directory of Open Access Journals (Sweden)

    Irakli Dzneladze

    Full Text Available Our previous studies demonstrated that INPP4B, a member of the PI3K/Akt signaling pathway, is overexpressed in a subset of AML patients and is associated with lower response to chemotherapy and shorter survival. INPP4B expression analysis in AML revealed a right skewed frequency distribution with 25% of patients expressing significantly higher levels than the majority. The 75% low/25% high cut-off revealed the prognostic power of INPP4B expression status in AML, which would not have been apparent with a standard median cut-off approach. Our identification of a clinically relevant non-median cut-off for INPP4B indicated a need for a generalizable non-median dichotomization approach to optimally study clinically relevant genes. To address this need, we developed Subgroup Identifier (SubID, a tool which examines the relationship between a continuous variable (e.g. gene expression, and a test parameter (e.g. CoxPH or Fisher's exact P values. In our study, Fisher's exact SubID was used to reveal EVI1 as a transcriptional regulator of INPP4B in AML; a finding which was validated in vitro. Next, we used CoxPH SubID to conduct a pan-cancer analysis of INPP4B's prognostic significance. Our analysis revealed that INPP4Blow is associated with shorter survival in kidney clear cell, liver hepatocellular, and bladder urothelial carcinomas. Conversely, INPP4Blow was shown to be associated with increased survival in pancreatic adenocarcinoma in three independent datasets. Overall, our study describes the development and application of a novel subgroup identification tool used to identify prognostically significant rare subgroups based upon gene expression, and for investigating the association between a gene with skewed frequency distribution and potentially important upstream and downstream genes that relate to the index gene.

  19. SubID, a non-median dichotomization tool for heterogeneous populations, reveals the pan-cancer significance of INPP4B and its regulation by EVI1 in AML.

    Science.gov (United States)

    Dzneladze, Irakli; Woolley, John F; Rossell, Carla; Han, Youqi; Rashid, Ayesha; Jain, Michael; Reimand, Jüri; Minden, Mark D; Salmena, Leonardo

    2018-01-01

    Our previous studies demonstrated that INPP4B, a member of the PI3K/Akt signaling pathway, is overexpressed in a subset of AML patients and is associated with lower response to chemotherapy and shorter survival. INPP4B expression analysis in AML revealed a right skewed frequency distribution with 25% of patients expressing significantly higher levels than the majority. The 75% low/25% high cut-off revealed the prognostic power of INPP4B expression status in AML, which would not have been apparent with a standard median cut-off approach. Our identification of a clinically relevant non-median cut-off for INPP4B indicated a need for a generalizable non-median dichotomization approach to optimally study clinically relevant genes. To address this need, we developed Subgroup Identifier (SubID), a tool which examines the relationship between a continuous variable (e.g. gene expression), and a test parameter (e.g. CoxPH or Fisher's exact P values). In our study, Fisher's exact SubID was used to reveal EVI1 as a transcriptional regulator of INPP4B in AML; a finding which was validated in vitro. Next, we used CoxPH SubID to conduct a pan-cancer analysis of INPP4B's prognostic significance. Our analysis revealed that INPP4Blow is associated with shorter survival in kidney clear cell, liver hepatocellular, and bladder urothelial carcinomas. Conversely, INPP4Blow was shown to be associated with increased survival in pancreatic adenocarcinoma in three independent datasets. Overall, our study describes the development and application of a novel subgroup identification tool used to identify prognostically significant rare subgroups based upon gene expression, and for investigating the association between a gene with skewed frequency distribution and potentially important upstream and downstream genes that relate to the index gene.

  20. Evaluation of postradiotherapy PSA patterns and correlation with 10-year disease free survival outcomes for prostate cancer

    International Nuclear Information System (INIS)

    Zelefsky, Michael J.; Ben-Porat, Leah; Chan, Heather M.; Fearn, Paul A.; Venkatraman, Ennapadam S.

    2006-01-01

    Purpose: To describe the prostate-specific antigen (PSA) pattern profiles observed after external beam radiotherapy with and without short-term neoadjuvant androgen deprivation therapy (ST-ADT) and to report the association of established posttreatment PSA patterns with long-term disease-free survival outcomes. Methods and Materials: A total of 1,665 patients were treated with conformal external beam radiotherapy for clinically localized prostate cancer. Of 570 patients who had the requisite >10 consecutive PSA measurements for statistical analysis, 194 patients received a median of 3 months of ADT before radiotherapy and 376 were treated with radiotherapy alone. The median follow up was 103 months. Results: In the group treated with ST-ADT, three distinct postradiotherapy PSA patterns were identified: a stable trend (44%), an increasing trend followed by stabilization of the PSA (25%), and an increasing trend (31%). Among the subgroup that demonstrated a rising and subsequent stabilizing patterns, PSA levels had gradually risen to a median value of 0.9 ng/mL after therapy, stabilized, and remained durably suppressed. The only identified trends among patients treated with external beam radiotherapy without ST-ADT were declining PSA levels followed by stable PSA trends or declining patterns followed by rising levels. Patients whose PSA levels stabilized after an initial rise or those with slowly rising PSA profiles had a lower incidence of distant metastasis compared to those with accelerated rises after therapy. Conclusions: For those treated with external beam radiotherapy in conjunction with ST-ADT, a significant percentage who develop a rising PSA after treatment are expected to manifest subsequent stabilization at plateaued levels of approximately 1.0 ng/mL, which can remain durably suppressed. The likelihood of distant metastasis in these patients is low despite the PSA stabilization at levels 1.0 ng/mL or higher and comparable to outcomes observed for those

  1. Median nitrate concentrations in groundwater in the New Jersey Highlands Region estimated using regression models and land-surface characteristics

    Science.gov (United States)

    Baker, Ronald J.; Chepiga, Mary M.; Cauller, Stephen J.

    2015-01-01

    Nitrate-concentration data are used in conjunction with land-use and land-cover data to estimate median nitrate concentrations in groundwater underlying the New Jersey (NJ) Highlands Region. Sources of data on nitrate in 19,670 groundwater samples are from the U.S. Geological Survey (USGS) National Water Information System (NWIS) and the NJ Private Well Testing Act (PWTA).

