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Sample records for sodium eszopiclone everolimus

  1. Eszopiclone

    Science.gov (United States)

    ... not take eszopiclone with or shortly after a heavy, high-fat meal. Eszopiclone may not work well ... daytime. Do not drive a car or operate machinery until you know how this medication affects you. ...

  2. Everolimus

    Science.gov (United States)

    ... that last several days; headaches; seizures; confusion; or personality changes.Everolimus may cause a blood clot in ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

  3. Eszopiclone (Lunesta): a new nonbenzodiazepine hypnotic agent

    OpenAIRE

    Brielmaier, Benjamin D.

    2006-01-01

    Randomized, placebo-controlled trials have shown that eszopiclone, a newly available nonbenzodiazepine hypnotic, effectively treats the symptoms of insomnia. Its pharmacokinetic and pharmacodynamic parameters are similar to those of the other currently available nonbenzodiazepine hypnotics (i.e., zolpidem and zaleplon). The unique quality of eszopiclone lies in its product labeling. It is not restricted to short-term use, unlike both zolpidem and zaleplon. Dosing of eszopiclone should begin a...

  4. Eszopiclone for late-life insomnia

    Directory of Open Access Journals (Sweden)

    Christina S McCrae

    2007-10-01

    Full Text Available Christina S McCrae1, Amanda Ross1, Ashley Stripling2, Natalie D Dautovich21Department of Clinical and Health Psychology, 2Department of Psychology, University of Florida, Gainesville, Florida, USAAbstract: Insomnia, the most common sleep disturbance in later life, affects 20%–50% of older adults. Eszopiclone, a short-acting nonbenzodiazepine hypnotic agent developed for the treatment of insomnia, has been available in Europe since 1992 and in the US since 2005. Although not yet evaluated for transient insomnia in older adults, eszopiclone has been shown to be safe and efficacious for short-term treatment (2 weeks of chronic, primary insomnia in older adults (64–91 years. Clinical studies in younger adults (mean = 44 years have shown eszopiclone can be used for 6–12 months without evidence of problems. Because the oldest participant in these longer-term trials was 69, it not known whether eszopiclone is effective for older adults [particularly the old old (75–84 years and oldest old (85+] when used over longer periods. This is unfortunate, because older individuals frequently suffer from chronic insomnia. Cognitive-behavioral therapy for insomnia, which effectively targets the behavioral factors that maintain chronic insomnia, represents an attractive treatment alternative or adjuvant to eszopiclone for older adults. To date, no studies have compared eszopiclone to other hypnotic medications or to nonpharmacological interventions, such as cognitive-behavioral therapy for insomnia, in older adults. All of the clinical trials reported herein were funded by Sepracor. This paper provides an overview of the literature on eszopiclone with special emphasis on its use for the treatment of late-life insomnia. Specific topics covered include pharmacology, pharmacodynamics, pharmacokinetics, clinical trial data, adverse events, drug interactions, tolerance/dependence, and economics/cost considerations for older adults. Keywords: aging, eszopiclone

  5. Eszopiclone: its use in the treatment of insomnia.

    Science.gov (United States)

    Monti, Jaime M; Pandi-Perumal, S R

    2007-08-01

    Eszopiclone is the S-isomer of racemic zopiclone, a cyclopyrrolone with sedative-hypnotic activity that has been available in Europe, Canada, and Latin America since 1987. Eszopiclone acts by binding to the GABA(A) receptor. In contrast to the benzodiazepine (BZD) hypnotics, eszopiclone has more selectivity for certain subunits of the GABA(A) receptor. Oral eszopiclone is rapidly absorbed and extensively distributed to body tissues including the brain. Peak plasma concentrations are attained 1.0-1.6 hours after a 3 mg dose, while the mean elimination half-life is 6 hours. The half-life increases with age to about 9.0 hours in patients 65 years or older. Eszopiclone's pharmacokinetic (PK) profile is not substantially modified in patients suffering from renal failure or mild-to-moderate hepatic impairment, although patients with severe hepatic insufficiency should have a reduced dose. The subjective perception of improved sleep following eszopiclone 2 or 3 mg treatment has been demonstrated in randomized, double-blind, placebo-controlled studies of up to 6 months' duration. In these studies the drug significantly reduced sleep onset latency (SOL), the number of awakenings, and wake time after sleep onset (WASO) whereas total sleep time (TST) and quality of sleep were increased in non-elderly and elderly subjects. Sleep laboratory studies of the effects of eszopiclone have confirmed the drug's clinical efficacy in subjects with chronic primary insomnia. Eszopiclone, unlike BZD hypnotics, does not significantly alter values corresponding to slow wave sleep (SWS or stages 3 and 4) and rapid eye movement (REM) sleep. Rebound insomnia following withdrawal of eszopiclone has been examined in only one study. Discontinuation of the active treatment with 2 mg was followed by rebound insomnia in non-elderly subjects. Three-mg doses of eszopiclone administered for a period of up to 12 months was associated with a sustained beneficial effect on sleep induction and maintenance

  6. Synthesis of RP 48497, an Impurity of Eszopiclone

    Directory of Open Access Journals (Sweden)

    Mao-Sheng Cheng

    2008-08-01

    Full Text Available Abstract: RP 48497 is a photodegradation product of eszopiclone, a non-benzodiazepine sedative-hypnotic used in the treatment of insomnia. We report herein the first synthesis of RP 48497 via reduction, chlorination, and recyclization of 6-(5-chloropyridin-2-yl-7-hydroxy-6,7-dihydropyrrolo[3,4-b]pyrazin-5-one (3, a key intermediate in the synthesis of eszopiclone. The structure of RP 48497 was confirmed by its 1H-NMR and MS data. The mechanism of the reduction step in the synthesis of RP 48497 was also studied and the key parameters were determined. These findings should be important for quality control purposes in the manufacture of eszopiclone.

  7. Plasticity-Related Gene Expression During Eszopiclone-Induced Sleep.

    Science.gov (United States)

    Gerashchenko, Dmitry; Pasumarthi, Ravi K; Kilduff, Thomas S

    2017-07-01

    Experimental evidence suggests that restorative processes depend on synaptic plasticity changes in the brain during sleep. We used the expression of plasticity-related genes to assess synaptic plasticity changes during drug-induced sleep. We first characterized sleep induced by eszopiclone in mice during baseline conditions and during the recovery from sleep deprivation. We then compared the expression of 18 genes and two miRNAs critically involved in synaptic plasticity in these mice. Gene expression was assessed in the cerebral cortex and hippocampus by the TaqMan reverse transcription polymerase chain reaction and correlated with sleep parameters. Eszopiclone reduced the latency to nonrapid eye movement (NREM) sleep and increased NREM sleep amounts. Eszopiclone had no effect on slow wave activity (SWA) during baseline conditions but reduced the SWA increase during recovery sleep (RS) after sleep deprivation. Gene expression analyses revealed three distinct patterns: (1) four genes had higher expression either in the cortex or hippocampus in the group of mice with increased amounts of wakefulness; (2) a large proportion of plasticity-related genes (7 out of 18 genes) had higher expression during RS in the cortex but not in the hippocampus; and (3) six genes and the two miRNAs showed no significant changes across conditions. Even at a relatively high dose (20 mg/kg), eszopiclone did not reduce the expression of plasticity-related genes during RS period in the cortex. These results indicate that gene expression associated with synaptic plasticity occurs in the cortex in the presence of a hypnotic medication. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  8. Improved renal function after early conversion from a calcineurin inhibitor to everolimus

    DEFF Research Database (Denmark)

    Mjörnstedt, L; Sørensen, S S; von Zur Mühlen, B

    2012-01-01

    .2) mL/min with everolimus versus a decrease of 0.4 (12.0) mL/min in controls (p graft or patient survival. The 12-month incidence of biopsy-proven acute rejection (BPAR) was 27.5% (n = 28) with everolimus and 11.0% (n = 11) in controls (p = 0.004). All......In an open-label, multicenter trial, de novo kidney transplant recipients at low to medium immunological risk were randomized at week 7 posttransplant to remain on CsA (n = 100, controls) or convert to everolimus (n = 102), both with enteric-coated mycophenolate sodium and corticosteroids...... controls (3.0%; p = 0.030). In conclusion, conversion from CsA to everolimus at week 7 after kidney transplantation was associated with a greater improvement in mGFR at month 12 versus CNI-treated controls but discontinuations and BPAR were more frequent....

  9. The effects of eszopiclone on sleep spindles and memory consolidation in schizophrenia: a randomized placebo-controlled trial.

    Science.gov (United States)

    Wamsley, Erin J; Shinn, Ann K; Tucker, Matthew A; Ono, Kim E; McKinley, Sophia K; Ely, Alice V; Goff, Donald C; Stickgold, Robert; Manoach, Dara S

    2013-09-01

    In schizophrenia there is a dramatic reduction of sleep spindles that predicts deficient sleep-dependent memory consolidation. Eszopiclone (Lunesta), a non-benzodiazepine hypnotic, acts on γ-aminobutyric acid (GABA) neurons in the thalamic reticular nucleus where spindles are generated. We investigated whether eszopiclone could increase spindles and thereby improve memory consolidation in schizophrenia. In a double-blind design, patients were randomly assigned to receive either placebo or 3 mg of eszopiclone. Patients completed Baseline and Treatment visits, each consisting of two consecutive nights of polysomnography. On the second night of each visit, patients were trained on the motor sequence task (MST) at bedtime and tested the following morning. Academic research center. Twenty-one chronic, medicated schizophrenia outpatients. We compared the effects of two nights of eszopiclone vs. placebo on stage 2 sleep spindles and overnight changes in MST performance. Eszopiclone increased the number and density of spindles over baseline levels significantly more than placebo, but did not significantly enhance overnight MST improvement. In the combined eszopiclone and placebo groups, spindle number and density predicted overnight MST improvement. Eszopiclone significantly increased sleep spindles, which correlated with overnight motor sequence task improvement. These findings provide partial support for the hypothesis that the spindle deficit in schizophrenia impairs sleep-dependent memory consolidation and may be ameliorated by eszopiclone. Larger samples may be needed to detect a significant effect on memory. Given the general role of sleep spindles in cognition, they offer a promising novel potential target for treating cognitive deficits in schizophrenia.

  10. Lack of change in glucose metabolism in eszopiclone-treated primary insomnia patients

    Directory of Open Access Journals (Sweden)

    Buxton OM

    2017-07-01

    Full Text Available Orfeu M Buxton,1-4 Milena K Pavlova,1,5 Shawn P O’Connor,1 Wei Wang,1,2 John W Winkelman1,6 1Division of Sleep Medicine, Harvard Medical School, 2Department of Medicine, Brigham and Women’s Hospital, 3Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, 4Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 5Department of Neurology, Brigham and Women’s Hospital, 6Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA Study objectives: Primary insomnia (PI may increase diabetes risk. We tested the hypothesis that the effects of PI on glucose metabolism could be improved by 2 months of pharmacological treatment.Methods: Adult men and women meeting clinical criteria for PI were studied (n=20, body mass index 25.1±2.7 kg/m2, age 39.7±7.9 in a randomized, double-blind, placebo-controlled clinical trial. The study consisted of two 1-day inpatient admissions to a General Clinical Research Center separated by 2 months of at-home treatment with 3 mg eszopiclone or placebo. During inpatient admissions, each subject underwent two intravenous glucose tolerance tests (IVGTTs pre- and post-treatment. Diet was controlled for micro- and macro-nutrient content and calories on the day prior to pre- and post-treatment IVGTTs. Subjects were randomized following completion of the initial IVGTT to take either placebo or eszopiclone 30 min prior to bedtime at home for 2 months.Results: Two-month eszopiclone treatment did not change insulin sensitivity, glucose tolerance, or any of the sleep measures significantly, compared with placebo. Changes in glycated hemoglobin (HbA1c, clinical measure of glycemic control were correlated with changes in diary-reported total sleep time in the eszopiclone group (r=0.66, p=0.0360, and in the combined groups’ data (r=0.55, p=0.0125. Changes in polysomnography-measured wake after sleep onset, a hallmark of PI, were positively related

  11. Everolimus in Heart Transplantation: An Update

    Directory of Open Access Journals (Sweden)

    Stephan W. Hirt

    2013-01-01

    Full Text Available The evidence base relating to the use of everolimus in heart transplantation has expanded considerably in recent years, providing clinically relevant information regarding its use in clinical practice. Unless there are special considerations to take into account, all de novo heart transplant patients can be regarded as potential candidates for immunosuppression with everolimus and reduced-exposure calcineurin inhibitor therapy. Caution about the use of everolimus immediately after transplantation should be exercised in certain patients with the risk of severe proteinuria, with poor wound healing, or with uncontrolled severe hyperlipidemia. Initiation of everolimus in the early phase aftertransplant is not advisable in patients with severe pretransplant end-organ dysfunction or in patients on a left ventricular assist device beforetransplant who are at high risk of infection or of wound healing complications. The most frequent reason for introducing everolimus in maintenance heart transplant patients is to support minimization or withdrawal of calcineurin inhibitor therapy, for example, due to impaired renal function or malignancy. Due to its potential to inhibit the progression of cardiac allograft vasculopathy and to reduce cytomegalovirus infection, everolimus should be initiated as soon as possible after heart transplantation. Immediate and adequate reduction of CNI exposure is mandatory from the start of everolimus therapy.

  12. Adjuvant Everolimus for Resected Kidney Cancer

    Science.gov (United States)

    In this clinical trial, patients with renal cell cancer who have undergone partial or complete nephrectomy will be randomly assigned to take everolimus tablets or matching placebo tablets daily for 54 weeks.

  13. Fatal acute pulmonary injury associated with everolimus.

    Science.gov (United States)

    Depuydt, Pieter; Nollet, Joke; Benoit, Dominique; Praet, Marleen; Caes, Frank

    2012-03-01

    To report a case of fatal alveolar hemorrhage associated with the use of everolimus in a patient who underwent a solid organ transplant. In a 71-year-old cardiac transplant patient, cyclosporine was replaced with everolimus because of worsening renal function. Over the following weeks, the patient developed nonproductive cough and increasing dyspnea. His condition deteriorated to acute respiratory failure with hemoptysis, requiring hospital admission. Bilateral patchy alveolar infiltrates were apparent on chest X-ray and computed tomography. Cardiac failure was ruled out and empiric antimicrobial therapy was initiated. Additional extensive workup could not document opportunistic infection. Everolimus was discontinued and high-dose corticosteroid therapy was initiated. Despite this, the patient required invasive mechanical ventilation and died because of refractory massive hemoptysis. Autopsy revealed diffuse alveolar hemorrhage. Everolimus is a mammalian target of rapamycin inhibitor approved for use as an immunosuppressant and antineoplastic agent. Its main advantage over calcineurin inhibitors (tacrolimus and cyclosporine) is a distinct safety profile. Although it has become clear that everolimus induces pulmonary toxicity more frequently than initially thought, most published cases thus far represented mild and reversible disease, and none was fatal. Here, we report a case of pulmonary toxicity developing over weeks following the introduction of everolimus, in which a fatal outcome could not be prevented by drug withdrawal and corticosteroid treatment. The association of everolimus and this syndrome was probable according to the Naranjo probability scale. This case indicates that with the increasing use of everolimus, clinicians should be aware of the rare, but life-threatening manifestation of pulmonary toxicity.

  14. Sodium

    Science.gov (United States)

    Table salt is a combination of two minerals - sodium and chloride Your body needs some sodium to work properly. It helps with the function ... in your body. Your kidneys control how much sodium is in your body. If you have too ...

  15. Effects of a short course of eszopiclone on continuous positive airway pressure adherence: a randomized trial.

    Science.gov (United States)

    Lettieri, Christopher J; Shah, Anita A; Holley, Aaron B; Kelly, William F; Chang, Audrey S; Roop, Stuart A

    2009-11-17

    Adherence to short-term continuous positive airway pressure (CPAP) may predict long-term use. Unfortunately, initial CPAP intolerance may lead to poor adherence or abandonment of therapy. To determine whether a short course of eszopiclone at the onset of therapy improves long-term CPAP adherence more than placebo in adults with obstructive sleep apnea. Parallel randomized, placebo-controlled trial from March 2007 to December 2008. Randomization, maintained and concealed centrally by pharmacy personnel, was computer-generated using fixed blocks of 10. Referring physicians, investigators, and patients were blinded to the treatment assignment until after the final data were collected. (ClinicalTrials.gov registration number: NCT00612157). Academic sleep disorder center. 160 adults (mean age, 45.7 years [SD, 7.3]; mean apnea-hypopnea index, 36.9 events/h [SD, 23]) with newly diagnosed obstructive sleep apnea initiating CPAP. Eszopiclone, 3 mg (n = 76), or matching placebo (n = 78) for the first 14 nights of CPAP. Use of CPAP was measured weekly for 24 weeks. Adherence to CPAP (primary outcome) and the rate of CPAP discontinuation and improvements in symptoms (secondary outcomes) were compared. Follow-up at 1, 3, and 6 months was completed by 150, 136, and 120 patients, respectively. Patients in the eszopiclone group used CPAP for 20.8% more nights (95% CI, 7.2% to 34.4%; P = 0.003), 1.3 more hours per night for all nights (CI, 0.4 to 2.2 hours; P = 0.005), and 1.1 more hours per night of CPAP use (CI, 0.2 to 2.1 hours; P = 0.019). The hazard ratio for discontinuation of CPAP was 1.90 (CI, 1.1 to 3.4; P = 0.033) times higher in the placebo group. Side effects were reported in 7.1% of patients and did not differ between groups. Patients had severe obstructive sleep apnea treated at a specialized sleep center with frequent follow-up; results may not be generalizable to different settings. Patients' tolerance to CPAP and their reasons for discontinuation were not assessed

  16. Everolimus for Advanced Pancreatic Neuroendocrine Tumors.

    NARCIS (Netherlands)

    Yao, James C.; Shah, Manisha H.; Ito, Tetsuhide; Bohas, Catherine Lombard; Wolin, Edward M.; Van Cutsem, Eric; Hobday, Timothy J.; Okusaka, Takuji; Capdevila, Jaume; de Vries, Elisabeth G. E.; Tomassetti, Paola; Pavel, Marianne E.; Hoosen, Sakina; Haas, Tomas; Lincy, Jeremie; Lebwohl, David; Oberg, Kjell

    2011-01-01

    Background: Everolimus, an oral inhibitor of mammalian target of rapamycin (mTOR), has shown antitumor activity in patients with advanced pancreatic neuroendocrine tumors, in two phase 2 studies. We evaluated the agent in a prospective, randomized, phase 3 study. Methods: We randomly assigned 410

  17. Economic outcomes of eszopiclone treatment in insomnia and comorbid major depressive disorder.

    Science.gov (United States)

    Snedecor, Sonya J; Botteman, Marc F; Schaefer, Kendyl; Sarocco, Phillip; Barry, Nadine; Pickard, A Simon

    2010-03-01

    Eszopiclone is effective for the treatment of insomnia in patients with insomnia and comorbid major depressive disorder (MDD). Both conditions impose significant economic burden, with the US societal cost of depression estimated at USD 50 billion annually. The purpose of this analysis was to examine the costs and benefits of eszopiclone co-administered with fluoxetine (ESZ+FLX) compared to placebo co-administered with fluoxetine (PBO+FLX) in adults meeting the DSM-IV criteria for insomnia and MDD. Data from 434 patients enrolled in an 8-week clinical trial who met the economic-subanalysis criteria were examined. The costs of medical care (in 2007 USUSD ) and lost work time were estimated from the Hamilton Depression Scale (HAM-D17) scores using published algorithms. Cost of lost productivity while at work was based on responses to the Work Limitations Questionnaire. The impact of therapy on quality-adjusted life years (QALYs) was estimated by transforming HAM-D17 (base case analysis) or Short Form Health Survey (SF-12) (scenario analyses) responses into health utility scores using published algorithms. Drug costs were estimated based on average wholesale price. The mean 8-week increases in QALYs from baseline were 0.0392 and 0.0334 for the ESZ+FLX and PBO+FLX groups, respectively. Mean per-patient costs were USD 1,279 and USD 1,198 for the respective groups. Thus, co-treatment resulted in net increases of 0.0058 QALYs and USD 81, leading to an incremental cost per QALY gained of approximately USD 14,000. Co-administration of eszopiclone and fluoxetine improved patients' insomnia symptoms and appeared to be a cost-effective treatment strategy for patients with insomnia and comorbid MDD. One limitation of this study is that optimal utility estimation techniques were not available. Utilities were instead derived indirectly using the HAM-D17 (disease-specific, not generic) or SF-12 (generic, but potentially insensitive to important changes in some conditions

  18. COMBINATION OF ESZOPICLONE AND MIND-BODY THERAPY AS NOVEL STRATEGY IN INSOMNIA TREATMENT

    Directory of Open Access Journals (Sweden)

    AAD Dalem Dwi Putra

    2013-02-01

    Full Text Available Insomnia is defined as a disorder of difficulty initiating sleep, difficulty maintaining sleep, sleep is not fresh during 1 month or more that makes a significant clinical disturbance or distress. Insomnia affects 15% to 40% of world general population and predominantly in women 65 to 79 years. Insomnia also reported in individuals aged 18 to 34 years. If neglected for a long time, insomnia can diminish job performance and quality of live for each individuals. The new strategy to solve this problem in the future is combining pharmacotherapy like eszopiclone a nonbenzodiazepine derivate and mind-body therapy (MBT to the patients. It can lowering severe risk of conventional drugs side effects, but from pharmacoeconomic this drug is not costly effective. It must combine with MBT to decrease frequency and duration of drug consumption.

  19. Regression of Cardiac Rhabdomyomas in a Neonate after Everolimus Treatment

    Directory of Open Access Journals (Sweden)

    Helen Bornaun

    2016-01-01

    Full Text Available Cardiac rhabdomyoma often shows spontaneous regression and usually requires only close follow-up. However, patients with symptomatic inoperable rhabdomyomas may be candidates for everolimus treatment. Our patient had multiple inoperable cardiac rhabdomyomas causing serious left ventricle outflow-tract obstruction that showed a dramatic reduction in the size after everolimus therapy, a mammalian target of rapamycin (mTOR inhibitor. After discontinuation of therapy, an increase in the diameter of masses occurred and everolimus was restarted. After 6 months of treatment, rhabdomyomas decreased in size and therapy was stopped. In conclusion, everolimus could be a possible novel therapy for neonates with clinically significant rhabdomyomas.

  20. sodium

    International Development Research Centre (IDRC) Digital Library (Canada)

    Les initiatives de réduction de la consommation de sel qui visent l'ensemble de la population et qui ciblent la teneur en sodium des aliments et sensibilisent les consommateurs sont susceptibles de réduire la consommation de sel dans toutes les couches de la population et d'améliorer la santé cardiovasculaire. Ce projet a ...

  1. The Role of Everolimus in Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Malek Meskawi

    2015-12-01

    Full Text Available Everolimus (RAD001 is an orally administered agent that inhibits the mammalian target of rapamycin serine-threonine kinase. A phase III pivotal trial on everolimus, published in 2008, provided the first evidence for the efficacy of sequential therapy for patients with metastatic clear cell renal cell carcinoma (RCC. In this study, everolimus was used after failure of one or several previous lines of therapy, and it demonstrated a 3-month survival benefit relative to placebo. Currently, based on the level 1 evidence, everolimus represents the molecule of choice for third-line therapy after failure of previous two tyrosine kinase inhibitors (TKIs. However, second-line use after failure of one TKI is challenged by two new molecules (nivolumab and cabozantinib, which proved to have better efficacy with similar toxicity profile. In non-clear cell metastatic RCC, the current evidence recommends everolimus as a second-line therapy after failure of previous first-line sunitinib.

  2. A polysomnographic placebo-controlled evaluation of the efficacy and safety of eszopiclone relative to placebo and zolpidem in the treatment of primary insomnia.

    Science.gov (United States)

    Erman, Milton K; Zammit, Gary; Rubens, Robert; Schaefer, Kendyl; Wessel, Thomas; Amato, David; Caron, Judy; Walsh, James K

    2008-06-15

    To evaluate the polysomnographic efficacy and the safety of a range of doses of eszopiclone relative to placebo in patients with primary insomnia. Zolpidem 10 mg was included as an active control. This multicenter, randomized, crossover study enrolled patients aged 21-64 years meeting the DSM-IV criteria for primary insomnia (n = 65). Patients received 2 nights treatment each with placebo, eszopiclone 1 mg, 2 mg, 2.5 mg, or 3 mg, and zolpidem 10 mg after randomization to one of 6 treatment sequences. Visits were separated by a 3-7 day washout. Objective efficacy was assessed by polysomnography (PSG). The primary endpoint was latency to persistent sleep (LPS); key secondary endpoints were sleep efficiency (SE) and wake time after sleep onset (WASO); other endpoints included wake time during sleep (WTDS) and number of awakenings (NAW), as well as patient-reported variables. LPS and SE were significantly different than placebo for all active treatments (p zolpidem 10 mg or the other eszopiclone doses. The incidence of central nervous system adverse events was 23.4% for zolpidem 10 mg, 6.2% to 12.5% for the eszopiclone doses, and 7.9% for placebo. Relative to placebo, all active treatments were effective in reducing LPS and increasing SE. Eszopiclone 3 mg was significantly different from placebo on the 3 PSG measures of sleep maintenance (WASO, WTDS, and NAW). Significant differences between zolpidem 10 mg and eszopiclone (2 mg or 3 mg) were not observed for PSG-measured outcomes, although the study was not powered to detect differences between the active drug conditions.

  3. The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Tek, Cenk; Palmese, Laura B; Krystal, Andrew D; Srihari, Vinod H; DeGeorge, Pamela C; Reutenauer, Erin L; Guloksuz, Sinan

    2014-12-01

    Insomnia is frequent in schizophrenia and may contribute to cognitive impairment as well as overuse of weight inducing sedative antipsychotics. We investigated the effects of eszopiclone on sleep and cognition for patients with schizophrenia-related insomnia in a double-blind placebo controlled study, followed by a two-week, single-blind placebo phase. Thirty-nine clinically stable outpatients with schizophrenia or schizoaffective disorder and insomnia were randomized to either 3mg eszopiclone (n=20) or placebo (n=19). Primary outcome measure was change in Insomnia Severity Index (ISI) over 8 weeks. Secondary outcome measure was change in MATRICS Consensus Cognitive Battery (MATRICS). Sleep diaries, psychiatric symptoms, and quality of life were also monitored. ISI significantly improved more in eszopiclone (mean=-10.7, 95% CI=-13.2; -8.2) than in placebo (mean=-6.9, 95% CI=-9.5; -4.3) with a between-group difference of -3.8 (95% CI=-7.5; -0.2). MATRICS score change did not differ between groups. On further analysis there was a significant improvement in the working memory test, letter-number span component of MATRICS (mean=9.8±9.2, z=-2.00, p=0.045) only for subjects with schizophrenia on eszopiclone. There were improvements in sleep diary items in both groups with no between-group differences. Psychiatric symptoms remained stable. Discontinuation rates were similar. Sleep remained improved during single-blind placebo phase after eszopiclone was stopped, but the working memory improvement in patients with schizophrenia was not durable. Eszopiclone stands as a safe and effective alternative for the treatment of insomnia in patients with schizophrenia. Its effects on cognition require further study. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma

    DEFF Research Database (Denmark)

    Motzer, Robert J; Escudier, Bernard; McDermott, David F

    2015-01-01

    BACKGROUND: Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, was associated with encouraging overall survival in uncontrolled studies involving previously treated patients with advanced renal-cell carcinoma. This randomized, open-label, phase 3 study compared nivolumab with everolimus...... of nivolumab per kilogram of body weight intravenously every 2 weeks or a 10-mg everolimus tablet orally once daily. The primary end point was overall survival. The secondary end points included the objective response rate and safety. RESULTS: The median overall survival was 25.0 months (95% confidence...... interval [CI], 21.8 to not estimable) with nivolumab and 19.6 months (95% CI, 17.6 to 23.1) with everolimus. The hazard ratio for death with nivolumab versus everolimus was 0.73 (98.5% CI, 0.57 to 0.93; P=0.002), which met the prespecified criterion for superiority (P≤0.0148). The objective response rate...

  5. Research and innovation in the development of everolimus for oncology.

    Science.gov (United States)

    Lebwohl, David; Thomas, George; Lane, Heidi A; O'Reilly, Terence; Escudier, Bernard; Yao, James C; Pavel, Marianne; Franz, David; Berg, William; Baladi, Jean-Francois; Stewart, Jubilee; Motzer, Robert J

    2011-03-01

    The critical role of increased activity of mammalian target of rapamycin (mTOR) in the pathophysiology of multiple diseases is well established. Inhibition of the mTOR pathway may block disease progression and improve patient outcomes. Everolimus, an mTOR inhibitor, began in clinical development as part of a regimen (Certican, Zortress) for prevention of organ transplant rejection and is now an approved oncology agent. The objective of this review is to discuss the history of key findings and innovative cancer research undertaken to successfully develop everolimus as an oncology therapy (Afinitor) now approved for patients with advanced renal cell carcinoma (RCC) and for subependymal giant cell astrocytomas (SEGAs) associated with tuberous sclerosis. In addition, data for the use of everolimus in the treatment of other cancers and rare diseases are also discussed. A PubMed search of English articles without time restrictions was conducted using the search terms 'everolimus or rapamycin' and 'cancer'. Bibliographies of retrieved articles were manually searched for additional relevant articles. Major cancer congresses were also searched. The clinical efficacy of everolimus alone and in combination with other agents has been observed in recently completed Phase II-III studies in a wide spectrum of tumors, including RCC, neuroendocrine tumors, tuberous sclerosis complex, SEGAs and angiomyolipomas, lymphoma and gastric, breast and hepatocellular cancers. These findings emphasize the importance of mTOR in diverse cancers and rare diseases and underscore the potential role for everolimus as an effective agent in multiple indications.

  6. A prospective, randomized evaluation of a novel everolimus-eluting coronary stent

    DEFF Research Database (Denmark)

    Stone, Gregg W; Teirstein, Paul S; Meredith, Ian T

    2011-01-01

    We sought to evaluate the clinical outcomes with a novel platinum chromium everolimus-eluting stent (PtCr-EES) compared with a predicate cobalt chromium everolimus-eluting stent (CoCr-EES) in patients undergoing percutaneous coronary intervention (PCI).......We sought to evaluate the clinical outcomes with a novel platinum chromium everolimus-eluting stent (PtCr-EES) compared with a predicate cobalt chromium everolimus-eluting stent (CoCr-EES) in patients undergoing percutaneous coronary intervention (PCI)....

  7. Improvement in renal function after everolimus introduction and calcineurin inhibitor reduction in maintenance thoracic transplant recipients

    DEFF Research Database (Denmark)

    Arora, Satish; Gude, Einar; Sigurdardottir, Vilborg

    2012-01-01

    The NOCTET (NOrdic Certican Trial in HEart and lung Transplantation) trial demonstrated that everolimus improves renal function in maintenance thoracic transplant (TTx) recipients. Nevertheless, introduction of everolimus is not recommended for patients with advanced renal failure. We evaluated...... NOCTET data to assess everolimus introduction amongst TTx recipients with advanced renal failure....

  8. Renal function three years after early conversion from a calcineurin inhibitor to everolimus

    DEFF Research Database (Denmark)

    Mjörnstedt, Lars; Schwartz Sørensen, Søren; von Zur Mühlen, Bengt

    2015-01-01

    In a 36-month, open-label, multicenter trial, 202 kidney transplant recipients were randomized at week 7 post-transplant to convert to everolimus or remain on cyclosporine: 182 were analyzed to month 36 (92 everolimus, 90 controls). Mean (SD) change in measured GFR (mGFR) from randomization to mo......, but discontinuation was more frequent with everolimus (33.7% vs. 10.0%). Conversion from cyclosporine to everolimus at 7 weeks post-transplant was associated with a significant benefit in renal function at 3 years when everolimus was continued....

  9. Everolimus Implicated in Case of Severe Gastrointestinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Paul Gonzales

    2017-01-01

    Full Text Available Breast cancer remains the leading cause of cancer and the third leading cause of cancer related deaths among our population with an estimated number of 246,660 new cases and 40,450 deaths in 2016. With treatment advancements, including targeted agents such as Everolimus, a mammalian target of rapamycin (mTOR inhibitor, survivability and quality of life continue to improve. However, with the use of these agents come adverse effects, some of which are still being characterized. Our case demonstrates recurrent episodes of gastrointestinal bleeding in a 60-year-old woman being treated with Everolimus for progressive metastatic breast cancer. On endoscopy, bleeding was secondary to erosive gastritis. Previous case reports have described bleeding due to gastric antral vascular ectasia (GAVE, which was described in two prior reported cases. In our case, bleeding also occurred on a reduced dose of Everolimus compared to what is previously reported (5 mg versus 10 mg. As a result of her gastrointestinal bleeding, she required multiple endoscopic interventions including argon plasma coagulation and multipolar heater probe to achieve hemostasis. This is the first case reported of gastrointestinal bleeding not consistent with GAVE and occurring while being on a reduced dose of Everolimus. It is important to document our case so that the Gastroenterology and Hematology communities can be educated and made aware for their patient populations on Everolimus.