  2. Use of the temporal median and trimmed mean mitigates effects of respiratory motion in multiple-acquisition abdominal diffusion imaging

    International Nuclear Information System (INIS)

    Jerome, N P; Orton, M R; D’Arcy, J A; Leach, M O; Collins, D J; Feiweier, T; Tunariu, N; Koh, D-M

    2015-01-01

    Respiratory motion commonly confounds abdominal diffusion-weighted magnetic resonance imaging, where averaging of successive samples at different parts of the respiratory cycle, performed in the scanner, manifests the motion as blurring of tissue boundaries and structural features and can introduce bias into calculated diffusion metrics. Storing multiple averages separately allows processing using metrics other than the mean; in this prospective volunteer study, median and trimmed mean values of signal intensity for each voxel over repeated averages and diffusion-weighting directions are shown to give images with sharper tissue boundaries and structural features for moving tissues, while not compromising non-moving structures. Expert visual scoring of derived diffusion maps is significantly higher for the median than for the mean, with modest improvement from the trimmed mean. Diffusion metrics derived from mono- and bi-exponential diffusion models are comparable for non-moving structures, demonstrating a lack of introduced bias from using the median. The use of the median is a simple and computationally inexpensive alternative to complex and expensive registration algorithms, requiring only additional data storage (and no additional scanning time) while returning visually superior images that will facilitate the appropriate placement of regions-of-interest when analysing abdominal diffusion-weighted magnetic resonance images, for assessment of disease characteristics and treatment response. (note)

  3. Resuscitation therapy for traumatic brain injury-induced coma in rats: mechanisms of median nerve electrical stimulation

    Directory of Open Access Journals (Sweden)

    Zhen Feng

    2015-01-01

    Full Text Available In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually increased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our findings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the prefrontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.

  4. An O(n log n) Version of the Averbakh-Berman Algorithm for the Robust Median of a Tree

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Georgiadis, Loukas; Katriel, Irit

    2008-01-01

    We show that the minmax regret median of a tree can be found in O(nlog n) time. This is obtained by a modification of Averbakh and Berman's O(nlog2 n)-time algorithm: We design a dynamic solution to their bottleneck subproblem of finding the middle of every root-leaf path in a tree....

  5. Survival After Palliative Radiotherapy in Patients with Breast Cancer and Bone-only Metastases.

    Science.gov (United States)

    Nieder, Carsten; Dalhaug, Astrid; Pawinski, Adam; Mannsåker, Bård; Haukland, Ellinor

    Patients with bone-only metastases survive longer than patients with widespread visceral disease. We analyzed the prognostic impact of different baseline parameters, such as abnormal blood tests and receptor status in patients who received local radiotherapy, in addition to contemporary systemic treatment, according to national guidelines. Retrospective uni- and multivariate analyses of 57 consecutive female patients treated in the time period 2007-2014 (median follow-up=29 months). The median age was 59 years and the median time interval from the initial diagnosis of breast cancer was 57 months. The median survival was 23 months from radiotherapy and 32 months from initial diagnosis of metastatic disease. Five-year survival rates were 13 and 21%, respectively. Survival after radiotherapy was significantly longer in patients who were prescribed higher radiation doses; 29 months after ≥30 Gy and 10 months after radiotherapy improves survival in patients with bone-only disease suitable for local therapy. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  6. Impact of different treatment methods on survival in advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Brasiuniene, B.; Juozaityte, E.; Barauskas, G.

    2005-01-01

    The aim of the study was to evaluate the impact of different treatment methods on survival of patients treated for advanced pancreatic cancer at Kaunas University of Medicine Hospital from 1987 to 2003. Data on 262 patients with advanced pancreatic cancer treated from 1987 to 2003 were analyzed retrospectively. Four groups of patients were analyzed. One hundred eighty patients underwent palliative bypass or endoscopic bile duct stenting or observation alone. Forty three patients in addition to surgery were treated by radiotherapy. Twenty five patients received gemcitabine in standard doses and schedules. Fourteen patients received concomitant chemoradiotherapy (with gemcitabine or 5-fluorouracil). All patients were grouped by treatment method and median survival was analyzed. Median survival of patients treated by palliative surgery only or observation alone was 1.9 month, and for patients treated by palliative surgery and radiotherapy was 6.1 months (p=0.00007). Median survival of patients treated with gemcitabine was 9.5 months (p<0.001), and median survival of patients treated with concomitant chemoradiotherapy was 8.5 months (p=0.00003). Patients diagnosed with advanced pancreatic cancer in addition to surgical treatment should be treated by chemotherapy, concomitant chemoradiotherapy or radiotherapy. (author)

  7. [Surgical silicone prostheses in the treatment of biliary tract cancers: long prostheses or short prostheses? Results apropos of 500 cases].

    Science.gov (United States)

    Kron, B

    1992-10-01

    The interest of surgical prostheses in the palliative treatment of biliary tract cancer is well established, on the basis of their good tolerance, the more than 15 year follow up experience and the number of patients operated upon. After exeresis, they allow re-establishment of continuity, either by use of a prosthesis in Y when the right and let ducts can be dissected, or by using two prostheses, a multiperforated long prosthesis reimplanted in the duodenum and a short prosthesis reimplanted in the common bile duct without attaining the sphincter of Oddi. Of the 1000 cases treated, 500 were the object of a statistical analysis, 46 being operated upon by the author, in 60% of cases for biliary tract cancer, either primary or as an extension from the gallbladder. One-third of the patients had advanced lesions and a short survival of less than 3 months. Two-thirds a median survival of 9 months. In 10%, a radical exeresis was performed with survival of more than one year without recurrence of jaundice. Failure of treatment with persistence of jaundice was due to advanced disease for which surgery is unsatisfactory. Essential complications were premature bile leaks (5%) without serious consequences if sufficient drainage was maintained, since it stopped spontaneously, and angiocholitis (6%), the result of territory exclusion or reflux. Recurrence of jaundice was related to extension of the neoplasm to the secondary bile ducts, and to hepatic metastases. Obstruction of the prosthesis before two months was rare (6%) and was preceded by angiocholitis. In the absence of recurrence of the cancer the prosthesis can be replaced surgically without difficulty.

  8. Nuclear war survival skills

    International Nuclear Information System (INIS)

    Kearney, C.H.

    1979-09-01

    This book includes chapters on psychological preparations, warning and communications, and evacuation. It describes the building of expedient shelters, their ventilation and cooling, the purification and storage of adequate water, the processing and cooking of whole grains and legumes, fallout meters, protection against fires and carbon monoxide, and expedient furnishings for shelters. Other chapters cover sanitation and preventive medicine, medical advice for nuclear survivors lacking the help of doctors, improvised footwear and clothing, and advice on minimum preparations that can be made at low cost and should be made before a crisis arises. One appendix of the handbook gives detailed, field-tested instructions for building six types of earth-covered expedient fallout shelters, with criteria to guide the choice of which shelter to build. Others contain instructions for making an efficient shelter-ventilating pump and a homemade fallout meter that is accurate and dependable with inexpensive materials found in most households. This report is primarily a compilation and summary of civil defense measures and inventions developed at ORNL over the past 14 years and field-tested in six states, from Florida to Utah. It is the first comprehensive handbook of survival information for use by untrained citizens who want to improve their chances of surviving a possible nuclear attack. Sections may be easily excerpted and reproduced for mass distribution through news media

  9. The effect of symptoms of carpal tunnel syndrome on ultrasonographic median nerve measures before and after wheelchair propulsion.

    Science.gov (United States)

    Impink, Bradley G; Collinger, Jennifer L; Boninger, Michael L

    2011-09-01

    To quantify median nerve characteristics before and after strenuous wheelchair propulsion and relate them to symptoms of carpal tunnel syndrome (CTS). We hypothesized that persons with and without symptoms of CTS would have significantly different nerve characteristics at baseline and after propulsion. A repeated-measures design was used to obtain ultrasound images of the median nerve at 3 levels of the wrist (radius, pisiform, and hamate) before and after wheelchair propulsion. Investigators were blinded to subject history related to CTS. The 2007 and 2008 National Veterans Wheelchair Games and the Human Engineering Research Laboratories. Fifty-four participants between the ages of 18 and 65 years with a nonprogressive disability who used a manual wheelchair as their primary means of mobility completed this study. Participants completed questionnaires regarding demographics and the presence and severity of symptoms of CTS. Ultrasound images of the median nerve were obtained before and after a 15-minute strenuous wheelchair-propulsion task. Baseline values and post-propulsion changes were determined for median nerve cross-sectional area, flattening ratio, and swelling ratio. Differences in median nerve variables between symptomatic and asymptomatic groups were assessed. No significant differences between symptom groups were identified at baseline; however, persons with symptoms of CTS showed a significantly different percent change from baseline compared with the asymptomatic participants for cross-sectional area at pisiform (P = .014) and flattening ratio at hamate (P = .022), and they showed a strong trend toward a difference in swelling ratio (P = .0502). For each of these variables, the change in the symptomatic group was in the opposite direction of the change in the asymptomatic group. We found several median nerve responses to wheelchair propulsion associated with symptoms of CTS. These responses occurred even though no baseline ultrasound difference was

  10. Association of collagen architecture with glioblastoma patient survival.

    Science.gov (United States)

    Pointer, Kelli B; Clark, Paul A; Schroeder, Alexandra B; Salamat, M Shahriar; Eliceiri, Kevin W; Kuo, John S

    2017-06-01

    OBJECTIVE Glioblastoma (GBM) is the most malignant primary brain tumor. Collagen is present in low amounts in normal brain, but in GBMs, collagen gene expression is reportedly upregulated. However, to the authors' knowledge, direct visualization of collagen architecture has not been reported. The authors sought to perform the first direct visualization of GBM collagen architecture, identify clinically relevant collagen signatures, and link them to differential patient survival. METHODS Second-harmonic generation microscopy was used to detect collagen in a GBM patient tissue microarray. Focal and invasive GBM mouse xenografts were stained with Picrosirius red. Quantitation of collagen fibers was performed using custom software. Multivariate survival analysis was done to determine if collagen is a survival marker for patients. RESULTS In focal xenografts, collagen was observed at tumor brain boundaries. For invasive xenografts, collagen was intercalated with tumor cells. Quantitative analysis showed significant differences in collagen fibers for focal and invasive xenografts. The authors also found that GBM patients with more organized collagen had a longer median survival than those with less organized collagen. CONCLUSIONS Collagen architecture can be directly visualized and is different in focal versus invasive GBMs. The authors also demonstrate that collagen signature is associated with patient survival. These findings suggest that there are collagen differences in focal versus invasive GBMs and that collagen is a survival marker for GBM.

  11. Survival of adult female elk in yellowstone following wolf restoration

    Science.gov (United States)

    Evans, S.B.; Mech, L.D.; White, P.J.; Sargeant, G.A.

    2006-01-01

    Counts of northern Yellowstone elk (Cervus elaphus) in northwestern Wyoming and adjacent Montana, USA, have decreased at an average rate of 6-8% per year since wolves (Canis lupus) were reintroduced in 1995. Population growth rates of elk are typically sensitive to variations in adult female survival; populations that are stable or increasing exhibit high adult female survival. We used survival records for 85 radiocollared adult female elk 1-19 years old to estimate annual survival from March 2000 to February 2004. Weighted average annual survival rates were approximately 0.83 (95% CI = 0.77-0.89) for females 1-15 years old and 0.80 (95% CI = 0.73-0.86) for all females. Our estimates were much lower than the rate of 0.99 observed during 1969-1975 when fewer elk were harvested by hunters, wolves were not present, and other predators were less numerous. Of 33 documented deaths included in our analysis, we attributed 11 to hunter harvest, 14 to predation (10 wolf, 2 unknown, 1 cougar [Puma concolor], and 1 bear [Ursus sp.]), 6 to unknown causes, and 2 to winter-kill. Most deaths occurred from December through March. Estimates of cause-specific annual mortality rates were 0.09 (0.05-0.14) for all predators, 0.08 (0.04-0.13) for hunting, and 0.07 (0.03-0.11) for wolves specifically. Wolf-killed elk were typically older (median = 12 yr) than hunter-killed elk (median = 9 yr, P = 0.03). However, elk that winter outside the park where they were exposed to hunting were also younger (median = 7 yr) than elk that we did not observe outside the park (median = 9 yr, P wolves and hunters may reflect characteristics of elk exposed to various causes of mortality, as well as differences in susceptibility. Unless survival rates of adult females increase, elk numbers are likely to continue declining. Hunter harvest is the only cause of mortality that is amenable to management at the present time.

  12. Effects of a psychosocial intervention on survival among patients with stage I breast and prostate cancer: a matched case-control study.