  10. Recommendations of everolimus use in liver transplant.

    Science.gov (United States)

    Rubín Suárez, Angel; Bilbao Aguirre, Itxarone; Fernández-Castroagudin, Javier; Pons Miñano, José Antonio; Salcedo Plaza, Magdalena; Varo Pérez, Evaristo; Prieto Castillo, Martín

    2017-11-01

    Mammalian target of rapamycin (mTOR) inhibitors, everolimus (EVL) and sirolimus are immunosuppressive agents with a minor nephrotoxic effect, limited to the development of proteinuria in some cases. The combination of EVL and low-dose tacrolimus has proven to be as safe and effective as standard therapy with tacrolimus for the prevention of acute cellular rejection. Early initiation of EVL-based immunosuppressive regimens with reduced exposure to calcineurin inhibitors has been shown to significantly improve renal function of LT recipients during induction and maintenance phases, with comparable efficacy and safety profiles. In patients with established kidney failure, initiating EVL may enable clinicians to reduce calcineurin inhibitors exposure, thereby contributing to the improved renal function of these patients. Although there is not sufficient evidence to recommend their use to prevent the recurrence of hepatocellular carcinoma and the progression of de novo tumours, they are used in this context in routine clinical practice. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  11. Effects of everolimus on macrophage-derived foam cell behavior

    International Nuclear Information System (INIS)

    Hsu, Steven; Koren, Eugen; Chan, Yen; Koscec, Mirna; Sheehy, Alexander; Kolodgie, Frank; Virmani, Renu; Feder, Debra

    2014-01-01

    Purpose: The purpose of this study was to investigate the effects of everolimus on foam cell (FC) viability, mRNA levels, and inflammatory cytokine production to better understand its potential inhibitory effects on atheroma progression. Methods and materials: Human THP1 macrophage-derived FC were formed using acetylated LDL (acLDL, 100 μg/mL) for 72 hours, followed by everolimus treatment (10 -5 –10 -11 M) for 24 hours. FC viability was quantified using fluorescent calcein AM/DAPI staining. FC lysates and media supernatants were analyzed for apoptosis and necrosis using a Cell Death ELISA PLUS assay. FC lysates and media supernatants were also analyzed for inflammatory cytokine (IL1β, IL8, MCP1, TNFα) mRNA levels and protein expression using quantitative reverse transcription real-time polymerase chain reaction (QPCR) and a Procarta® immunoassay, respectively. mRNA levels of autophagy (MAP1LC3), apoptosis (survivin, clusterin), and matrix degradation (MMP1, MMP9) markers were evaluated by Quantigene® Plex assay and verified with QPCR. Additionally, hypercholesterolemic rabbits received everolimus-eluting stents (EES) for 28 or 60 days. RAM-11 immunohistochemical staining was performed to compare %RAM-11 positive area between stented sections and unstented proximal sections. Statistical significance was calculated using one-way ANOVA (p ≤ 0.05). Results: Calcein AM/DAPI staining showed that FC exposed to everolimus (10 -5 M) had significantly decreased viability compared to control. FC apoptosis was significantly increased at a high dose of everolimus (10 -5 M), with no necrotic effects at any dose tested. Everolimus did not affect endothelial (HUVEC) and smooth muscle (HCASMC) cell apoptosis or necrosis. Everolimus (10 -5 M) significantly increased MAP1LC3, caused an increased trend in clusterin (p = 0.10), and significantly decreased survivin and MMP1 mRNA levels in FC. MCP1 cytokine mRNA levels and secreted protein expression was significantly decreased

  12. Effects of everolimus on macrophage-derived foam cell behavior

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Steven, E-mail: steven.hsu@av.abbott.com [Abbott Vascular, 3200 Lakeside Drive, Santa Clara, CA 95054 (United States); Koren, Eugen; Chan, Yen; Koscec, Mirna; Sheehy, Alexander [Abbott Vascular, 3200 Lakeside Drive, Santa Clara, CA 95054 (United States); Kolodgie, Frank; Virmani, Renu [CVPath Institute, Inc., 19 Firstfield Road, Gaithersburg, MD 20878 (United States); Feder, Debra [Abbott Vascular, 3200 Lakeside Drive, Santa Clara, CA 95054 (United States)

    2014-07-15

    Purpose: The purpose of this study was to investigate the effects of everolimus on foam cell (FC) viability, mRNA levels, and inflammatory cytokine production to better understand its potential inhibitory effects on atheroma progression. Methods and materials: Human THP1 macrophage-derived FC were formed using acetylated LDL (acLDL, 100 μg/mL) for 72 hours, followed by everolimus treatment (10{sup -5}–10{sup -11} M) for 24 hours. FC viability was quantified using fluorescent calcein AM/DAPI staining. FC lysates and media supernatants were analyzed for apoptosis and necrosis using a Cell Death ELISA{sup PLUS} assay. FC lysates and media supernatants were also analyzed for inflammatory cytokine (IL1β, IL8, MCP1, TNFα) mRNA levels and protein expression using quantitative reverse transcription real-time polymerase chain reaction (QPCR) and a Procarta® immunoassay, respectively. mRNA levels of autophagy (MAP1LC3), apoptosis (survivin, clusterin), and matrix degradation (MMP1, MMP9) markers were evaluated by Quantigene® Plex assay and verified with QPCR. Additionally, hypercholesterolemic rabbits received everolimus-eluting stents (EES) for 28 or 60 days. RAM-11 immunohistochemical staining was performed to compare %RAM-11 positive area between stented sections and unstented proximal sections. Statistical significance was calculated using one-way ANOVA (p ≤ 0.05). Results: Calcein AM/DAPI staining showed that FC exposed to everolimus (10{sup -5} M) had significantly decreased viability compared to control. FC apoptosis was significantly increased at a high dose of everolimus (10{sup -5} M), with no necrotic effects at any dose tested. Everolimus did not affect endothelial (HUVEC) and smooth muscle (HCASMC) cell apoptosis or necrosis. Everolimus (10{sup -5} M) significantly increased MAP1LC3, caused an increased trend in clusterin (p = 0.10), and significantly decreased survivin and MMP1 mRNA levels in FC. MCP1 cytokine mRNA levels and secreted protein

  13. Everolimus Alleviates Obstructive Hydrocephalus due to Subependymal Giant Cell Astrocytomas.

    Science.gov (United States)

    Moavero, Romina; Carai, Andrea; Mastronuzzi, Angela; Marciano, Sara; Graziola, Federica; Vigevano, Federico; Curatolo, Paolo

    2017-03-01

    Subependymal giant cell astrocytomas (SEGAs) are low-grade tumors affecting up to 20% of patients with tuberous sclerosis complex (TSC). Early neurosurgical resection has been the only standard treatment until few years ago when a better understanding of the molecular pathogenesis of TSC led to the use of mammalian target of rapamycin (mTOR) inhibitors. Surgical resection of SEGAs is still considered as the first line treatment in individuals with symptomatic hydrocephalus and intratumoral hemorrhage. We describe four patients with symptomatic or asymptomatic hydrocephalus who were successfully treated with the mTOR inhibitor everolimus. We collected the clinical data of four consecutive patients presenting with symptomatic or asymptomatic hydrocephalus due to a growth of subependymal giant cell atrocytomas and who could not undergo surgery for different reasons. All patients experienced a clinically significant response to everolimus and an early shrinkage of the SEGA with improvement in ventricular dilatation. Everolimus was well tolerated by all individuals. Our clinical series demonstrate a possible expanding indication for mTOR inhibition in TSC, which can be considered in patients with asymptomatic hydrocephalus or even when the symptoms already appeared. It offers a significant therapeutic alternative to individuals that once would have undergone immediate surgery. Everolimus might also allow postponement of a neurosurgical resection, making it elective with an overall lower risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Comparison of an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II)

    DEFF Research Database (Denmark)

    Serruys, Patrick W; Chevalier, Bernard; Sotomi, Yohei

    2016-01-01

    BACKGROUND: No medium-term data are available on the random comparison between everolimus-eluting bioresorbable vascular scaffolds and everolimus-eluting metallic stents. The study aims to demonstrate two mechanistic properties of the bioresorbable scaffold: increase in luminal dimensions as a re...

  15. Effect of Post-Dilatation Following Primary PCI With Everolimus-Eluting Bioresorbable Scaffold Versus Everolimus-Eluting Metallic Stent Implantation

    DEFF Research Database (Denmark)

    Yamaji, Kyohei; Brugaletta, Salvatore; Sabaté, Manel

    2017-01-01

    OBJECTIVES: This study sought to investigate the effect of post-dilatation on angiographic and intracoronary imaging parameters in the setting of primary percutaneous coronary intervention comparing the everolimus-eluting bioresorbable scaffold (BRS) with the everolimus-eluting metallic stent (EE...

  16. Everolimus: a review of its pharmacologic properties and use in solid organ transplantation

    Directory of Open Access Journals (Sweden)

    Paul Huiras

    2011-10-01

    Full Text Available The aim of this review article is to review the pharmacology, pharmacokinetics, efficacy and safety of everolimus. Primary literature was obtained via MEDLINE. Studies and abstracts evaluating everolimus in solid organ transplantation were considered for evaluation. English-language studies and abstracts only were selected for inclusion. Everolimus, a proliferation signal inhibitor that prevents growth factor-induced cell proliferation, is effective in reducing the incidence of acute rejection in solid organ transplantation. This agent is also useful in reducing cyclosporine-related nephrotoxicity. Everolimus directly inhibits vascular remodelling and intimal thickening, which are often associated with chronic rejection. Clinical trials have shown that everolimus is generally safe. The most commonly reported adverse events were haematologic effects and hyperlipidaemia. Everolimus is the second proliferation signal inhibitor to be proven effective in preventing acute rejection in solid organ transplant recipients. However, its exact role in the transplant immunosuppressive armamentarium is still unknown.

  17. Everolimus initiation and early calcineurin inhibitor withdrawal in heart transplant recipients

    DEFF Research Database (Denmark)

    Andreassen, A K; Andersson, B; Gustafsson, F

    2014-01-01

    In a randomized, open-label trial, everolimus was compared to cyclosporine in 115 de novo heart transplant recipients. Patients were assigned within 5 days posttransplant to low-exposure everolimus (3–6 ng/mL) with reduced-exposure cyclosporine (n = 56), or standard-exposure cyclosporine (n = 59...... infection was less common with everolimus (5.4% vs. 30.5%, p heart transplantation. Since postoperative safety...

  18. Everolimus: a review of its pharmacologic properties and use in solid organ transplantation

    OpenAIRE

    Huiras, Paul; Gabardi, Steven

    2011-01-01

    The aim of this review article is to review the pharmacology, pharmacokinetics, efficacy and safety of everolimus. Primary literature was obtained via MEDLINE. Studies and abstracts evaluating everolimus in solid organ transplantation were considered for evaluation. English-language studies and abstracts only were selected for inclusion. Everolimus, a proliferation signal inhibitor that prevents growth factor-induced cell proliferation, is effective in reducing the incidence of acute rejectio...

  19. Everolimus Initiation With Early Calcineurin Inhibitor Withdrawal in De Novo Heart Transplant Recipients

    DEFF Research Database (Denmark)

    Andreassen, A K; Andersson, B; Gustafsson, F

    2016-01-01

    In a randomized, open-label trial, de novo heart transplant recipients were randomized to everolimus (3-6 ng/mL) with reduced-exposure calcineurin inhibitor (CNI; cyclosporine) to weeks 7-11 after transplant, followed by increased everolimus exposure (target 6-10 ng/mL) with cyclosporine withdrawal...... events occurred in 37.3% and 19.6% of everolimus- and CNI-treated patients, respectively (p = 0.078). These results suggest that early CNI withdrawal after heart transplantation supported by everolimus, mycophenolic acid and steroids with lymphocyte-depleting induction is safe at intermediate follow...

  20. A Semi-Physiological Population Model to Quantify the Effect of Hematocrit on Everolimus Pharmacokinetics and Pharmacodynamics in Cancer Patients

    NARCIS (Netherlands)

    Erp, N.P. van; Herpen, C.M. van; Wit, D. de; Willemsen, A.; Burger, D.M.; Huitema, A.D.; Kapiteijn, E.; Heine, R. ter

    2016-01-01

    INTRODUCTION AND OBJECTIVE: Everolimus (a drug from the class of mammalian target of rapamycin [mTOR] inhibitors) is associated with frequent toxicity-related dose reductions. Everolimus accumulates in erythrocytes, but the extent to which hematocrit affects everolimus plasma pharmacokinetics and

  1. Everolimus for Primary Intestinal Lymphangiectasia With Protein-Losing Enteropathy.

    Science.gov (United States)

    Ozeki, Michio; Hori, Tomohiro; Kanda, Kaori; Kawamoto, Norio; Ibuka, Takashi; Miyazaki, Tatsuhiko; Fukao, Toshiyuki

    2016-03-01

    Primary intestinal lymphangiectasia (PIL), also known as Waldmann's disease, is an exudative enteropathy resulting from morphologic abnormalities in the intestinal lymphatics. In this article, we describe a 12-year-old boy with PIL that led to protein-losing enteropathy characterized by diarrhea, hypoalbuminemia associated with edema (serum albumin level: 1.0 g/dL), and hypogammaglobulinemia (serum IgG level: 144 mg/dL). Severe hypoalbuminemia, electrolyte abnormalities, and tetany persisted despite a low-fat diet and propranolol. Everolimus (1.6 mg/m(2)/day) was added to his treatment as an antiangiogenic agent. With everolimus treatment, the patient's diarrhea resolved and replacement therapy for hypoproteinemia was less frequent. Hematologic and scintigraphy findings also improved (serum albumin level: 2.5 g/dL). There were no adverse reactions during the 12-month follow-up. To the best of our knowledge, this is the first report of everolimus use in a patient with PIL. Copyright © 2016 by the American Academy of Pediatrics.

  2. A phase Ib study of everolimus combined with metformin for patients with advanced cancer.

    Science.gov (United States)

    Molenaar, Remco J; van de Venne, Tim; Weterman, Mariëtte J; Mathot, Ron A; Klümpen, Heinz-Josef; Richel, Dick J; Wilmink, Johanna W

    2018-02-01

    Background The efficacy to monotherapy with the mTOR inhibitor everolimus in advanced cancer is often limited due to therapy resistance. Combining everolimus with metformin may decrease the chance of therapy resistance. Methods Patients received everolimus and metformin in a 3 + 3 dose-escalation scheme. Objectives were to determine the dose-limiting toxicities (DLTs), maximum tolerated dose, toxic effects, pharmacokinetics and anti-tumour efficacy. Results 9 patients received study treatment for a median duration of 48 days (range: 4-78). 6 patients discontinued due to toxicity and 3 patients because of progressive disease. At the starting dose level of 10 mg everolimus qd and 500 mg metformin bid, 3 out of 5 patients experienced a DLT. After de-escalation to 5 mg everolimus qd and 500 mg metformin bid, considerable toxicity was still observed and patient enrollment was terminated. In pharmacokinetic analyses, metformin was eliminated slower when co-administered with everolimus than as single-agent. After 9 weeks of treatment, 3 patients were still on study and all had stable disease. Conclusion The combination of everolimus and metformin is poorly tolerated in patients with advanced cancer. The pharmacokinetic interaction between everolimus and metformin may have implications for diabetic cancer patients that are treated with these drugs. Our results advocate for future clinical trials with combinations of other mTOR inhibitors and biguanides.

  3. Everolimus-induced pneumonitis associates with favourable outcome in patients with metastatic renal cell carcinoma

    DEFF Research Database (Denmark)

    Penttilä, P; Donskov, F; Rautiola, J

    2017-01-01

    BACKGROUND: Mammalian target of rapamycin inhibitors may induce pneumonitis. We analysed the association of pneumonitis with outcomes in everolimus treated metastatic renal cell carcinoma (mRCC) patients. PATIENTS AND METHODS: Eighty-five mRCC patients received everolimus at Helsinki University...

  4. Everolimus: a proliferation signal inhibitor with clinical applications in organ transplantation, oncology, and cardiology.

    Science.gov (United States)

    Gabardi, Steven; Baroletti, Steven A

    2010-10-01

    Everolimus, a proliferation signal inhibitor in the mammalian target of rapamycin (mTOR) drug class, has many clinical applications, including in organ transplantation, oncology, and cardiology. It currently has United States Food and Drug Administration (FDA) approval for prophylaxis against rejection in de novo renal transplant recipients, treatment of renal cell carcinoma, and use as a drug-eluting stent. To review the pharmacology, pharmacokinetics, efficacy, and safety of everolimus, we performed a search of the MEDLINE database (January 1997-April 2010) for all English-language articles of in vitro and in vivo studies that evaluated everolimus, as well as abstracts from recent scientific meetings and the manufacturer. In transplantation, everolimus demonstrates immunosuppressive properties and has been used to prevent acute rejection in cardiac, liver, lung, and renal transplant recipients. It appears that this agent may be potent enough to allow for the minimization or removal of calcineurin inhibitors in the long-term management of renal transplant recipients. In oncology, everolimus has been proven effective for the management of treatment-resistant renal cell carcinoma. In cardiology, everolimus is available as a drug-coated stent and is used in percutaneous coronary interventions for prevention of restenosis. In transplant recipients and patients with renal cell carcinoma, everolimus appears to have an extensive adverse-event profile. The pharmacologic properties of everolimus differentiate this agent from other drugs used in these clinical areas, and its pharmacokinetic properties differentiate it from sirolimus.

  5. Optimizing everolimus exposure when combined with calcineurin inhibitors in solid organ transplantation

    NARCIS (Netherlands)

    T. van Gelder (Teun); L. Fischer (Lutz); Shihab, F. (Fuad); M. Shipkova (Maria)

    2017-01-01

    textabstractThe mammalian target of rapamycin (mTOR) inhibitor everolimus is a narrow therapeutic index drug for which optimal exposure levels are essential. The consistent pharmacokinetic profile of everolimus allows trough concentration (C0) measurement to be an appropriate and reliable index for

  6. Everolimus with reduced calcineurin inhibitor in thoracic transplant recipients with renal dysfunction: a multicenter, randomized trial

    DEFF Research Database (Denmark)

    Gullestad, Lars; Iversen, Martin; Mortensen, Svend-Aage

    2010-01-01

    The proliferation signal inhibitor everolimus offers the potential to reduce calcineurin inhibitor (CNI) exposure and alleviate CNI-related nephrotoxicity. Randomized trials in maintenance thoracic transplant patients are lacking.......The proliferation signal inhibitor everolimus offers the potential to reduce calcineurin inhibitor (CNI) exposure and alleviate CNI-related nephrotoxicity. Randomized trials in maintenance thoracic transplant patients are lacking....

  7. Telomerase Inhibition by Everolimus Suppresses Smooth Muscle Cell Proliferation and Neointima Formation Through Epigenetic Gene Silencing

    Directory of Open Access Journals (Sweden)

    Jun Aono, MD, PhD

    2016-01-01

    Full Text Available Proliferation of smooth muscle cells (SMCs during neointima formation is prevented by drug-eluting stents. The replicative capacity of mammalian cells is enhanced by telomerase expression; however, the contribution of telomerase to the proliferative response underlying neointima formation and its potential role as a pharmacological target are unknown. The present study investigated the mechanisms underlying the mitogenic function of telomerase, and tested the hypothesis that everolimus, which is commonly used on drug-eluting stents, suppresses SMC proliferation by targeting telomerase. Inhibition of neointima formation by everolimus was lost in mice overexpressing telomerase reverse transcriptase (TERT, indicating that repression of telomerase confers the anti-proliferative efficacy of everolimus. Everolimus reduced TERT expression in SMC through an Ets-1-dependent inhibition of promoter activation. The inhibition of TERT-dependent SMC proliferation by everolimus occurred in the absence of telomere shortening but rather as a result of a G1→S-phase arrest. Although everolimus failed to inhibit phosphorylation of the retinoblastoma protein as the gatekeeper of S-phase entry, it potently repressed downstream target genes. Chromatin immunoprecipitation assays demonstrated that TERT induced E2F binding to S-phase gene promoters and supported histone acetylation. These effects were sensitive to inhibition by everolimus. These results characterize telomerase as a previously unrecognized target for the antiproliferative activity of everolimus, and further identify a novel mitogenic pathway in SMC that depends on the epigenetic activation of S-phase gene promoters by TERT.

  8. Amenorrhea as a rare drug-related adverse event associated with everolimus for pancreatic neuroendocrine tumors.

    Science.gov (United States)

    Kawaguchi, Yoshiaki; Maruno, Atsuko; Kawashima, Yohei; Ito, Hiroyuki; Ogawa, Masami; Mine, Tetsuya

    2014-11-14

    The patient was an asymptomatic 43-year-old woman. Abdominal ultrasonography and enhanced computed tomography showed a tumor lesion accompanied by multiple cystic changes in the liver and the pancreatic tail. Endoscopic ultrasound-fine needle aspiration was performed on the pancreatic tumor lesion and revealed pancreatic neuroendocrine tumor (PNET). As it was unresectable due to multiple liver metastases, the decision was made to initiate treatment with everolimus and transcatheter arterial chemoembolization. The patient ceased menstruating after the start of everolimus administration. When the administration was discontinued due to interstitial lung disease, menstruation resumed, but then again stopped with everolimus resumption. An association between everolimus and amenorrhea was highly suspected. Amenorrhea occurred as a rare adverse event of everolimus. As the younger women might be included in PNETs patients, we should put this adverse event into consideration.

  9. Glycolysis in Panc-1 human pancreatic cancer cells is inhibited by everolimus.

    Science.gov (United States)

    Liu, Ling; Gong, Liansheng; Zhang, Yangde; Li, Nianfeng

    2013-01-01

    The aim of this study was to evaluate the effects and molecular mechanisms of everolimus on Panc-1 human pancreatic cancer cells. Panc-1 human pancreatic cancer cells were treated with everolimus (10 μg/ml) at selected time points (6, 12 and 24 h). Cell proliferation and apoptosis were evaluated by MTT and flow cytometric analyses. The glycolytic activity was determined by measuring the activity of the key enzyme lactate dehydrogenase (LDH) and lactate production. The activity of mammalian target of rapamycin (mTOR) signaling was measured by western blotting. The expression of genes, including hexokinase 2 (HK2) and microRNA-143 (miR-143), was evaluated by real-time polymerase chain reaction (PCR). The administration of everolimus time-dependently inhibited proliferation and glycolysis and induced apoptosis in the Panc-1 human pancreatic cancer cells. As the time of treatment with everolimus increased, the mTOR signaling activity decreased, indicated by lower phosphorylation levels of S6 kinase; however, the phosphorylation levels of mTOR barely changed. Moreover, our data showed an everolimus-induced increase in miR-143 and decrease in HK2 in Panc-1 cells in a time-dependent manner. In conclusion, the current study indicates a novel role of everolimus in its antitumor effect as an inhibitor of glycolysis in Panc-1 human pancreatic cancer cells. Furthermore, our data highlights the significance of exploring the mechanisms of everolimus and miR-143 in malignant tumors.

  10. Role of everolimus in the treatment of renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Saby George

    2009-08-01

    Full Text Available Saby George1, Ronald M Bukowski21University of Texas Health Sciences Center, MC-8221, Division of Hematology and Oncology, San Antonio, Texas, USA; 2CCF Lerner College of Medicine Division of Hematology and Oncology, Cleveland, Ohio, USAAbstract: The therapeutic options in metastatic renal cell carcinoma have been recently expanded by the discovery of the VHL gene, the mutation of which is associated with development of clear cell carcinoma, and overexpression of the angiogenesis pathway, resulting in a very vascular tumor. This breakthrough in science led to the development of a variety of small molecules inhibiting the VEGF-dependent angiogenic pathway, such as sunitinib and sorafenib. These agents prolong overall and progression-free survival, respectively. The result was the development of robust front-line therapies which ultimately fail and are associated with disease progression. In this setting, there existed an unmet need for developing second-line therapies for patients with refractory metastatic renal cell carcinoma (MRCC. Everolimus (RAD 001 is an oral inhibitor of the mammalian target of rapamycin (mTOR pathway. The double-blind, randomized, placebo-controlled phase III trial of everolimus (RECORD-1 conducted in MRCC patients after progression on sunitinib or sorafenib, or both, demonstrated a progression-free survival benefit favoring the study drug (4.9 months vs 1.9 months, HR 0.33, 95% CI 0.25 to 0.43, P ≤ 0 0.001. Everolimus thus established itself as a standard of care in the second-line setting for patients with MRCC who have failed treatment with VEGF receptor inhibitors.Keywords: mTOR inhibitor, mammalian target of rapamycin inhibitor, signal transduction inhibitor, renal cell carcinoma, targeted therapy

  11. Telomerase Inhibition by Everolimus Suppresses Smooth Muscle Cell Proliferation and Neointima Formation Through Epigenetic Gene Silencing.

    Science.gov (United States)

    Aono, Jun; Ruiz-Rodriguez, Ernesto; Qing, Hua; Findeisen, Hannes M; Jones, Karrie L; Heywood, Elizabeth B; Bruemmer, Dennis

    2016-01-01

    The present study sought to investigate the mechanisms underlying the mitogenic function of telomerase and to test the hypothesis that everolimus, commonly used on drug-eluting stents, suppresses smooth muscle cells (SMC) proliferation by targeting telomerase. Proliferation of SMC during neointima formation is prevented by drug-eluting stents. Although the replicative capacity of mammalian cells is enhanced by telomerase expression, the contribution of telomerase to the proliferative response underlying neointima formation and its potential role as a pharmacological target remain to be investigated. We first employed constitutive expression of telomerase reverse transcriptase (TERT) in cell systems to study transcriptional mechanisms by which telomerase activates a mitogenic program. Second, overexpression of telomerase in mice provided a model to study the role of telomerase as a drug target for the antiproliferative efficacy of everolimus. Inhibition of neointima formation by everolimus is lost in mice overexpressing TERT, indicating that repression of telomerase confers the antiproliferative efficacy of everolimus. Everolimus reduces TERT expression in SMC through an Ets-1-dependent inhibition of promoter activation. The inhibition of TERT-dependent SMC proliferation by everolimus occurred in the absence of telomere shortening but rather as a result of a G1→S phase arrest. Although everolimus failed to inhibit phosphorylation of the retinoblastoma protein as the gatekeeper of S-phase entry, it potently repressed downstream target genes. Using chromatin immunoprecipitation assays, we finally demonstrate that TERT induces E2F binding to S-phase gene promoters and supports histone acetylation, effects that are inhibited by everolimus and mediate its antiproliferative activity. These results characterize telomerase as a previously unrecognized target for the antiproliferative activity of everolimus. Our studies further identify a novel mitogenic pathway in SMC

  12. Recommendations for use of everolimus after heart transplantation: results from a Latin-American Consensus Meeting.

    Science.gov (United States)

    Bocchi, E A; Ahualli, L; Amuchastegui, M; Boullon, F; Cerutti, B; Colque, R; Fernandez, D; Fiorelli, A; Olaya, P; Vulcado, N; Perrone, S V

    2006-04-01

    Despite improvements during the last decades, heart transplantation remains associated with several medical complications, which limit clinical outcomes: acute rejection with hemodynamic compromise, cytomegalovirus (CMV) infections, allograft vasculopathy, chronic renal failure, and neoplasias. Everolimus, a proliferation signal inhibitor, represents a new option for adjunctive immunosuppressive therapy. Everolimus displays better efficacy in de novo heart transplant patients than azathioprine for prophylaxis of biopsy-proven acute rejection episodes of at least ISHLT grade 3A (P Latin America produced recommendations for everolimus use in daily practice based on available data and their own experience.

  13. Enantioselective determination of (R)-zopiclone and (S)-zopiclone (eszopiclone) in human hair by micropulverized extraction and chiral liquid chromatography/high resolution mass spectrometry.

    Science.gov (United States)

    Miyaguchi, Hajime; Kuwayama, Kenji

    2017-10-13

    Zopiclone and its (S)-enantiomer (eszopiclone) are commonly prescribed for insomnia. Despite the high demand for enantioselective differentiation, the chiral analysis of zopiclone in hair has not been reported. In this study, a method for the enantioselective quantification of zopiclone in human hair was developed. The extraction medium and duration were optimized using real eszopiclone-positive hair samples. Specifically, micropulverized extraction with 3.0M ammonium phosphate buffer (pH 8.4) involving salting-out assisted liquid-liquid extraction with acetonitrile was utilized to minimize the degradation of zopiclone and for rapid and facile operation. On the other hand, recovery of the conventional solid-liquid extraction involved overnight soaking in 3.0M ammonium phosphate buffer (pH 8.4) was only 0.58±0.12% of the maximum recovery achieved by the present method due to the decomposition in the phosphate buffer. An excellent chiral separation (Rs=5.0) was achieved using a chiral stationary phase comprising cellulose tris(3,5-dichlorophenylcarbamate) and a volatile mobile phase of 10mM ammonium carbonate (pH 8.0)-acetonitrile (25:75, v/v). Detection was carried out using liquid chromatography/high resolution mass spectrometry (LC/HRMS) with electrospray ionization. A Q Exactive mass spectrometer equipped with a quadrupole-Orbitrap analyzer was used for detection. The concentration of 0.50pg/mg was defined as the lowest limit of quantification using 5mg of hair sample. Using the developed approach, the concentration of eszopiclone in hair after a single 2-mg dose was found to be 441pg/mg, which was higher than all the reported values regarding a single administration of zopiclone. After daily administration of racemic zopiclone (3.75mg/day), the concentrations of (R)-enantiomer and (S)-enantiomer in the black hair were 5.30-8.31ng/mg and 7.96-12.8ng/mg, respectively, and the concentration of the (S)-enantiomer was always higher than that of the (R

  14. Polymorphisms associated with everolimus pharmacokinetics, toxicity and survival in metastatic breast cancer.

    Directory of Open Access Journals (Sweden)

    Tomas Pascual

    Full Text Available Metastatic breast cancer (MBC progressing after endocrine therapy frequently activates PI3K/AKT/mTOR pathway. The BOLERO-2 trial showed that everolimus-exemestane achieves increased progression free survival (PFS compared with exemestane. However, there is great inter-patient variability in toxicity and response to exemestane-everolimus treatment. The objective of this study was to perform an exploratory study analyzing the implication of single nucleotide polymorphisms (SNPs on outcomes from this treatment through a pharmacogenetic analysis.Blood was collected from 90 postmenopausal women with hormone receptor-positive, HER2-negative MBC treated with exemestane-everolimus following progression after prior treatment with a non-steroidal aromatase inhibitor. Everolimus pharmacokinetics was measured in 37 patients. Twelve SNPs in genes involved in everolimus pharmacokinetics and pharmacodynamics were genotyped and associations assessed with drug plasma levels, clinically relevant toxicities (non-infectious pneumonitis, mucositis, hyperglycemia and hematological toxicities, dose reductions or treatment suspensions due to toxicity, progression free survival (PFS and overall survival.We found that CYP3A4 rs35599367 variant (CYP3A4*22 allele carriers had higher everolimus blood concentration compared to wild type patients (P = 0.019. ABCB1 rs1045642 was associated with risk of mucositis (P = 0.031, while PIK3R1 rs10515074 and RAPTOR rs9906827 were associated with hyperglycemia and non-infectious pneumonitis (P = 0.016 and 0.024, respectively. Furthermore, RAPTOR rs9906827 was associated with PFS (P = 0.006.CYP3A4*22 allele influenced plasma concentration of everolimus and several SNPs in PI3K/AKT/mTOR pathway genes were associated with treatment toxicities and prognosis. These results require replication, but suggest that germline variation could influence everolimus outcomes in MBC.

  15. Evaluation of the Impact of the Cancer Therapy Everolimus on the Central Nervous System in Mice

    Science.gov (United States)

    Dubois, Martine; Le Joncour, Vadim; Tonon, Marie-Christine; Anouar, Youssef; Proust, François; Morin, Fabrice; Gandolfo, Pierrick; Joly, Florence; Hilber, Pascal; Castel, Hélène

    2014-01-01

    Cancer and treatments may induce cognitive impairments in cancer patients, and the causal link between chemotherapy and cognitive dysfunctions was recently validated in animal models. New cancer targeted therapies have become widely used, and their impact on brain functions and quality of life needs to be explored. We evaluated the impact of everolimus, an anticancer agent targeting the mTOR pathway, on cognitive functions, cerebral metabolism, and hippocampal cell proliferation/vascular density in mice. Adult mice received everolimus daily for 2 weeks, and behavioral tests were performed from 1 week after the last treatment. Everolimus-treated mice displayed a marked reduction in weight gain from the last day of the treatment period. Ex vivo analysis showed altered cytochrome oxidase activity in selective cerebral regions involved in energy balance, food intake, reward, learning and memory modulation, sleep/wake cycle regulation, and arousal. Like chemotherapy, everolimus did not alter emotional reactivity, learning and memory performances, but in contrast to chemotherapy, did not affect behavioral flexibility or reactivity to novelty. In vivo hippocampal neural cell proliferation and vascular density were also unchanged after everolimus treatments. In conclusion, two weeks daily everolimus treatment at the clinical dose did not evoke alteration of cognitive performances evaluated in hippocampal- and prefrontal cortex-dependent tasks that would persist at one to four weeks after the end of the treatment completion. However, acute everolimus treatment caused selective CO modifications without altering the mTOR effector P70S6 kinase in cerebral regions involved in feeding behavior and/or the sleep/wake cycle, at least in part under control of the solitary nucleus and the parasubthalamic region of the hypothalamus. Thus, this area may represent a key target for everolimus-mediating peripheral modifications, which has been previously associated with symptoms such as

  16. Evaluation of the impact of the cancer therapy everolimus on the central nervous system in mice.

    Directory of Open Access Journals (Sweden)

    Martine Dubois

    Full Text Available Cancer and treatments may induce cognitive impairments in cancer patients, and the causal link between chemotherapy and cognitive dysfunctions was recently validated in animal models. New cancer targeted therapies have become widely used, and their impact on brain functions and quality of life needs to be explored. We evaluated the impact of everolimus, an anticancer agent targeting the mTOR pathway, on cognitive functions, cerebral metabolism, and hippocampal cell proliferation/vascular density in mice. Adult mice received everolimus daily for 2 weeks, and behavioral tests were performed from 1 week after the last treatment. Everolimus-treated mice displayed a marked reduction in weight gain from the last day of the treatment period. Ex vivo analysis showed altered cytochrome oxidase activity in selective cerebral regions involved in energy balance, food intake, reward, learning and memory modulation, sleep/wake cycle regulation, and arousal. Like chemotherapy, everolimus did not alter emotional reactivity, learning and memory performances, but in contrast to chemotherapy, did not affect behavioral flexibility or reactivity to novelty. In vivo hippocampal neural cell proliferation and vascular density were also unchanged after everolimus treatments. In conclusion, two weeks daily everolimus treatment at the clinical dose did not evoke alteration of cognitive performances evaluated in hippocampal- and prefrontal cortex-dependent tasks that would persist at one to four weeks after the end of the treatment completion. However, acute everolimus treatment caused selective CO modifications without altering the mTOR effector P70S6 kinase in cerebral regions involved in feeding behavior and/or the sleep/wake cycle, at least in part under control of the solitary nucleus and the parasubthalamic region of the hypothalamus. Thus, this area may represent a key target for everolimus-mediating peripheral modifications, which has been previously associated

  17. Everolimus-induced Pneumonitis after Drug-eluting Stent Implantation: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Susumu, E-mail: susumu1029@gmail.com; Kikuchi, Naoshi; Ichikawa, Atsuo; Sano, Go; Satoh, Keita; Sugino, Keishi; Isobe, Kazutoshi; Takai, Yujiro [Toho University School of Medicine, Department of Respiratory Medicine (Japan); Shibuya, Kazutoshi [Toho University School of Medicine, Department of Pathology (Japan); Homma, Sakae [Toho University School of Medicine, Department of Respiratory Medicine (Japan)

    2013-08-01

    Despite the wide use of everolimus as an antineoplastic coating agent for coronary stents to reduce the rate of restenosis, little is known about the health hazards of everolimus-eluting stents (EES). We describe a case of pneumonitis that developed 2 months after EES implantation for angina. Lung pathology demonstrated an organizing pneumonia pattern that responded to corticosteroid therapy. Although the efficacy of EES for ischemic heart disease is well established, EES carries a risk of pneumonitis.

  18. Randomised comparison of a bioresorbable everolimus-eluting scaffold with a metallic everolimus-eluting stent for ischaemic heart disease caused by de novo native coronary artery lesions

    DEFF Research Database (Denmark)

    Chevalier, Bernard; Onuma, Yoshinobu; van Boven, Ad J

    2016-01-01

    AIMS: The one-year randomised data of the ABSORB II trial showed that the everolimus-eluting bioresorbable scaffold and the everolimus-eluting metallic stent were comparable for the composite secondary clinical outcomes of patient-oriented composite endpoint (PoCE) and device-oriented composite...... Clara, CA, USA) or treatment with an everolimus-eluting metallic stent (XIENCE; Abbott Vascular). The trial enrolled 501 patients. Clinical follow-up at two years was available in 320 patients in the Absorb BVS arm and 160 patients in the XIENCE arm. At two years, the PoCE for the Absorb and XIENCE arms......-six percent and 34% of patients remained on DAPT at two years, respectively. Ninety-two percent of patients in both arms remained on aspirin. CONCLUSIONS: Two-year clinical results demonstrate sustained low rates of PoCE, MACE, DoCE and TVF with the Absorb BVS as compared to the XIENCE stent....

  19. Efficacy of treatment of insomnia in migraineurs with eszopiclone (Lunesta®) and its effect on total sleep time, headache frequency, and daytime functioning: A randomized, double-blind, placebo-controlled, parallel-group, pilot study.

    Science.gov (United States)

    Spierings, Egilius L H; McAllister, Peter J; Bilchik, Tanya R

    2015-04-01

    A review on headache and insomnia revealed that insomnia is a risk factor for increased headache frequency and headache intensity in migraineurs. The authors designed a randomized, double blind, placebo-controlled, parallel-group, pilot study in which migraineurs who also had insomnia were enrolled, to test this observation. In the study, the authors treated 79 subjects with IHS-II migraine with and/or without aura and with DSM-IV primary insomnia for 6 weeks with 3 mg eszopiclone (Lunesta(®)) or placebo at bedtime. The treatment was preceded by a 2-week baseline period and followed by a 2-week run-out period. Of the 79 subjects treated, 75 were evaluable, 35 in the eszopiclone group, and 40 in the placebo group. At baseline, the groups were comparable except for sleep latency. Of the three remaining sleep variables, total sleep time, nighttime awakenings, and sleep quality, the number of nighttime awakenings during the 6-week treatment period was significantly lower in the eszopiclone group than in the placebo group (P = 0.03). Of the three daytime variables, alertness, fatigue, and functioning, this was also the case for fatigue (P = 005). The headache variables, frequency, duration, and intensity, did not show a difference from placebo during the 6-week treatment period. The study did not meet primary endpoint, that is, the difference in total sleep time during the 6-week treatment period between eszopiclone and placebo was less than 40 minutes. Therefore, it failed to answer the question as to whether insomnia is, indeed, a risk factor for increased headache frequency and headache intensity in migraineurs.