    Science.gov (United States)

    Shrock, D; Palmer, R F; Taylor, B

    1999-05-01

    Psychosocial factors have been linked to the development and progression of cancer and shown to be relevant in cancer care. However, the evidence that psychosocial interventions affect cancer survival is less conclusive. Few methodologically sound studies have addressed this issue. To investigate the effects of a 6-week psychosocial intervention on survival among patients with stage I breast and prostate cancer. Matched case-control. 3 rural hospitals or cancer centers in central Pennsylvania. 21 breast and 29 prostate stage I cancer patients (treatment group) matched with 74 breast and 65 prostate stage I cancer patients from the same hospitals who did not receive the intervention (control group). Six 2-hour health psychology classes conducted by a licensed staff psychologist. Survival time was compared between the 2 groups and with national norms. The intervention group lived significantly longer than did matched controls. At 4- to 7-year follow-up (median = 4.2 years), none of the breast cancer patients in the intervention group died, whereas 12% of those in the control group died. Twice as many matched-control prostate cancer patients died compared with those in the intervention group (28% vs 14%). Control group survival was similar to national norms. These results are consistent with prior clinical trials and suggest that short-term psychosocial interventions that encourage the expression of emotions, provide social support, and teach coping skills can influence survival among cancer patients. However, self-selection bias cannot be ruled out as an alternative explanation for the results. These interventions merit further consideration and research.

  13. Radiation-induced myelopathy in long-term surviving metastatic spinal cord compression patients after hypofractionated radiotherapy: a clinical and magnetic resonance imaging analysis

    International Nuclear Information System (INIS)

    Maranzano, Ernesto; Bellavita, Rita; Floridi, Piero; Celani, Grazia; Righetti, Enrico; Lupattelli, Marco; Panizza, Bianca Moira; Frattegiani, Alessandro; Pelliccioli, Gian Piero; Latini, Paolo

    2001-01-01

    Background and purpose: Hypofractionated radiotherapy is often administered in metastatic spinal cord compression (MSCC), but no studies have been published on the incidence of radiation-induced myelopathy (RIM) in long-term surviving patients. Our report addresses this topic. Patients and methods: Of 465 consecutive MSCC patients submitted to radiotherapy between 1988 and 1997, 13 live patients (seven females, six males, median age 69 years, median follow-up 69 months) surviving for 2 years or more were retrospectively reviewed to evaluate RIM. All patients underwent radiotherapy. Eight patients underwent a short-course regimen of 8 Gy, with 7 days rest, and then another 8 Gy. Five patients underwent a split-course regimen of 5 Gy x3, 4 days rest, and then 3 Gy x5. Only one patient also underwent laminectomy. Full neurological examination and magnetic resonance imaging (MRI) were performed. Results: Of 12 patients submitted to radiotherapy alone, 11 were ambulant (eight without support and three with support) with good bladder function. In nine of these 11 patients, MRI was negative; in one case MRI evidenced an in-field relapse 30 months after the end of radiotherapy, and in the other, two new MSCC foci outside the irradiated spine. In the remaining patient RIM was suspected at 18 months after radiotherapy when the patient became paraplegic and cystoplegic, and magnetic resonance images evidenced an ischemic injury in the irradiated area. The only patient treated with surgery plus postoperative radiotherapy worsened and remained paraparetic. Magnetic resonance images showed cord atrophy at the surgical level, explained as an ischemic necrosis due to surgery injury. Conclusions: On the grounds of our data regarding RIM in long-term surviving MSCC patients, we believe that a hypofractionated radiotherapy regimen can be used for the majority of patients. For a minority of patients, more protracted radiation regimens could be considered

  14. Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

    1994-01-01

    . The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

  15. How can tropical cyclones survive?

    Science.gov (United States)

    Smedman, Ann-Sofi

    2013-04-01

    How can tropical cyclones survive? It is important for understanding the development of tropical cyclones to be able to quantify the exchange of enthalpy and momentum between air and water. Air-sea fluxes are often formulated as drag CD and enthalpy CK exchange coefficients. Emanuel, 1986, derived an expression for potential intensity that depends on local environment parameters and is proportional to the ratio of enthalpy and drag coefficients. This ratio should be larger than 0.75 for a cyclone to develop. There are no direct surface measurements of CK/ CD under hurricane conditions and extrapolation from most open-ocean measurements at 25 m/s gives values of CK/ CD0.75 is in accordance with Emanuel's prediction. The high CK values are observed during situations when there is a regime shift of the structure of turbulence in the boundary layer. From spectral analysis it was found that as the boundary layer approaches neutral stratification, smaller-scale eddies become increasingly important in the turbulent transport of humidity and sensible heat and thus enhance the exchange coefficient CK. This turbulence regime is called the UVCN regime and require high wind speed, small temperature difference between air and water, sufficiently strong wind gradients and growing sea condition ( Smedman et al., 2007, Sahlee et al., 2008). What is the difference between world oceans and enclosed seas? The answer is the waves. The wave field over the open oceans is swell dominated but in enclosed seas and coastal areas swell is restricted mainly to low wind speed conditions, and swell is short lived because of short distances to the shores. When swell is present the MABL will be dominated by large eddies of zi size creating weak gradients of wind, temperature and humidity and thus small scale eddies cannot be formed leading to reduced CK-values. However, during hurricane condition the waves are expected to be young, stratification is close to neutral and gradients are sufficiently

  16. A Phase 1/2 and Biomarker Study of Preoperative Short Course Chemoradiation With Proton Beam Therapy and Capecitabine Followed By Early Surgery for Resectable Pancreatic Ductal Adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Theodore S., E-mail: tshong1@partners.org [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ryan, David P.; Borger, Darrell R.; Blaszkowsky, Lawrence S.; Yeap, Beow Y. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Deshpande, Vikram; Shinagare, Shweta [Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Wo, Jennifer Y.; Boucher, Yves [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Wadlow, Raymond C.; Kwak, Eunice L.; Allen, Jill N.; Clark, Jeffrey W.; Zhu, Andrew X. [Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ferrone, Cristina R. [Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Mamon, Harvey J. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Adams, Judith; Winrich, Barbara; Grillo, Tarin [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); and others

    2014-07-15

    Purpose: To evaluate the safety, efficacy and biomarkers of short-course proton beam radiation and capecitabine, followed by pancreaticoduodenectomy in a phase 1/2 study in pancreatic ductal adenocarcinoma (PDAC) patients. Methods and Materials: Patients with radiographically resectable, biopsy-proven PDAC were treated with neoadjuvant short-course (2-week) proton-based radiation with capecitabine, followed by surgery and adjuvant gemcitabine. The primary objective was to demonstrate a rate of toxicity grade ≥3 of <20%. Exploratory biomarker studies were performed using surgical specimen tissues and peripheral blood. Results: The phase 2 dose was established at 5 daily doses of 5 GyE. Fifty patients were enrolled, of whom 35 patients were treated in the phase 2 portion. There were no grade 4 or 5 toxicities, and only 2 of 35 patients (4.1%) experienced a grade 3 toxicity event (chest wall pain grade 1, colitis grade 1). Of 48 patients eligible for analysis, 37 underwent pancreaticoduodenectomy. Thirty of 37 (81%) had positive nodes. Locoregional failure occurred in 6 of 37 resected patients (16.2%), and distant recurrence occurred in 35 of 48 patients (72.9%). With median follow-up of 38 months, the median progression-free survival for the entire group was 10 months, and overall survival was 17 months. Biomarker studies showed significant associations between worse survival outcomes and the KRAS point mutation change from glycine to aspartic acid at position 12, stromal CXCR7 expression, and circulating biomarkers CEA, CA19-9, and HGF (all, P<.05). Conclusions: This study met the primary endpoint by showing a rate of 4.1% grade 3 toxicity for neoadjuvant short-course proton-based chemoradiation. Treatment was associated with favorable local control. In exploratory analyses, KRAS{sup G12D} status and high CXCR7 expression and circulating CEA, CA19-9, and HGF levels were associated with poor survival.

  17. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system.

    Science.gov (United States)

    De Palma, Angela; Sollitto, Francesco; Loizzi, Domenico; Di Gennaro, Francesco; Scarascia, Daniele; Carlucci, Annalisa; Giudice, Giuseppe; Armenio, Andrea; Ludovico, Rossana; Loizzi, Michele

    2016-03-01

    We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16-83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. An optimal chest wall stabilization and reconstruction was achieved with the Synthes(®) titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long

  18. Improved survival in rhesus macaques immunized with modified vaccinia virus Ankara recombinants expressing simian immunodeficiency virus envelope correlates with reduction in memory CD4+ T-cell loss and higher titers of neutralizing antibody.

    Science.gov (United States)

    Ourmanov, Ilnour; Kuwata, Takeo; Goeken, Robert; Goldstein, Simoy; Iyengar, Ranjani; Buckler-White, Alicia; Lafont, Bernard; Hirsch, Vanessa M

    2009-06-01

    Previous studies demonstrated that immunization of macaques with simian immunodeficiency virus (SIV) Gag-Pol and Env recombinants of the attenuated poxvirus modified vaccinia virus Ankara (MVA) provided protection from high viremia and AIDS following challenge with a pathogenic strain of SIV. Although all animals became infected, plasma viremia was significantly reduced in animals that received the MVA-SIV recombinant vaccines compared with animals that received nonrecombinant MVA. Most importantly, the reduction in viremia resulted in a significant increase in median and cumulative survival. Continued analysis of these animals over the subsequent 9 years has shown that they maintain a survival advantage, although all but two of the macaques have progressed to AIDS. Importantly, improved survival correlated with preservation of memory CD4(+) T cells in the peripheral blood. The greatest survival advantage was observed in macaques immunized with regimens containing SIV Env, and the titer of neutralizing antibodies to the challenge virus prior to or shortly following challenge correlated with preservation of CD4(+) T cells. These data are consistent with a role for neutralizing antibodies in nonsterilizing protection from high viremia and associated memory CD4(+) T-cell loss.

  19. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings...... (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups......, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low...

  20. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings...... (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups......, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low...

  1. Surviving relatives after suicide

    DEFF Research Database (Denmark)

    Nørrelykke, Helle; Cohrt, Pernille

    and that suicide has become a subject of research, prevention and treatment. Auxiliary Strategies In the 1990s there have been established the Centre for Suicide Research and the Centre for Prevention of Suicide in Denmark and there has been drafted a national policy document which focuses on the need......We would like to focus on the surviving relatives after suicides, because it is generally accepted that it is especially difficult to recover after the loss from suicide and because we know as a fact that one suicide affects five persons on average. Every year approximately 700 people commit...... suicide in Denmark. This means that at least 400 people undergo the trauma it is when one of their near relatives commits suicide. We also know that the loss from suicide involves a lot of conflicting feelings - like anger, shame, guilt and loss and that the lack of therapy/treatment of these difficult...

  2. Surgical Resection for Hepatoblastoma-Updated Survival Outcomes.

    Science.gov (United States)

    Sunil, Bhanu Jayanand; Palaniappan, Ravisankar; Venkitaraman, Balasubramanian; Ranganathan, Rama

    2017-09-30

    Hepatoblastoma is the most common liver malignancy in the pediatric age group. The management of hepatoblastoma involves multidisciplinary approach. Patients with hepatoblastoma who underwent liver resection between 2000 and 2013 were analyzed and survival outcomes were studied. The crude incidence rate of hepatoblastoma at the Madras Metropolitan Tumor Registry (MMTR) is 0.4/1,00,000 population per year. Twelve patients underwent liver resection for hepatoblastoma during the study period; this included eight males and four females. The median age at presentation was 1.75 years (Range 5 months to 3 years). The median serum AFP in the study population was 20,000 ng/ml (Range 4.5 to 1,40,000 ng/ml). Three patients had stage I, one patient had stage II, and eight patients had stage III disease as per the PRETEXT staging system. Two patients were categorized as high risk and ten patients were categorized as standard risk. Seven of these patients received two to four cycles of neoadjuvant chemotherapy (PLADO regimen), and one patient received neoadjuvant radiation up to 84 Gy. Major liver resection was performed in nine patients. Nine patients received adjuvant chemotherapy. The most common histological subtype was embryonal type. Microscopic margin was positive in three cases. One patient recurred 7 months after surgery and the site of failure was the lung. The 5-year overall survival of the case series was 91%. The median survival was 120 months. Liver resections can be safely performed in pediatric populations after neoadjuvant treatment. Patients undergoing surgery had good disease control and long-term survival.

  3. Short-course radiotherapy in elderly patients with glioblastoma. Feasibility and efficacy of results from a single centre

    Energy Technology Data Exchange (ETDEWEB)

    Fariselli, L.; Pinzi, V.; Milanesi, I.; Marchetti, M. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Dept. of Neurosurgery; Silvani, A.; Salmaggi, A. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Div. of Neurooncology; Farinotti, M. [Neurological Carlo Besta Institute Foundation, Milan (Italy). Epidemiology Unit

    2013-06-15

    Background: The incidence of glioblastoma (GBM) in the elderly population is currently increasing, with a peak seen between 65 and 84 years. The optimal treatment in terms of both efficacy and quality of life still remains a relevant and debated issue today. The purpose of our study was to evaluate the feasibility of short-course hypofractionated accelerated radiotherapy (HART) in GBM patients aged over 70 years and with a good Karnofsky performance score (KPS). Methods: A review of medical records at the 'Istituto Neurologico C. Besta' was undertaken; patients aged {>=} 70 years who had undergone adjuvant HART for GBM between January 2000 and January 2004 were included in the study. HART was administered to a total dose of 45 Gy, 2.5 Gy/fraction, in three daily fractions for three consecutive days/cycle fractions each, delivered in two cycles (split 15 days). Results: A total of 33 patients were evaluable for the current analysis. Median follow-up was 10 months. According to CTCAE (version 3.0) criteria, none of the patients developed radiation-induced neurological status deterioration or necrosis. KPS evaluation after HART was found to be stable in 73 % of patients, improved in 24 %, and worse in 3 %. The median overall survival time of the entire study population was 8 months (range 2-24). Conclusions: Our findings suggest that a hypofractionated accelerated schedule can be a safe and effective option in the treatment of GBM in the elderly. (orig.)