  20. CheckMate 025 Randomized Phase 3 Study: Outcomes by Key Baseline Factors and Prior Therapy for Nivolumab Versus Everolimus in Advanced Renal Cell Carcinoma

    DEFF Research Database (Denmark)

    Escudier, Bernard; Sharma, Padmanee; McDermott, David F

    2017-01-01

    /kg every 2 wk or everolimus 10mg once daily. RESULTS AND LIMITATIONS: The minimum follow-up was 14 mo. Baseline subgroup distributions were balanced between nivolumab and everolimus arms. Nivolumab demonstrated an OS improvement versus everolimus across subgroups, including Memorial Sloan Kettering Cancer...... Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium risk groups; age

  1. Impact of everolimus: update on immunosuppressive therapy strategies and patient outcomes after renal transplantation

    Directory of Open Access Journals (Sweden)

    Helio Tedesco-Silva Jr

    2011-01-01

    Full Text Available Helio Tedesco-Silva Jr, Claudia Rosso Felipe, Tainá Veras de Sandes Freitas, Marina Pontello Cristeli, Carolina Araújo Rodrigues, José Osmar Medina PestanaNephrology Division, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, BrazilAbstract: Everolimus is an immunosuppressive agent used for the prophylaxis of acute rejection after kidney transplantation. Everolimus inhibits the activity of the serine/threonine kinase mammalian target of rapamycin (mTOR, a key enzyme that controls cell growth and metabolism, producing cell cycle arrest from the G1 to S phase. As a consequence, everolimus has antiproliferative and antineoplastic effects. Everolimus is a drug with a narrow therapeutic index. The pharmacokinetics of everolimus indicates a need for twice-daily dosing. Intra- and interindividual variability and drug–drug interactions suggest the need for therapeutic drug monitoring to maximize the efficacy/toxicity ratio. The good correlation between exposure (area under the concentration–time curve and trough concentration indicates that monitoring of everolimus trough concentrations is an adequate strategy after kidney transplantation. Everolimus is indicated for low- to moderate-risk de novo kidney transplant candidates. There are no conclusive studies thus far indicating that everolimus can be used in high-risk patients, such as sensitized patients, retransplants, and African Americans. In de novo kidney transplant recipients, the recommended initial dose of everolimus is 0.75 mg twice daily, adjusted to maintain blood trough concentrations of 3–8 ng/mL, in combination with progressive reduction in blood trough cyclosporine concentrations to 25–50 ng/mL. In combination with reduced trough blood tacrolimus concentrations of 4–7 ng/mL the recommended initial dose of everolimus is 1.5 mg twice daily, adjusted to maintain trough blood concentrations of 3–8 ng/mL. Everolimus can also be used as a conversion strategy

  2. Comparison of an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II): a 3 year, randomised, controlled, single-blind, multicentre clinical trial

    NARCIS (Netherlands)

    Serruys, Patrick W.; Chevalier, Bernard; Sotomi, Yohei; Cequier, Angel; Carrié, Didier; Piek, Jan J.; van Boven, Ad J.; Dominici, Marcello; Dudek, Dariusz; McClean, Dougal; Helqvist, Steffen; Haude, Michael; Reith, Sebastian; de Sousa Almeida, Manuel; Campo, Gianluca; Iñiguez, Andrés; Sabaté, Manel; Windecker, Stephan; Onuma, Yoshinobu

    2016-01-01

    No medium-term data are available on the random comparison between everolimus-eluting bioresorbable vascular scaffolds and everolimus-eluting metallic stents. The study aims to demonstrate two mechanistic properties of the bioresorbable scaffold: increase in luminal dimensions as a result of

  3. Anti-tumor effects of everolimus and metformin are complementary and glucose-dependent in breast cancer cells

    NARCIS (Netherlands)

    Ariaans, Gerke; Jalving, Mathilde; de Vries, Emma Geertruida Elisabeth; de Jong, Steven

    2017-01-01

    Background: Clinical efficacy of the mTOR inhibitor everolimus is limited in breast cancer and regularly leads to side-effects including hyperglycemia. The AMPK inhibitor and anti-diabetic drug metformin may counteract everolimus-induced hyperglycemia, as well as enhancing anti-cancer efficacy. We

  4. Everolimus downregulates estrogen receptor and induces autophagy in aromatase inhibitor-resistant breast cancer cells

    International Nuclear Information System (INIS)

    Lui, Asona; New, Jacob; Ogony, Joshua; Thomas, Sufi; Lewis-Wambi, Joan

    2016-01-01

    mTOR inhibition of aromatase inhibitor (AI)-resistant breast cancer is currently under evaluation in the clinic. Everolimus/RAD001 (Afinitor®) has had limited efficacy as a solo agent but is projected to become part of combination therapy for AI-resistant breast cancer. This study was conducted to investigate the anti-proliferative and resistance mechanisms of everolimus in AI-resistant breast cancer cells. In this study we utilized two AI-resistant breast cancer cell lines, MCF-7:5C and MCF-7:2A, which were clonally derived from estrogen receptor positive (ER+) MCF-7 breast cancer cells following long-term estrogen deprivation. Cell viability assay, colony formation assay, cell cycle analysis and soft agar anchorage-independent growth assay were used to determine the efficacy of everolimus in inhibiting the proliferation and tumor forming potential of MCF-7, MCF-7:5C, MCF-7:2A and MCF10A cells. Confocal microscopy and transmission electron microscopy were used to evaluate LC3-II production and autophagosome formation, while ERE-luciferase reporter, Western blot, and RT-PCR analyses were used to assess ER expression and transcriptional activity. Everolimus inhibited the proliferation of MCF-7:5C and MCF-7:2A cells with relatively equal efficiency to parental MCF-7 breast cancer cells. The inhibitory effect of everolimus was due to G1 arrest as a result of downregulation of cyclin D1 and p21. Everolimus also dramatically reduced estrogen receptor (ER) expression (mRNA and protein) and transcriptional activity in addition to the ER chaperone, heat shock protein 90 protein (HSP90). Everolimus restored 4-hydroxy-tamoxifen (4OHT) sensitivity in MCF-7:5C cells and enhanced 4OHT sensitivity in MCF-7 and MCF-7:2A cells. Notably, we found that autophagy is one method of everolimus insensitivity in MCF-7 breast cancer cell lines. This study provides additional insight into the mechanism(s) of action of everolimus that can be used to enhance the utility of mTOR inhibitors as

  5. Effect of everolimus initiation and early calcineurin inhibitor withdrawal on myocardial FOXP3+ regulatory T cells in heart transplantation

    DEFF Research Database (Denmark)

    Mirza, Kiran; Gustafsson, Finn; Gullestad, Lars

    2016-01-01

    BACKGROUND: Through immunosuppression CD4+FoxP3+ regulatory T-cells (Tregs) play an indispensable role in allograft rejection. Post-HTx treatment with everolimus is associated with slower progression of cardiac allograft vasculopathy (CAV) - chronic rejection - than CNI based therapy. We hypothes......BACKGROUND: Through immunosuppression CD4+FoxP3+ regulatory T-cells (Tregs) play an indispensable role in allograft rejection. Post-HTx treatment with everolimus is associated with slower progression of cardiac allograft vasculopathy (CAV) - chronic rejection - than CNI based therapy. We...... hypothesized treatment with everolimus reduced the risk of CAV by modulating myocardial FoxP3 levels. METHODS: 15 patients from the Schedule trial comparing everolimus, MMF, steroid and early CNI (Everolimus, n=8) withdrawal to conventional CNI based immunosuppression (Controls, n=7) after de novo HTx were...

  6. Clinical evidence of the efficacy of everolimus and its potential in the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Saksena R

    2013-05-01

    Full Text Available Rujuta Saksena, Serena T WongThe Cancer Institute of New Jersey, New Brunswick, NJ, USAAbstract: The PI3K/Akt/mTOR (phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway regulates several key cellular functions and its dysregulation creates an environment that promotes tumorigenesis as well as resistance to therapy. The mTOR inhibitor everolimus has emerged as a promising agent in the treatment of breast cancer and was recently approved in combination with exemestane for advanced hormone receptor–positive disease after progression on a nonsteroidal aromatase inhibitor. Everolimus may also be effective in combination with cytotoxic and human epidermal growth factor receptor-2-directed therapies for the treatment of other subtypes of breast cancer. This paper highlights preclinical and clinical data that have emerged on the role of mTOR inhibition in breast cancer. Although generally well tolerated, everolimus carries a unique side effect profile of which both patients and providers should be made aware. Recommendations related to the administration of everolimus in the clinical setting are also discussed.Keywords: everolimus, breast cancer, mTOR inhibition

  7. [The drug of the month: everolimus (Afinitor) for the treatment of metastatic breast cancer].

    Science.gov (United States)

    Jerusalem, G; Rorive, A; Collignon, J

    2014-09-01

    Sequential endocrine treatments are recommended for estrogen receptor (ER) positive human epidermal growth factor receptor 2 (HER 2) negative metastatic breast cancers except in the case of symptomatic visceral disease. However, patients who suffer from disease progression while receiving a non-steroidal aromatase inhibitor (NSAI) have a very poor prognosis with standard endocrine therapy alone. Recently, based onthe results of the BOLERO 2 trial, the mammalian target of rapamycin (mTOR) inhibitor everolimus, combined with exemestane, a steroidal aromatase inhibitor, has been approved in Europe and the US for patients suffering from ER positive HER2 negative advanced breast cancer previously treated by a NSAI. The median progression-free survival (PFS) increased from 3.2 to 7.8 months in patients receiving everolimus and exemestane compared to placebo and exemestane. The magnitude of benefit was consistent in all pre-specified subgroups. Side effects were manageable and the quality of life was at least maintained. Everolimus has also beenrecently studied in HER2 positive locally advanced or metastatic disease in heavily pretreated patients (BOLERO 3 trial). This trial met its primary endpoint. The median PFS was increased in patients receiving trastuzumab, vinorelbine and everolimus compared to patients receiving trastuzumab, vinorelbine and placebo. We review pharmacological data and side effects of the drug. We also review the most important clinical trials leading to reimbursement of everolimus in metastatic breast cancer.

  8. A Randomized, Double-Blind, Placebo-Controlled Trial of Eszopiclone for the Treatment of Insomnia in Patients with Chronic Low Back Pain

    Science.gov (United States)

    Goforth, Harold W.; Preud'homme, Xavier A.; Krystal, Andrew D.

    2014-01-01

    Study Objectives: Insomnia, which is very common in patients with chronic low back pain (LBP), has long been viewed as a pain symptom that did not merit specific treatment. Recent data suggest that adding insomnia therapy to pain-targeted treatment should improve outcome; however, this has not been empirically tested in LBP or in any pain condition treated with a standardized pain medication regimen. We sought to test the hypothesis that adding insomnia therapy to pain-targeted treatment might improve sleep and pain in LBP. Design: Double-blind, placebo-controlled, parallel-group, 1-mo trial. Setting: Duke University Medical Center Outpatient Sleep Clinic. Patients: Fifty-two adult volunteers with LBP of at least 3 mo duration who met diagnostic criteria for insomnia (mean age: 42.5 y; 63% females). Interventions: Subjects were randomized to eszopiclone (ESZ) 3 mg plus naproxen 500 mg BID or matching placebo plus naproxen 500 mg twice a day. Measurements and Results: ESZ significantly improved total sleep time (mean increase: ESZ, 95 min; placebo, 9 min) (primary outcome) and nearly all sleep measures as well as visual analog scale pain (mean decrease: ESZ, 17 mm; placebo, 2 mm) (primary pain outcome), and depression (mean Hamilton Depression Rating Scale improvement ESZ, 3.8; placebo, 0.4) compared with placebo. Changes in pain ratings were significantly correlated with changes in sleep. Conclusions: The addition of insomnia-specific therapy to a standardized naproxen pain regimen significantly improves sleep, pain, and depression in patients with chronic low back pain (LBP). The findings indicate the importance of administering both sleep and pain-directed therapies to patients with LBP in clinical practice and provide strong evidence that improving sleep disturbance may improve pain. Trial Registration: clinicaltrials.gov identifier: NCT00365976 Citation: Goforth HW, Preud'homme XA, Krystal AD. A randomized, double-blind, placebo-controlled trial of eszopiclone

  9. Everolimus in clinical practice after liver transplantation: a single-center experience

    Directory of Open Access Journals (Sweden)

    O. A. Gerasimova

    2017-01-01

    Full Text Available Aim. Single-center analysis of everolimus treatment after liver transplantation. Materials and methods. 23 patients having received Certican after OLT in RSCRST were observed in period from 6 months to 5 years; comparison group consisted of 50 patients who received immunosuppressive scheme with tacrolimus. Conversion to everolimus was performed in the period from 1 month after OLT after discharge and at later time according to the indications: hepatocellular cancer, cumulative CNI nephrotoxicity, the development of malignancies, and intolerance to CNI. The concentrations of CNI and everolimus in the blood (target concentration of tacrolimus 1.5–2 ng/ml, everolimus 3–8 ng/ml were monitored. Glomerular filtration rate (GFR was determined using the CKD-EPI equation. Adverse events of everolimus were evaluated. Results. The immunosuppressive scheme with everolimus is presented; adverse events with dose-dependent hypercholesterolemia (34.7% as the main; the average level of blood cholesterol was not significantly different from that in the control group, 5.6 ± 0.9 vs 5.1 ± 1.4 mmol/l (Z = 1.3, p = 0.17. Renal function was stable throughout the observation period (35 ± 16 months. GFR (CKD-EPI before conversion was 75.8 ± 17.5 ml/min. 6 patients treated with Certican for 5 years had final GFR 96.6 ± 5.1 ml/min. GFR in the group of Certican at 12 months post conversion was 87.5 ± 16.3 ml/min vs 94.2 ± 16.8 ml/min (p = 0.08 in the control group. We revealed metastases to the liver and lungs in 5 patients from 13 patients with HCC, survival rate in this group depended on the compliance with the Milan criteria (Z = 2.4, p = 0.02. Conclusion. Everolimus allows maintaining of a stable renal function to prevent progression of renal failure; conversion should be initiated as early as possible. Combination of everolimus with reduced dose of CNI is optimal. Despite the fact that side effects are developing in most patients, adequate monitoring of

  10. Everolimus use and associated factors among post-menopausal women with hormonal receptor positive/human epidermal growth factor receptor 2 negative metastatic breast cancer.

    Science.gov (United States)

    Li, Nanxin; Hao, Yanni; Xie, Jipan; Lin, Peggy L; Zhou, Zhou; Zhong, Yichen; Signorovitch, James E; Wu, Eric Q

    2015-08-01

    Everolimus has been shown to be an effective HR+/HER2- mBC treatment in both clinical trials and real-world practice. The current study aims at understanding factors associated with everolimus use and how it is used in the real world. A retrospective chart review was conducted among postmenopausal HR+/HER2- mBC women who received everolimus, endocrine therapy (ET), or chemotherapy (CT) for mBC between 1 July 2012 and 15 April 2013 after an NSAI failure. Factors associated with everolimus use versus ET or CT were identified using multivariable logistic regressions. Reasons for prescribing everolimus and everolimus treatment patterns were described. Liver metastasis and high tumor volume were associated with a higher likelihood of everolimus use versus ET (OR = 1.67, OR = 1.62) but a lower likelihood of everolimus use versus CT (OR = 0.43, OR = 0.30). Medicare-only insurance (OR = 0.30) as well as ECOG ≥2 (OR = 3.72) and prior CT in mBC (OR = 2.76) were associated with a lower and higher likelihood of everolimus use versus CT, respectively. The top reason for prescribing everolimus was efficacy (69-85%). About 15% and 29% of everolimus users in second line and third line or above received prior CT for mBC. Exemestane was the most common concomitant therapy with everolimus (56-87%). The majority of patients initiated everolimus at the labeled dose of 10 mg daily (>80%) and maintained this dose (>80%). In the real world, everolimus was used in more severe patients than ET but less severe patients than CT based on visceral metastasis, tumor volume, and performance status. The top reason for prescribing everolimus was efficacy. A large proportion of patients received first or second line CT before everolimus initiation. The majority of patients used everolimus according to the labeled combination and dose. Future studies are needed to determine optimal sequencing of everolimus, ET, and CT for HR+/HER2- mBC.

  11. Everolimus for Advanced Pancreatic Neuroendocrine Tumours: A Subgroup Analysis Evaluating Japanese Patients in the RADIANT-3 Trial

    Science.gov (United States)

    Ito, Tetsuhide; Okusaka, Takuji; Ikeda, Masafumi; Igarashi, Hisato; Morizane, Chigusa; Nakachi, Kohei; Tajima, Takeshi; Kasuga, Akio; Fujita, Yoshie; Furuse, Junji

    2012-01-01

    Objective Everolimus, an inhibitor of the mammalian target of rapamycin, has recently demonstrated efficacy and safety in a Phase III, double-blind, randomized trial (RADIANT-3) in 410 patients with low- or intermediate-grade advanced pancreatic neuroendocrine tumours. Everolimus 10 mg/day provided a 2.4-fold improvement compared with placebo in progression-free survival, representing a 65% risk reduction for progression. The purpose of this analysis was to investigate the efficacy and safety of everolimus in the Japanese subgroup enrolled in the RADIANT-3 study. Methods Subgroup analysis of the Japanese patients was performed comparing efficacy and safety between everolimus 10 mg/day orally (n = 23) and matching placebo (n = 17). The primary endpoint was progression-free survival. Safety was evaluated on the basis of the incidence of adverse drug reactions. Results Progression-free survival was significantly prolonged with everolimus compared with placebo. The median progression-free survival was 19.45 months (95% confidence interval, 8.31–not available) with everolimus vs 2.83 months (95% confidence interval, 2.46–8.34) with placebo, resulting in an 81% risk reduction in progression (hazard ratio, 0.19; 95% confidence interval, 0.08–0.48; P< 0.001). Adverse drug reactions occurred in all 23 (100%) Japanese patients receiving everolimus and in 13 (77%) patients receiving placebo; most were grade 1/2 in severity. The most common adverse drug reactions in the everolimus group were rash (n = 20; 87%), stomatitis (n = 17; 74%), infections (n = 15; 65%), nail disorders (n = 12; 52%), epistaxis (n = 10; 44%) and pneumonitis (n = 10; 44%). Conclusions These results support the use of everolimus as a valuable treatment option for Japanese patients with advanced pancreatic neuroendocrine tumours. PMID:22859827

  12. Comparison of zotarolimus-eluting and everolimus-eluting coronary stents

    DEFF Research Database (Denmark)

    Serruys, Patrick W; Silber, Sigmund; Garg, Scot

    2010-01-01

    New-generation coronary stents that release zotarolimus or everolimus have been shown to reduce the risk of restenosis. However, it is unclear whether there are differences in efficacy and safety between the two types of stents on the basis of prospectively adjudicated end points endorsed...

  13. Wound complications and surgical events in de novo heart transplant patients treated with everolimus

    DEFF Research Database (Denmark)

    Rashidi, Mitra; Esmaily, Sorosh; Fiane, Arnt E

    2016-01-01

    OBJECTIVES: The use of mammalian target of rapamycin (mTOR) inhibitors have been limited by adverse events (AE), including delayed wound healing. We retrospectively reviewed all AE and serious AE (SAE) in The Scandinavian heart transplant (HTx) everolimus (EVE) de novo trial with early calcineurin...

  14. Cost utility analysis of everolimus in the treatment of metastatic renal cell cancer in the Netherlands

    NARCIS (Netherlands)

    Mihajlović, J.; Minović, I.; Bruinsma, A.; Postma, M.J.

    2013-01-01

    Objectives: Metastatic renal cell cancer (mRCC) is becoming an important part of Dutch health care expenditure due to expensive pharmaceutical options for disease control and lack of adequate prevention methods. New targeted therapeutics, such as sunitinib, sorafenib and everolimus, have recently

  15. Incidence and Potential Mechanism(s) of Post-Procedural Rise of Cardiac Biomarker in Patients With Coronary Artery Narrowing After Implantation of an Everolimus-Eluting Bioresorbable Vascular Scaffold or Everolimus-Eluting Metallic Stent

    DEFF Research Database (Denmark)

    Ishibashi, Yuki; Muramatsu, Takashi; Nakatani, Shimpei

    2015-01-01

    OBJECTIVES: This study sought to evaluate the mechanism of post-procedural cardiac biomarker (CB) rise following device implantation. BACKGROUND: A fully bioresorbable Absorb scaffold, compared with everolimus-eluting metallic stents (EES), might be associated with a higher incidence...

  16. The SYNERGY biodegradable polymer everolimus eluting coronary stent: Porcine vascular compatibility and polymer safety study.

    Science.gov (United States)

    Wilson, Gregory J; Marks, Angela; Berg, Kimberly J; Eppihimer, Michael; Sushkova, Natalia; Hawley, Steve P; Robertson, Kimberly A; Knapp, David; Pennington, Douglas E; Chen, Yen-Lane; Foss, Aaron; Huibregtse, Barbara; Dawkins, Keith D

    2015-11-15

    SYNERGY is a novel platinum chromium alloy stent that delivers abluminal everolimus from an ultrathin poly-lactide-co-glycide (PLGA) biodegradable polymer. This study evaluated the in vivo degradation of the polymer coating, everolimus release time course, and vascular compatibility of the SYNERGY stent. SYNERGY stents were implanted in arteries of domestic swine. Devices were explanted at predetermined time points (up to 120 days) and the extent of PLGA coating or everolimus remaining on the stents was quantified. Everolimus levels in the arterial tissue were also evaluated. A pathological analysis on coronary arteries of single and overlapping stents was performed at time points between 5 and 270 days. PLGA bioabsorption began immediately after implantation, and drug release was essentially complete by 90 days; PLGA absorption was substantially complete by 120 days (>90% of polymer was absorbed) leaving a bare metal SYNERGY stent. Vascular response was similar among SYNERGY and control stents (bare metal, polymer-only, and 3× polymer-only). Mild increases in para-strut fibrin were seen for SYNERGY at an early time point with no significant differences in all other morphological and morphometric parameters through 270 days or endothelial function (eNOS immunostaining) at 90 or 180 days. Inflammation was predominantly minimal to mild for all device types. In a swine model, everolimus was released by 90 days and PLGA bioabsorption was complete shortly thereafter. The SYNERGY stent and its biodegradable polymer, even at a 3× safety margin, demonstrated vascular compatibility similar to bare metal stent controls. © 2015 Wiley Periodicals, Inc.

  17. A randomized, double-blind, placebo-controlled trial of eszopiclone for the treatment of insomnia in patients with chronic low back pain.

    Science.gov (United States)

    Goforth, Harold W; Preud'homme, Xavier A; Krystal, Andrew D

    2014-06-01

    Insomnia, which is very common in patients with chronic low back pain (LBP), has long been viewed as a pain symptom that did not merit specific treatment. Recent data suggest that adding insomnia therapy to pain-targeted treatment should improve outcome; however, this has not been empirically tested in LBP or in any pain condition treated with a standardized pain medication regimen. We sought to test the hypothesis that adding insomnia therapy to pain-targeted treatment might improve sleep and pain in LBP. Double-blind, placebo-controlled, parallel-group, 1-mo trial. Duke University Medical Center Outpatient Sleep Clinic. Fifty-two adult volunteers with LBP of at least 3 mo duration who met diagnostic criteria for insomnia (mean age: 42.5 y; 63% females). Subjects were randomized to eszopiclone (ESZ) 3 mg plus naproxen 500 mg BID or matching placebo plus naproxen 500 mg twice a day. ESZ SIGNIFICANTLY IMPROVED TOTAL SLEEP TIME (MEAN INCREASE: ESZ, 95 min; placebo, 9 min) (primary outcome) and nearly all sleep measures as well as visual analog scale pain (mean decrease: ESZ, 17 mm; placebo, 2 mm) (primary pain outcome), and depression (mean Hamilton Depression Rating Scale improvement ESZ, 3.8; placebo, 0.4) compared with placebo. Changes in pain ratings were significantly correlated with changes in sleep. The addition of insomnia-specific therapy to a standardized naproxen pain regimen significantly improves sleep, pain, and depression in patients with chronic low back pain (LBP). The findings indicate the importance of administering both sleep and pain-directed therapies to patients with LBP in clinical practice and provide strong evidence that improving sleep disturbance may improve pain. clinicaltrials.gov identifier: NCT00365976.

  18. The impact of everolimus versus mycophenolate on blood and lymphocyte cyclosporine exposure in heart-transplant recipients

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Barth, David; Delgado, Diego H

    2009-01-01

    CsA C2 levels and blood CsA AUC(0-12) in groups of patients treated with MMF or everolimus (R(2) 0.93 and 0.96, respectively; P 2) = 0.98), there was poor correlation...... between whole-blood C2 and lymphocyte AUC(0-12) in patients treated with everolimus (R(2) = 0.24). CONCLUSION: Standard blood CsA levels accurately predict intralymphocytic exposure to CsA in patients concomitantly treated with MMF but not in patients treated with everolimus........ METHODS: Twelve-hour pharmacokinetic studies of whole-blood and intralymphocytic CsA concentrations were conducted in long-term heart-transplant recipients treated with mycophenolate mofetil (MMF) + CsA (n = 8) and everolimus + CsA (n = 9). RESULTS: There was a highly significant correlation between blood...

  19. Everolimus in advanced, progressive, well-differentiated, non-functional neuroendocrine tumors: RADIANT-4 lung subgroup analysis.

    Science.gov (United States)

    Fazio, Nicola; Buzzoni, Roberto; Delle Fave, Gianfranco; Tesselaar, Margot E; Wolin, Edward; Van Cutsem, Eric; Tomassetti, Paola; Strosberg, Jonathan; Voi, Maurizio; Bubuteishvili-Pacaud, Lida; Ridolfi, Antonia; Herbst, Fabian; Tomasek, Jiri; Singh, Simron; Pavel, Marianne; Kulke, Matthew H; Valle, Juan W; Yao, James C

    2018-01-01

    In the phase III RADIANT-4 study, everolimus improved median progression-free survival (PFS) by 7.1 months in patients with advanced, progressive, well-differentiated (grade 1 or grade 2), non-functional lung or gastrointestinal neuroendocrine tumors (NETs) vs placebo (hazard ratio, 0.48; 95% confidence interval [CI], 0.35-0.67; P < .00001). This exploratory analysis reports the outcomes of the subgroup of patients with lung NETs. In RADIANT-4, patients were randomized (2:1) to everolimus 10 mg/d or placebo, both with best supportive care. This is a post hoc analysis of the lung subgroup with PFS, by central radiology review, as the primary endpoint; secondary endpoints included objective response rate and safety measures. Ninety of the 302 patients enrolled in the study had primary lung NET (everolimus, n = 63; placebo, n = 27). Median PFS (95% CI) by central review was 9.2 (6.8-10.9) months in the everolimus arm vs 3.6 (1.9-5.1) months in the placebo arm (hazard ratio, 0.50; 95% CI, 0.28-0.88). More patients who received everolimus (58%) experienced tumor shrinkage compared with placebo (13%). Most frequently reported (≥5% incidence) grade 3-4 drug-related adverse events (everolimus vs. placebo) included stomatitis (11% vs. 0%), hyperglycemia (10% vs. 0%), and any infections (8% vs. 0%). In patients with advanced, progressive, well-differentiated, non-functional lung NET, treatment with everolimus was associated with a median PFS improvement of 5.6 months, with a safety profile similar to that of the overall RADIANT-4 cohort. These results support the use of everolimus in patients with advanced, non-functional lung NET. The trial is registered with ClinicalTrials.gov (no. NCT01524783). © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  20. Everolimus for Previously Treated Advanced Gastric Cancer: Results of the Randomized, Double-Blind, Phase III GRANITE-1 Study

    Science.gov (United States)

    Ohtsu, Atsushi; Ajani, Jaffer A.; Bai, Yu-Xian; Bang, Yung-Jue; Chung, Hyun-Cheol; Pan, Hong-Ming; Sahmoud, Tarek; Shen, Lin; Yeh, Kun-Huei; Chin, Keisho; Muro, Kei; Kim, Yeul Hong; Ferry, David; Tebbutt, Niall C.; Al-Batran, Salah-Eddin; Smith, Heind; Costantini, Chiara; Rizvi, Syed; Lebwohl, David; Van Cutsem, Eric

    2013-01-01

    Purpose The oral mammalian target of rapamycin inhibitor everolimus demonstrated promising efficacy in a phase II study of pretreated advanced gastric cancer. This international, double-blind, phase III study compared everolimus efficacy and safety with that of best supportive care (BSC) in previously treated advanced gastric cancer. Patients and Methods Patients with advanced gastric cancer that progressed after one or two lines of systemic chemotherapy were randomly assigned to everolimus 10 mg/d (assignment schedule: 2:1) or matching placebo, both given with BSC. Randomization was stratified by previous chemotherapy lines (one v two) and region (Asia v rest of the world [ROW]). Treatment continued until disease progression or intolerable toxicity. Primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), overall response rate, and safety. Results Six hundred fifty-six patients (median age, 62.0 years; 73.6% male) were enrolled. Median OS was 5.4 months with everolimus and 4.3 months with placebo (hazard ratio, 0.90; 95% CI, 0.75 to 1.08; P = .124). Median PFS was 1.7 months and 1.4 months in the everolimus and placebo arms, respectively (hazard ratio, 0.66; 95% CI, 0.56 to 0.78). Common grade 3/4 adverse events included anemia, decreased appetite, and fatigue. The safety profile was similar in patients enrolled in Asia versus ROW. Conclusion Compared with BSC, everolimus did not significantly improve overall survival for advanced gastric cancer that progressed after one or two lines of previous systemic chemotherapy. The safety profile observed for everolimus was consistent with that observed for everolimus in other cancers. PMID:24043745

  1. Impact of prior therapies on everolimus activity: an exploratory analysis of RADIANT-4.

    Science.gov (United States)

    Buzzoni, Roberto; Carnaghi, Carlo; Strosberg, Jonathan; Fazio, Nicola; Singh, Simron; Herbst, Fabian; Ridolfi, Antonia; Pavel, Marianne E; Wolin, Edward M; Valle, Juan W; Oh, Do-Youn; Yao, James C; Pommier, Rodney

    2017-01-01

    Recently, everolimus was shown to improve median progression-free survival (PFS) by 7.1 months in patients with advanced, progressive, well-differentiated, nonfunctional neuroendocrine tumors (NET) of lung or gastrointestinal (GI) tract compared with placebo (HR, 0.48; 95% CI, 0.35-0.67; P <0.00001) in the Phase III, RADIANT-4 study. This post hoc analysis evaluates the impact of prior therapies (somatostatin analogs [SSA], chemotherapy, and radiotherapy) on everolimus activity. ClinicalTrials.gov identifier: NCT01524783. Patients were randomized (2:1) to everolimus 10 mg/day or placebo, both with best supportive care. Subgroups of patients who received prior SSA, chemotherapy, or radiotherapy (including peptide receptor radionuclide therapy) were analyzed and reported. A total of 302 patients were enrolled, of whom, 163 (54%) had any prior SSA use (mostly for tumor control), 77 (25%) received chemotherapy, and 63 (21%) were previously exposed to radiotherapy. Patients who received everolimus had longer median PFS compared with placebo, regardless of previous SSA (with SSA: 11.1 vs 4.5 months [HR, 0.56 {95% CI, 0.37-0.85}]; without SSA: 9.5 vs 3.7 months [0.57 {0.36-0.89}]), chemotherapy (with chemotherapy: 9.2 vs 2.1 months [0.35 {0.19-0.64}]; without chemotherapy: 11.2 vs 5.4 months [0.60 {0.42-0.86}]), or radiotherapy (with radiotherapy: 9.2 vs 3.0 months [0.47 {0.24-0.94}]; without radiotherapy: 11 vs 5.1 months [0.59 {0.42-0.83}]) exposure. The most frequent drug-related adverse events included stomatitis (59%-65%), fatigue (27%-35%), and diarrhea (24%-34%) among the subgroups. These results suggest that everolimus improves PFS in patients with advanced, progressive lung or GI NET, regardless of prior therapies. Safety findings were consistent with the known safety profile of everolimus in NET.

  2. Phase I-II study of everolimus and low-dose oral cyclophosphamide in patients with metastatic renal cell cancer

    International Nuclear Information System (INIS)

    Huijts, Charlotte M; Santegoets, Saskia J; Eertwegh, Alfons J van den; Pijpers, Laura S; Haanen, John B; Gruijl, Tanja D de; Verheul, Henk M; Vliet, Hans J van der

    2011-01-01

    For patients with metastatic renal cell cancer (mRCC) who progressed on vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor therapy, the orally administered mammalian target of rapamycin (mTOR) inhibitor everolimus has been shown to prolong progression free survival. Intriguingly, inhibition of mTOR also promotes expansion of immunosuppressive regulatory T cells (Tregs) that can inhibit anti-tumor immune responses in a clinically relevant way in various tumor types including RCC. This study intends to investigate whether the antitumor efficacy of everolimus can be increased by preventing the detrimental everolimus induced expansion of Tregs using a metronomic schedule of cyclophosphamide. This phase I-II trial is a national multi-center study of different doses and schedules of low-dose oral cyclophosphamide in combination with a fixed dose of everolimus in patients with mRCC not amenable to or progressive after a VEGF-receptor tyrosine kinase inhibitor containing treatment regimen. In the phase I part of the study the optimal Treg-depleting dose and schedule of metronomic oral cyclophosphamide when given in combination with everolimus will be determined. In the phase II part of the study we will evaluate whether the percentage of patients progression free at 4 months of everolimus treatment can be increased from 50% to 70% by adding metronomic cyclophosphamide (in the dose and schedule determined in the phase I part). In addition to efficacy, we will perform extensive immune monitoring with a focus on the number, phenotype and function of Tregs, evaluate the safety and feasibility of the combination of everolimus and cyclophosphamide, perform monitoring of selected angiogenesis parameters and analyze everolimus and cyclophosphamide drug levels. This phase I-II study is designed to determine whether metronomic cyclophosphamide can be used to counter the mTOR inhibitor everolimus induced Treg expansion in patients with metastatic renal cell

  3. Phase I-II study of everolimus and low-dose oral cyclophosphamide in patients with metastatic renal cell cancer

    Directory of Open Access Journals (Sweden)

    Huijts Charlotte M

    2011-11-01

    Full Text Available Abstract Background For patients with metastatic renal cell cancer (mRCC who progressed on vascular endothelial growth factor (VEGF receptor tyrosine kinase inhibitor therapy, the orally administered mammalian target of rapamycin (mTOR inhibitor everolimus has been shown to prolong progression free survival. Intriguingly, inhibition of mTOR also promotes expansion of immunosuppressive regulatory T cells (Tregs that can inhibit anti-tumor immune responses in a clinically relevant way in various tumor types including RCC. This study intends to investigate whether the antitumor efficacy of everolimus can be increased by preventing the detrimental everolimus induced expansion of Tregs using a metronomic schedule of cyclophosphamide. Methods/design This phase I-II trial is a national multi-center study of different doses and schedules of low-dose oral cyclophosphamide in combination with a fixed dose of everolimus in patients with mRCC not amenable to or progressive after a VEGF-receptor tyrosine kinase inhibitor containing treatment regimen. In the phase I part of the study the optimal Treg-depleting dose and schedule of metronomic oral cyclophosphamide when given in combination with everolimus will be determined. In the phase II part of the study we will evaluate whether the percentage of patients progression free at 4 months of everolimus treatment can be increased from 50% to 70% by adding metronomic cyclophosphamide (in the dose and schedule determined in the phase I part. In addition to efficacy, we will perform extensive immune monitoring with a focus on the number, phenotype and function of Tregs, evaluate the safety and feasibility of the combination of everolimus and cyclophosphamide, perform monitoring of selected angiogenesis parameters and analyze everolimus and cyclophosphamide drug levels. Discussion This phase I-II study is designed to determine whether metronomic cyclophosphamide can be used to counter the mTOR inhibitor everolimus

  4. Critical appraisal of the role of everolimus in advanced neuroendocrine tumors of pancreatic origin

    Directory of Open Access Journals (Sweden)

    Mulet-Margalef N

    2012-09-01

    Full Text Available Núria Mulet-Margalef, Jaume CapdevilaMedical Oncology Department, Vall d'Hebron University Hospital, Barcelona, SpainAbstract: For many years, the treatment of advanced pancreatic neuroendocrine tumors (pNETs has been limited almost entirely to somatostatin analogs and streptozocin-based chemotherapy, with modest benefit. Increasing knowledge of the biologic features of pNETs has allowed the design of molecular-based clinical trials, which have taken a step forward in the management of these tumors. In this review, we discuss the molecular rationale for the development of everolimus for patients with advanced pNETs, critically review the clinical data obtained by the main studies in this setting, and discuss essential considerations based on recent findings in pNET biology for future drug development involving the phosphatidylinositol 3' kinase-AKT-mTOR pathway.Keywords: pancreatic neuroendocrine tumors, everolimus, targeted therapies

  5. Everolimus: the first approved product for patients with advanced renal cell cancer after sunitinib and/or sorafenib

    Directory of Open Access Journals (Sweden)

    Chris Coppin

    2010-04-01

    Full Text Available Chris CoppinMedical Oncology, BC Cancer Agency and University of British Columbia, Vancouver, CanadaAbstract: Everolimus (RAD001, Afinitor® Novartis is the first oral inhibitor of mTOR (mammalian target of rapamycin to reach the oncology clinic. Everolimus 10 mg daily achieves complete inhibition of its target at below the maximum tolerable dose for most patients. A phase III randomized placebo-controlled trial has examined the impact of everolimus in patients with clear cell renal cancers and progressive disease on or within 6 months of the VEGFR tyrosine kinase inhibitors sunitinib and/or sorafenib. The primary endpoint of progression-free survival was increased from median 1.9 to 4.9 months (hazard ratio 0.33, P < 0.001 and 25% were still progression-free after 10 months of everolimus therapy. There was a delay in time to decline of performance status and trends to improvement in quality of life, disease-related symptoms, and overall survival despite crossover of the majority of patients assigned to placebo. In 2009, everolimus was approved in the US and Europe as the only validated option for this indication. Toxicities are usually mild to moderate and can be managed with dose reduction or interruption if necessary. Opportunistic infections and non-infectious pneumonitis are seen as a class effect. Management of common practical management issues are discussed. Clinical trials are in progress to examine additional roles for everolimus in renal cancer, alone and in combination with other agents.Keywords: everolimus, drug therapy, advanced renal cancer