  4. "Fate: The short film"

    OpenAIRE

    Maya Quintana, Jennifer

    2014-01-01

    "Fate: The Short Film" is a four minute short film which reflects the idea that nobody can escape from the fate. It has a good picture and sound quality with an understandable message for all public and with the collaboration of actors, filmmaker, stylist, script advisor and media technician.

  5. Socioeconomic Status, Not Race, Is Associated With Reduced Survival in Esophagectomy Patients.

    Science.gov (United States)

    Erhunmwunsee, Loretta; Gulack, Brian C; Rushing, Christel; Niedzwiecki, Donna; Berry, Mark F; Hartwig, Matthew G

    2017-07-01

    Black patients with esophageal cancer have worse survival than white patients. This study examines this racial disparity in conjunction with socioeconomic status (SES) and explores whether race-based outcome differences exist using a national database. The associations between race and SES with overall survival of patients treated with esophagectomy for stages I to III esophageal cancer between 2003 and 2011 in the National Cancer Data Base were investigated using the Kaplan-Meier method and proportional hazards analyses. Median income by zip code and proportion of the zip code residents without a high school diploma were grouped into income and education quartiles, respectively and used as surrogates for SES. The association between race and overall survival stratified by SES is explored. Of 11,599 esophagectomy patients who met study criteria, 3,503 (30.2%) were in the highest income quartile, 2,847 (24.5%) were in the highest education quartile, and 610 patients (5%) were black. Before adjustment for SES, black patients had worse overall survival than white patients (median survival 23.0 versus 34.7 months, log rank p race was not. Prior studies have suggested that survival of esophageal cancer patients after esophagectomy is associated with race. Our study suggests that race is not significantly related to overall survival when adjusted for other prognostic variables. Socioeconomic status, however, remains significantly related to overall survival in our model. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Prognostic classification index in Iranian colorectal cancer patients: Survival tree analysis

    Directory of Open Access Journals (Sweden)

    Amal Saki Malehi

    2016-01-01

    Full Text Available Aims: The aim of this study was to determine the prognostic index for separating homogenous subgroups in colorectal cancer (CRC patients based on clinicopathological characteristics using survival tree analysis. Methods: The current study was conducted at the Research Center of Gastroenterology and Liver Disease, Shahid Beheshti Medical University in Tehran, between January 2004 and January 2009. A total of 739 patients who already have been diagnosed with CRC based on pathologic report were enrolled. The data included demographic and clinical-pathological characteristic of patients. Tree-structured survival analysis based on a recursive partitioning algorithm was implemented to evaluate prognostic factors. The probability curves were calculated according to the Kaplan-Meier method, and the hazard ratio was estimated as an interest effect size. Result: There were 526 males (71.2% of these patients. The mean survival time (from diagnosis time was 42.46± (3.4. Survival tree identified three variables as main prognostic factors and based on their four prognostic subgroups was constructed. The log-rank test showed good separation of survival curves. Patients with Stage I-IIIA and treated with surgery as the first treatment showed low risk (median = 34 months whereas patients with stage IIIB, IV, and more than 68 years have the worse survival outcome (median = 9.5 months. Conclusion: Constructing the prognostic classification index via survival tree can aid the researchers to assess interaction between clinical variables and determining the cumulative effect of these variables on survival outcome.

  7. Fifteen-Year Biochemical Relapse-Free Survival, Cause-Specific Survival, and Overall Survival Following I125 Prostate Brachytherapy in Clinically Localized Prostate Cancer: Seattle Experience

    International Nuclear Information System (INIS)

    Sylvester, John E.; Grimm, Peter D.; Wong, Jason; Galbreath, Robert W.; Merrick, Gregory; Blasko, John C.

    2011-01-01

    Purpose: To report 15-year biochemical relapse-free survival (BRFS), cause-specific survival (CSS), and overall survival (OS) outcomes of patients treated with I 125 brachytherapy monotherapy for clinically localized prostate cancer early in the Seattle experience. Methods and Materials: Two hundred fifteen patients with clinically localized prostate cancer were consecutively treated from 1988 to 1992 with I 125 monotherapy. They were prospectively followed as a tight cohort. They were evaluated for BRFS, CSS, and OS. Multivariate analysis was used to evaluate outcomes by pretreatment clinical prognostic factors. BRFS was analyzed by the Phoenix (nadir + 2 ng/mL) definition. CSS and OS were evaluated by chart review, death certificates, and referring physician follow-up notes. Gleason scoring was performed by general pathologists at a community hospital in Seattle. Time to biochemical failure (BF) was calculated and compared by Kaplan-Meier plots. Results: Fifteen-year BRFS for the entire cohort was 80.4%. BRFS by D'Amico risk group classification cohort analysis was 85.9%, 79.9%, and 62.2% for low, intermediate, and high-risk patients, respectively. Follow-up ranged from 3.6 to 18.4 years; median follow-up was 15.4 years for biochemically free of disease patients. Overall median follow-up was 11.7 years. The median time to BF in those who failed was 5.1 years. CSS was 84%. OS was 37.1%. Average age at time of treatment was 70 years. There was no significant difference in BRFS between low and intermediate risk groups. Conclusion: I 125 monotherapy results in excellent 15-year BRFS and CSS, especially when taking into account the era of treatment effect.

  8. [Shunt and short circuit].

    Science.gov (United States)

    Rangel-Abundis, Alberto

    2006-01-01

    Shunt and short circuit are antonyms. In French, the term shunt has been adopted to denote the alternative pathway of blood flow. However, in French, as well as in Spanish, the word short circuit (court-circuit and cortocircuito) is synonymous with shunt, giving rise to a linguistic and scientific inconsistency. Scientific because shunt and short circuit made reference to a phenomenon that occurs in the field of the physics. Because shunt and short circuit are antonyms, it is necessary to clarify that shunt is an alternative pathway of flow from a net of high resistance to a net of low resistance, maintaining the stream. Short circuit is the interruption of the flow, because a high resistance impeaches the flood. This concept is applied to electrical and cardiovascular physiology, as well as to the metabolic pathways.

  9. Verkkosivujen ja sosiaalisen median käyttäminen ennakoivan turvallisuusviestinnän välineenä

    OpenAIRE

    Virta, Esa-Pekka

    2016-01-01

    Tämän opinnäytetyön tavoitteena oli laatia selvitys eräälle ammattikorkeakoululle verkkosivujen sekä sosiaalisen median käyttämisestä ennakoivan turvallisuusviestinnän välineenä. Ennakoivaa turvallisuusviestintää on Suomessa tutkittu melko vähän kun sitä verrataan turvallisuusjohtamista koskeviin tutkimuksiin. Verkkosivujen sekä sosiaalisen median käyttämistä ennakoivan turvallisuusviestinnän välineenä ei ole tutkittu juuri ollenkaan ja tästä syntyi idea tuottaa tämä selvitys. Opinnäytetyön t...

  10. Idiopathic short stature

    Directory of Open Access Journals (Sweden)

    Vlaški Jovan

    2013-01-01

    Full Text Available Growth is a complex process and the basic characteristic of child- hood growth monitoring provides insight into the physiological and pathological events in the body. Statistically, the short stature means departure from the values of height for age and sex (in a particular environment, which is below -2 standard deviation score, or less than -2 standard deviation, i.e. below the third percentile. Advances in molecular genetics have contributed to the improvement of diagnostics in endocrinology. Analysis of patients’ genotypes should not be performed before taking a classical history, detailed clinical examination and appropriate tests. In patients with idiopathic short stature specific causes are excluded, such as growth hormone deficiency, Turner syndrome, short stature due to low birth weight, intrauterine growth retardation, small for gestational age, dysmorphology syndromes and chronic childhood diseases. The exclusion of abovementioned conditions leaves a large number of children with short stature whose etiology includes patients with genetic short stature or familial short stature and those who are low in relation to genetic potential, and who could also have some unrecognized endocrine defect. Idiopathic short stature represents a short stature of unknown cause of heterogeneous etiology, and is characterized by a normal response of growth hormone during stimulation tests (>10 ng/ml or 20 mJ/l, without other disorders, of normal body mass and length at birth. In idiopathic short stature standard deviation score rates <-2.25 (-2 to -3 or <1.2 percentile. These are also criteria for the initiation of growth hormone therapy. In children with short stature there is also the presence of psychological and social suffering. Goals of treatment with growth hormone involve achieving normal height and normal growth rate during childhood.

  11. Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme

    International Nuclear Information System (INIS)

    Kase, Marju; Minajeva, Ave; Niinepuu, Kristi; Kase, Sandra; Vardja, Markus; Asser, Toomas; Jaal, Jana

    2013-01-01

    The aim of the study was to assess the impact of CD133-positive (CD133+) cancer stem cell proportions on treatment results of glioblastoma multiforme (GBM) patients. Patients with GBM (n = 42) received postoperative radiotherapy (± chemotherapy). Surgically excised GBM tissue sections were immunohistochemically examined for CD133 expression. The proportions of CD133+ GBM cells were determined (%). The proportion of CD133+ GBM stem cells was established by 2 independent researchers whose results were in good accordance (R = 0.8, p < 0.01). Additionally, CD133 expression levels were correlated with patients overall survival. The proportion of CD133+ cells varied between patients, being from 0.5% to 82%. Mean and median proportions of CD133+ cells of the entire study group were 33% ± 24% (mean ± SD) and 28%, respectively. Clinical data do not support the association between higher proportion of stem cells and the aggressiveness of GBM. Median survival time of the study group was 10.0 months (95% CI 9.0–11.0). The survival time clearly depended on the proportion of CD133+ cells (log rank test, p = 0.02). Median survival times for patients with low (< median) and high (≥ median) proportion of CD133+ cells were 9.0 months (95% CI 7.6–10.5) and 12.0 months (95% CI 9.3–14.7), respectively. In multivariate analysis, the proportion of CD133+ cells emerged as a significant independent predictor for longer overall survival (HR 2.0, 95% CI 1.0–3.8, p = 0.04). In patients with higher stem cell proportion, significantly longer survival times after postoperative radiotherapy were achieved. Underlying reasons and possible higher sensitivity of GBM stem cells to fractionated radio-therapy should be clarified in further studies

  12. Sample size calculations based on a difference in medians for positively skewed outcomes in health care studies

    Directory of Open Access Journals (Sweden)

    Aidan G. O’Keeffe

    2017-12-01

    Full Text Available Abstract Background In healthcare research, outcomes with skewed probability distributions are common. Sample size calculations for such outcomes are typically based on estimates on a transformed scale (e.g. log which may sometimes be difficult to obtain. In contrast, estimates of median and variance on the untransformed scale are generally easier to pre-specify. The aim of this paper is to describe how to calculate a sample size for a two group comparison of interest based on median and untransformed variance estimates for log-normal outcome data. Methods A log-normal distribution for outcome data is assumed and a sample size calculation approach for a two-sample t-test that compares log-transformed outcome data is demonstrated where the change of interest is specified as difference in median values on the untransformed scale. A simulation study is used to compare the method with a non-parametric alternative (Mann-Whitney U test in a variety of scenarios and the method is applied to a real example in neurosurgery. Results The method attained a nominal power value in simulation studies and was favourable in comparison to a Mann-Whitney U test and a two-sample t-test of untransformed outcomes. In addition, the method can be adjusted and used in some situations where the outcome distribution is not strictly log-normal. Conclusions We recommend the use of this sample size calculation approach for outcome data that are expected to be positively skewed and where a two group comparison on a log-transformed scale is planned. An advantage of this method over usual calculations based on estimates on the log-transformed scale is that it allows clinical efficacy to be specified as a difference in medians and requires a variance estimate on the untransformed scale. Such estimates are often easier to obtain and more interpretable than those for log-transformed outcomes.