  6. Therapeutic potential and adverse events of everolimus for treatment of hepatocellular carcinoma – systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Yamanaka, Kenya; Petrulionis, Marius; Lin, Shibo; Gao, Chao; Galli, Uwe; Richter, Susanne; Winkler, Susanne; Houben, Philipp; Schultze, Daniel; Hatano, Etsuro; Schemmer, Peter

    2013-01-01

    Everolimus is an orally administrated mammalian target of rapamycin (mTOR) inhibitor. Several large-scale randomized controlled trials (RCTs) have demonstrated the survival benefits of everolimus at the dose of 10 mg/day for solid cancers. Furthermore, mTOR-inhibitor-based immunosuppression is associated with survival benefits for patients with hepatocellular carcinoma (HCC) who have received liver transplantation. However, a low rate of tumor reduction and some adverse events have been pointed out. This review summarizes the antitumor effects and adverse events of everolimus and evaluates its possible application in advanced HCC. For the meta-analysis of adverse events, we used the RCTs for solid cancers. The odds ratios of adverse events were calculated using the Peto method. Manypreclinical studies demonstrated that everolimus had antitumor effects such as antiproliferation and antiangiogenesis. However, some differences in the effects were observed among in vivo animal studies for HCC treatment. Meanwhile, clinical studies demonstrated that the response rate of single-agent everolimus was low, though survival benefits could be expected. The meta-analysis revealed the odds ratios (95% confidence interval [CI]) of stomatitis: 5.42 [4.31–6.73], hyperglycemia: 3.22 [2.37–4.39], anemia: 3.34 [2.37–4.67], pneumonitis: 6.02 [3.95–9.16], aspartate aminotransferase levels: 2.22 [1.37–3.62], and serum alanine aminotransferase levels: 2.94 [1.72–5.02], respectively. Everolimus at the dose of 10 mg/day significantly increased the risk of the adverse events. In order to enable its application to the standard conventional therapies of HCC, further studies are required to enhance the antitumor effects and manage the adverse events of everolimus

  7. Two-dose-level confirmatory study of the pharmacokinetics and tolerability of everolimus in Chinese patients with advanced solid tumors

    Directory of Open Access Journals (Sweden)

    Jappe Annette

    2011-01-01

    Full Text Available Abstract Background This phase I, randomized, multicenter, open-label study investigated the pharmacokinetics, safety, and efficacy of the oral mammalian target of rapamycin inhibitor everolimus in Chinese patients with advanced solid tumors. Methods A total of 24 patients with advanced breast cancer (n = 6, gastric cancer (n = 6, non-small cell lung cancer (n = 6, or renal cell carcinoma (n = 6 who were refractory to/unsuitable for standard therapy were randomized 1:1 to oral everolimus 5 or 10 mg/day. Primary end points were pharmacokinetic parameters and safety and tolerability. Pharmacokinetic 24-h profiles were measured on day 15; trough level was measured on days 2, 8, 15, 16, and 22. Tolerability was assessed continuously. This final analysis was performed after all patients had received 6 months of study drug or had discontinued. Results Everolimus was absorbed rapidly; median Tmax was 3 h (range, 1-4 and 2 h (range, 0.9-6 in the 5 and 10 mg/day groups, respectively. Pharmacokinetic parameters increased dose proportionally from the 5 and 10 mg/day doses. Steady-state levels were achieved by day 8 or earlier. The most common adverse events suspected to be related to everolimus therapy were increased blood glucose (16.7% and 41.7% and fatigue (16.7% and 33.3% in the everolimus 5 and 10 mg/day dose cohorts, respectively. Best tumor response was stable disease in 10 (83% and 6 (50% patients in the 5 and 10 mg/day groups, respectively. Conclusions Everolimus 5 or 10 mg/day was well tolerated in Chinese patients with advanced solid tumors. The observed safety and pharmacokinetic profile of everolimus from this study were consistent with previous studies. Trial registration Chinese Health Authorities 2008L09346

  8. Supplementary Administration of Everolimus Reduces Cardiac Systolic Function in Kidney Transplant Recipients.

    Science.gov (United States)

    Tsujimura, Kazuma; Ota, Morihito; Chinen, Kiyoshi; Nagayama, Kiyomitsu; Oroku, Masato; Nishihira, Morikuni; Shiohira, Yoshiki; Abe, Masami; Iseki, Kunitoshi; Ishida, Hideki; Tanabe, Kazunari

    2017-05-26

    BACKGROUND The effect of everolimus, one of the mammalian targets of rapamycin inhibitors, on cardiac function was evaluated in kidney transplant recipients. MATERIAL AND METHODS Seventy-six participants who underwent kidney transplant between March 2009 and May 2016 were retrospectively reviewed. To standardize everolimus administration, the following criteria were used: (1) the recipient did not have a donor-specific antigen before kidney transplantation; (2) the recipient did not have proteinuria and uncontrollable hyperlipidemia after kidney transplantation; and (3) acute rejection was not observed on protocol biopsy 3 months after kidney transplantation. According to these criteria, everolimus administration for maintenance immunosuppression after kidney transplantation was included. Cardiac function was compared between the treatment group (n=30) and non-treatment group (n=46). RESULTS The mean observation periods of the treatment and non-treatment groups were 41.3±12.6 and 43.9±19.8 months, respectively (p=0.573). The mean ejection fraction and fractional shortening of the treatment and non-treatment groups after kidney transplant were 66.5±7.9% vs. 69.6±5.5% (p=0.024) and 37.1±6.2% vs. 39.3±4.7% (p=0.045), respectively. In the treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation did not differ significantly (p=0.604 and 0.606, respectively). In the non-treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation differed significantly (p=0.004 and 0.006, respectively). CONCLUSIONS Supplementary administration of everolimus after kidney transplantation can reduce cardiac systolic function.

  9. Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer.

    Science.gov (United States)

    Lousberg, Laurence; Jerusalem, Guy

    2016-01-01

    Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.

  10. Vascular Response of the Segments Adjacent to the Proximal and Distal Edges of the ABSORB Everolimus-Eluting Bioresorbable Vascular Scaffold

    DEFF Research Database (Denmark)

    Gogas, Bill D; Serruys, Patrick W; Diletti, Roberto

    2012-01-01

    This study sought to investigate in vivo the vascular response at the proximal and distal edges of the second-generation ABSORB everolimus-eluting bioresorbable vascular scaffold (BVS).......This study sought to investigate in vivo the vascular response at the proximal and distal edges of the second-generation ABSORB everolimus-eluting bioresorbable vascular scaffold (BVS)....

  11. A randomized comparison of a durable polymer Everolimus-eluting stent with a bare metal coronary stent: The SPIRIT first trial

    NARCIS (Netherlands)

    Serruys, Patrick W.; Ong, Andrew T. L.; Piek, Jan J.; Neumann, Franz-Josef; van der Giessen, Willem J.; Wiemer, Marcus; Zeiher, Andreas; Grube, Eberhard; Haase, Jürgen; Thuesen, Leif; Hamm, Christian; Otto-Terlouw, Patricia C.

    2005-01-01

    Background: Everolimus is a sirolimus analogue with similar efficacy in animal models, and has been previously successfully tested in humans using an erodable polymer.Methods: This first-in-man single blind multi-centre randomized controlled trial assessed the safety and efficacy of everolimus

  12. A randomised comparison of an everolimus-eluting coronary stent with a paclitaxel-eluting coronary stent:the SPIRIT II trial

    NARCIS (Netherlands)

    Serruys, Patrick W.; Ruygrok, Peter; Neuzner, Jörg; Piek, Jan J.; Seth, Ashok; Schofer, Joachim J.; Richardt, Gert; Wiemer, Marcus; Carrié, Didier; Thuesen, Leif; Boone, Els; Miquel-Herbert, Karine; Daemen, Joost

    2006-01-01

    Background: Everolimus has been successfully tested in humans using both an erodable and a durable polymer in small previous studies.Methods: This single blind multi-centre non-inferiority randomised (3:1) controlled trial evaluated the safety and performance of the XIENCE V Everolimus Eluting

  13. 18F-FDG and 18F-FLT-PET Imaging for Monitoring Everolimus Effect on Tumor-Growth in Neuroendocrine Tumors

    DEFF Research Database (Denmark)

    Johnbeck, Camilla Bardram; Munk Jensen, Mette; Nielsen, Carsten Haagen

    2014-01-01

    INTRODUCTION: The mTOR inhibitor everolimus has shown promising results in some but not all neuroendocrine tumors. Therefore, early assessment of treatment response would be beneficial. In this study, we investigated the in vivo and in vitro treatment effect of everolimus in neuroendocrine tumors...

  14. Long-term outcomes of thoracic transplant recipients following conversion to everolimus with reduced calcineurin inhibitor in a multicenter, open-label, randomized trial lv

    DEFF Research Database (Denmark)

    Gullestad, Lars; Eiskjaer, Hans; Gustafsson, Finn

    2016-01-01

    The NOCTET study randomized 282 patients ≥1 year after heart or lung transplantation to continue conventional calcineurin inhibitor (CNI) therapy or to start everolimus with reduced-exposure CNI. Last follow-up, at ≥5 years postrandomization (mean: 5.6 years) was attended by 72/140 everolimus...

  15. The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: a substudy of the RESOLUTE All Comers Trial

    DEFF Research Database (Denmark)

    Garg, Scot; Serruys, Patrick W; Silber, Sigmund

    2011-01-01

    This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents.......This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents....

  16. The MANDELA study: A multicenter, randomized, open-label, parallel group trial to refine the use of everolimus after heart transplantation.

    Science.gov (United States)

    Deuse, Tobias; Bara, Christoph; Barten, Markus J; Hirt, Stephan W; Doesch, Andreas O; Knosalla, Christoph; Grinninger, Carola; Stypmann, Jörg; Garbade, Jens; Wimmer, Peter; May, Christoph; Porstner, Martina; Schulz, Uwe

    2015-11-01

    In recent years a series of trials has sought to define the optimal protocol for everolimus-based immunosuppression in heart transplantation, with the goal of minimizing exposure to calcineurin inhibitors (CNIs) and harnessing the non-immunosuppressive benefits of everolimus. Randomized studies have demonstrated that immunosuppressive potency can be maintained in heart transplant patients receiving everolimus despite marked CNI reduction, although very early CNI withdrawal may be inadvisable. A potential renal advantage has been shown for everolimus, but the optimal time for conversion and the adequate reduction in CNI exposure remain to be defined. Other reasons for use of everolimus include a substantial reduction in the risk of cytomegalovirus infection, and evidence for inhibition of cardiac allograft vasculopathy, a major cause of graft loss. The ongoing MANDELA study is a 12-month multicenter, randomized, open-label, parallel-group study in which efficacy, renal function and safety are compared in approximately 200 heart transplant patients. Patients receive CNI therapy, steroids and everolimus or mycophenolic acid during months 3 to 6 post-transplant, and are then randomized at month 6 post-transplant (i) to convert to CNI-free immunosuppression with everolimus and mycophenolic acid or (ii) to continue reduced-exposure CNI, with concomitant everolimus. Patients are then followed to month 18 post-transplant The rationale and expectations for the trial and its methodology are described herein. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Everolimus long-term use in patients with tuberous sclerosis complex: Four-year update of the EXIST-2 study.

    Directory of Open Access Journals (Sweden)

    John J Bissler

    Full Text Available We examined the long-term effects of everolimus in patients with renal angiomyolipoma associated with tuberous sclerosis complex or sporadic lymphangioleiomyomatosis.Following favorable results from the double-blind core phase of EXIST-2 (NCT00790400, patients were allowed to receive open-label everolimus (extension phase. Patients initially randomly assigned to everolimus continued on the same dose; those who were receiving placebo crossed over to everolimus 10 mg/day. Dose modifications were based on tolerability. The primary end point was angiomyolipoma response rate, defined as a ≥50% reduction from baseline in the sum volume of target renal angiomyolipomas in the absence of new target angiomyolipomas, kidney volume increase of >20% from nadir, and angiomyolipoma-related bleeding grade ≥2. The key secondary end point was safety.Of the 112 patients who received ≥1 dose of everolimus, 58% (95% CI, 48.3% to 67.3% achieved angiomyolipoma response. Almost all patients (97% experienced reduction in renal lesion volumes at some point during the study period. Median duration of everolimus exposure was 46.9 months. Sixteen (14.3% patients experienced angiomyolipoma progression at some point in the study. No angiomyolipoma-related bleeding or nephrectomies were reported. One patient on everolimus underwent embolization for worsening right flank pain. Subependymal giant cell astrocytoma lesion response was achieved in 48% of patients and skin lesion response in 68% of patients. The most common adverse events suspected to be treatment-related were stomatitis (42%, hypercholesterolemia (30.4%, acne (25.9%, aphthous stomatitis and nasopharyngitis (each 21.4%. Ten (8.9% patients withdrew because of an adverse event. Renal function remained stable, and the frequency of emergent adverse events generally decreased over time.Everolimus treatment remained safe and effective over approximately 4 years. The overall risk/benefit assessment supports the use

  18. Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis.

    Science.gov (United States)

    Yardley, Denise A; Noguchi, Shinzaburo; Pritchard, Kathleen I; Burris, Howard A; Baselga, José; Gnant, Michael; Hortobagyi, Gabriel N; Campone, Mario; Pistilli, Barbara; Piccart, Martine; Melichar, Bohuslav; Petrakova, Katarina; Arena, Francis P; Erdkamp, Frans; Harb, Wael A; Feng, Wentao; Cahana, Ayelet; Taran, Tetiana; Lebwohl, David; Rugo, Hope S

    2013-10-01

    Effective treatments for hormone-receptor-positive (HR(+)) breast cancer (BC) following relapse/progression on nonsteroidal aromatase inhibitor (NSAI) therapy are needed. Initial Breast Cancer Trials of OraL EveROlimus-2 (BOLERO-2) trial data demonstrated that everolimus and exemestane significantly prolonged progression-free survival (PFS) versus placebo plus exemestane alone in this patient population. BOLERO-2 is a phase 3, double-blind, randomized, international trial comparing everolimus (10 mg/day) plus exemestane (25 mg/day) versus placebo plus exemestane in postmenopausal women with HR(+) advanced BC with recurrence/progression during or after NSAIs. The primary endpoint was PFS by local investigator review, and was confirmed by independent central radiology review. Overall survival, response rate, and clinical benefit rate were secondary endpoints. Final study results with median 18-month follow-up show that median PFS remained significantly longer with everolimus plus exemestane versus placebo plus exemestane [investigator review: 7.8 versus 3.2 months, respectively; hazard ratio = 0.45 (95% confidence interval 0.38-0.54); log-rank P NSAIs. These results further support the use of everolimus plus exemestane in this patient population. ClinicalTrials.gov #NCT00863655.

  19. FDG-PET as a predictive biomarker for therapy with everolimus in metastatic renal cell cancer

    International Nuclear Information System (INIS)

    Chen, James L; Appelbaum, Daniel E; Kocherginsky, Masha; Cowey, Charles L; Kimryn Rathmell, Wendy; McDermott, David F; Stadler, Walter M

    2013-01-01

    The mTOR (mammalian target of rapamycin) inhibitor, everolimus, affects tumor growth by targeting cellular metabolic proliferation pathways and delays renal cell carcinoma (RCC) progression. Preclinical evidence suggests that baseline elevated tumor glucose metabolism as quantified by FDG-PET ([ 18 F] fluorodeoxy-glucose positron emission tomography) may predict antitumor activity. Metastatic RCC (mRCC) patients refractory to vascular endothelial growth factor (VEGF) pathway inhibition were treated with standard dose everolimus. FDG-PET scans were obtained at baseline and 2 weeks; serial computed tomography (CT) scans were obtained at baseline and every 8 weeks. Maximum standardized uptake value (SUVmax) of the most FDG avid lesion, average SUVmax of all measured lesions and their corresponding 2-week relative changes were examined for association with 8-week change in tumor size. A total of 63 patients were enrolled; 50 were evaluable for the primary endpoint of which 48 had both PET scans. Patient characteristics included the following: 36 (72%) clear cell histology and median age 59 (range: 37–80). Median pre- and 2-week treatment average SUVmax were 6.6 (1–17.9) and 4.2 (1–13.9), respectively. Response evaluation criteria in solid tumors (RECIST)-based measurements demonstrated an average change in tumor burden of 0.2% (−32.7% to 35.9%) at 8 weeks. Relative change in average SUVmax was the best predictor of change in tumor burden (all evaluable P = 0.01; clear cell subtype P = 0.02), with modest correlation. Baseline average SUVmax was correlated with overall survival and progression-free survival (PFS) (P = 0.023; 0.020), but not with change in tumor burden. Everolimus therapy decreased SUVs on follow-up PET scans in mRCC patients, but changes were only modestly correlated with changes in tumor size. Thus, clinical use of FDG-PET-based biomarkers is challenged by high variability. In this phase II trial, FDG-PET was explored as a predictive biomarker

  20. Comparison of in vivo acute stent recoil between the bioabsorbable everolimus-eluting coronary stent and the everolimus-eluting cobalt chromium coronary stent: insights from the ABSORB and SPIRIT trials

    DEFF Research Database (Denmark)

    Tanimoto, Shuzou; Serruys, Patrick W; Thuesen, Leif

    2007-01-01

    OBJECTIVES: This study sought to evaluate and compare in vivo acute stent recoil of a novel bioabsorbable stent and a metallic stent. BACKGROUND: The bioabsorbable everolimus-eluting coronary stent (BVS) is composed of a poly-L-lactic acid backbone, coated with a bioabsorbable polymer containing...... the antiproliferative drug, everolimus, and expected to be totally metabolized and absorbed in the human body. Because the BVS is made from polymer, it may have more acute recoil than metallic stents in vivo. METHODS: A total of 54 patients, who underwent elective stent implantation for single de novo native coronary...... artery lesions, were enrolled: 27 patients treated with the BVS and 27 patients treated with the everolimus-eluting cobalt chromium stent (EES). Acute absolute recoil, assessed by quantitative coronary angiography, was defined as the difference between mean diameter of the last inflated balloon...

  1. Efficacy and Safety of Everolimus for Maintenance Immunosuppression of Kidney Transplantation: A Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Jinyu Liu

    Full Text Available Conversion to everolimus is often used in kidney transplantation to overcome calcineurin inhibitor (CNI nephrotoxicity but there is conflicting evidence for this approach.To investigate the benefits and harm from randomized clinical trials (RCTs involving the conversion from CNI to everolimus after kidney transplantation.Databases were searched up to March 2016. Two reviewers independently assessed trials for eligibility and quality, and extracted data. Results are expressed as risk ratio (RR or mean difference (MD with 95% confidence intervals (CI.Eleven RCTs, with a total of 1,633 patients, met the final inclusion criteria. Patients converted to everolimus had improved renal function at 1 year posttransplant with an estimated glomerular filtration rate (eGFR of 5.36 mL/min per 1.73 m2 greater than patients remaining on CNI (p = 0.0005 and the longer-term results (> 1 year of renal function was identical to that of 1 year. There was not a substantial difference in graft loss, mortality, and the occurrence of adverse events (AEs or serious AEs. However, the risks of acute rejection and trial termination due to AEs with everolimus are respectively 1.82 and 2.63 times greater than patients staying on CNI at 1 year posttransplant (p = 0.02, p = 0.03, respectively. Further, those patients who converted to everolimus had a substantially greater risk of anemia, hyperlipidemia, hypercholesterolemia, hypokalemia, proteinuria, stomatitis, mouth ulceration, and acne.Conversion from CNI to everolimus after kidney transplantation is associated with improved renal function in the first 5 years posttransplant but increases the risk of acute rejection at 1 year posttransplant and may not be well endured.

  2. Long-Term Use of Everolimus in Patients with Tuberous Sclerosis Complex: Final Results from the EXIST-1 Study.

    Directory of Open Access Journals (Sweden)

    David N Franz

    Full Text Available Everolimus, a mammalian target of rapamycin (mTOR inhibitor, has demonstrated efficacy in treating subependymal giant cell astrocytomas (SEGAs and other manifestations of tuberous sclerosis complex (TSC. However, long-term use of mTOR inhibitors might be necessary. This analysis explored long-term efficacy and safety of everolimus from the conclusion of the EXIST-1 study (NCT00789828.EXIST-1 was an international, prospective, double-blind, placebo-controlled phase 3 trial examining everolimus in patients with new or growing TSC-related SEGA. After a double-blind core phase, all remaining patients could receive everolimus in a long-term, open-label extension. Everolimus was initiated at a dose (4.5 mg/m2/day titrated to a target blood trough of 5-15 ng/mL. SEGA response rate (primary end point was defined as the proportion of patients achieving confirmed ≥50% reduction in the sum volume of target SEGA lesions from baseline in the absence of worsening nontarget SEGA lesions, new target SEGA lesions, and new or worsening hydrocephalus. Of 111 patients (median age, 9.5 years who received ≥1 dose of everolimus (median duration, 47.1 months, 57.7% (95% confidence interval [CI], 47.9-67.0 achieved SEGA response. Of 41 patients with target renal angiomyolipomas at baseline, 30 (73.2% achieved renal angiomyolipoma response. In 105 patients with ≥1 skin lesion at baseline, skin lesion response rate was 58.1%. Incidence of adverse events (AEs was comparable with that of previous reports, and occurrence of emergent AEs generally decreased over time. The most common AEs (≥30% incidence suspected to be treatment-related were stomatitis (43.2% and mouth ulceration (32.4%.Everolimus use led to sustained reduction in tumor volume, and new responses were observed for SEGA and renal angiomyolipoma from the blinded core phase of the study. These findings support the hypothesis that everolimus can safely reverse multisystem manifestations of TSC in a

  3. Everolimus immunosuppression reduces the serum expression of fibrosis markers in liver transplant recipients.

    Science.gov (United States)

    Fernández-Yunquera, Ainhoa; Ripoll, Cristina; Bañares, Rafael; Puerto, Marta; Rincón, Diego; Yepes, Ismael; Catalina, Vega; Salcedo, Magdalena

    2014-06-24

    To evaluate the expression of serum fibrosis markers in liver transplantation (LT) recipients on everolimus monotherapy compared to patients on an anti-calcineurin regimen. This cross-sectional case-control study included LT patients on everolimus monotherapy (cases) (E) (n = 30) and matched controls on an anti-calcineurin regimen (calcineurin inhibitors, CNI), paired by etiology of liver disease and time since LT (n = 30). Clinical characteristics, blood tests and elastography were collected. Serum levels of transforming growth factor-β (TGF-β), angiopoietin-1, tumor necrosis factor (TNF), platelet derived growth factor, amino-terminal propeptide of type III procollagen (PIIINP), hyaluronic acid (HA), VCM-1 (ng/mL), interleukin (IL)-10, interferon-inducible protein 10 (IP-10), vascular endothelial growth factor and hepatocyte growth factor (HGF) (pg/mL) were determined by enzyme-linked immunosorbent assay. Expression of these markers between E and CNI was compared. Stratified analysis was done according to factors that may influence liver fibrosis. Variables are described with medians (interquartillic range) or percentages. A total of 60 patients [age: 59 (49-64), hepatitis C virus (HCV): n = 21 (35%), time from LT: 73 mo (16-105)] were included. Patients had been on everolimus for a median of 15 mo. No differences in inflammatory activity, APRI test or liver elastography were found between the groups. No significant differences were observed between the groups in serum levels of PIIINP, metalloproteinase type = 1, angiopoietin, HGF, IP-10, TNF-α, IL-10 and vascular cell adhesion molecule. Patients on E had a lower expression of TGF-β [E: 12.7 (3.7-133.6), CNI: 152.5 (14.4-333.2), P = 0.009] and HA [E: 702.89 (329.4-838.2), CNI: 1513.6 (691.9-1951.4), P = 0.001] than those on CNI. This difference was maintained in the stratified analysis when recipient age is more than 50 years (TFG-β1: P = 0.06; HA: P = 0.005), in patients without active neoplasia (TFG-β1

  4. Impact of prior therapies on everolimus activity: an exploratory analysis of RADIANT-4

    Directory of Open Access Journals (Sweden)

    Buzzoni R

    2017-10-01

    Full Text Available Roberto Buzzoni,1 Carlo Carnaghi,2 Jonathan Strosberg,3 Nicola Fazio,4 Simron Singh,5 Fabian Herbst,6 Antonia Ridolfi,7 Marianne E Pavel,8 Edward M Wolin,9 Juan W Valle,10 Do-Youn Oh,11 James C Yao,12 Rodney Pommier13 1IRCCS Foundation, National Institute of Tumors, Milan, Italy; 2Humanitas Clinical and Research Center, Rozzano, Italy; 3Moffitt Cancer Center, Tampa, FL, USA; 4European Institute of Oncology, Milan, Italy; 5Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 6Novartis AG, Basel, Switzerland; 7Novartis Pharma S.A.S., Rueil-Malmaison, France; 8Medizinische Klinik 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; 9Montefiore Einstein Center for Cancer Care, Bronx, NY, USA; 10Institute of Cancer Sciences, University of Manchester, The Christie Hospital, Manchester, UK; 11Seoul National University Hospital, Seoul, Republic of Korea; 12University of Texas M.D. Anderson Cancer Center, Houston, TX, USA; 13Oregon Health & Science University, Portland, OR, USA Background: Recently, everolimus was shown to improve median progression-free survival (PFS by 7.1 months in patients with advanced, progressive, well-differentiated, nonfunctional neuroendocrine tumors (NET of lung or gastrointestinal (GI tract compared with placebo (HR, 0.48; 95% CI, 0.35–0.67; P<0.00001 in the Phase III, RADIANT-4 study. This post hoc analysis evaluates the impact of prior therapies (somatostatin analogs [SSA], chemotherapy, and radiotherapy on everolimus activity. Trial registration: ClinicalTrials.gov identifier: NCT01524783. Patients and methods: Patients were randomized (2:1 to everolimus 10 mg/day or placebo, both with best supportive care. Subgroups of patients who received prior SSA, chemotherapy, or radiotherapy (including peptide receptor radionuclide therapy were analyzed and reported. Results: A total of 302 patients were enrolled, of whom, 163 (54% had any prior SSA use (mostly for tumor control, 77 (25% received

  5. A bioresorbable everolimus-eluting scaffold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions (ABSORB II): an interim 1-year analysis of clinical and procedural secondary outcomes from a randomised controlled trial

    NARCIS (Netherlands)

    Serruys, Patrick W.; Chevalier, Bernard; Dudek, Dariusz; Cequier, Angel; Carrié, Didier; Iniguez, Andres; Dominici, Marcello; van der Schaaf, René J.; Haude, Michael; Wasungu, Luc; Veldhof, Susan; Peng, Lei; Staehr, Peter; Grundeken, Maik J.; Ishibashi, Yuki; Garcia-Garcia, Hector M.; Onuma, Yoshinobu

    2015-01-01

    Despite rapid dissemination of an everolimus-eluting bioresorbable scaffold for treatment for coronary artery disease, no data from comparisons with its metallic stent counterpart are available. In a randomised controlled trial we aimed to compare an everolimus-eluting bioresorbable scaffold with an

  6. Everolimus-eluting bioresorbable stent vs. durable polymer everolimus-eluting metallic stent in patients with ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Sabaté, Manel; Windecker, Stephan; Iñiguez, Andres

    2015-01-01

    AIMS: Patients with ST-segment elevation myocardial infarction (STEMI) feature thrombus-rich lesions with large necrotic core, which are usually associated with delayed arterial healing and impaired stent-related outcomes. The use of bioresorbable vascular scaffolds (Absorb) has the potential...... to overcome these limitations owing to restoration of native vessel lumen and physiology at long term. The purpose of this randomized trial was to compare the arterial healing response at short term, as a surrogate for safety and efficacy, between the Absorb and the metallic everolimus-eluting stent (EES...... was the 6-month optical frequency domain imaging healing score (HS) based on the presence of uncovered and/or malapposed stent struts and intraluminal filling defects. Main secondary endpoint included the device-oriented composite endpoint (DOCE) according to the Academic Research Consortium definition...

  7. The combination of sorafenib and everolimus shows antitumor activity in preclinical models of malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Pignochino, Ymera; Dell’Aglio, Carmine; Inghilleri, Simona; Zorzetto, Michele; Basiricò, Marco; Capozzi, Federica; Canta, Marta; Piloni, Davide; Cemmi, Francesca; Sangiolo, Dario; Gammaitoni, Loretta; Soster, Marco; Marchiò, Serena; Pozzi, Ernesto; Morbini, Patrizia; Luisetti, Maurizio; Aglietta, Massimo; Grignani, Giovanni; Stella, Giulia M

    2015-01-01

    Malignant Pleural Mesothelioma (MPM) is an aggressive tumor arising from mesothelial cells lining the pleural cavities characterized by resistance to standard therapies. Most of the molecular steps responsible for pleural transformation remain unclear; however, several growth factor signaling cascades are known to be altered during MPM onset and progression. Transducers of these pathways, such as PIK3CA-mTOR-AKT, MAPK, and ezrin/radixin/moesin (ERM) could therefore be exploited as possible targets for pharmacological intervention. This study aimed to identify ‘druggable’ pathways in MPM and to formulate a targeted approach based on the use of commercially available molecules, such as the multikinase inhibitor sorafenib and the mTOR inhibitor everolimus. We planned a triple approach based on: i) analysis of immunophenotypes and mutational profiles in a cohort of thoracoscopic MPM samples, ii) in vitro pharmacological assays, ii) in vivo therapeutic approaches on MPM xenografts. No mutations were found in ‘hot spot’ regions of the mTOR upstream genes (e.g. EGFR, KRAS and PIK3CA). Phosphorylated mTOR and ERM were specifically overexpressed in the analyzed MPM samples. Sorafenib and everolimus combination was effective in mTOR and ERM blockade; exerted synergistic effects on the inhibition of MPM cell proliferation; triggered ROS production and consequent AMPK-p38 mediated-apoptosis. The antitumor activity was displayed when orally administered to MPM-bearing NOD/SCID mice. ERM and mTOR pathways are activated in MPM and ‘druggable’ by a combination of sorafenib and everolimus. Combination therapy is a promising therapeutic strategy against MPM. The online version of this article (doi:10.1186/s12885-015-1363-1) contains supplementary material, which is available to authorized users

  8. An acute episode of rhabdomyolysis associated with everolimus and cabergoline intake in a postpartum kidney recipient

    Directory of Open Access Journals (Sweden)

    B. I. Yaremin

    2017-01-01

    Full Text Available Kidney transplantation is one of the most promising ways to ensure the onset and successful maintenance of pregnancy in patients with end-stage chronic renal disease. A multicomponent drug therapy in such patients creates risks for fetal development, primarily due to the teratogenicity of mTOR receptor inhibitors and mycophenolate. Moreover, the inhibitors of the proliferative signal may have potential drug interactions, which can result in additional complications.Rhabdomyolysis is one of them. The paper describes the clinical case of an acute episode of reversible rhabdomyolysis in a patient on everolimus therapy.

  9. Everolimus-associated acute kidney injury in patients with metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    A Chandra

    2017-01-01

    Full Text Available Recently, everolimus (Evl has been introduced in the management of hormone receptor-positive metastatic breast cancer, in combination with aromatase inhibitors. Evl-induced acute kidney injury has hitherto been described in other malignancies, especially renal cell cancer, but only once before in a patient with breast cancer. We describe two cases of Evl-associated nephrotoxicity in patients with breast cancer, one of whom underwent a renal biopsy showing acute tubular necrosis. Both our patients improved after withdrawal of the offending agent and have normal renal functions on follow-up.

  10. Low sodium diet (image)

    Science.gov (United States)

    ... for you. Look for these words on labels: low-sodium, sodium-free, no salt added, sodium-reduced, ... for you. Look for these words on labels: low-sodium, sodium-free, no salt added, sodium-reduced, ...

  11. Arterial healing following primary PCI using the Absorb everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) versus the durable polymer everolimus-eluting metallic stent (XIENCE) in patients with acute ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Räber, Lorenz; Onuma, Yoshinobu; Brugaletta, Salvatore

    2015-01-01

    Aims: The Absorb bioresorbable vascular scaffold (Absorb BVS) provides similar clinical outcomes compared with a durable polymer-based everolimus-eluting metallic stent (EES) in stable coronary artery disease patients. ST-elevation myocardial infarction (STEMI) lesions have been associated with d...

  12. Cost-Effectiveness of Everolimus for Second-Line Treatment of Metastatic Renal Cell Carcinoma in Serbia

    NARCIS (Netherlands)

    Mihajlovic, Jovan; Pechlivanoglou, Petros; Sabo, Ana; Tomic, Zdenko; Postma, Maarten J.

    2013-01-01

    Background: New targeted therapeutics for metastatic renal cell carcinoma (mRCC) enable an increment in progression-free survival (PFS) ranging from 2 to 6 months. Compared with best supportive care, everolimus demonstrated an additional PFS of 3 months in patients with mRCC whose disease had

  13. Early conversion from calcineurin inhibitor- to everolimus-based therapy following kidney transplantation : Results of the randomized ELEVATE trial

    NARCIS (Netherlands)

    de Fijter, Johan W; Holdaas, Hallvard; Øyen, Ole; Sanders, Jan Stephan; Sundar, Sankaran; Bemelman, Frederike J; Sommerer, Claudia; Pascual, Julio; Avihingsanon, Yingyos; Pongskul, Cholatip; Oppenheimer, Frederic; Toselli, Lorenzo; Russ, Graeme; Wang, Zailong; Lopez, Patricia; Kochuparampil, Jossy; Cruzado, Josep M; van der Giet, Markus

    In a 24-month, multicenter, open-label, randomized trial, 715 de novo kidney transplant recipients were randomized at 10-14 weeks to convert to everolimus (n=359) or remain on standard calcineurin inhibitor (CNI) therapy (n=356; 231 tacrolimus; 125 cyclosporine), all with mycophenolic acid and

  14. Hidden Sodium

    Centers for Disease Control (CDC) Podcasts

    2013-03-04

    In this podcast, learn about reducing sodium intake by knowing what to eat and the main sources of sodium in the diet. It's important for a healthy lifestyle.  Created: 3/4/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/4/2013.

  15. Dietary sodium

    DEFF Research Database (Denmark)

    Graudal, Niels

    2015-01-01

    The 2013 Institute of Medicine (IOM) report "Sodium Intake in Populations: Assessment of Evidence" did not support the current recommendations of the IOM and the American Heart Association (AHA) to reduce daily dietary sodium intake to below 2,300 mg. The report concluded that the population...

  16. Efficacy of palbociclib plus fulvestrant after everolimus in hormone receptor-positive metastatic breast cancer.

    Science.gov (United States)

    du Rusquec, Pauline; Palpacuer, Clément; Campion, Loic; Patsouris, Anne; Augereau, Paule; Gourmelon, Carole; Robert, Marie; Dumas, Laurence; Caroline, Folliard; Campone, Mario; Frenel, Jean-Sébastien

    2018-04-01

    Palbociclib, a CDK4-6 inhibitor, combined with endocrine therapy (ET) is a new standard of treatment for Hormone Receptor-positive Metastatic Breast Cancer. We present the first real-life efficacy and tolerance data of palbociclib plus fulvestrant in this population. From November 2015 to November 2016, patients receiving in our institution palbociclib + fulvestrant according to the Temporary Authorization for Use were prospectively analyzed. 60 patients were treated accordingly; median age was 61 years; 50 patients (83.3%) had visceral metastasis, and 10 (16.7%) had bone-only disease. Patients had previously received a median of 5 (1-14) lines of treatment, including ET (median 3) and chemotherapy (median 2); 28 (46.7%) received previously fulvestrant and all everolimus. With a median follow-up of 10.3 months, median progression-free survival (mPFS) was 5.8 months (95% CI 3.9-7.3). Patients pretreated with fulvestrant had a similar PFS of 6.4 months (HR 1.00; 95% CI 0.55-1.83; P = 1.00). The most common AEs (adverse events) were neutropenia (93%), anemia (65%), and thrombocytopenia (55%). In this heavily pretreated population including everolimus, fulvestrant plus palbociclib provides an mPFS of 5.8 months with the same magnitude of benefit for fulvestrant-pretreated patients.