  13. Preparation of denatured sup(99m)Tc labeled HSA aerosols of different median diameters for various imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Raghunath, B.; Kotrappa, P.; Soni, P.S.; Ganatra, R.D. (Bhabha Atomic Research Centre, Bombay (India))

    1982-02-01

    The preparation of denatured sup(99m)Tc-labelled human serum albumin (HSA) aerosols of different median diameters is described using the BARC (Bhabha Atomic Research Centre) dry aerosol generation and delivery system. The applications of these radioactive aerosols are demonstrated in aerosol scintigraphy of lungs, mucociliary movement studies and lymphoscintigraphy in rabbits. It is concluded that the BARC system gives a simplified, rapid and versatile procedure for generation of denatured volume tagged HSA aerosols for a variety of clinical applications.

  14. Anatomical study of the motor branches of the median nerve to the forearm and guidelines for selective neurectomy.

    Science.gov (United States)

    Parot, Catalina; Leclercq, Caroline

    2016-07-01

    The median nerve is responsible for the motor innervation of most of the muscles usually involved in upper limb spasticity. Selective neurectomy is one of the treatments utilized to reduce spasticity. The purpose of this study was to describe the variations of the motor branches of the median nerve in the forearm and draw recommendations for an appropriate planning of selective neurectomy. The median nerve was dissected in the forearm of 20 fresh cadaver upper limbs. Measurements included number, origin, division, and entry point of each motor branch into the muscles. One branch for the pronator teres was the most common pattern. In 9/20 cases, it arose as a common trunk with other branches. A single trunk innervated the flexor carpi radialis with a common origin with other branches in 17/20 cases. Two, three or four branches innervated the flexor digitorum superficialis, the first one frequently through a common trunk with other branches. They were very difficult to identify unless insertions of pronator teres and flexor digitorum superficialis were detached. The flexor digitorum profundus received one to five branches and flexor pollicis longus one to two branches from the anterior interosseous nerve. There is no regular pattern of the motor branches of the median nerve in the forearm. Our findings differ in many points from the classical literature. Because of the frequency of common trunks for different muscles, we recommend the use of peroperative electrical stimulation. Selective neurotomy of flexor digitorum superficialis is technically difficult, because the entry point of some of their terminal branches occurs just below the arch and deep to the muscle belly.

  15. Understanding Fish Linear Acceleration Using an Undulatory Biorobotic Model with Soft Fluidic Elastomer Actuated Morphing Median Fins.

    Science.gov (United States)

    Wen, Li; Ren, Ziyu; Di Santo, Valentina; Hu, Kainan; Yuan, Tao; Wang, Tianmiao; Lauder, George V

    2018-04-10

    Although linear accelerations are an important common component of the diversity of fish locomotor behaviors, acceleration is one of the least-understood aspects of propulsion. Analysis of acceleration behavior in fishes with both spiny and soft-rayed median fins demonstrates that fin area is actively modulated when fish accelerate. We implemented an undulatory biomimetic robotic fish model with median fins manufactured using multimaterial three-dimensional printing-a spiny-rayed dorsal fin, soft-rayed dorsal/anal fins, and a caudal fin-whose stiffnesses span three orders of magnitude. We used an array of fluidic elastomeric soft actuators to mimic the dorsal/anal inclinator and erector/depressor muscles of fish, which allowed the soft fins to be erected or folded within 0.3 s. We experimentally show that the biomimetic soft dorsal/anal fin can withstand external loading. We found that erecting the soft dorsal/anal fins significantly enhanced the linear acceleration rate, up to 32.5% over the folded fin state. Surprisingly, even though the projected area of the body (in the lateral plane) increased 16.9% when the median fins were erected, the magnitude of the side force oscillation decreased by 24.8%, which may have led to significantly less side-to-side sway in the robotic swimmer. Visualization of fluid flow in the wake of median fins reveals that during linear acceleration, the soft dorsal fin generates a wake flow opposite in direction to that of the caudal fin, which creates propulsive jets with time-variant circulations and jet angles. Erectable/foldable fins provide a new design space for bioinspired underwater robots with structures that morph to adapt to different locomotor behaviors. This biorobotic fish model is also a potentially promising system for studying the dynamics of complex multifin fish swimming behaviors, including linear acceleration, steady swimming, and burst and coast, which are difficult to analyze in freely swimming fishes.

  16. Distal median nerve dysfunction

    Science.gov (United States)

    ... later on. Inflammation of the tendons ( tendonitis ) or joints ( arthritis ) can also put pressure on the nerve. ... how fast electrical signals move through a nerve Neuromuscular ultrasound to view problems with the muscles and ...

  17. Ranking by Medians

    Science.gov (United States)

    Martin, Brian

    2016-01-01

    Brian Martin describes a difficult committee meeting he once attended which consisted of one representative from each department. When the meeting ended it left a bitter taste for many who participated. Having learned from this experience, Martin became a chair of the committee and tried a new system that overcame many of the previous problems.…

  18. Hyperbolicity in median graphs

    Indian Academy of Sciences (India)

    mic problems in hyperbolic spaces and hyperbolic graphs have been .... that in general the main obstacle is that we do not know the location of ...... [25] Jonckheere E and Lohsoonthorn P, A hyperbolic geometry approach to multipath routing,.

  19. Median sternotomy and ventral stabilisation using pins and polymethylmethacrylate for a comminuted T5 vertebral fracture in a Miniature Schnauzer.

    Science.gov (United States)

    Guiot, L P; Allman, D A

    2011-01-01

    A 2.9 kg Miniature Schnauzer was referred to our clinic, the Emergency & Critical Care Medicine Service at the Michigan State University Veterinary Teaching Hospital, following a dog fight. Physical examination findings upon admission included multiple thoracic wounds, absence of hindlimb deep pain, and marked Schiff-Sherrington syndrome. Computed tomography imaging revealed thoracic wall penetration and a comminuted T5 vertebral fracture. Thoracic exploration and thoracic wall repair were performed through a median sternotomy. The vertebral fracture was exposed and stabilised intra-thoracically through the same approach using pins and polymethylmethacrylate. The pins were placed percutaneously into the vertebral bodies of the adjacent vertebrae. Recovery was uncomplicated and fracture healing was documented eight weeks postoperatively. Spinal trauma secondary to dog fights is relatively common. The presence of concurrent penetrating thoracic injury negatively affects prognosis and necessitates thoracic exploration as soon as feasible. The approach should allow complete thoracic exploration to repair parietal and visceral damage, thus indicating the need for median sternotomy rather than an intercostal approach. The present case report suggested that median sternotomy can be used to safely apply stabilisation devices for the treatment of concurrent spinal trauma. Direct visualisation of the vertebral bodies permitted optimal implant anchorage as compared to potentially more hazardous techniques such as dorsal pinning.

  20. 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.