  17. Phase II study of everolimus in children and adults with neurofibromatosis type 2 and progressive vestibular schwannomas

    Science.gov (United States)

    Karajannis, Matthias A.; Legault, Geneviève; Hagiwara, Mari; Giancotti, Filippo G.; Filatov, Alexander; Derman, Anna; Hochman, Tsivia; Goldberg, Judith D.; Vega, Emilio; Wisoff, Jeffrey H.; Golfinos, John G.; Merkelson, Amanda; Roland, J. Thomas; Allen, Jeffrey C.

    2014-01-01

    Background Activation of the mammalian target of rapamycin (mTOR) signaling pathway is thought to be a key driver of tumor growth in Merlin (NF2)-deficient tumors. Everolimus is an oral inhibitor of mTOR complex 1 (mTORC1) with antitumor activity in a variety of cancers. Methods We conducted a single-institution, prospective, 2-stage, open-label phase II study to estimate the response rate to everolimus in neurofibromatosis type 2 (NF2) patients with progressive vestibular schwannoma (VS). Ten eligible patients were enrolled, including 2 pediatric patients. Everolimus was administered at a daily dose of 10 mg (adults) or 5 mg/m2/day (children <18 y) orally in continuous 28-day courses, for up to 12 courses. Response was assessed every 3 months with MRI, using 3-dimensional volumetric tumor analysis, and audiograms. Nine patients were evaluable for the primary response, defined as ≥15% decrease in VS volume. Hearing response was evaluable as a secondary endpoint in 8 patients. Results None of the 9 patients with evaluable disease experienced a clinical or MRI response. No objective imaging or hearing responses were observed in stage 1 of the trial, and the study was closed according to predefined stopping rules. Conclusion Everolimus is ineffective for the treatment of progressive VS in NF2 patients. We are currently conducting a pharmacokinetic/pharmacodynamic (“phase 0”) study of everolimus in presurgical VS patients to elucidate the biological basis for apparent treatment resistance to mTORC1 inhibition in these tumors. PMID:24311643

  18. Two-year outcomes in thoracic transplant recipients after conversion to everolimus with reduced calcineurin inhibitor within a multicenter, open-label, randomized trial

    DEFF Research Database (Denmark)

    Gullestad, Lars; Mortensen, Svend-Aage; Eiskjær, Hans

    2010-01-01

    Use of the mammalian target of rapamycin inhibitor everolimus with an accompanying reduction in calcineurin inhibitor (CNI) exposure has shown promise in preserving renal function in maintenance thoracic transplant patients, but robust, long-term data are required....

  19. Dynamic tumor modeling of the dose–response relationship for everolimus in metastatic renal cell carcinoma using data from the phase 3 RECORD-1 trial

    International Nuclear Information System (INIS)

    Stein, Andrew; Wang, Wenping; Carter, Alison A; Chiparus, Ovidiu; Hollaender, Norbert; Kim, Hyewon; Motzer, Robert J; Sarr, Celine

    2012-01-01

    The phase 3 RECORD-1 trial (NCT00410124) established the efficacy and safety of everolimus in patients with metastatic renal cell carcinoma (mRCC) who progress on sunitinib or sorafenib. In RECORD-1, patients received 10 mg everolimus daily, with dose reduction to 5 mg daily allowed for toxicity. We have developed a model of tumor growth dynamics utilizing serial measurements of the sum of the longest tumor diameters (SLD) from individual RECORD-1 patients to define the dose–response relationship of everolimus. The model predicts that after 1 year of continuous dosing, the change in SLD of target lesions will be +142.1% ± 98.3%, +22.4% ± 17.2%, and –15.7% ± 11.5% in the average patient treated with placebo, 5 mg everolimus, and 10 mg everolimus, respectively. This nonlinear, mixed-effects modeling approach can be used to describe the dynamics of each individual patient, as well as the overall population. This allows evaluation of how an actual dosing history and individual covariates impact on the observed drug effect, and offers the possibility of predicting clinical observations as a function of time. In this pharmacodynamic model of tumor response, everolimus more effectively shrinks target lesions in mRCC when dosed 10 mg daily versus 5 mg daily, although a 5-mg dose still shows an antitumor effect. These data support earlier studies that established 10 mg daily as the preferred clinical dose of everolimus, and improve our understanding of the everolimus dose–response relationship

  20. CheckMate 025 Randomized Phase 3 Study: Outcomes by Key Baseline Factors and Prior Therapy for Nivolumab Versus Everolimus in Advanced Renal Cell Carcinoma.

    Science.gov (United States)

    Escudier, Bernard; Sharma, Padmanee; McDermott, David F; George, Saby; Hammers, Hans J; Srinivas, Sandhya; Tykodi, Scott S; Sosman, Jeffrey A; Procopio, Giuseppe; Plimack, Elizabeth R; Castellano, Daniel; Gurney, Howard; Donskov, Frede; Peltola, Katriina; Wagstaff, John; Gauler, Thomas C; Ueda, Takeshi; Zhao, Huanyu; Waxman, Ian M; Motzer, Robert J

    2017-12-01

    The randomized, phase 3 CheckMate 025 study of nivolumab (n=410) versus everolimus (n=411) in previously treated adults (75% male; 88% white) with advanced renal cell carcinoma (aRCC) demonstrated significantly improved overall survival (OS) and objective response rate (ORR). To investigate which baseline factors were associated with OS and ORR benefit with nivolumab versus everolimus. Subgroup OS analyses were performed using Kaplan-Meier methodology. Hazard ratios were estimated using the Cox proportional hazards model. Nivolumab 3mg/kg every 2 wk or everolimus 10mg once daily. The minimum follow-up was 14 mo. Baseline subgroup distributions were balanced between nivolumab and everolimus arms. Nivolumab demonstrated an OS improvement versus everolimus across subgroups, including Memorial Sloan Kettering Cancer Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium risk groups; age guide treatment decisions, and further supports nivolumab as the standard of care in previously treated patients with aRCC. We investigated the impact of demographic and pretreatment features on survival benefit and tumor response with nivolumab versus everolimus in advanced renal cell carcinoma (aRCC). Survival benefit and response were observed for multiple subgroups, supporting the use of nivolumab as a new standard of care across a broad range of patients with previously treated aRCC. The trial is registered on ClinicalTrials.gov as NCT01668784. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  1. Sodium Oxybate

    Science.gov (United States)

    ... or give your sodium oxybate to anyone else; selling or sharing it is against the law. Store ... dehydrogenase deficiency (an inherited condition in which certain substances build up in the body and cause retardation ...

  2. Sodium Azide

    Science.gov (United States)

    ... Exposure to a large amount of sodium azide by any route may cause these other health effects as well: Convulsions Low blood pressure Loss of consciousness Lung injury Respiratory failure leading to death Slow heart rate ...

  3. Cloud point extraction coupled with microwave-assisted back-extraction (CPE-MABE) for determination of Eszopiclone (Z-drug) using UV-Visible, HPLC and mass spectroscopic (MS) techniques: Spiked and in vivo analysis.

    Science.gov (United States)

    Kori, Shivpoojan; Parmar, Ankush; Goyal, Jony; Sharma, Shweta

    2018-02-01

    A procedure for the determination of Eszopiclone (ESZ) from complex matrices i.e. in vitro (spiked matrices), as well as in vivo (mice model) was developed using cloud point extraction coupled with microwave-assisted back-extraction (CPE-MABE). Analytical measurements have been carried using UV-Visible, HPLC and MS techniques. The proposed method has been validated according to ICH guidelines and legitimate reproducible and reliability of protocol is assessed through intraday and inter-day precision UV-Visible techniques, corresponding to assessed linearity range. The coaservate phase in CPE was back extracted under microwaves exposure, with isooctane at pre-concentration factor ~50 when 5mL of sample solution was pre-concentrated to 0.1mL. Under optimized conditions i.e. Aqueous-Triton X-114 4% (w/v), pH4.0, NaCl 4% (w/v) and equilibrium temperature of 45°C for 20min, average extraction recovery has been obtained between 89.8 and 99.2% and 84.0-99.2% from UV-Visible and HPLC analysis, respectively. The method has been successfully applied to the pharmacokinetic estimation (post intraperitoneal administration) of ESZ in mice. MS analysis precisely depicted the presence of active N‑desmethyl zopiclone in impales as well as in mice plasma. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus.

    Science.gov (United States)

    Menghi, Viola; Comai, Giorgia; Baraldi, Olga; Liviano D'Arcangelo, Giovanni; Lazzarotto, Tiziana; La Manna, Gaetano

    2016-01-01

    Cytomegalovirus (CMV) infection remains a major cause of morbidity, graft failure, and death in kidney transplant recipients. We describe a case of a 53-year-old CMV-seronegative man who underwent renal transplant from a CMV-positive donor and who developed ganciclovir- (GCV-) resistant CMV infection. Foscarnet was started while immunosuppressive therapy was modified with the introduction of everolimus minimizing tacrolimus dosage. Only two weeks after the start of this treatment regimen was the patient's viral load negative. At two-year follow-up the patient has no clinical or laboratory signs of CMV infection and a good and stable renal function or graft survival. In our case, administration of an mTOR inhibitor combined with foscarnet led to rapid and persistent viral clearance without compromising short- and medium-term graft function. This combination therapy supports the need for the kidney transplant community to individualize a target therapy for each type of GCV-resistant CMV infection.

  5. Safety and Efficacy of Everolimus- Versus Sirolimus-Eluting Stents

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Christiansen, Evald Høj

    2016-01-01

    BACKGROUND: Long-term safety and efficacy for everolimus-eluting stents (EES) versus those of sirolimus-eluting stents (SES) are unknown. OBJECTIVES: This study compared 5-year outcomes for EES with those for SES from the SORT OUT IV (Scandinavian Organization for Randomized Trials with Clinical...... rate was lower with EES (HR: 0.71, 95% CI: 0.55 to 0.90; p = 0.006; p interaction = 0.12). Definite stent thrombosis was lower with EES (0.4%) than with SES (2.0%; HR: 0.18, 95% CI: 0.07 to 0.46), with a lower risk of very late definite stent thrombosis in the EES group (0.2% vs. 1.4%, respectively; HR...... in Non-selected Patients With Coronary Heart Disease [SORT OUT IV]; NCT00552877)....

  6. Influence of CYP3A5 genetic variation on everolimus maintenance dosing after cardiac transplantation.

    Science.gov (United States)

    Lesche, Dorothea; Sigurdardottir, Vilborg; Setoud, Raschid; Englberger, Lars; Fiedler, Georg M; Largiadèr, Carlo R; Mohacsi, Paul; Sistonen, Johanna

    2015-12-01

    Everolimus (ERL) has become an alternative to calcineurin inhibitors (CNIs) due to its renal-sparing properties, especially in heart transplant (HTx) recipients with kidney dysfunction. However, ERL dosing is challenging due to its narrow therapeutic window combined with high interindividual pharmacokinetic variability. Our aim was to evaluate the effect of clinical and genetic factors on ERL dosing in a pilot cohort of 37 HTx recipients. Variants in CYP3A5, CYP3A4, CYP2C8, POR, NR1I2, and ABCB1 were genotyped, and clinical data were retrieved from patient charts. While ERL trough concentration (C0 ) was within the targeted range for most patients, over 30-fold variability in the dose-adjusted ERL C0 was observed. Regression analysis revealed a significant effect of the non-functional CYP3A5*3 variant on the dose-adjusted ERL C0 (p = 0.031). ERL dose requirement was 0.02 mg/kg/d higher in patients with CYP3A5*1/*3 genotype compared to patients with CYP3A5*3/*3 to reach the targeted C0 (p = 0.041). ERL therapy substantially improved estimated glomerular filtration rate (28.6 ± 6.6 mL/min/1.73 m(2)) in patients with baseline kidney dysfunction. Everolimus pharmacokinetics in HTx recipients is highly variable. Our preliminary data on patients on a CNI-free therapy regimen suggest that CYP3A5 genetic variation may contribute to this variability. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Efficacy of everolimus in ABO-incompatible kidney transplantation: a retrospective study

    Directory of Open Access Journals (Sweden)

    Tsujimura K

    2017-09-01

    Full Text Available Kazuma Tsujimura,1 Morihito Ota,1 Kiyoshi Chinen,1 Kiyomitsu Nagayama,2 Masato Oroku,2 Morikuni Nishihira,2 Yoshiki Shiohira,2 Kunitoshi Iseki,3 Hideki Ishida,4 Kazunari Tanabe4 1Department of Surgery, 2Department of Nephrology, 3Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan; 4Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan Background: There are limited reports on the use of everolimus for maintaining immunosuppression in ABO-incompatible (ABOi kidney transplantation (KT. As everolimus (EVR is effective for preventing calcineurin inhibitor (CNI nephrotoxicity without increasing the risk of chronic rejection and viral infection, we aimed to assess the efficacy of EVR in ABOi KT.Patients and methods: We retrospectively studied 22 patients who underwent KT and received EVR. Patients in the ABOi KT group (n=7 were compared with those in the ABO-compatible kidney transplantation group (ABOc KT; n=15. We recorded the frequency of CNI nephrotoxicity, chronic rejection, and viral infection in the 2 groups.Results: CNI nephrotoxicity, chronic rejection, and viral infection occurred in the ABOi KT and ANOc KT groups at rates of 28.3% (2/7 patients and 13.3% (2/15 patients (P=0.388, 28.3% (2/7 patients and 26.7% (4/15 patients (P=0.926, and 14.3% (1/7 patients and 26.7% (4/15 patients (P=0.517, respectively.Conclusion: Administration of EVR is effective in preventing CNI nephrotoxicity after KT. The rate of CNI nephrotoxicity was lower in the ABOc KT group than in the ABOi KT group. The rate of chronic rejection and viral infection was comparable between the groups. This study was conducted in a small cohort of patients. Hence, further evaluation with large sample sizes is necessary in the future to confirm the outcomes. Keywords: blood group incompatibility, immunosuppression, kidney transplantation

  8. Virtual histology assessment of cardiac allograft vasculopathy following introduction of everolimus--results of a multicenter trial

    DEFF Research Database (Denmark)

    Arora, Stina Jørgensen; Erikstad, I; Ueland, T

    2012-01-01

    of cardiac allograft vasculopathy (CAV). Parallel measurement of a range of inflammatory markers was also performed. A similar rate of quantitative CAV progression was observed in the everolimus (n = 30) and standard CNI group (n = 48) (plaque index 1.9 ± 3.8% and 1.6 ± 3.9%, respectively; p = 0.65). However...... with time since HTx >5.1 years and was accompanied by a significant increase in levels of von Willebrand (vWF) factor (p = 0.04) and vascular cell adhesion molecule (VCAM) (p = 0.03). Conversion to everolimus and reduced CNI is associated with a significant increase in calcified and necrotic intimal...

  9. A Phase 1 Study of Everolimus + Weekly Cisplatin + Intensity Modulated Radiation Therapy in Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Fury, Matthew G.; Lee, Nancy Y.; Sherman, Eric; Ho, Alan L.; Rao, Shyam; Heguy, Adriana; Shen, Ronglai; Korte, Susan; Lisa, Donna; Ganly, Ian; Patel, Snehal; Wong, Richard J.; Shaha, Ashok; Shah, Jatin; Haque, Sofia; Katabi, Nora; Pfister, David G.

    2013-01-01

    Purpose: Elevated expression of eukaryotic protein synthesis initiation factor 4E (eIF4E) in histologically cancer-free margins of resected head and neck squamous cell carcinomas (HNSCCs) is mediated by mammalian target of rapamycin complex 1 (mTORC1) and has been associated with increased risk of disease recurrence. Preclinically, inhibition of mTORC1 with everolimus sensitizes cancer cells to cisplatin and radiation. Methods and Materials: This was single-institution phase 1 study to establish the maximum tolerated dose of daily everolimus given with fixed dose cisplatin (30 mg/m 2 weekly × 6) and concurrent intensity modulated radiation therapy for patients with locally and/or regionally advanced head-and-neck cancer. The study had a standard 3 + 3 dose-escalation design. Results: Tumor primary sites were oral cavity (4), salivary gland (4), oropharynx (2), nasopharynx (1), scalp (1), and neck node with occult primary (1). In 4 of 4 cases in which resected HNSCC surgical pathology specimens were available for immunohistochemistry, elevated expression of eIF4E was observed in the cancer-free margins. The most common grade ≥3 treatment-related adverse event was lymphopenia (92%), and dose-limiting toxicities (DLTs) were mucositis (n=2) and failure to thrive (n=1). With a median follow up of 19.4 months, 2 patients have experienced recurrent disease. The maximum tolerated dose was everolimus 5 mg/day. Conclusions: Head-and-neck cancer patients tolerated everolimus at therapeutic doses (5 mg/day) given with weekly cisplatin and intensity modulated radiation therapy. The regimen merits further evaluation, especially among patients who are status post resection of HNSCCs that harbor mTORC1-mediated activation of eIF4E in histologically negative surgical margins

  10. A Phase 1 Study of Everolimus + Weekly Cisplatin + Intensity Modulated Radiation Therapy in Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fury, Matthew G. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States); Lee, Nancy Y. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Sherman, Eric; Ho, Alan L. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States); Rao, Shyam [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Heguy, Adriana [Department of Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Shen, Ronglai [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Korte, Susan; Lisa, Donna [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ganly, Ian; Patel, Snehal; Wong, Richard J.; Shaha, Ashok; Shah, Jatin [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Haque, Sofia [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katabi, Nora [Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Pfister, David G. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States)

    2013-11-01

    Purpose: Elevated expression of eukaryotic protein synthesis initiation factor 4E (eIF4E) in histologically cancer-free margins of resected head and neck squamous cell carcinomas (HNSCCs) is mediated by mammalian target of rapamycin complex 1 (mTORC1) and has been associated with increased risk of disease recurrence. Preclinically, inhibition of mTORC1 with everolimus sensitizes cancer cells to cisplatin and radiation. Methods and Materials: This was single-institution phase 1 study to establish the maximum tolerated dose of daily everolimus given with fixed dose cisplatin (30 mg/m{sup 2} weekly × 6) and concurrent intensity modulated radiation therapy for patients with locally and/or regionally advanced head-and-neck cancer. The study had a standard 3 + 3 dose-escalation design. Results: Tumor primary sites were oral cavity (4), salivary gland (4), oropharynx (2), nasopharynx (1), scalp (1), and neck node with occult primary (1). In 4 of 4 cases in which resected HNSCC surgical pathology specimens were available for immunohistochemistry, elevated expression of eIF4E was observed in the cancer-free margins. The most common grade ≥3 treatment-related adverse event was lymphopenia (92%), and dose-limiting toxicities (DLTs) were mucositis (n=2) and failure to thrive (n=1). With a median follow up of 19.4 months, 2 patients have experienced recurrent disease. The maximum tolerated dose was everolimus 5 mg/day. Conclusions: Head-and-neck cancer patients tolerated everolimus at therapeutic doses (5 mg/day) given with weekly cisplatin and intensity modulated radiation therapy. The regimen merits further evaluation, especially among patients who are status post resection of HNSCCs that harbor mTORC1-mediated activation of eIF4E in histologically negative surgical margins.

  11. Pooled analysis of menstrual irregularities from three major clinical studies evaluating everolimus for the treatment of tuberous sclerosis complex.

    Directory of Open Access Journals (Sweden)

    Steven Sparagana

    Full Text Available To determine the impact of everolimus on female fertility, including menstrual irregularities, secondary amenorrhea, and luteinizing and follicle stimulating hormone levels in female patients.A pooled analysis from 3 prospective studies consisting of a core phase (≥6 months and a long-term follow-up open-label extension.One phase 2 single-center and two phase 3 multicenter studies.Data were obtained from female participants, restricted to those between 10 and 55 years of age, during 1 of 3 of the described clinical trials of everolimus. Patients had received ≥ 1 dose of everolimus.Incidence of fertility events.A total of 43/112 patients (38.4% experienced at least 1 menstrual irregularity. The most common events were amenorrhea (24.1% and irregular menstruation (17.0%. Seven patients (6.3% experienced grade 3/4 amenorrhea. When only the longest duration period of amenorrhea for each patient was considered, the median duration was 291 days. Fifteen patients attained menarche during the treatment period in any of the pooled studies. The mean age of menarche for this group was 12.4 years, similar to that of patients who were postmenarche at study entry (12.2 years. A total of 19/92 patients (20.7% who were postmenarche at baseline or during the study experienced an irregular menstruation event. An increased luteinizing hormone level was reported as an adverse event in 3/112 patients (3%, and follicle-stimulating hormone levels were within normal limits for these patients.No new safety concerns emerged regarding endocrine function and menstruation in female patients with tuberous sclerosis complex-associated subependymal giant cell astrocytoma or angiomyolipoma, who were receiving everolimus.ClinicalTrials.gov NCT00411619, NCT00789828, NCT00790400.

  12. The effect of everolimus on renal angiomyolipoma in pediatric patients with tuberous sclerosis being treated for subependymal giant cell astrocytoma.

    Science.gov (United States)

    Bissler, John J; Franz, David N; Frost, Michael D; Belousova, Elena; Bebin, E Martina; Sparagana, Steven; Berkowitz, Noah; Ridolfi, Antonia; Kingswood, J Christopher

    2018-01-01

    Patients with tuberous sclerosis complex (TSC) often have multiple TSC-associated hamartomas, particularly in the brain and kidney. This was a post hoc analysis of pediatric patients being treated for subependymal giant cell astrocytomas (SEGAs) during the phase 3, randomized, double-blind, placebo-controlled EXIST-1 trial. Patients were initially randomly assigned to receive everolimus 4.5 mg/m 2 /day (target blood trough 5-15 mg/dl) or placebo and could continue in an open-label extension phase. Angiomyolipoma response rates were analyzed in patients aged 20% increase in kidney volume from nadir, and angiomyolipoma-related bleeding ≥ grade 2. Tolerability was also assessed. Overall, this analysis included 33 patients. Renal angiomyolipoma response was achieved by 75.8% of patients (95% confidence interval, 57.7-88.9%), with sustained mean reductions in renal angiomyolipoma volume over nearly 4 years of treatment. In addition, most (≥80%) achieved clinically relevant reductions in angiomyolipoma volume (≥50%), beginning at week 24 and continuing for the remainder of the study. Everolimus was generally well tolerated in this subgroup, with most adverse events being grade 1 or 2 in severity. Although everolimus is currently not indicated for this use, this analysis from EXIST-1 demonstrates its long-term efficacy and safety for the treatment of renal angiomyolipoma in pediatric patients undergoing treatment for TSC-associated SEGA.

  13. [Everolimus plus exemestane in postmenopausal patients with estrogen-receptor-positive advanced breast cancer - Japanese subgroup analysis of BOLERO -2].

    Science.gov (United States)

    Ito, Yoshinori; Masuda, Norikazu; Iwata, Hiroji; Mukai, Hirofumi; Horiguchi, Jun; Tokuda, Yutaka; Kuroi, Katsumasa; Mori, Asuka; Ohno, Nobutsugu; Noguchi, Shinzaburo

    2015-01-01

    In a phase 3, double-blind, randomized, international study (the BOLERO-2), the addition of mTOR inhibitor everolimus to exemestane was evaluated in postmenopausal women with estrogen-receptor-positive (ER⁺) advanced/recurrent breast cancer that was refractory to any nonsteroidal aromatase inhibitor (NSAI). This report presents the safety and updated (18- month) efficacy results from the Japanese subset (n=106) of BOLERO-2. After a median follow-up of 18 months, the median progression-free survival time was 8.5 months with everolimus plus exemestane compared to 4.2 months with placebo plus exemestane. The most common adverse events (AEs) with everolimus plus exemestane were stomatitis, rash, dysgeusia, and non-infectious lung disease. The AEs reported with the combination therapy were mostly of grade 1 or 2 and manageable with appropriate intervention. In conclusion, this combination could be a useful addition to the armamentarium of treatments for Japanese postmenopausal women with ER⁺ advanced/recurrent breast cancer progressing on NSAIs.

  14. The Promus Premier everolimus-eluting platinum chromium stent with durable polymer evaluated in a real world all-comer population in Rotterdam cardiology hospital (the P-SEARCH registry)

    NARCIS (Netherlands)

    Lemmert, M.E.; Mieghem, N.M. van; Geuns, R.J.M. van; Diletti, R.; Bommel, R.J. van; Domburg, R.T. van; Jaegere, P.P. de; Regar, E.; Zijlstra, F.; Boersma, E.; Daemen, J.

    2017-01-01

    BACKGROUND: A new-generation everolimus eluting platinum-chromium stent (EePCS), offering improved radial strength, radiopacity and conformability compared to everolimus-eluting cobalt-chromium stents (EeCCS), was evaluated with regard to safety and efficacy in an all-comer cohort. METHODS: A total

  15. 1-year clinical outcomes of diabetic patients treated with everolimus-eluting bioresorbable vascular scaffolds: a pooled analysis of the ABSORB and the SPIRIT trials.

    Science.gov (United States)

    Muramatsu, Takashi; Onuma, Yoshinobu; van Geuns, Robert-Jan; Chevalier, Bernard; Patel, Tejas M; Seth, Ashok; Diletti, Roberto; García-García, Hector M; Dorange, Cécile C; Veldhof, Susan; Cheong, Wai-Fung; Ozaki, Yukio; Whitbourn, Robert; Bartorelli, Antonio; Stone, Gregg W; Abizaid, Alexandre; Serruys, Patrick W

    2014-05-01

    The aim of this study was to evaluate 1-year clinical outcomes of diabetic patients treated with the Absorb bioresorbable vascular scaffold (BVS). Clinical outcomes of diabetic patients after BVS implantation have been unreported. This study included 101 patients in the ABSORB Cohort B trial and the first consecutive 450 patients with 1 year of follow-up in the ABSORB EXTEND trial. A total of 136 diabetic patients were compared with 415 nondiabetic patients. In addition, 882 diabetic patients treated with everolimus-eluting metal stents (EES) in pooled data from the SPIRIT trials (SPIRIT FIRST [Clinical Trial of the Abbott Vascular XIENCE V Everolimus Eluting Coronary Stent System], SPIRIT II [A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System], SPIRIT III [Clinical Trial of the XIENCE V Everolimus Eluting Coronary Stent System (EECSS)], SPIRIT IV Clinical Trial [Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System]) were used for the comparison by applying propensity score matching. The primary endpoint was a device-oriented composite endpoint (DoCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization at 1-year follow-up. The cumulative incidence of DoCE did not differ between diabetic and nondiabetic patients treated with the BVS (3.7% vs. 5.1%, p = 0.64). Diabetic patients treated with the BVS had a similar incidence of the DoCE compared with diabetic patients treated with EES in the matched study group (3.9% for the BVS vs. 6.4% for EES, p = 0.38). There were no differences in the incidence of definite or probable scaffold/stent thrombosis (0.7% for both diabetic and nondiabetic patients with the BVS; 1.0% for diabetic patients with the BVS vs. 1.7% for diabetic patients with EES in the matched study group). In the present analyses, diabetic patients treated with the BVS showed similar rates of DoCEs compared with nondiabetic patients treated with the BVS and

  16. Test Your Sodium Smarts

    Science.gov (United States)

    ... You may be surprised to learn how much sodium is in many foods. Sodium, including sodium chloride ... foods with little or no salt. Test your sodium smarts by answering these 10 questions about which ...

  17. Everolimus and long acting octreotide as a volume reducing treatment of polycystic livers (ELATE: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chrispijn Melissa

    2011-11-01

    Full Text Available Abstract Background Polycystic liver disease (PLD is defined as having more than 20 liver cysts and can present as a severe and disabling condition. Most symptoms are caused by the mass effect of the liver size and include abdominal pain and distension. The somatostatin analogues octreotide and lanreotide have proven to reduce polycystic liver volume. mTOR inhibitors such as everolimus inhibit cell proliferation and might thereby reduce growth of liver cysts. This trial aims to assess the benefit of combination therapy of everolimus and octreotide compared to octreotide monotherapy. In this study we present the structure of the trial and the characteristics of the included patients. Methods/design This is a randomized open-label clinical trial comparing the effect of 12 months of everolimus and octreotide to octreotide monotherapy in PLD patients. Primary outcome is change in liver volume determined by CT-volumetry. Secondary outcomes are changes in abdominal symptoms and quality of life. Moreover, safety and tolerability of the drugs will be assessed. Discussion This trial will compare the relative efficacy of combination therapy with octreotide and everolimus to octreotide monotherapy. Since they apply to different pathways of cystogenesis we expect that combining octreotide and everolimus will result in a cumulative reduction of polycystic liver volume. Trial registration number ClinicalTrials.gov: NCT01157858

  18. Phase 1 Trial of Everolimus and Radiation Therapy for Salvage Treatment of Biochemical Recurrence in Prostate Cancer Patients Following Prostatectomy

    International Nuclear Information System (INIS)

    Narayan, Vivek; Vapiwala, Neha; Mick, Rosemarie; Subramanian, Pearl; Christodouleas, John P.; Bekelman, Justin E.; Deville, Curtiland; Rajendran, Ramji; Haas, Naomi B.

    2017-01-01

    Purpose: In up to half of patients treated with salvage radiation therapy (SRT) for rising prostate-specific antigen levels, a second biochemical recurrence ultimately develops. Phosphatase and tensin homolog inactivation is implicated in prostate cancer progression, and upregulation of the mammalian target of rapamycin pathway can lead to tumor hypoxia and radioresistance. Everolimus is a mammalian target of rapamycin inhibitor with both antitumor and radiosensitizing effects. Methods and Materials: We performed a phase 1 study using a modified 3 + 3 dose-escalation design to evaluate the safety and tolerability of everolimus in combination with standard SRT for the treatment of biochemical recurrence following prostatectomy. After a 2-week run-in period of everolimus daily therapy, patients received prostate bed irradiation with daily cone beam computed tomography localization in 37 fractions of 1.8 Gy each (total dose, 66.6 Gy). Patients were monitored for both acute (≤90 days) and chronic (>90 days) treatment-related toxicities. Results: Eighteen patients received everolimus at dose levels of 5 mg (n=6), 7.5 mg (n=6), or 10 mg (n=6) daily in conjunction with SRT. No dose-limiting toxicities were observed. Common acute treatment-related toxicities included grade 1 or 2 mucositis (55.6%), grade 1 or 2 fatigue (38.9%), grade 1 or 2 rash (61.1%), and grade 1 urinary symptoms (61.1%). A grade 3 acute toxicity occurred in 4 patients (22.2%) (n=1 for rash, anemia, lymphopenia, and neutropenia), and no patients had a chronic toxicity of grade 3 or greater. After a median follow-up time of 17.8 months (range, 1.2-46.0 months), an undetectable prostate-specific antigen nadir was achieved in 9 patients (56.3%) and a second biochemical recurrence developed in 5 patients (31.3%). Conclusions: Everolimus at a dose of ≤10 mg daily appears to be safe and tolerable in combination with fractionated post-prostatectomy radiation therapy.

  19. Phase 1 Trial of Everolimus and Radiation Therapy for Salvage Treatment of Biochemical Recurrence in Prostate Cancer Patients Following Prostatectomy.

    Science.gov (United States)

    Narayan, Vivek; Vapiwala, Neha; Mick, Rosemarie; Subramanian, Pearl; Christodouleas, John P; Bekelman, Justin E; Deville, Curtiland; Rajendran, Ramji; Haas, Naomi B

    2017-02-01

    In up to half of patients treated with salvage radiation therapy (SRT) for rising prostate-specific antigen levels, a second biochemical recurrence ultimately develops. Phosphatase and tensin homolog inactivation is implicated in prostate cancer progression, and upregulation of the mammalian target of rapamycin pathway can lead to tumor hypoxia and radioresistance. Everolimus is a mammalian target of rapamycin inhibitor with both antitumor and radiosensitizing effects. We performed a phase 1 study using a modified 3 + 3 dose-escalation design to evaluate the safety and tolerability of everolimus in combination with standard SRT for the treatment of biochemical recurrence following prostatectomy. After a 2-week run-in period of everolimus daily therapy, patients received prostate bed irradiation with daily cone beam computed tomography localization in 37 fractions of 1.8 Gy each (total dose, 66.6 Gy). Patients were monitored for both acute (≤90 days) and chronic (>90 days) treatment-related toxicities. Eighteen patients received everolimus at dose levels of 5 mg (n=6), 7.5 mg (n=6), or 10 mg (n=6) daily in conjunction with SRT. No dose-limiting toxicities were observed. Common acute treatment-related toxicities included grade 1 or 2 mucositis (55.6%), grade 1 or 2 fatigue (38.9%), grade 1 or 2 rash (61.1%), and grade 1 urinary symptoms (61.1%). A grade 3 acute toxicity occurred in 4 patients (22.2%) (n=1 for rash, anemia, lymphopenia, and neutropenia), and no patients had a chronic toxicity of grade 3 or greater. After a median follow-up time of 17.8 months (range, 1.2-46.0 months), an undetectable prostate-specific antigen nadir was achieved in 9 patients (56.3%) and a second biochemical recurrence developed in 5 patients (31.3%). Everolimus at a dose of ≤10 mg daily appears to be safe and tolerable in combination with fractionated post-prostatectomy radiation therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Phase 1 Trial of Everolimus and Radiation Therapy for Salvage Treatment of Biochemical Recurrence in Prostate Cancer Patients Following Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Narayan, Vivek [Division of Hematology/Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vapiwala, Neha [Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Mick, Rosemarie [Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Subramanian, Pearl [Division of Hematology/Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P.; Bekelman, Justin E.; Deville, Curtiland; Rajendran, Ramji [Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Haas, Naomi B., E-mail: naomi.haas@uphs.upenn.edu [Division of Hematology/Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2017-02-01

    Purpose: In up to half of patients treated with salvage radiation therapy (SRT) for rising prostate-specific antigen levels, a second biochemical recurrence ultimately develops. Phosphatase and tensin homolog inactivation is implicated in prostate cancer progression, and upregulation of the mammalian target of rapamycin pathway can lead to tumor hypoxia and radioresistance. Everolimus is a mammalian target of rapamycin inhibitor with both antitumor and radiosensitizing effects. Methods and Materials: We performed a phase 1 study using a modified 3 + 3 dose-escalation design to evaluate the safety and tolerability of everolimus in combination with standard SRT for the treatment of biochemical recurrence following prostatectomy. After a 2-week run-in period of everolimus daily therapy, patients received prostate bed irradiation with daily cone beam computed tomography localization in 37 fractions of 1.8 Gy each (total dose, 66.6 Gy). Patients were monitored for both acute (≤90 days) and chronic (>90 days) treatment-related toxicities. Results: Eighteen patients received everolimus at dose levels of 5 mg (n=6), 7.5 mg (n=6), or 10 mg (n=6) daily in conjunction with SRT. No dose-limiting toxicities were observed. Common acute treatment-related toxicities included grade 1 or 2 mucositis (55.6%), grade 1 or 2 fatigue (38.9%), grade 1 or 2 rash (61.1%), and grade 1 urinary symptoms (61.1%). A grade 3 acute toxicity occurred in 4 patients (22.2%) (n=1 for rash, anemia, lymphopenia, and neutropenia), and no patients had a chronic toxicity of grade 3 or greater. After a median follow-up time of 17.8 months (range, 1.2-46.0 months), an undetectable prostate-specific antigen nadir was achieved in 9 patients (56.3%) and a second biochemical recurrence developed in 5 patients (31.3%). Conclusions: Everolimus at a dose of ≤10 mg daily appears to be safe and tolerable in combination with fractionated post-prostatectomy radiation therapy.

  1. Effectiveness of Chlorinated Water, Sodium Hypochlorite, Sodium ...

    African Journals Online (AJOL)

    This study evaluated the efficacy of chlorinated water, sodium hypochlorite solution, sodium chloride solution and sterile distilled water in eliminating pathogenic bacteria on the surfaces of raw vegetables. Lettuce vegetables were dipped in different concentrations of chlorinated water, sodium hypochlorite solution, sodium ...

  2. RTOG 0913: A Phase 1 Study of Daily Everolimus (RAD001) in Combination With Radiation Therapy and Temozolomide in Patients With Newly Diagnosed Glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Chinnaiyan, Prakash, E-mail: prakash.chinnaiyan@moffitt.org [Department of Radiation Oncology, Experimental Therapeutics and Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Won, Minhee [Radiation Therapy Oncology Group, Philadelphia, Pennsylvania (United States); Wen, Patrick Y. [Center for Neuro-Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, Massachusetts (United States); Rojiani, Amyn M. [Department of Pathology, Medical College of Georgia, Augusta, Georgia (United States); Wendland, Merideth [Radiation Oncology, US Oncology-Willamette Valley Cancer Institute, Eugene, Oregon (United States); Dipetrillo, Thomas A. [Department of Radiation Oncology, Rhode Island Hospital, Providence, Rhode Island (United States); Corn, Benjamin W. [Department of Radiation Oncology, Tel Aviv Medical Center, Tel Aviv (Israel); Mehta, Minesh P. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States)

    2013-08-01

    Purpose: To determine the safety of the mammalian target of rapamycin inhibitor everolimus (RAD001) administered daily with concurrent radiation and temozolomide in newly diagnosed glioblastoma patients. Methods and Materials: Everolimus was administered daily with concurrent radiation (60 Gy in 30 fractions) and temozolomide (75 mg/m{sup 2} per day). Everolimus was escalated from 2.5 mg/d (dose level 1) to 5 mg/d (dose level 2) to 10 mg/d (dose level 3). Adjuvant temozolomide was delivered at 150 to 200 mg/m{sup 2} on days 1 to 5, every 28 days, for up to 12 cycles, with concurrent everolimus at the previously established daily dose of 10 mg/d. Dose escalation continued if a dose level produced dose-limiting toxicities (DLTs) in fewer than 3 of the first 6 evaluable patients. Results: Between October 28, 2010, and July 2, 2012, the Radiation Therapy Oncology Group 0913 protocol initially registered a total of 35 patients, with 25 patients successfully meeting enrollment criteria receiving the drug and evaluable for toxicity. Everolimus was successfully escalated to the predetermined maximum tolerated dose of 10 mg/d. Two of the first 6 eligible patients had a DLT at each dose level. DLTs included gait disturbance, febrile neutropenia, rash, fatigue, thrombocytopenia, hypoxia, ear pain, headache, and mucositis. Other common toxicities were grade 1 or 2 hypercholesterolemia and hypertriglyceridemia. At the time of analysis, there was 1 death reported, which was attributed to tumor progression. Conclusions: Daily oral everolimus (10 mg) combined with both concurrent radiation and temozolomide followed by adjuvant temozolomide is well tolerated, with an acceptable toxicity profile. A randomized phase 2 clinical trial with mandatory correlative biomarker analysis is currently under way, designed to both determine the efficacy of this regimen and identify molecular determinants of response.

  3. Budget impact analysis of everolimus for the treatment of hormone receptor positive, human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer in the United States.

    Science.gov (United States)

    Xie, Jipan; Diener, Melissa; De, Gourab; Yang, Hongbo; Wu, Eric Q; Namjoshi, Madhav

    2013-01-01

    To estimate the budget impact of everolimus as the first and second treatment option after letrozole or anastrozole (L/A) failure for post-menopausal women with hormone receptor positive (HR+), human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer (ABC). Pharmacy and medical budget impacts (2011 USD) were estimated over the first year of everolimus use in HR+, HER2- ABC from a US payer perspective. Epidemiology data were used to estimate target population size. Pre-everolimus entry treatment options included exemestane, fulvestrant, and tamoxifen. Pre- and post-everolimus entry market shares were estimated based on market research and assumptions. Drug costs were based on wholesale acquisition cost. Patients were assumed to be on treatment until progression or death. Annual medical costs were calculated as the average of pre- and post-progression medical costs weighted by the time in each period, adjusted for survival. One-way and two-way sensitivity analyses were conducted to assess the model robustness. In a hypothetical 1,000,000 member plan, 72 and 159 patients were expected to be candidates for everolimus treatment as first and second treatment option, respectively, after L/A failure. The total budget impact for the first year post-everolimus entry was $0.044 per member per month [PMPM] (pharmacy budget: $0.058 PMPM; medical budget: -$0.014 PMPM), assuming 10% of the target population would receive everolimus. The total budget impacts for the first and second treatment options after L/A failure were $0.014 PMPM (pharmacy budget: $0.018; medical budget: -$0.004) and $0.030 PMPM (pharmacy budget: $0.040; medical budget: -$0.010), respectively. Results remained robust in sensitivity analyses. Assumptions about some model input parameters were necessary and may impact results. Increased pharmacy costs for HR+, HER2- ABC following everolimus entry are expected to be partially offset by reduced medical service costs. Pharmacy and total

  4. A comprehensive review of everolimus clinical reports: a new mammalian target of rapamycin inhibitor.

    Science.gov (United States)

    Gurk-Turner, Cheryle; Manitpisitkul, Wana; Cooper, Matthew

    2012-10-15

    As new immunosuppressive agents are introduced to the market, clinicians are faced with the daunting task of sifting through the published literature to decide the value that the agent will add to their own practice. We often must extrapolate information provided through study in other solid-organ transplantation populations than our specific area of interest as we interpret the results and outcomes. With these challenges in mind, this compilation of published work for the newest mammalian target of rapamycin inhibitor everolimus (Certican; Novartis Pharmaceuticals, Hanover, NJ) (Zortress; Novartis Pharmaceuticals, Basel, Switzerland) is intended to provide a concise but thorough presentation of available literature so that the reader who may be unfamiliar with the agent can make their own judgment. Both Ovid and PubMed search engines were queried with a particular focus on high-impact articles noted in the Web of Science or Citation Index. Work described solely in abstract or case report form was excluded, as well as meta-analyses or those that were editorial or commentary in nature. Included were publications presented using the English language that described adult human subjects who received a heart, lung, kidney, or liver allograft. The goal of this strategy was to allow for the inclusion of pertinent literature in an unbiased fashion. Tables are provided that outline trial specific information, leaving a discussion of major outcomes to the text of the review.

  5. Interstitial Lung Disease Associated with mTOR Inhibitors in Solid Organ Transplant Recipients: Results from a Large Phase III Clinical Trial Program of Everolimus and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Patricia Lopez

    2014-01-01

    Full Text Available Interstitial lung disease (ILD has been reported with the use of mammalian target of rapamycin inhibitors (mTORi. The clinical and safety databases of three Phase III trials of everolimus in de novo kidney (A2309, heart (A2310, and liver (H2304 transplant recipients (TxR were searched using a standardized MedDRA query (SMQ search for ILD followed by a case-by-case medical evaluation. A literature search was conducted in MEDLINE and EMBASE. Out of the 1,473 de novo TxR receiving everolimus in Phase III trials, everolimus-related ILD was confirmed in six cases (one kidney, four heart, and one liver TxR representing an incidence of 0.4%. Everolimus was discontinued in three of the four heart TxR, resulting in ILD improvement or resolution. Outcome was fatal in the kidney TxR (in whom everolimus therapy was continued and in the liver TxR despite everolimus discontinuation. The literature review identified 57 publications on ILD in solid organ TxR receiving everolimus or sirolimus. ILD presented months or years after mTORi initiation and symptoms were nonspecific and insidious. The event was more frequent in patients with a late switch to mTORi. In most cases, ILD was reversed after prompt mTORi discontinuation. ILD induced by mTORi is an uncommon and potentially fatal event warranting early recognition and drug discontinuation.

  6. The mTOR kinase inhibitor Everolimus decreases S6 kinase phosphorylation but fails to reduce mutant huntingtin levels in brain and is not neuroprotective in the R6/2 mouse model of Huntington's disease

    Directory of Open Access Journals (Sweden)

    Frentzel Stefan

    2010-06-01

    Full Text Available Abstract Background Huntington's disease (HD is a progressive neurodegenerative disorder caused by a CAG repeat expansion within the huntingtin gene. Mutant huntingtin protein misfolds and accumulates within neurons where it mediates its toxic effects. Promoting mutant huntingtin clearance by activating macroautophagy is one approach for treating Huntington's disease (HD. In this study, we evaluated the mTOR kinase inhibitor and macroautophagy promoting drug everolimus in the R6/2 mouse model of HD. Results Everolimus decreased phosphorylation of the mTOR target protein S6 kinase indicating brain penetration. However, everolimus did not activate brain macroautophagy as measured by LC3B Western blot analysis. Everolimus protected against early declines in motor performance; however, we found no evidence for neuroprotection as determined by brain pathology. In muscle but not brain, everolimus significantly decreased soluble mutant huntingtin levels. Conclusions Our data suggests that beneficial behavioral effects of everolimus in R6/2 mice result primarily from effects on muscle. Even though everolimus significantly modulated its target brain S6 kinase, this did not decrease mutant huntingtin levels or provide neuroprotection.

  7. Sodium in diet

    Science.gov (United States)

    Diet - sodium (salt); Hyponatremia - sodium in diet; Hypernatremia - sodium in diet; Heart failure - sodium in diet ... Too much sodium in the diet may lead to: High blood pressure in some people A serious buildup of fluid in people with heart failure , cirrhosis of ...

  8. Comparison of everolimus- and paclitaxel-eluting stents in patients with acute and stable coronary syndromes: pooled results from the SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) Trials.

    Science.gov (United States)

    Planer, David; Smits, Pieter C; Kereiakes, Dean J; Kedhi, Elvin; Fahy, Martin; Xu, Ke; Serruys, Patrick W; Stone, Gregg W

    2011-10-01

    This study sought to compare the clinical outcomes of everolimus-eluting stents (EES) versus paclitaxel-eluting stents (PES) in patients with acute coronary syndromes (ACS) and stable coronary artery disease (CAD). Although randomized trials have shown superiority of EES to PES, the safety and efficacy of EES in ACS is unknown. We performed a patient-level pooled analysis from the prospective, randomized SPIRIT (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) II, III, IV, and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) trials in which 2,381 patients with ACS and 4,404 patients with stable CAD were randomized to EES or to PES. Kaplan-Meier estimates of death, myocardial infarction (MI), ischemia-driven target lesion revascularization, and stent thrombosis were assessed at 2 years and stratified by clinical presentation (ACS vs. stable CAD). At 2 years, patients with ACS compared with stable CAD had higher rates of death (3.2% vs. 2.4%, hazard ratio [HR]: 1.37 [95% confidence interval (CI): 1.02 to 1.85], p = 0.04) and MI (4.9% vs. 3.4%, HR: 1.45 [95% CI: 1.14 to 1.85], p = 0.02). In patients with ACS, EES versus PES reduced the rate of death or MI (6.6% vs. 9.3%, HR: 0.70 [95% CI: 0.52 to 0.94], p = 0.02), stent thrombosis (0.7% vs. 2.9%, HR: 0.25 [95% CI: 0.12 to 0.52], p = 0.0002), and ischemia-driven target lesion revascularization (4.7% vs. 6.2%, HR: 0.69 [95% CI: 0.48 to 0.99], p = 0.04). In patients with stable CAD, EES reduced the rate of death or MI (4.5% vs. 7.1%, HR: 0.62 [95% CI: 0.48 to 0.80], p = 0.0002), stent thrombosis (0.7% vs. 1.8%, HR: 0.34 [95% CI: 0.19 to 0.62], p = 0.0002), and ischemia-driven target lesion revascularization (3.9% vs. 6.9%, HR: 0.55 [95% CI: 0.42 to 0.73], p SPIRIT II]; NCT00180310; SPIRIT III: A Clinical Evaluation of the Investigational Device XIENCE V Everolimus Eluting Coronary Stent System [EECSS] in the

  9. Sodium technology handbook

    International Nuclear Information System (INIS)

    2005-09-01

    This document was published as a textbook for the education and training of personnel working for operations and maintenances of sodium facilities including FBR plants and those engaged in R and D activities related to sodium technology. This handbook covers the following technical areas. Properties of sodium. Compatibilities of sodium with materials. Thermalhydraulics and structural integrity. Sodium systems and components. Sodium instrumentations. Sodium handling technology. Sodium related accident evaluation and countermeasures for FBRs. Operation, maintenance and repair technology of sodium facilities. Safety measures related to sodium. Laws, regulations and internal rules related to sodium. The plannings and discussions of the handbook were made in the Sodium Technology Education Committee organized in O-arai Engineering Center consisting of the representatives of the related departments including Tsuruga headquarters. Experts in various departments participated in writing individual technical subjects. (author)

  10. The sodium coolant

    International Nuclear Information System (INIS)

    Rodriguez, G.

    2004-01-01

    The sodium is the best appropriate coolant for the fast neutrons reactors technology. Thus the fast neutrons reactors development is intimately bound to the sodium technology. This document presents the sodium as a coolant point of view: atomic structure and characteristics, sodium impacts on the fast neutron reactors technology, chemical properties of the sodium and the consequences, quality control in a nuclear reactor, sodium treatment. (A.L.B.)

  11. The mTOR inhibitor, everolimus (RAD001), overcomes resistance to imatinib in quiescent Ph-positive acute lymphoblastic leukemia cells

    International Nuclear Information System (INIS)

    Kuwatsuka, Y; Minami, M; Minami, Y; Sugimoto, K; Hayakawa, F; Miyata, Y; Abe, A; Goff, D J; Kiyoi, H; Naoe, T

    2011-01-01

    In Ph-positive (Ph + ) leukemia, the quiescent cell state is one of the reasons for resistance to the BCR-ABL-kinase inhibitor, imatinib. In order to examine the mechanisms of resistance due to quiescence and the effect of the mammalian target of rapamycin inhibitor, everolimus, for such a resistant population, we used Ph + acute lymphoblastic leukemia patient cells serially xenotransplanted into NOD/SCID/IL2rγ null (NOG) mice. Spleen cells from leukemic mice showed a higher percentage of slow-cycling G 0 cells in the CD34 + CD38 − population compared with the CD34 + CD38 + and CD34 − populations. After ex vivo imatinib treatment, more residual cells were observed in the CD34 + CD38 − population than in the other populations. Although slow-cycling G 0 cells were insensitive to imatinib in spite of BCR-ABL and CrkL dephosphorylation, combination treatment with everolimus induced substantial cell death, including that of the CD34 + CD38 − population, with p70-S6 K dephosphorylation and decrease of MCL-1 expression. The leukemic non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mouse system with the in vivo combination treatment with imatinib and everolimus showed a decrease of tumor burden including CD34 + cells. These results imply that treatment with everolimus can overcome resistance to imatinib in Ph + leukemia due to quiescence

  12. Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: patient level meta-analysis.

    Science.gov (United States)

    Valgimigli, Marco; Sabaté, Manel; Kaiser, Christoph; Brugaletta, Salvatore; de la Torre Hernandez, Jose Maria; Galatius, Soeren; Cequier, Angel; Eberli, Franz; de Belder, Adam; Serruys, Patrick W; Ferrante, Giuseppe

    2014-11-04

    To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents. Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported. Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients. The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death. The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; Pstents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis. © Valgimigli et al 2014.

  13. Everolimus and sirolimus in combination with cyclosporine have different effects on renal metabolism in the rat.

    Directory of Open Access Journals (Sweden)

    Rahul Bohra

    Full Text Available Enhancement of calcineurin inhibitor nephrotoxicity by sirolimus (SRL is limiting the clinical use of this drug combination. We compared the dose-dependent effects of the structurally related everolimus (EVL and sirolimus (SRL alone, and in combination with cyclosporine (CsA, on the rat kidney. Lewis rats were treated by oral gavage for 28 days using a checkerboard dosing format (0, 3.0, 6.0 and 10.0 CsA and 0, 0.5, 1.5 and 3.0 mg/kg/day SRL or EVL, n = 4/dose combination. After 28 days, oxidative stress, energy charge, kidney histologies, glomerular filtration rates, and concentrations of the immunosuppressants were measured along with (1H-magnetic resonance spectroscopy (MRS and gas chromatography- mass spectrometry profiles of cellular metabolites in urine. The combination of CsA with SRL led to higher urinary glucose concentrations and decreased levels of urinary Krebs cycle metabolites when compared to controls, suggesting that CsA+SRL negatively impacted proximal tubule metabolism. Unsupervised principal component analysis of MRS spectra distinguished unique urine metabolite patterns of rats treated with CsA+SRL from those treated with CsA+EVL and the controls. SRL, but not EVL blood concentrations were inversely correlated with urine Krebs cycle metabolite concentrations. Interestingly, the higher the EVL concentration, the closer urine metabolite patterns resembled those of controls, while in contrast, the combination of the highest doses of CsA+SRL showed the most significant differences in metabolite patterns. Surprisingly in this rat model, EVL and SRL in combination with CsA had different effects on kidney biochemistry, suggesting that further exploration of EVL in combination with low dose calcineurin inhibitors may be of potential benefit.

  14. Efficacy and safety of everolimus in combination with trastuzumab and paclitaxel in Asian patients with HER2+ advanced breast cancer in BOLERO-1.

    Science.gov (United States)

    Toi, Masakazu; Shao, Zhimin; Hurvitz, Sara; Tseng, Ling-Ming; Zhang, Qingyuan; Shen, Kunwei; Liu, Donggeng; Feng, Jifeng; Xu, Binghe; Wang, Xiaojia; Lee, Keun Seok; Ng, Ting Ying; Ridolfi, Antonia; Noel-Baron, Florence; Ringeisen, Francois; Jiang, Zefei

    2017-04-11

    The current exploratory analysis was performed to evaluate the efficacy and safety of everolimus for treatment of human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer in the Asian subset of patients in the BOLERO-1 trial. Postmenopausal women with HER2+ advanced breast cancer, who had not received systemic therapy for advanced disease, were randomized 2:1 to receive everolimus or placebo, plus trastuzumab and paclitaxel. The two primary end points were investigator-assessed progression-free survival (PFS) in the full population and in the hormone receptor-negative (HR-) subpopulation. Secondary end points included assessment of the objective response rate, the clinical benefit rate, and safety. In the Asian subset, median PFS was similar in the everolimus (n = 198) and placebo (n = 105) arms in the full analysis set (hazard ratio = 0.82 (95% CI 0.61-1.11)). In the HR- subpopulation, everolimus prolonged median PFS by 10.97 months vs placebo (25.46 vs 14.49 months; hazard ratio = 0.48 (95% CI 0.29-0.79)). In the everolimus arm of the Asian subset, the most common adverse events of any grade were stomatitis (62.2%), diarrhea (48.0%), rash (43.4%) and neutropenia (42.3%). Neutropenia (grade 3: 27.6%; grade 4: 4.6%) and decreased neutrophil count (grade 3: 11.2%; grade 4: 3.6%) were the most frequent grade 3/4 adverse events. Serious adverse events included pneumonia (5.1%), pneumonitis (3.1%), and interstitial lung disease (3.1%). There were three deaths (1.5%) during treatment in the everolimus arm vs none in the placebo arm. The efficacy and safety of everolimus plus trastuzumab and paclitaxel as first-line treatment for HER2+ advanced breast cancer in the Asian subset was consistent with that reported previously in the overall population. ClinicalTrials.gov, NCT00876395 . Registered on 2 April 2009.

  15. A randomized study to compare bioactive titanium stents and everolimus-eluting stents in diabetic patients (TITANIC XV): 1-year results.

    Science.gov (United States)

    López-Mínguez, José R; Nogales-Asensio, Juan M; Doncel-Vecino, Luis J; Merchán-Herrera, Antonio; Pomar-Domingo, Francisco; Martínez-Romero, Pedro; Fernández-Díaz, José A; Valdesuso-Aguilar, Raúl; Moreu-Burgos, José; Díaz-Fernández, José

    2014-07-01

    Up to 25% of patients who undergo a percutaneous coronary intervention show some limitation in the use of drug-eluting stents. The aim of this study was to evaluate if titanium-nitride-oxide-coated stents could be a good alternative to everolimus-eluting stents in diabetic patients. A total of 173 diabetic patients with lesions at moderate risk of restenosis (exclusion criteria: diameter 28 mm in vessels < 3mm, chronic occlusion) were randomized to a titanium group (83 patients) or an everolimus group (90 patients). Baseline characteristics were well balanced; 28.3% of patients were insulin dependent. At 1 year, the incidence of major adverse cardiac events (death, nonfatal myocardial infarction, stroke, or repeat target vessel revascularization) was significantly higher in the titanium group than in the everolimus group (total, 14.5% vs 4.4%; P = .02; noninsulin-dependent subgroup, 9.7% vs 3.2%; P = .14; insulin-dependent subgroup, 28.6% vs 7.1%; P = .04). The incidence of death, nonfatal myocardial infarction, stroke, or any revascularization was 16.9% in the titanium group and 7.8% in the everolimus group (P = .06). Target lesion and vessel revascularizations occurred in 8.4% compared with 3.3% (P = .15) and in 13.3% compared with 3.3% (P = .01) in the titanium and everolimus groups, respectively. Angiographic follow-up at 9 months showed significantly less late lumen loss in the everolimus group (in-segment, 0.52 [standard deviation, 0.58) mm vs -0.05 [0.32] mm; in-stent, 0.76 [0.54] mm vs 0.13 [0.31] mm; P < .0001). The everolimus-eluting stent is superior to the titanium stent for clinical and angiographic end points in diabetic patients with lesions at moderate risk of restenosis. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  16. Early Introduction of Everolimus Immunosuppressive Regimen in Liver Transplantation with Extra-Anatomic Aortoiliac-Hepatic Arterial Graft Anastomosis

    Directory of Open Access Journals (Sweden)

    Emanuele Felli

    2014-01-01

    Full Text Available Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage.

  17. Cabozantinib Versus Everolimus in Patients with Advanced Renal Cell Carcinoma: Results of a Randomised Phase III Trial (METEOR

    Directory of Open Access Journals (Sweden)

    Toni Choueiri

    2015-11-01

    Full Text Available The METEOR trial of cabozantinib versus everolimus in advanced renal cell carcinoma (RCC was reported by Prof Choueiri at the European Cancer Congress 2015. This presentation follows the publication in the New England Journal of Medicine of the METEOR trial back-to-back with the CheckMate 025 trial of nivolumab versus everolimus in the same patient setting. Excitingly, these trials demonstrated, for the first time, significant benefits over the standard of care for heavily pre-treated patients with advanced RCC. Cabozantinib, an oral multi-targeted tyrosine kinase inhibitor (TKI aims to address the challenge of resistance to targeted therapy with TKIs. While the METEOR trial has not yet reached its final analysis of overall survival (OS, the clear progression-free survival (PFS benefit, acceptable safety profile, and similar tolerability to other TKIs shown by cabozantinib indicate that this represents a promising new treatment option for second-line or subsequent therapy for patients with advanced RCC.

  18. Biodegradable-Polymer Biolimus-Eluting Stents versus Durable-Polymer Everolimus-Eluting Stents at One-Year Follow-Up: A Registry-Based Cohort Study.

    Science.gov (United States)

    Parsa, Ehsan; Saroukhani, Sepideh; Majlessi, Fereshteh; Poorhosseini, Hamidreza; Lofti-Tokaldany, Masoumeh; Jalali, Arash; Salarifar, Mojtaba; Nematipour, Ebrahim; Alidoosti, Mohammad; Aghajani, Hassan; Amirzadegan, Alireza; Kassaian, Seyed Ebrahim

    2016-04-01

    We compared outcomes of percutaneous coronary intervention patients who received biodegradable-polymer biolimus-eluting stents with those who received durable-polymer everolimus-eluting stents. At Tehran Heart Center, we performed a retrospective analysis of the data from January 2007 through December 2011 on 3,270 consecutive patients with coronary artery disease who underwent percutaneous coronary intervention with the biodegradable-polymer biolimus-eluting stent or the durable-polymer everolimus-eluting stent. We excluded patients with histories of coronary artery bypass grafting or percutaneous coronary intervention, acute ST-segment-elevation myocardial infarction, or the implantation of 2 different stent types. Patients were monitored for 12 months. The primary endpoint was a major adverse cardiac event, defined as a composite of death, nonfatal myocardial infarction, and target-vessel and target-lesion revascularization. Durable-polymer everolimus-eluting stents were implanted in 2,648 (81%) and biodegradable-polymer biolimus-eluting stents in 622 (19%) of the study population. There was no significant difference between the 2 groups (2.7% vs 2.7%; P=0.984) in the incidence of major adverse cardiac events. The cumulative adjusted probability of major adverse cardiac events in the biodegradable-polymer biolimus-eluting stent group did not differ from that of such events in the durable-polymer everolimus-eluting stent group (hazard ratio=0.768; 95% confidence interval, 0.421-1.44; P=0.388). We conclude that in our patients the biodegradable-polymer biolimus-eluting stent was as effective and safe, during the 12-month follow-up period, as was the durable-polymer everolimus-eluting stent.

  19. Lifetime cost of everolimus vs axitinib in patients with advanced renal cell carcinoma who failed prior sunitinib therapy in the US.

    Science.gov (United States)

    Perrin, Allison; Sherman, Steven; Pal, Sumanta; Chua, Andrew; Gorritz, Magdaliz; Liu, Zhimei; Wang, Xufang; Culver, Kenneth; Casciano, Roman; Garrison, Louis P

    2015-03-01

    Everolimus and axitinib are approved in the US to treat patients with advanced renal cell carcinoma (RCC) after failure on sunitinib or sorafenib, and one prior systemic therapy (e.g., sunitinib), respectively. Two indirect comparisons performed to evaluate progression-free survival in patients treated with everolimus vs axitinib suggested similar efficacy between the two treatments. Therefore, this analysis compares the lifetime costs of these two therapies among sunitinib-refractory advanced RCC patients from a US payer perspective. A Markov model was developed to simulate a cohort of sunitinib-refractory advanced RCC patients and estimate the cost of treating patients with everolimus vs axitinib. The following health states were included: stable disease without adverse events (AEs), stable disease with AEs, disease progression (PD), and death. The model included the following resources: active treatments, post-progression treatments, adverse events, physician and nurse visits, scans and tests, and palliative care. Resource utilization inputs were derived from a US claims database analysis. Additionally, a 3% annual discount rate was applied to costs, and the robustness of the model results was tested by conducting sensitivity analyses, including those on dosing scheme and post-progression treatment costs. Base case results demonstrated that patients treated with everolimus cost an average of $12,985 (11%) less over their lifetimes than patients treated with axitinib. The primary difference in costs was related to active treatment, which was largely driven by axitinib's higher dose intensity. RESULTS remained consistent across sensitivity analyses for AE and PD treatment costs, as well as dose intensity and discount rates. The results suggest that everolimus likely leads to lower lifetime costs than axitinib for sunitinib-refractory advanced RCC patients in the US.

  20. Liquid sodium pool fires

    Energy Technology Data Exchange (ETDEWEB)

    Casselman, C [DSN/SESTR, Centre de Cadarache, Saint-Paul-lez-Durance (France)

    1979-03-01

    Experimental sodium pool combustion results have led to a definition of the combustion kinetics, and have revealed the hazards of sodium-concrete contact reactions and the possible ignition of organic matter (paint) by hydration of sodium peroxide aerosols. Analysis of these test results shows that the controlling mechanism is sodium evaporation diffusion. (author)

  1. Liquid sodium pool fires

    International Nuclear Information System (INIS)

    Casselman, C.

    1979-01-01

    Experimental sodium pool combustion results have led to a definition of the combustion kinetics, and have revealed the hazards of sodium-concrete contact reactions and the possible ignition of organic matter (paint) by hydration of sodium peroxide aerosols. Analysis of these test results shows that the controlling mechanism is sodium evaporation diffusion. (author)

  2. Five-year clinical and functional multislice computed tomography angiographic results after coronary implantation of the fully resorbable polymeric everolimus-eluting scaffold in patients with de novo coronary artery disease

    DEFF Research Database (Denmark)

    Onuma, Yoshinobu; Dudek, Dariusz; Thuesen, Leif

    2013-01-01

    This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California).......This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California)....

  3. Small liquid sodium leaks

    International Nuclear Information System (INIS)

    Dufresne, J.; Rochedereux, Y.; Antonakas, D.; Casselman, C.; Malet, J.C.

    1986-05-01

    Usually, pessimistic considerations inassessing the safety of secondary sodium loops in LMFBR reactor lead to assume guillotine rupture releasing a large amount of sodium estimate the consequences of large sodium fires. In order to reduce these consequences, one has to detect the smallest leak as soon as possible and to evaluate the future of an initial small leak. Analysis of the relationship between crack size and sodium outflow rate; Analysis of a sodium pipe with a small open crack

  4. The Impact of Post-Procedural Asymmetry, Expansion, and Eccentricity of Bioresorbable Everolimus-Eluting Scaffold and Metallic Everolimus-Eluting Stent on Clinical Outcomes in the ABSORB II Trial.

    Science.gov (United States)

    Suwannasom, Pannipa; Sotomi, Yohei; Ishibashi, Yuki; Cavalcante, Rafael; Albuquerque, Felipe N; Macaya, Carlos; Ormiston, John A; Hill, Jonathan; Lang, Irene M; Egred, Mohaned; Fajadet, Jean; Lesiak, Maciej; Tijssen, Jan G; Wykrzykowska, Joanna J; de Winter, Robbert J; Chevalier, Bernard; Serruys, Patrick W; Onuma, Yoshinobu

    2016-06-27

    The study sought to investigate the relationship between post-procedural asymmetry, expansion, and eccentricity indices of metallic everolimus-eluting stent (EES) and bioresorbable vascular scaffold (BVS) and their respective impact on clinical events at 1-year follow-up. Mechanical properties of a fully BVS are inherently different from those of permanent metallic stent. The ABSORB II (A bioresorbable everolimus-eluting scaffold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions) trial compared the BVS and metallic EES in the treatment of a de novo coronary artery stenosis. Protocol-mandated intravascular ultrasound imaging was performed pre- and post-procedure in 470 patients (162 metallic EES and 308 BVS). Asymmetry index (AI) was calculated per lesion as: (1 - minimum scaffold/stent diameter/maximum scaffold/stent diameter). Expansion index and optimal scaffold/stent expansion followed the definition of the MUSIC (Multicenter Ultrasound Stenting in Coronaries) study. Eccentricity index (EI) was calculated as the ratio of minimum and maximum scaffold/stent diameter per cross section. The incidence of device-oriented composite endpoint (DoCE) was collected. Post-procedure, the metallic EES group was more symmetric and concentric than the BVS group. Only 8.0% of the BVS arm and 20.0% of the metallic EES arm achieved optimal scaffold/stent expansion (p 0.30 is an independent predictor of DoCE (hazard ratio: 3.43; 95% confidence interval: 1.08 to 10.92; p = 0.037). BVS implantation is more frequently associated with post-procedural asymmetric and eccentric morphology compared to metallic EES. Post-procedural devices asymmetry were independently associated with DoCE following percutaneous coronary intervention. However, this approach should be viewed as hypothesis generating due to low event rates. (ABSORB II Randomized Controlled Trial [ABSORB II]; NCT01425281). Copyright © 2016 American

  5. Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis

    Energy Technology Data Exchange (ETDEWEB)

    Ota, Hideaki [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Mahmoudi, Michael [University of Surrey, Guildford Road, Surrey, GU2-7XH (United Kingdom); Torguson, Rebecca; Satler, Lowell F.; Suddath, William O.; Pichard, Augusto D. [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Waksman, Ron, E-mail: ron.waksman@medstar.net [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States)

    2015-04-15

    Objective: The aim of this study was to compare the safety and efficacy of the everolimus-eluting stents (EES) with the paclitaxel-eluting stent (PES) and sirolimus-eluting stent (SES) for the treatment of bare-metal in-stent restenosis. Background: The optimal treatment for bare-metal in-stent restenosis remains controversial. Methods: The study cohort comprised 322 consecutive patients (543 lesions) who presented with bare-metal in-stent restenosis to our institution and underwent coronary artery stent implantation with EES (114 patients; 181 lesions), PES (65 patients; 116 lesions) and SES (143 patients; 246 lesions). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, MI, or TLR at 1-year. Results: The three groups were well matched for the conventional risk factors except for age and chronic kidney disease. The 1-year analyzed clinical parameters were similar in the three groups: death (EES = 3.5%, PES = 4.6%, SES = 4.2%; p = 0.94), MI (EES = 3.5%, PES = 6.3%, SES = 2.1%; p = 0.31), TLR (EES = 9.8%, PES = 9.5%, SES = 5.7%; p = 0.42), TVR (EES = 14.3%, PES = 11.1%, SES = 11.3%; p = 0.74), definite ST (EES = 0.9%, PES = 3.1%, SES = 3.5%; p = 0.38) and MACE (EES = 14.0%, PES = 15.4%, SES = 10.5%; p = 0.54). Male gender (hazard ratio = 0.47; 95% confidence interval = 0.25–0.88) and number of treated lesions (hazard ratio = 1.47; 95% confidence interval = 1.06–2.05) were found to be independent predictors of MACE. Conclusion: The results of the present study indicate that EES may provide similar safety and efficacy as first generation DES for the treatment of patients presenting with bare-metal in-stent restenosis.

  6. Real-world effectiveness of everolimus-based therapy versus fulvestrant monotherapy in HR(+)/HER2(-) metastatic breast cancer.

    Science.gov (United States)

    Hao, Yanni; Lin, Peggy L; Xie, Jipan; Li, Nanxin; Koo, Valerie; Ohashi, Erika; Wu, Eric Q; Rogerio, Jaqueline

    2015-08-01

    Assessing real-world effectiveness of everolimus-based therapy (EVE) versus fulvestrant monotherapy (FUL) among postmenopausal women with hormone receptor-positive (HR(+))/HER2(-) metastatic breast cancer (mBC) after progression on nonsteroidal aromatase inhibitor (NSAI). Medical charts of community-based patients who received EVE or FUL for mBC after NSAI were examined. Progression-free survival (PFS), time on treatment and time to chemotherapy were compared using Kaplan-Meier curves and Cox proportional hazards models adjusting for line of therapy and patient characteristics. 192 patients received EVE and 156 FUL. After adjusting for patient characteristics, EVE was associated with significantly longer PFS than FUL (hazard ratio: 0.71; p = 0.045). EVE was associated with better PFS than FUL among NSAI-refractory postmenopausal HR(+)/HER2(-) mBC patients.

  7. Vitamins C and K3: A Powerful Redox System for Sensitizing Leukemia Lymphocytes to Everolimus and Barasertib.

    Science.gov (United States)

    Ivanova, Donika; Zhelev, Zhivko; Lazarova, Dessislava; Getsov, Plamen; Bakalova, Rumiana; Aoki, Ichio

    2018-03-01

    Recent studies provided convincing evidence for the anticancer activity of combined application of vitamin C and pro-vitamin K3 (menadione). The molecular pathways underlying this process are still not well established. The present study aimed to investigate the effect of the combination of vitamin C plus pro-vitamin K3 on the redox status of leukemia and normal lymphocytes, as well as their sensitizing effect for a variety of anticancer drugs. Cytotoxicity of the substances was analyzed by trypan blue staining and automated counting of live and dead cells. Apoptosis was analyzed by fluorescein isothiocyanate-annexin V test. Oxidative stress was evaluated by the intracellular levels of reactive oxygen and nitrogen species and protein-carbonyl products. Combined administration of 300 μM vitamin C plus 3 μM pro-vitamin K3 reduced the viability of leukemia lymphocytes by ~20%, but did not influence the viability of normal lymphocytes. All combinations of anticancer drug plus vitamins C and K3 were characterized by synergistic cytotoxicity towards Jurkat cells, compared to cells treated with drug alone for 24 h. In the case of barasertib and everolimus, this synergistic cytotoxicity increased within 72 hours. It was accompanied by strong induction of apoptosis, but a reduction of level of hydroperoxides and moderately increased protein-carbonyl products in leukemia cells. Leukemia lymphocytes were more sensitive to combined administration of anticancer drug (everolimus or barasertib) plus vitamins C and K3, compared to normal lymphocytes. The combination of vitamin C plus K3 seems to be a powerful redox system that could specifically influence redox homeostasis of leukemia cells and sensitize them to conventional chemotherapy. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  8. Sodium Ferric Gluconate Injection

    Science.gov (United States)

    Sodium ferric gluconate injection is used to treat iron-deficiency anemia (a lower than normal number of ... are also receiving the medication epoetin (Epogen, Procrit). Sodium ferric gluconate injection is in a class of ...

  9. Naproxen sodium overdose

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002507.htm Naproxen sodium overdose To use the sharing features on this page, please enable JavaScript. Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) used ...

  10. Sodium hydroxide poisoning

    Science.gov (United States)

    Sodium hydroxide is a very strong chemical. It is also known as lye and caustic soda. This ... poisoning from touching, breathing in (inhaling), or swallowing sodium hydroxide. This article is for information only. Do ...

  11. Sodium pumping: pump problems

    International Nuclear Information System (INIS)

    Guer, M.; Guiton, P.

    Information on sodium pumps for LMFBR type reactors is presented concerning ring pump design, pool reactor pump design, secondary pumps, sodium bearings, swivel joints of the oscillating annulus, and thermal shock loads

  12. Docusate Sodium and Pregnancy

    Science.gov (United States)

    ... a risk of miscarriage. Can use of docusate sodium during pregnancy cause birth defects? Few studies have been done to look at the possible risks of docusate sodium during pregnancy. However, the available studies show that when used ...

  13. Sodium carbonate poisoning

    Science.gov (United States)

    Sodium carbonate (known as washing soda or soda ash) is a chemical found in many household and industrial products. This article focuses on poisoning due to sodium carbonate. This article is for information only. Do NOT ...

  14. ELTA: Citatrademark: Sodium measurement

    International Nuclear Information System (INIS)

    Mauvais, O.

    2002-01-01

    ELTA is pleased to present its last model of Sodium analyzers: CITA 2340: Automatically controlled sodium meter, integrating more automation and performances results respecting costs and wastes reduction. (authors)

  15. Phosphorylation of mTOR and S6RP predicts the efficacy of everolimus in patients with metastatic renal cell carcinoma

    International Nuclear Information System (INIS)

    Li, Siming; Kong, Yan; Si, Lu; Chi, Zhihong; Cui, Chuanliang; Sheng, Xinan; Guo, Jun

    2014-01-01

    The incidence of renal cell cancer (RCC) has been increasing for the past decade, and the 5-year survival for patients with metastatic RCC (mRCC) is rather low. Everolimus (RAD001), a new inhibitor for mammalian target of rapamycin (mTOR), is generally well tolerated, and demonstrates clinical benefit to patients with anti-VEGF-refractory mRCC. However, factors for selection of patients who may benefit from everolimus remain largely unknown. Here we aimed to explore potential molecular indicators for mRCC patients who may benefit from everolimus treatment. Paraffin-embedded tumor tissue specimens derived from 18 mRCC patients before everolimus treatment, who participated the phase 1b trial of everolimus in VEGF receptor (VEGFR)-tyrosine kinase inhibitor (TKI)-refractory Chinese patients with mRCC (clinicaltrials.gov, NCT01152801), were examined for the expression levels of phosphorylated AKT, mTOR, eukaryotic initiation factor 4E (eIF4E) binding protein-1 (4EBP1) and 40S ribosomal protein S6 (S6RP) by immunohistochemistry. Clinical benefit rate (complete response [CR], partial response [PR], plus stable disease [SD] ≥ 6 months) and progression-free survival time (PFS) were correlated with expression levels of these mTOR-associated molecules. In these 18 patients, there were 1 PR, 15 SDs (including 9 SDs ≥ 6 months), and 2 progressive diseases (PD). The clinical benefit rate (CBR) was 55.6% (10/18), and the median PFS time was 8.4 months. Patients with positive expression of phospho-mTOR showed a better CBR (71.4% versus 0%, P = 0.023) and PFS time (11.3 versus 3.7 months, P = 0.001) than those patients with negative expression. The median PFS of patients with positive phospho-S6RP expression was longer (11.3 versus 3.7 months, P = 0.002) than that of patients negative for phospho-S6RP expression. However, expression levels of phospho-4EBP1 and phospho-AKT were unassociated to efficacy of everolimus treatment with respect to CBR and PFS. Co-expression of

  16. Liquid sodium technology research

    International Nuclear Information System (INIS)

    Kim, W.C.; Lee, Y.W.; Nam, H.Y.; Chun, S.Y.; Kim, J.; Won, S.Y.

    1982-01-01

    This report describes the technology of impurity control and measurement of liquid sodium, problems associated with material degradation and change of heat transfer characteristics in liquid sodium, and the conceptual design of multipurpose sodium test loop. Discussion and the subsequent analysis are also made with regard to the test results for the sodium-H 2 0 reaction and its effects on the system. (author)

  17. Sodium sieving in children

    NARCIS (Netherlands)

    Rusthoven, Esther; Krediet, Raymond T.; Willems, Hans L.; Monnens, Leo A.; Schröder, Cornelis H.

    2005-01-01

    Sodium sieving is a consequence of dissociation between the amount of water and sodium transported over the peritoneal membrane. This dissociation occurs in the presence of aquaporin-mediated water transport. Sieving of sodium can be used as a rough measure for aquaporin-mediated water transport.

  18. Bioavailability of everolimus administered as a single 5 mg tablet versus five 1 mg tablets: a randomized, open-label, two-way crossover study of healthy volunteers.

    Science.gov (United States)

    Thudium, Karen; Gallo, Jorge; Bouillaud, Emmanuel; Sachs, Carolin; Eddy, Simantini; Cheung, Wing

    2015-01-01

    The mammalian target of rapamycin (mTOR) inhibitor everolimus has a well-established pharmacokinetics profile. We conducted a randomized, single-center, open-label, two-sequence, two-period crossover study of healthy volunteers to assess the relative bioavailability of everolimus administered as one 5 mg tablet or five 1 mg tablets. Subjects were randomized 1:1 to receive everolimus dosed as one 5 mg tablet or as five 1 mg tablets on day 1, followed by a washout period on days 8-14 and then the opposite formulation on day 15. Blood sampling for pharmacokinetic evaluation was performed at prespecified time points, with 17 samples taken for each treatment period. Primary variables for evaluation of relative bioavailability were area under the concentration-time curve from time zero to infinity (AUCinf) and maximum blood concentration (Cmax). Safety was assessed by reporting the incidence of adverse events (AEs). Twenty-two participants received everolimus as one 5 mg tablet followed by five 1 mg tablets (n=11) or the opposite sequence (n=11). The Cmax of five 1 mg tablets was 48% higher than that of one 5 mg tablet (geometric mean ratio, 1.48; 90% confidence interval [CI], 1.35-1.62). AUCinf was similar (geometric mean ratio, 1.08; 90% CI, 1.02-1.16), as were the extent of absorption and the distribution and elimination kinetics. AEs, all grade 1 or 2, were observed in 54.5% of subjects. Although the extent of absorption was similar, the Cmax of five 1 mg tablets was higher than that of one 5 mg tablet, suggesting these formulations lead to different peak blood concentrations and are not interchangeable at the dose tested.

  19. Addition of Everolimus Post VEGFR Inhibition Treatment Failure in Advanced Sarcoma Patients Who Previously Benefited from VEGFR Inhibition: A Case Series

    OpenAIRE

    ElNaggar, Adam C.; Hays, John L.; Chen, James L.

    2016-01-01

    Background Patients with metastatic sarcoma who progress on vascular endothelial growth factor receptor inhibitors (VEGFRi) have limited treatment options. Upregulation of the mTOR pathway has been demonstrated to be a means of resistance to targeted VEGFRi in metastatic sarcoma. Patients and methods Retrospective cohort study to evaluate the clinical benefit at four months of combining mTOR inhibition (mTORi) via everolimus with VEGFRi in patients who have derived benefit from single-agent V...

  20. The mTOR inhibitor, everolimus (RAD001), overcomes resistance to imatinib in quiescent Ph-positive acute lymphoblastic leukemia cells

    Energy Technology Data Exchange (ETDEWEB)

    Kuwatsuka, Y; Minami, M; Minami, Y; Sugimoto, K; Hayakawa, F; Miyata, Y; Abe, A [Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Goff, D J [Moores Cancer Center, University of California San Diego School of Medicine, La Jolla, CA (United States); Kiyoi, H [Department of Infectious Diseases, Nagoya University Hospital, Nagoya (Japan); Naoe, T [Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2011-05-01

    In Ph-positive (Ph{sup +}) leukemia, the quiescent cell state is one of the reasons for resistance to the BCR-ABL-kinase inhibitor, imatinib. In order to examine the mechanisms of resistance due to quiescence and the effect of the mammalian target of rapamycin inhibitor, everolimus, for such a resistant population, we used Ph{sup +} acute lymphoblastic leukemia patient cells serially xenotransplanted into NOD/SCID/IL2rγ{sup null} (NOG) mice. Spleen cells from leukemic mice showed a higher percentage of slow-cycling G{sub 0} cells in the CD34{sup +}CD38{sup −} population compared with the CD34{sup +}CD38{sup +} and CD34{sup −} populations. After ex vivo imatinib treatment, more residual cells were observed in the CD34{sup +}CD38{sup −} population than in the other populations. Although slow-cycling G{sub 0} cells were insensitive to imatinib in spite of BCR-ABL and CrkL dephosphorylation, combination treatment with everolimus induced substantial cell death, including that of the CD34{sup +}CD38{sup −} population, with p70-S6 K dephosphorylation and decrease of MCL-1 expression. The leukemic non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mouse system with the in vivo combination treatment with imatinib and everolimus showed a decrease of tumor burden including CD34{sup +} cells. These results imply that treatment with everolimus can overcome resistance to imatinib in Ph{sup +} leukemia due to quiescence.

  1. Economic evaluation of everolimus versus sorafenib for the treatment of metastatic renal cell carcinoma after failure of first-line sunitinib.

    Science.gov (United States)

    Casciano, Roman; Chulikavit, Maruit; Di Lorenzo, Giuseppe; Liu, Zhimei; Baladi, Jean-Francois; Wang, Xufang; Robertson, Justin; Garrison, Lou

    2011-01-01

    A recent indirect comparison study showed that sunitinib-refractory metastatic renal cell carcinoma (mRCC) patients treated with everolimus are expected to have improved overall survival outcomes compared to patients treated with sorafenib. This analysis examines the likely cost-effectiveness of everolimus versus sorafenib in this setting from a US payer perspective. A Markov model was developed to simulate a cohort of sunitinib-refractory mRCC patients and to estimate the cost per incremental life-years gained (LYG) and quality-adjusted life-years (QALYs) gained. Markov states included are stable disease without adverse events, stable disease with adverse events, disease progression, and death. Transition probabilities were estimated using a subset of the RECORD-1 patient population receiving everolimus after sunitinib, and a comparable population receiving sorafenib in a single-arm phase II study. Costs of antitumor therapies were based on wholesale acquisition cost. Health state costs accounted for physician visits, tests, adverse events, postprogression therapy, and end-of-life care. The model extrapolated beyond the trial time horizon for up to 6 years based on published trial data. Deterministic and probabilistic sensitivity analyses were conducted. The estimated gain over sorafenib treatment was 1.273 LYs (0.916 QALYs) at an incremental cost of $81,643. The deterministic analysis resulted in an incremental cost-effectiveness ratio (ICER) of $64,155/LYG ($89,160/QALY). The probabilistic sensitivity analysis demonstrated that results were highly consistent across simulations. As the ICER fell within the cost per QALY range for many other widely used oncology medicines, everolimus is projected to be a cost-effective treatment relative to sorafenib for sunitinib-refractory mRCC. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Outcomes in Patients With Metastatic Renal Cell Carcinoma Who Develop Everolimus-Related Hyperglycemia and Hypercholesterolemia: Combined Subgroup Analyses of the RECORD-1 and REACT Trials.

    Science.gov (United States)

    Bono, Petri; Oudard, Stephane; Bodrogi, Istvan; Hutson, Thomas E; Escudier, Bernard; Machiels, Jean-Pascal; Thompson, John A; Figlin, Robert A; Ravaud, Alain; Basaran, Mert; Porta, Camillo; Bracarda, Sergio; Brechenmacher, Thomas; Lin, Chinjune; Voi, Maurizio; Grunwald, Viktor; Motzer, Robert J

    2016-10-01

    Hyperglycemia and hypercholesterolemia are class effects of mammalian target of rapamycin inhibitors. The purpose of this study was to characterize safety and efficacy of patients with metastatic renal cell carcinoma (mRCC) treated with everolimus in RECORD-1 (REnal Cell cancer treatment with Oral RAD001 given Daily) and REACT (RAD001 Expanded Access Clinical Trial in RCC) who developed these events. Adults with vascular endothelial growth factor-refractory mRCC received everolimus 10 mg/d in the randomized RECORD-1 (n = 277) and open-label REACT (n = 1367) studies. Outcomes included safety, treatment duration, overall response, and progression-free survival for patients who developed hypercholesterolemia or hyperglycemia. In RECORD-1, 12% (33 of 277) and 20% (55 of 277) of patients developed any grade hyperglycemia or hypercholesterolemia, respectively, with only 6% (78 of 1367) and 1% (14 of 1367) of the same events, respectively, in REACT. Median everolimus treatment duration was similar for patients with hyperglycemia or hypercholesterolemia (RECORD-1, 6.2 and 6.2 months, respectively; REACT, 4.4 and 4.5 months, respectively), but longer than the overall populations (RECORD-1, 4.6 months; REACT, 3.2 months). In RECORD-1/REACT, 82%/68% of patients with hyperglycemia and 75%/71% of patients with hypercholesterolemia achieved partial response or stable disease. The incidence of clinically notable Grade 3 or 4 adverse events, other than anemia and lymphopenia, appeared to be similar across trials and subgroups. Although there was a trend for improved progression-free survival with development of hyperglycemia or hypercholesterolemia, the association was not statistically significant. Hyperglycemia and hypercholesterolemia were observed in low numbers of patients, and although these events might be associated with improved response to everolimus, the differences were not significant. These findings should be validated with prospective biomarker studies. Copyright

  3. The role of mTOR inhibitors in the prevention of organ rejection in adult liver transplant patients: a focus on everolimus

    Directory of Open Access Journals (Sweden)

    Casanovas T

    2014-06-01

    Full Text Available Teresa Casanovas Liver Transplant Unit, Bellvitge University Hospital, Barcelona, Spain Abstract: Liver transplantation remains the therapy of choice for patients with end-stage liver disease and in selected cases of hepatocellular carcinoma. While short-term allograft survival has improved significantly in recent years, there has been little improvement in long-term survival after liver transplantation. A growing body of evidence on factors influencing the long-term outcomes and the safety profiles of existing immunosuppressive agents after liver transplant points to a need to continue searching for alternative strategies. The calcineurin inhibitors (CNIs (cyclosporine and tacrolimus currently represent the backbone of most immunosuppressor regimens. They have had a revolutionary effect on the overall success of transplantation, as is reflected in greatly reduced rates of acute rejection. However, the CNIs have significant toxicities that produce renal dysfunction, cardiovascular disease, and other unwanted effects, such as malignancies. The recognition of these risk factors has sparked interest in regimens that limit exposure to CNIs. Nowadays, the use of immunosuppressive drugs with different mechanisms of action, which allow for a reduction or avoidance of CNIs, is common. Everolimus, which belongs to the mammalian target-of-rapamycin inhibitor family and is best known for its use in kidney and heart transplantation, has recently been approved for liver transplantation. This overview discusses the emerging evidence on the role of everolimus in the prevention of rejection after liver transplantation, in de novo transplants, conversion regimens, or as a rescue therapy. In addition, some of the most relevant and current clinical problems related to everolimus in this field are discussed. Keywords: everolimus, mTOR inhibitors, tacrolimus, liver transplant, cyclosporine, renal impairment

  4. FTY720 and everolimus in de novo renal transplant patients at risk for delayed graft function: results of an exploratory one-yr multicenter study.

    Science.gov (United States)

    Tedesco-Silva, H; Lorber, M I; Foster, C E; Sollinger, H W; Mendez, R; Carvalho, D B; Shapiro, R; Rajagopalan, P R; Mayer, H; Slade, J; Kahan, B D

    2009-01-01

    This exploratory, multicenter, open-label study evaluated the efficacy and safety of FTY720, as a part of an immunosuppressive regimen, in combination with everolimus and steroids in de novo renal transplant recipients at increased risk of delayed graft function (DGF). Patients received FTY720 (5 mg) and everolimus (4 mg) 2-12 h pre-transplantation, followed by 2.5 mg/d FTY720 and concentration-controlled everolimus (4-8 ng/mL) post-transplant for 12 months. Induction therapy was prohibited. After enrollment of 56 of the planned 200 patients between 2000 and 2002, the recruitment was terminated. The primary endpoint, rate of graft loss, or death at three months was 15.4% and the biopsy-confirmed acute rejection was 42.3%. Death or graft loss at 12 months in the DGF and non-DGF arms was 36.0% and 25.9%, respectively. The mean estimated creatinine clearance at three months was 63 and 55 mL/min in the non-DGF and DGF groups, respectively, while at 12 months it was 56 mL/min in both the groups. Although there was no comparator arm, the results from this exploratory study (compared with data from other phases II and III trials) indicated no apparent benefits of FTY720-based regimens for prevention of acute rejection and preservation of renal function in renal transplant recipients at high risk of DGF.

  5. Report of sodium cavitation

    International Nuclear Information System (INIS)

    Murai, Hitoshi; Shima, Akira; Oba, Toshisaburo; Kobayashi, Ryoji; Hashimoto, Hiroyuki

    1975-01-01

    The damage of components for LMFBRs due to sodium cavitation is serious problem. This report summarizes the following items, (1) mechanism of the incipience of sodium cavitation, (2) damage due to sodium cavitation, (3) detection method for sodium cavitation, and (4) estimation method for sodium cavitation by the comparison with water cavitation. Materials were collected from the reports on liquid metal cavitation, sodium cavitation and water cavitation published from 1965 to now. The mechanism of the incipience of sodium cavitation cavitation parameters (mean location, distributed amount or occurrence aspect and stability), experiment of causing cavitation with Venturi tube, and growth of bubbles within superheated sodium. The sodium cavitation damage was caused by magnetostriction vibration method and with Venturi tube. The state of damage was investigated with the cavitation performance of a sodium pump, and the damage was examined in view of the safety of LMFBR plants. Sodium cavitation was detected with acoustic method, radiation method, and electric method. The effect of physical property of liquid on incipient cavitation was studied. These are thermodynamic effect based on quasistatic thermal equilibrium condition and the effect of the physical property of liquid based on bubble dynamics. (Iwase, T.)

  6. Sodium safety manual

    International Nuclear Information System (INIS)

    Hayes, D.J.; Gardiner, R.L.

    1980-09-01

    The sodium safety manual is based upon more than a decade of experience with liquid sodium at Berkeley Nuclear Laboratories (BNL). It draws particularly from the expertise and experience developed in the course of research work into sodium fires and sodium water reactions. It draws also on information obtained from the UKAEA and other sodium users. Many of the broad principles will apply to other Establishments but much of the detail is specific to BNL and as a consequence its application at other sites may well be limited. Accidents with sodium are at best unpleasant and at worst lethal in an extremely painful way. The object of this manual is to help prevent sodium accidents. It is not intended to give detailed advice on specific precautions for particular situations, but rather to set out the overall strategy which will ensure that sodium activities will be pursued safely. More detail is generally conveyed to staff by the use of local instructions known as Sodium Working Procedures (SWP's) which are not reproduced in this manual although a list of current SWP's is included. Much attention is properly given to the safe design and operation of larger facilities; nevertheless evidence suggests that sodium accidents most frequently occur in small-scale work particularly in operations associated with sodium cleaning and special care is needed in all such cases. (U.K.)

  7. Dialysate sodium and sodium gradient in maintenance hemodialysis: a neglected sodium restriction approach?

    OpenAIRE

    Munoz Mendoza, Jair; Sun, Sumi; Chertow, Glenn M.; Moran, John; Doss, Sheila; Schiller, Brigitte

    2011-01-01

    Background. A higher sodium gradient (dialysate sodium minus pre-dialysis plasma sodium) during hemodialysis (HD) has been associated with sodium loading; however, its role is not well studied. We hypothesized that a sodium dialysate prescription resulting in a higher sodium gradient is associated with increases in interdialytic weight gain (IDWG), blood pressure (BP) and thirst.

  8. RECORD-4 multicenter phase 2 trial of second-line everolimus in patients with metastatic renal cell carcinoma: Asian versus non-Asian population subanalysis.

    Science.gov (United States)

    Yang, Lin; Alyasova, Anna; Ye, Dingwei; Ridolfi, Antonia; Dezzani, Luca; Motzer, Robert J

    2018-02-17

    RECORD-4 assessed everolimus in patients with metastatic renal cell carcinoma (mRCC) who progressed after 1 prior anti-vascular endothelial growth factor (VEGF) or cytokine and reinforced the clinical benefit of second-line everolimus. Because of the high percentage of patients from China enrolled in RECORD-4 (41%) and some reported differences in responses to certain targeted agents between Chinese and Western patients, this subanalysis evaluated outcomes in Asian versus non-Asian patients. RECORD-4 enrolled patients with clear cell mRCC into 3 cohorts based on prior first-line therapy: sunitinib, other anti-VEGF (sorafenib, bevacizumab, pazopanib, other), or cytokines. Patients received everolimus 10 mg/d until progression of disease (RECIST, v1.0) or intolerance. Primary end point was progression-free survival per investigator review. Data cutoff was Sept 1, 2014. Among Asian (n = 55) versus non-Asian (n = 79) patients, 98% versus 84% had good/intermediate MSKCC prognosis; 73% versus 65% were men, and 85% versus 73% were < 65 years of age. All (100%) Asian patients were of Chinese ethnicity. Median duration of exposure was 5.5 mo for Asian and 6.0 mo for non-Asian patients. Among Asian versus non-Asian patients, median progression-free survival (months) was 7.4 versus 7.8 overall, 7.4 versus 4.0 with prior sunitinib, and 5.7 versus 9.2 with prior other anti-VEGFs. Clinical benefit rate was similar between populations: 74.5% (95% CI 61.0-85.3) for Asian patients and 74.7% (95% CI 63.6-83.8) for non-Asian patients. Most patients achieved stable disease as best overall response (Asian, 63.6%; non-Asian, 69.6%). Overall rate of grade 3/4 adverse events appeared similar for Asian (58%) and non-Asian patients (54%). This RECORD-4 subanalysis demonstrated comparable efficacy and adverse event profiles of second-line everolimus in Asian and non-Asian patients. Efficacy and safety outcomes by prior therapy should be interpreted with caution because of small

  9. The use of everolimus in the treatment of neurocognitive problems in tuberous sclerosis (TRON): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Randell, Elizabeth; McNamara, Rachel; Davies, D Mark; Owen-Jones, Eleri; Kirby, Nigel; Angel, Lianna; Drew, Cheney; Cannings-John, Rebecca; Smalley, Michelle; Saxena, Anurag; McDermott, Emer; Stockwell, Laura; de Vries, Petrus J; Hood, Kerry; Sampson, Julian R

    2016-08-11

    Tuberous sclerosis complex (TSC) is a genetic disorder affecting about 1 in 6000 people and is characterised by the development of tumours in many organs, including the skin and kidneys, and by a range of neurological and neuropsychiatric manifestations. TSC-associated neuropsychiatric disorders (TAND) occur in the majority of those with TSC, and they have a significant impact on patients and their families, given the everyday impact of TAND on education, employment, family and social life. The potential benefits of better treatment for TAND therefore include reduction in health care demands and wider benefits for patients and their carers. We have planned a single-centre, two-arm, individually randomised, phase II, double-blind, placebo-controlled trial of everolimus versus placebo in the treatment of neurocognitive problems in patients with tuberous sclerosis. Everolimus is a licensed medicine in this patient group, but for a different target of effect. The present trial is a proof-of-principle study developed to provide effect size estimates which may be used to inform the design of subsequent trials. Forty-eight patients aged 16-60 years with tuberous sclerosis who have an IQ >60 and a significant deficit (at least -2 SD) in one or more primary outcome measures will be randomly allocated in a ratio of 2:1 to receive everolimus or placebo, respectively. Participants will be assessed for eligibility and then be started on study medication 4 weeks later. They will then be randomised and receive placebo or everolimus for 24 weeks. Neurocognitive and safety assessments will be carried out at baseline and weeks 4, 12, 24 and 36. This study is designed to determine the effect sizes of treatment with everolimus or placebo for 6 months on specific neurocognitive functions-recall memory (verbal and non-verbal) and executive function-in people affected by TSC who have significant deficits in these functions. These data will provide new evidence to determine whether

  10. Comparative vascular responses three months after paclitaxel and everolimus-eluting stent implantation in streptozotocin-induced diabetic porcine coronary arteries

    Directory of Open Access Journals (Sweden)

    Sheehy Alexander

    2012-06-01

    Full Text Available Abstract Background Diabetes remains a significant risk factor for restenosis/thrombosis following stenting. Although vascular healing responses following drug-eluting stent (DES treatment have been characterized previously in healthy animals, comparative assessments of different DES in a large animal model with isolated features of diabetes remains limited. We aimed to comparatively assess the vascular response to paclitaxel-eluting (PES and everolimus-eluting (EES stents in a porcine coronary model of streptozotocin (STZ-induced type I diabetes. Method Twelve Yucatan swine were induced hyperglycemic with a single STZ dose intravenously to ablate pancreatic β-cells. After two months, each animal received one XIENCE V® (EES and one Taxus Liberte (PES stent, respectively, in each coronary artery. After three months, vascular healing was assessed by angiography and histomorphometry. Comparative in vitro effects of everolimus and paclitaxel (10-5 M–10-12 M after 24 hours on carotid endothelial (EC and smooth muscle (SMC cell viability under hyperglycemic (42 mM conditions were assayed by ELISA. Caspase-3 fluorescent assay was used to quantify caspase-3 activity of EC treated with everolimus or paclitaxel (10-5 M, 10-7 M for 24 hours. Results After 3 months, EES reduced neointimal area (1.60 ± 0.41 mm, p vs. 0.08 ± 0.05, greater medial necrosis grade (0.52 ± 0.26 vs. 0.0 ± 0.0, and persistently elevated fibrin scores (1.60 ± 0.60 vs. 0.63 ± 0.41 with PES compared to EES (p In vitro, paclitaxel significantly increased (p -7 M, while everolimus did not affect EC/SMC apoptosis/necrosis within the dose range tested. In ECs, paclitaxel (10-5 M significantly increased caspase-3 activity (p  Conclusion After 3 months, both DES exhibited signs of delayed healing in a STZ-induced diabetic swine model. PES exhibited greater neointimal area, increased inflammation, greater medial necrosis, and

  11. Solubilities of sodium nitrate, sodium nitrite, and sodium aluminate in simulated nuclear waste

    International Nuclear Information System (INIS)

    Reynolds, D.A.; Herting, D.L.

    1984-09-01

    Solubilities were determined for sodium nitrate, sodium nitrite, and sodium aluminate in synthetic nuclear waste liquor. Solubilities were determined as a function of temperature and solution composition (concentrations of sodium hydroxide, sodium nitrate, sodium nitrite, and sodium aluminate). Temperature had the greatest effect on the solubilities of sodium nitrate and sodium nitrite and a somewhat lesser effect on sodium aluminate solubility. Hydroxide had a great effect on the solubilities of all three salts. Other solution components had minor effects. 2 references, 8 figures, 11 tables

  12. Sodium aerosol recovering device

    International Nuclear Information System (INIS)

    Fujimori, Koji; Ueda, Mitsuo; Tanaka, Kazuhisa.

    1997-01-01

    A main body of a recovering device is disposed in a sodium cooled reactor or a sodium cooled test device. Air containing sodium aerosol is sucked into the main body of the recovering device by a recycling fan and introduced to a multi-staged metal mesh filter portion. The air about against each of the metal mesh filters, and the sodium aerosol in the air is collected. The air having a reduced sodium aerosol concentration circulates passing through a recycling fan and pipelines to form a circulation air streams. Sodium aerosol deposited on each of the metal mesh filters is scraped off periodically by a scraper driving device to prevent clogging of each of the metal filters. (I.N.)

  13. [Sodium intake during pregnancy].

    Science.gov (United States)

    Delemarre, F M; Franx, A; Knuist, M; Steegers, E A

    1999-10-23

    International studies have yielded contradictory results on efficacy of a sodium-restricted diet during pregnancy in preventing and curing hypertension of pregnancy. In the Netherlands three studies have been performed to investigate the value of dietary sodium restriction in pregnancy; they concerned epidemiology, prevention and treatment. Midwives often prescribed this dietary intervention. Urinary sodium excretion was not related to blood pressure changes in pregnancy. Dietary sodium restriction from the third month of pregnancy onwards did not reduce the incidence of pregnancy-induced hypertension. Maternal side effects were a decreased intake of nutrients, decreased maternal weight gain, lowered plasma volume and stimulation of the renin-angiotensin-aldosterone system. A dietary sodium restriction in women with early symptoms of pregnancy-induced hypertension showed no therapeutic effect on blood pressure. There is no place for dietary sodium restriction in the prevention or treatment of hypertension in pregnancy.

  14. Sodium fire protection

    International Nuclear Information System (INIS)

    Raju, C.; Kale, R.D.

    1979-01-01

    Results of experiments carried out with sodium fires to develop extinguishment techniques are presented. Characteristics, ignition temperature, heat evolution and other aspects of sodium fires are described. Out of the powders tested for extinguishment of 10 Kg sodium fires, sodium bi-carbonate based dry chemical powder has been found to be the best extinguisher followed by large sized vermiculite and then calcium carbonate powders distributed by spray nozzles. Powders, however, do not extinguish large fires effectively due to sodium-concrete reaction. To control large scale fires in a LMFBR, collection trays with protective cover have been found to cause oxygen starvation better than flooding with inert gas. This system has an added advantage in that there is no damage to the sodium facilities as has been in the case of powders which often contain chlorine compounds and cause stress corrosion cracking. (M.G.B.)

  15. Sodium fire suppression

    Energy Technology Data Exchange (ETDEWEB)

    Malet, J C [DSN/SESTR, Centre de Cadarache, Saint-Paul-lez-Durance (France)

    1979-03-01

    Ignition and combustion studies have provided valuable data and guidelines for sodium fire suppression research. The primary necessity is to isolate the oxidant from the fuel, rather than to attempt to cool the sodium below its ignition temperature. Work along these lines has led to the development of smothering tank systems and a dry extinguishing powder. Based on the results obtained, the implementation of these techniques is discussed with regard to sodium fire suppression in the Super-Phenix reactor. (author)

  16. Sodium fire suppression

    International Nuclear Information System (INIS)

    Malet, J.C.

    1979-01-01

    Ignition and combustion studies have provided valuable data and guidelines for sodium fire suppression research. The primary necessity is to isolate the oxidant from the fuel, rather than to attempt to cool the sodium below its ignition temperature. Work along these lines has led to the development of smothering tank systems and a dry extinguishing powder. Based on the results obtained, the implementation of these techniques is discussed with regard to sodium fire suppression in the Super-Phenix reactor. (author)

  17. The Additional Costs per Month of Progression-Free Survival and Overall Survival: An Economic Model Comparing Everolimus with Cabozantinib, Nivolumab, and Axitinib for Second-Line Treatment of Metastatic Renal Cell Carcinoma.

    Science.gov (United States)

    Swallow, Elyse; Messali, Andrew; Ghate, Sameer; McDonald, Evangeline; Duchesneau, Emilie; Perez, Jose Ricardo

    2018-04-01

    When considering optimal second-line treatments for metastatic renal cell carcinoma (mRCC), clinicians and payers seek to understand the relative clinical benefits and costs of treatment. To use an economic model to compare the additional cost per month of overall survival (OS) and of progression-free survival (PFS) for cabozantinib, nivolumab, and axitinib with everolimus for the second-line treatment of mRCC from a third-party U.S. payer perspective. The model evaluated mean OS and PFS and costs associated with drug acquisition/administration; adverse event (AE) treatment; monitoring; and postprogression (third-line treatment, monitoring, and end-of-life costs) over 1- and 2-year horizons. Efficacy, safety, and treatment duration inputs were estimated from regimens' pivotal clinical trials; for everolimus, results were weighted across trials. Mean 1- and 2-year OS and mean 1-year PFS were estimated using regimens' reported OS and PFS Kaplan-Meier curves. Dosing and administration inputs were consistent with approved prescribing information and the clinical trials used to estimate efficacy and safety inputs. Cost inputs came from published literature and public data. Additional cost per additional month of OS or PFS was calculated using the ratio of the cost difference per treated patient and the corresponding difference in mean OS or PFS between everolimus and each comparator. One-way sensitivity analyses were conducted by varying efficacy and cost inputs. Compared with everolimus, cabozantinib, nivolumab, and axitinib were associated with 1.6, 0.3, and 0.5 additional months of PFS, respectively, over 1 year. Cabozantinib and nivolumab were associated with additional months of OS compared with everolimus (1 year: 0.7 and 0.8 months; 2 years: 1.6 and 2.3 months; respectively); axitinib was associated with fewer months (1 year: -0.2 months; 2 years: -0.7 months). The additional costs of treatment with cabozantinib, nivolumab, or axitinib versus everolimus over 1

  18. Sodium fill of FFTF

    International Nuclear Information System (INIS)

    Waldo, J.B.; Greenwell, R.K.; Keasling, T.A.; Collins, J.R.; Klos, D.B.

    1980-02-01

    With construction of the Fast Flux Test Facility (FFTF) completed, the first major objective in the startup program was to fill the sodium systems. A sodium fill sequence was developed to match construction completion, and as systems became available, they were inerted, preheated, and filled with sodium. The secondary sodium systems were filled first while dry refueling system testing was in progress in the reactor vessel. The reactor vessel and the primary loops were filled last. This paper describes the methods used and some of the key results achieved for this major FFTF objective

  19. Fires of sodium installations

    International Nuclear Information System (INIS)

    Hajek, L.; Tlalka, R.

    1984-01-01

    A survey is presented of the literature dealing with fires of sodium installations between 1974 and 1981. Also described are three experimental fires of ca 50 kg of sodium in an open area, monitored by UJV Rez. The experimental conditions of the experiments are described and a phenomenological description is presented of the course of the fires. The experiments showed a relationship between wind velocity in the area surrounding the fire and surface temperature of the sodium flame. Systems analysis methods were applied to sodium area, spray and tube fires. (author)

  20. Novel and evolving therapies in the treatment of malignant phaeochromocytoma: experience with the mTOR inhibitor everolimus (RAD001).

    Science.gov (United States)

    Druce, M R; Kaltsas, G A; Fraenkel, M; Gross, D J; Grossman, A B

    2009-09-01

    Phaeochromocytoma and paraganglioma are rare neuroendocrine tumours (NETS). They may be benign or malignant but the pathological distinction is mainly made when metastases are present. Available treatments in the form of surgery, chemotherapy, and radionuclide therapy may improve symptoms and biochemical markers, but the results for the control of tumour bulk are less favourable. Furthermore, responses to treatment are frequently short-lived. This short review outlines the main molecular and histological features of malignant phaeochromocytoma and the difficulties in differentiating between benign and malignant disease. We list current therapies used for malignant pheochromocytoma; however, these generally achieve relatively low success rates. Hence, there is a need for new and more effective therapies. In vitro studies have implicated the PI3/Akt/mTOR pathway in the pathogenesis of malignant NETS, including phaeochromocytoma. Everolimus (RAD001, Novartis UK) is a compound that inhibits mTOR (mammalian Target Of Rapamycin) signalling. We have used RAD001 in four patients with progressive malignant paraganglioma/phaeochromocytoma in addition to other therapies (with institutional approval for compassionate use), and evaluated the effects of this treatment. We outline these four cases and review the theoretical background for this therapy, although the outcomes were relatively disappointing.

  1. Simultaneous Determination of Cyclosporine A, Tacrolimus, Sirolimus, and Everolimus in Whole-Blood Samples by LC-MS/MS

    Directory of Open Access Journals (Sweden)

    Mustafa Karapirli

    2012-01-01

    Full Text Available Objectives. Cyclosporine A (CyA, tacrolimus (TRL, sirolimus (SIR, and everolimus (RAD are immunosuppressive drugs frequently used in organ transplantation. Our aim was to confirm a robust sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS method for determination of CyA, TRL, SIR, and RAD in whole-blood samples. Materials and Methods. We used an integrated online solid-phase extraction-LC-MS/MS system and atmospheric pressure ionization tandem mass spectrometry (API-MS/MS in the multiple reaction monitoring (MRM detection mode. CyA, TRL, SIR, and RAD were simultaneously analyzed in whole blood treated with precipitation reagent taken from transplant patients. Results. System performance parameters were suitable for using this method as a high-throughput technique in clinical practice. The high concentration of one analyte in the sample did not affect the concentration of other analytes. Total analytical time was 2.5 min, and retention times of all analytes were shorter than 2 minutes. Conclusion. This LC-MS/MS method can be preferable for therapeutic drug monitoring of these immunosuppressive drugs (CyA, TRL, SRL, and RAD in whole blood. Sample preparation was too short and simple in this method, and it permits robust, rapid, sensitive, selective, and simultaneous determination of these drugs.

  2. Effect of conversion from calcineurin inhibitors to everolimus on hepatitis C viremia in adult kidney transplant recipients.

    Science.gov (United States)

    Pacheco, Larissa Sgaria; Garcia, Valter Duro; Prá, Ronivan Luis Dal; Cardoso, Bruna Doleys; Rodrigues, Mariana Ferras; Zanetti, Helen Kris; Meinerz, Gisele; Neumann, Jorge; Gnatta, Diego; Keitel, Elizete

    2018-05-14

    Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors. Thirty patients were randomized and 28 were followed-up for 12 months (conversion group, Group 1 =15 and control group, Group 2 =13). RT-PCR HCV levels reported in log values were comparable in both groups and among patients in the same group. The statistical analysis showed no interaction effect between time and group (p value G*M= 0.852), overtime intra-groups (p-value M=0.889) and between group (p-value G=0.286). Group 1 showed a higher incidence of dyslipidemia (p=0.03) and proteinuria events (p=0.01), while no difference was observed in the incidence of anemia (p=0.17), new onset of post-transplant diabetes mellitus (p=1.00) or urinary tract infection (p=0.60). The mean eGFR was similar in both groups. Our study did not show viral load decrease after conversion to EVR with maintenance of antiproliferative therapy.

  3. Visibility in sodium fume

    International Nuclear Information System (INIS)

    Hughes, G.W.; Anderson, N.R.

    1971-01-01

    The appearance of sodium fume of unknown concentration and the effects of short term exposure on unprotected workers is described. The molecular extinction coefficient of sodium fume is calculated from which light transmission data, and a rapid method for the estimation of the fume concentration is proposed. (author)

  4. Sodium outleakage detection

    International Nuclear Information System (INIS)

    Casselman, C.

    1979-01-01

    Effective detection of outleakage from sodium facilities permits timely intervention capable of limiting the consequences of such leakage. Two types of detection systems are described: local and overall detection. The use of two independent systems in sodium facilities is recommended. (author)

  5. Annular sodium flowsensor

    International Nuclear Information System (INIS)

    Kaiser, W.C.; Brewer, J.; Forster, G.A.

    1983-01-01

    This paper describes a unique eddy-current type liquid sodium flowsensor, designed as a joint effort between Argonne National Laboratory and Kaman Instrumentation Corp. Test results are included for operation of the flowsensor mounted on a sodium test loop whose configuration simulates the actual operating conditions, except for the magnetic field of the ALIP

  6. Everolimus Plus Endocrine Therapy for Postmenopausal Women With Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: A Clinical Trial.

    Science.gov (United States)

    Royce, Melanie; Bachelot, Thomas; Villanueva, Cristian; Özgüroglu, Mustafa; Azevedo, Sergio J; Cruz, Felipe Melo; Debled, Marc; Hegg, Roberto; Toyama, Tatsuya; Falkson, Carla; Jeong, Joon; Srimuninnimit, Vichien; Gradishar, William J; Arce, Christina; Ridolfi, Antonia; Lin, Chinjune; Cardoso, Fatima

    2018-03-22

    Cotargeting the mammalian target of rapamycin pathway and estrogen receptor may prevent or delay endocrine resistance in patients receiving first-line treatment for advanced breast cancer. To investigate the combination of everolimus plus endocrine therapy in first-line and second-line treatment settings for postmenopausal women with estrogen receptor-positive, human epidermal growth receptor 2-negative advanced breast cancer. In the multicenter, open-label, single-arm, phase 2 BOLERO-4 (Breast Cancer Trials of Oral Everolimus) clinical trial, 245 patients were screened for eligibility; 202 were enrolled between March 7, 2013, and December 17, 2014. A median follow-up of 29.5 months had been achieved by the data cutoff date (December 17, 2016). Patients received first-line treatment with everolimus, 10 mg/d, plus letrozole, 2.5 mg/d. Second-line treatment with everolimus, 10 mg/d, plus exemestane, 25 mg/d, was offered at the investigator's discretion upon initial disease progression. The primary end point was investigator-assessed progression-free survival in the first-line setting per Response Evaluation Criteria in Solid Tumors, version 1.0. Safety was assessed in patients who received at least 1 dose of study medication and at least 1 postbaseline safety assessment. A total of 202 women treated in the first-line setting had a median age of 64.0 years (interquartile range, 58.0-70.0 years) with metastatic (194 [96.0%]) or locally advanced (8 [4.0%]) breast cancer. Median progression-free survival was 22.0 months (95% CI, 18.1-25.1 months) with everolimus and letrozole. Median overall survival was not reached; 24-month estimated overall survival rate was 78.7% (95% CI, 72.1%-83.9%). Fifty patients started second-line treatment; median progression-free survival was 3.7 months (95% CI, 1.9-7.4 months). No new safety signals were observed. In the first-line setting, the most common all-grade adverse event was stomatitis (139 [68.8%]); the most common grade 3 to 4

  7. Total-body sodium and sodium excess

    International Nuclear Information System (INIS)

    Aloia, J.F.; Cohn, S.H.; Abesamis, C.; Babu, T.; Zanzi, I.; Ellis, K.

    1980-01-01

    Total-body levels of sodium (TBNa), chlorine (TBCI), calcium (TBCa), and potassium (TBK) were measured by neutron activation and analysis of results by whole body counting in 66 postmenopausal women. The relationship between TBNa, and TBCl, TBK, and TBCa on the one hand, and height and weight on the other, were found to compare with those previously reported. The hypothesis that TBNa and TBCl are distributed normally could not be rejected. The sodium excess (Na/sub es/) is defined as the sodium that is present in excess of that associated with the extracellular fluid (chlorine) space; the Na/sub es/ approximates nonexchangeable bone sodium. In these 66 postmenopausal women, and in patients with different endocrinopathies previously described, the values on Na/sub es/ did not differ from the normal values except in the thyrotoxicosis patients, where they were decreased. A close relationship between Na/sub es/ and TBCa was maintained in the endocrinopathies studied. This relationship was found in conditions accompanied by either an increment or a loss of skeletal mass. It appears that the NA/sub es/ value is primarily dependent upon the calcium content of bone

  8. Clinical Application of Everolimus in Field of Organ Transplantation%依维莫司在器官移植领域的临床应用

    Institute of Scientific and Technical Information of China (English)

    刘丽; 王华光

    2015-01-01

    Objective To summary the clinical application of everolimus in the field of organ transplantation by describing the action mechanism, pharmacokinetics, influence factors, clinical evaluation, adverse reaction, and so on. Methods By consulting the literatures about the mechanism, pharmacokinetics and clinical researches of everolimus in recent years, the important informations were extracted, analyzed and summarized for conducting this review. Results and Conclusion Everolimus can maintain better renal function in the as-pect of organ transplantation;various factors, such as food, drugs, can affect its pharmacokinetic properties. With the existing research clin-ical treatment regimen as the guidance, individualized medication regime and monitoring its blood concentration can increase the curative effect and reduce the adverse reactions.%目的:从作用机制、药代动力学性质及影响因素、临床评价、不良反应等方面简述依维莫司在器官移植领域的临床应用。方法查阅近几年文献,提取重要信息,通过分析、归纳进行综述。结果与结论依维莫司用于器官移植能维持较好的肾功能。食物、药物等多种因素均能影响其药代动力学性质。以已有的研究性临床治疗方案为指导,采用依维莫司个体化给药方案,监测其血药浓度,可提高疗效、降低不良反应。

  9. Incidence and risk of treatment-related mortality with mTOR inhibitors everolimus and temsirolimus in cancer patients: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Wei-Xiang Qi

    Full Text Available BACKGROUND: Two novel mammalian targets of rapamycin (mTOR inhibitors everolimus and temsirolimus are now approved by regulatory agencies and have been widely investigated among various types of solid tumors, but the risk of fatal adverse events (FAEs with these drugs is not well defined. METHODS: We searched PubMed, EMBASE, and Cochrane library databases for relevant trials. Eligible studies included prospective phase II and III trials evaluating everolimus and temsirolimus in patients with all malignancies and data on FAEs were available. Statistical analyses were conducted to calculate the summary incidence, RRs and 95% confidence intervals (CIs by using either random effects or fixed effect models according to the heterogeneity of the included studies. RESULTS: A total of 3322 patients with various advanced solid tumors from 12 trials were included. The overall incidence of mTOR inhibitors associated FAEs was 1.8% (95%CI: 1.3-2.5%, and the incidences of everolimus related FAEs were comparable to that of temsirolimus (1.7% versus 1.8%. Compared with the controls, the use of mTOR inhibitors was associated with an increased risk of FAEs, with a RR of 3.24 (95%CI: 1.21-8.67, p = 0.019. On subgroup analysis, a non-statistically significant increase in the risk of FAEs was found according to different mTOR inhibitors, tumor types or controlled therapy. No evidence of publication bias was observed. CONCLUSION: With the present evidence, the use of mTOR inhibitors seems to increase the risk of FAEs in patients with advanced solid tumors. More high quality trials are still needed to investigate this association.

  10. Risk and timing of clinical events according to diabetic status of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting stent: 2-year results from a propensity score matched comparison of ABSORB EXTEND and SPIRIT trials.

    Science.gov (United States)

    Campos, Carlos M; Caixeta, Adriano; Franken, Marcelo; Bartorelli, Antonio L; Whitbourn, Robert J; Wu, Chiung-Jen; Li Paul Kao, Hsien; Rosli, Mohd Ali; Carrie, Didier; De Bruyne, Bernard; Stone, Gregg W; Serruys, Patrick W; Abizaid, Alexandre

    2018-02-15

    to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon. The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR). After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups. In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Methodology for Extraction of Remaining Sodium of Used Sodium Containers

    International Nuclear Information System (INIS)

    Jung, Minhwan; Kim, Jongman; Cho, Youngil; Jeong, Jiyoung

    2014-01-01

    Sodium used as a coolant in the SFR (Sodium-cooled Fast Reactor) reacts easily with most elements due to its high reactivity. If sodium at high temperature leaks outside of a system boundary and makes contact with oxygen, it starts to burn and toxic aerosols are produced. In addition, it generates flammable hydrogen gas through a reaction with water. Hydrogen gas can be explosive within the range of 4.75 vol%. Therefore, the sodium should be handled carefully in accordance with standard procedures even though there is a small amount of target sodium remainings inside the containers and drums used for experiment. After the experiment, all sodium experimental apparatuses should be dismantled carefully through a series of draining, residual sodium extraction, and cleaning if they are no longer reused. In this work, a system for the extraction of the remaining sodium of used sodium drums has been developed and an operation procedure for the system has been established. In this work, a methodology for the extraction of remaining sodium out of the used sodium container has been developed as one of the sodium facility maintenance works. The sodium extraction system for remaining sodium of the used drums was designed and tested successfully. This work will contribute to an establishment of sodium handling technology for PGSFR. (Prototype Gen-IV Sodium-cooled Fast Reactor)

  12. Sodium oxide aerosol filtration

    Energy Technology Data Exchange (ETDEWEB)

    Duverger de Cuy, G [DSN/SESTR, Centre de Cadarache, Saint-Paul-lez-Durance (France)

    1979-03-01

    In the scope of the sodium aerosol trapping research effort by the CEA/DSN, the retention capacity and yield were measured for very high efficiency fiberglass filters and several types of prefilters (cyclone agglomerator, fabric prefilters, water scrubbers). (author)

  13. Sodium oxide aerosol filtration

    International Nuclear Information System (INIS)

    Duverger de Cuy, G.

    1979-01-01

    In the scope of the sodium aerosol trapping research effort by the CEA/DSN, the retention capacity and yield were measured for very high efficiency fiberglass filters and several types of prefilters (cyclone agglomerator, fabric prefilters, water scrubbers). (author)

  14. Sodium distiller II

    International Nuclear Information System (INIS)

    Goncalves, A.C.; Castro, P.M. e; Torres, A.R.; Correa, S.M.

    1990-01-01

    A sodium distiller allows the evaluation of the sodium purity, contained in plants and circuits of Fast Reactors. The sodium distillers of the IEN Reactor's Department was developed initially as a prototype, for the testing of the distillation process and in a second step, as a equipment dedicated to attendance the operation of these circuits. This last one was build in stainless steel, with external heat, rotating crucible of nickel for four samples, purge system for pipe cleaning and a sight glass that permits the observation of the distillation during all the operation. The major advantage of this equipment is the short time to do a distillation operation, which permits its routine utilization. As a consequence of the development of the distillers and its auxiliary systems an important amount of new information was gathered concerning components and systems behaviour under high temperature, vacuum and sodium. (author)

  15. Sodium hypochlorite poisoning

    Science.gov (United States)

    ... that can cause choking and serious breathing problems. Symptoms of sodium hypochlorite poisoning may include: Burning, red eyes Chest pain Coma Coughing (from the fumes) Delirium Gagging sensation Low blood pressure Pain in the ...

  16. Rationale and Design of a Randomized Clinical Comparison of Everolimus-Eluting (Xience V/Promus) and Sirolimus-Eluting (Cypher Select+) Coronary Stents in Unselected Patients with Coronary Heart Disease

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Tilsted, Hans Henrik

    2010-01-01

    with Clinical Outcome (SORT OUT) IV trial was designed as a prospective, multi-center, open-label, all-comer, two-arm, randomized, non-inferiority study comparing the everolimus-eluting stent with the sirolimus-eluting stent in the treatment of atherosclerotic coronary artery lesions. Based on a non...

  17. Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluoropolymer-coated everolimus-eluting stent at 13-month follow-up: an optical coherence tomography substudy from the RESOLUTE All Comers trial

    DEFF Research Database (Denmark)

    Gutiérrez-Chico, Juan Luis; van Geuns, Robert Jan; Regar, Evelyn

    2011-01-01

    To compare the tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent (ZES) vs. a fluoropolymer-coated everolimus-eluting stent (EES) at 13 months, using optical coherence tomography (OCT) in an 'all-comers' population of patients, in order to clarify the mechanism of eventual...

  18. Long-Term Follow-Up of Patients after Percutaneous Coronary Intervention with Everolimus-Eluting Bioresorbable Vascular Scaffold.

    Science.gov (United States)

    Meneguz-Moreno, Rafael Alexandre; Costa, José de Ribamar; Moscoso, Freddy Antônio Britto; Staico, Rodolfo; Tanajura, Luiz Fernando Leite; Centemero, Marinella Patrizia; Chaves, Auréa Jacob; Abizaid, Andrea Claudia Leão de Sousa; Sousa, Amanda Guerra de Moraes Rego E; Abizaid, Alexandre Antonio Cunha

    2017-02-01

    Bioresorbable vascular scaffolds (BVS) were developed to improve the long-term results of percutaneous coronary intervention, restoring vasomotion. To report very late follow-up of everolimus-eluting Absorb BVS (Abbott Vascular, Santa Clara, USA) in our center. Observational retrospective study, in a single Brazilian center, from August 2011 to October 2013, including 49 patients submitted to Absorb BVS implantation. Safety and efficacy outcomes were analyzed in the in-hospital and very late follow-up phases (> 2 years). All 49 patients underwent a minimum follow-up of 2.5 years and a maximum of 4.6 years. Mean age was 56.8 ± 7.6 years, 71.4% of the patients were men, and 26.5% were diabetic. Regarding clinical presentation, the majority (94%) had stable angina or silent ischemia. Device success was achieved in 100% of cases with 96% overall procedure success rate. Major adverse cardiovascular events rate was 4% at 30 days, 8.2% at 1 year, and 12.2% at 2 years, and there were no more events until 4.6 years. There were 2 cases of thrombosis (1 subacute and 1 late). In this preliminary analysis, Absorb BVS showed to be a safe and effective device in the very late follow-up. Establishing the efficacy and safety profiles of these devices in more complex scenarios is necessary. Os suportes vasculares bioabsorvíveis (SVB) foram desenvolvidos com o intuito de melhorar os resultados da intervenção coronária percutânea a longo prazo, restabelecendo-se a vasomotricidade. Reportar o seguimento muito tardio do implante do SVB eluidor de everolimus Absorb® (Abbot Vascular, Santa Clara, EUA) em nosso centro. Estudo observacional, retrospectivo, em um único centro brasileiro, que incluiu 49 pacientes submetidos ao implante do SVB Absorb® entre agosto/2011 e outubro/2013. Foram analisados os desfechos de segurança e eficácia na fase hospitalar e bastante tardia (> 2 anos). Todos os 49 pacientes completaram um seguimento mínimo de 2,5 anos, sendo o máximo de 4,6 anos

  19. Liquid sodium oxygenmeter

    International Nuclear Information System (INIS)

    Jakes, D.; Fresl, M.; Svoboda, V.

    1979-02-01

    The results of test runs of two design varieties of liquid sodium oxygenmeter in sodium loops are described. The accuracy and sensitivity are discussed reached using this instrument within 1 and 10 p.p.m. of oxygen concentration. A change in the used reference system is proposed based on practical experiences and thermochemical calculations. Ceramic electrolyte corrosion is analysed and the possible interpretation of the corrosion effect on the galvanic cell electromotive force is suggested. (author)

  20. Too Much Sodium

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.

  1. Attenuation of everolimus-induced cytotoxicity by a protective autophagic pathway involving ERK activation in renal cell carcinoma cells

    Science.gov (United States)

    Zeng, Yizhou; Tian, Xiaofang; Wang, Quan; He, Weiyang; Fan, Jing; Gou, Xin

    2018-01-01

    Aim The mammalian target of rapamycin (mTOR) pathway is a critical target for cancer treatment and the mTOR inhibitor everolimus (RAD001) has been approved for treatment of renal cell carcinoma (RCC). However, the limited efficacy of RAD001 has led to the development of drug resistance. Autophagy is closely related to cell survival and death, which may be activated under RAD001 stimulation. The aim of the present study was to identify the underlying mechanisms of RAD001 resistance in RCC cells through cytoprotective autophagy involving activation of the extracellular signal-regulated kinase (ERK) pathway. Methods and results: RAD001 strongly induced autophagy of RCC cells in a dose- and time-dependent manner, as confirmed by Western blot analysis. Importantly, suppression of autophagy by the pharmacological inhibitor chloroquine effectively enhanced RAD001-induced apoptotic cytotoxicity, as demonstrated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and Western blot analysis, indicating a cytoprotective role for RAD001-induced autophagy. In addition, as was shown by the MTT assay, flow cytometry, and Western blot analysis, RAD001 robustly activated ERK, but not c-Jun N-terminal kinase and p38. Activation of ERK was inhibited by the pharmacological inhibitor selumetinib (AZD6244), which effectively promoted RAD001-induced cell death. Moreover, employing AZD6244 markedly attenuated RAD001-induced autophagy and enhanced RAD001-induced apoptosis, which play a central role in RAD001-induced cell death. Furthermore, RAD001-induced autophagy is regulated by ERK-mediated phosphorylation of Beclin-1 and B-cell lymphoma 2, as confirmed by Western blot analysis. Conclusion These results suggest that RAD001-induced autophagy involves activation of the ERK, which may impair cytotoxicity of RAD001 in RCC cells. Thus, inhibition of the activation of ERK pathway-mediated autophagy may be useful to overcome chemoresistance to RAD001. PMID:29719377

  2. ONC201 Targets AR and AR-V7 Signaling, Reduces PSA, and Synergizes with Everolimus in Prostate Cancer.

    Science.gov (United States)

    Lev, Avital; Lulla, Amriti R; Ross, Brian C; Ralff, Marie D; Makhov, Petr B; Dicker, David T; El-Deiry, Wafik S

    2018-05-01

    Androgen receptor (AR) signaling plays a key role in prostate cancer progression, and androgen deprivation therapy (ADT) is a mainstay clinical treatment regimen for patients with advanced disease. Unfortunately, most prostate cancers eventually become androgen-independent and resistant to ADT with patients progressing to metastatic castration-resistant prostate cancer (mCRPC). Constitutively activated AR variants (AR-V) have emerged as mediators of resistance to AR-targeted therapy and the progression of mCRPC, and they represent an important therapeutic target. Out of at least 15 AR-Vs described thus far, AR-V7 is the most abundant, and its expression correlates with ADT resistance. ONC201/TIC10 is the founding member of the imipridone class of small molecules and has shown anticancer activity in a broad range of tumor types. ONC201 is currently being tested in phase I/II clinical trials for advanced solid tumors, including mCRPC, and hematologic malignancies. There has been promising activity observed in patients in early clinical testing. This study demonstrates preclinical single-agent efficacy of ONC201 using in vitro and in vivo models of prostate cancer. ONC201 has potent antiproliferative and proapoptotic effects in both castration-resistant and -sensitive prostate cancer cells. Furthermore, the data demonstrate that ONC201 downregulates the expression of key drivers of prostate cancer such as AR-V7 and downstream target genes including the clinically used biomarker PSA (KLK3). Finally, the data also provide a preclinical rationale for combination of ONC201 with approved therapeutics for prostate cancer such as enzalutamide, everolimus (mTOR inhibitor), or docetaxel. Implications: The preclinical efficacy of ONC201 as a single agent or in combination, in hormone-sensitive or castration-resistant prostate cancer, suggests the potential for immediate clinical translation. Mol Cancer Res; 16(5); 754-66. ©2018 AACR . ©2018 American Association for Cancer

  3. 18F-FDG and 18F-FLT-PET imaging for monitoring everolimus effect on tumor-growth in neuroendocrine tumors: studies in human tumor xenografts in mice.

    Directory of Open Access Journals (Sweden)

    Camilla Bardram Johnbeck

    Full Text Available The mTOR inhibitor everolimus has shown promising results in some but not all neuroendocrine tumors. Therefore, early assessment of treatment response would be beneficial. In this study, we investigated the in vivo and in vitro treatment effect of everolimus in neuroendocrine tumors and evaluated the performance of 18F-FDG and the proliferation tracer 18F-FLT for treatment response assessment by PET imaging.The effect of everolimus on the human carcinoid cell line H727 was examined in vitro with the MTT assay and in vivo on H727 xenograft tumors. The mice were scanned at baseline with 18F-FDG or 18F-FLT and then treated with either placebo or everolimus (5 mg/kg daily for 10 days. PET/CT scans were repeated at day 1,3 and 10.Everolimus showed significant inhibition of H727 cell proliferation in vitro at concentrations above 1 nM. In vivo tumor volumes measured relative to baseline were significantly lower in the everolimus group compared to the control group at day 3 (126±6% vs. 152±6%; p = 0.016, day 7 (164±7% vs. 226±13%; p<0.001 and at day 10 (194±10% vs. 281±18%; p<0.001. Uptake of 18F-FDG and 18F-FLT showed little differences between control and treatment groups, but individual mean uptake of 18F-FDG at day 3 correlated with tumor growth day 10 (r2 = 0.45; P = 0.034, 18F-FLT mean uptake at day 1 correlated with tumor growth day 7 (r2 = 0.63; P = 0.019 and at day 3 18F-FLT correlated with tumor growth day 7 (r2 = 0.87; P<0.001 and day 10 (r2 = 0.58; P = 0.027.Everolimus was effective in vitro and in vivo in human xenografts lung carcinoid NETs and especially early 18F-FLT uptake predicted subsequent tumor growth. We suggest that 18F-FLT PET can be used for tailoring therapy for neuroendocrine tumor patients through early identification of responders and non-responders.

  4. Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

    Science.gov (United States)

    Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

    2015-06-01

    Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- m

  5. Differentiated analysis of an everolimus-eluting stent and a paclitaxel-eluting stent among higher risk subgroups for restenosis: results from the SPIRIT II trial.

    Science.gov (United States)

    Khattab, Ahmed A; Richardt, Gert; Verin, Vitali; Kelbaek, Henning; Macaya, Carlos; Berland, Jacques; Miquel-Hebert, Karine; Dorange, Cécile; Serruys, Patrick W

    2008-03-01

    Restenosis is higher among certain subpopulations when subjected to percutaneous coronary interventions even when using drug-eluting stents. The randomised SPIRIT II trial demonstrated the superiority of the XIENCE V Everolimus Eluting Coronary Stent System over the TAXUS Paclitaxel-Eluting Stent System in terms of in-stent late loss at six months among 300 patients treated for de novo native coronary artery lesions. In this post-hoc analysis of SPIRIT II we focused on six-month angiographic outcomes of diabetic patients (n=69), left anterior descending arteries (n=149), long lesions >20 mm (n=43), small vessels B2 and C lesions (n=233). In-stent late loss was consistently less among all subgroups when treated by everolimus-eluting stents compared to paclitaxel-eluting stents: diabetics 0.15+/-0.26 mm versus 0.39+/-0.34 mm, p=0.006; LAD 0.12+/-0.23 mm versus 0.44+/-0.37 mm, pB2/C lesions 0.12+/-0.31 mm versus 0.36+/-0.36 mm, pSPIRIT II trial population.

  6. Sodium fires and its extinguishment

    International Nuclear Information System (INIS)

    Mikhedov, V.G.

    1979-01-01

    The fire safety problems of NPP with sodium coolants in USSR are presented. The design of sodium reactors is made with premises with sodium coolants being hermetic and filled with nitrogen. Some engineering solutions of fire safety including design, elaboration and choice of construction and protection materials are presented. Some theoretical aspects of sodium burning are presented as well as methods of sodium fire extinguishing methods including the use of powder

  7. A pilot study of JI-101, an inhibitor of VEGFR-2, PDGFR-β, and EphB4 receptors, in combination with everolimus and as a single agent in an ovarian cancer expansion cohort.

    Science.gov (United States)

    Werner, Theresa L; Wade, Mark L; Agarwal, Neeraj; Boucher, Kenneth; Patel, Jesal; Luebke, Aaron; Sharma, Sunil

    2015-12-01

    JI-101 is an oral multi-kinase inhibitor that targets vascular endothelial growth factor receptor type 2 (VEGFR-2), platelet derived growth factor receptor β (PDGFR-β), and ephrin type-B receptor 4 (EphB4). None of the currently approved angiogenesis inhibitors have been reported to inhibit EphB4, and therefore, JI-101 has a novel mechanism of action. We conducted a pilot trial to assess the pharmacokinetics (PK), tolerability, and efficacy of JI-101 in combination with everolimus in advanced cancers, and pharmacodynamics (PD), tolerability, and efficacy of JI-101 in ovarian cancer. This was the first clinical study assessing anti-tumor activity of JI-101 in a combinatorial regimen. In the PK cohort, four patients received single agent 10 mg everolimus on day 1, 10 mg everolimus and 200 mg JI-101 combination on day 8, and single agent 200 mg JI-101 on day 15. In the PD cohort, eleven patients received single agent JI-101 at 200 mg twice daily for 28 day treatment cycles. JI-101 was well tolerated as a single agent and in combination with everolimus. No serious adverse events were observed. Common adverse events were hypertension, nausea, and abdominal pain. JI-101 increased exposure of everolimus by approximately 22%, suggestive of drug-drug interaction. The majority of patients had stable disease at their first set of restaging scans (two months), although no patients demonstrated a response to the drug per RECIST criteria. The novel mechanism of action of JI-101 is promising in ovarian cancer treatment and further prospective studies of this agent may be pursued in a less refractory patient population or in combination with cytotoxic chemotherapy.

  8. Comparison of medical costs and healthcare resource utilization of post-menopausal women with HR+/HER2- metastatic breast cancer receiving everolimus-based therapy or chemotherapy: a retrospective claims database analysis.

    Science.gov (United States)

    Li, Nanxin; Hao, Yanni; Koo, Valerie; Fang, Anna; Peeples, Miranda; Kageleiry, Andrew; Wu, Eric Q; Guérin, Annie

    2016-01-01

    To analyze medical costs and healthcare resource utilization (HRU) associated with everolimus-based therapy or chemotherapy among post-menopausal women with hormone-receptor-positive, human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Patients with HR+/HER2- mBC who discontinued a non-steroidal aromatase inhibitor and began a new line of treatment with everolimus-based therapy or chemotherapy (index therapy/index date) between July 20, 2012 and April 30, 2014 were identified from two large claims databases. All-cause, BC-related, and adverse event (AE)-related medical costs (in 2014 USD) and all-cause HRU per patient per month (PPPM) were analyzed for both treatment groups across patients' first four lines of therapies for mBC. Adjusted differences in costs and HRU between the everolimus and chemotherapy treatment group were estimated pooling all lines and using multivariable generalized linear models, accounting for difference in patient characteristics. A total of 3298 patients were included: 902 everolimus-treated patients and 2636 chemotherapy-treated patients. Compared to chemotherapy, everolimus was associated with significantly lower all-cause (adjusted mean difference = $3455, p well as significantly lower HRU (emergency room incidence rate ratio [IRR] = 0.83; inpatient IRR = 0.74; inpatient days IRR = 0.65; outpatient IRR = 0.71; BC-related outpatient IRR = 0.57; all p chemotherapy.

  9. Development of sodium technology

    International Nuclear Information System (INIS)

    Hwang, Sung Tai; Nam, H. Y.; Choi, Y. D.

    2000-05-01

    The objective of present study is to produce the experimental data for development and verification of computer codes for development of LMR and to develop the preliminary technologies for the future large scale verification experiments. A MHD experimental test loop has been constructed for the quantitative analysis of the effect of magnetic field on the sodium flow and experiments are carried out for three EM pumps. The previous pressure drop correlations are evaluated using the experimental data obtained from the pressure drop experiment in a 19-pin fuel assembly with wire spacer. An dimensionless variable is proposed to describe the amplitude and frequency of the fluctuation of free surface using the experimental data obtained from free surface experimental apparatus and an empirical correlation is developed using this dimensionless variable. An experimental test loop is constructed to measure the flow characteristics in IHX shell side and the local pressure drop in fuel assembly, and to test the vibration behaviour of fuel pins due to flow induced vibration. The sodium two-phase flow measuring technique using the electromagnetic flowmeter is developed and the sodium differential pressure drop measuring technique using the method of direct contact of sodium and oil is established. The work on the analysis of sodium fire characteristics and produce data for vlidation of computer code is performed. Perfect reopen time of self plugged leak path was observed to be about 130 minutes after water leak initiation. Reopen shape of a specimen appeared to be double layer of circular type, and reopen size of this specimen surface was about 2mm diameter on sodium side. In small water leakage experiments, the following correlation equation about the reopen time between sodium temperature and initial leak rate was obtained, τ c = δ·g -0.83 ·10 (3570/T Na -3.34) , in 400-500 deg C of liquid sodium atmosphere. The characteristics of pressure propagation and gas flow, and

  10. Development of sodium technology

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Sung Tai; Nam, H Y; Choi, Y D [and others

    2000-05-01

    The objective of present study is to produce the experimental data for development and verification of computer codes for development of LMR and to develop the preliminary technologies for the future large scale verification experiments. A MHD experimental test loop has been constructed for the quantitative analysis of the effect of magnetic field on the sodium flow and experiments are carried out for three EM pumps. The previous pressure drop correlations are evaluated using the experimental data obtained from the pressure drop experiment in a 19-pin fuel assembly with wire spacer. An dimensionless variable is proposed to describe the amplitude and frequency of the fluctuation of free surface using the experimental data obtained from free surface experimental apparatus and an empirical correlation is developed using this dimensionless variable. An experimental test loop is constructed to measure the flow characteristics in IHX shell side and the local pressure drop in fuel assembly, and to test the vibration behaviour of fuel pins due to flow induced vibration. The sodium two-phase flow measuring technique using the electromagnetic flowmeter is developed and the sodium differential pressure drop measuring technique using the method of direct contact of sodium and oil is established. The work on the analysis of sodium fire characteristics and produce data for vlidation of computer code is performed. Perfect reopen time of self plugged leak path was observed to be about 130 minutes after water leak initiation. Reopen shape of a specimen appeared to be double layer of circular type, and reopen size of this specimen surface was about 2mm diameter on sodium side. In small water leakage experiments, the following correlation equation about the reopen time between sodium temperature and initial leak rate was obtained, {tau}{sub c} = {delta}{center_dot}g{sup -0.83}{center_dot}10{sup (3570/T{sub Na}-3.34)}, in 400-500 deg C of liquid sodium atmosphere. The characteristics

  11. Sodium fire tests for investigating the sodium leak in Monju

    International Nuclear Information System (INIS)

    Seino, Hiroshi; Miyahara, Shinya; Miyake, Osamu; Tanabe, Hiromi

    1996-01-01

    As a part of the work for investigating the sodium leak accident which occurred in Monju on December 8, 1995, three tests, (1) sodium leak test, (2) sodium fire test-I, and (3) sodium fire test-II, were carried out at OEC/PNC. Main objectives of these tests are to confirm leak and burning behavior of sodium from the damaged thermometer, and effects of the sodium fire on integrity of the surrounding structure, etc. The main conclusions obtained from the tests are shown as below. 1) Average sodium leak rate obtained from the sodium leak test was about 50 g/sec. This was equivalent to the value estimated from level change in the sodium overflow tank in the Monju accident. 2) Observation from video cameras in the sodium fire tests revealed that in early stages of sodium leak, sodium dropped down out of the flexible tube of thermometer in drips. This dripping and burning were expanded in range as sodium splashed on the duct. 3) Though, in the sodium fire test-I, there was a decrease of about 1 mm at a thickness of the burning pan in the vicinity in just under in the leak point, there were completely no crack and failure. In the meantime, in the sodium fire test-II the six open holes were found in the floor liner. By this liner failure, the reaction between sodium and concrete might take place. At present, while the detailed evaluation on the sodium fire test-II has been mainly carried out, the investigation for clarifying the cause of the liner failure has been also carried out. (author)

  12. The combustion of sodium

    International Nuclear Information System (INIS)

    Newman, R.N.

    1978-01-01

    The burning rates of sodium in the form of vapour jets, droplets, sprays and unconfined and confined pools have been reviewed. Attention has been paid to assessing the value of models in the various combustion modes. Additional models have been constructed for the descriptions of laminar and turbulent vapour jets, stationary droplets, forced convection over ambient pool fires together with correlations for peak pressures in confined pool environments. Where appropriate experiments with sodium have not been conducted, the likely behaviour is predicted by comparison with the burning of other fuels, particularly in the field of large free ambient fires. Some areas where further knowledge is required are highlighted. (author)

  13. Sodium cooled fast reactor

    Energy Technology Data Exchange (ETDEWEB)

    Hokkyo, N; Inoue, K; Maeda, H

    1968-11-21

    In a sodium cooled fast neutron reactor, an ultrasonic generator is installed at a fuel assembly hold-down mechanism positioned above a blanket or fission gas reservoir located above the core. During operation of the reactor an ultrsonic wave of frequency 10/sup 3/ - 10/sup 4/ Hz is constantly transmitted to the core to resonantly inject the primary bubble with ultrasonic energy to thereby facilitate its growth. Hence, small bubbles grow gradually to prevent the sudden boiling of sodium if an accident occurs in the cooling system during operation of the reactor.

  14. Too Much Sodium

    Centers for Disease Control (CDC) Podcasts

    2012-02-07

    This podcast is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.  Created: 2/7/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/7/2012.

  15. The SPIRIT V study: a clinical evaluation of the XIENCE V everolimus-eluting coronary stent system in the treatment of patients with de novo coronary artery lesions.

    Science.gov (United States)

    Grube, Eberhard; Chevalier, Bernard; Smits, Peter; Džavík, Vladimir; Patel, Tejas M; Mullasari, Ajit S; Wöhrle, Jochen; Stuteville, Marrianne; Dorange, Cécile; Kaul, Upendra

    2011-02-01

    The SPIRIT V (A Clinical Evaluation of the XIENCE V Everolimus-Eluting Coronary Stent System in the Treatment of Patients With De Novo Coronary Artery Lesions) study is a post-market surveillance experience of the XIENCE V (Abbott Vascular, Santa Clara, California) everolimus-eluting stent (EES) in patients with higher-risk coronary anatomy. Previous pre-approval studies have shown the safety and efficacy of EES in highly selected groups of patients. The SPIRIT V trial is a prospective, open label, single arm, multicenter study. Two thousand seven hundred patients with multiple de novo coronary artery lesions suitable for treatment with a planned maximum of 4 EES were enrolled at 93 centers in Europe, Asia Pacific, Canada, and South Africa. Lesions had a reference vessel diameter between 2.25 and 4.0 mm and a length of ≤ 28 mm by visual estimation. An independent clinical events committee adjudicated all end point-related events. The primary end point was the composite rate of all death, myocardial infarction (MI), and target vessel revascularization at 30 days. Secondary end points included stent thrombosis and acute success (clinical device and procedure success). At 30 days, the primary composite end point of all death, MI, and target vessel revascularization was 2.7%. At 1 year, rates of cardiac death, overall MI, and target lesion revascularization were 1.1%, 3.5%, and 1.8%, respectively. The cumulative rate of definite and probable stent thrombosis was low at 0.66% at 1 year. Use of EES in patients with multiple, complex de novo lesions yielded 1-year major adverse cardiac events, stent thrombosis, and target lesion revascularization rates that are comparable to those of the more controlled SPIRIT II and SPIRIT III trials-which included patients with restricted inclusion/exclusion criteria-and other all-comer population, physician-initiated studies like the X-SEARCH (Xience Stent Evaluated At Rotterdam Cardiology Hospital) and COMPARE (A Randomized

  16. Sorafenib and everolimus for patients with unresectable high-grade osteosarcoma progressing after standard treatment: a non-randomised phase 2 clinical trial.

    Science.gov (United States)

    Grignani, Giovanni; Palmerini, Emanuela; Ferraresi, Virginia; D'Ambrosio, Lorenzo; Bertulli, Rossella; Asaftei, Sebastian Dorin; Tamburini, Angela; Pignochino, Ymera; Sangiolo, Dario; Marchesi, Emanuela; Capozzi, Federica; Biagini, Roberto; Gambarotti, Marco; Fagioli, Franca; Casali, Paolo Giovanni; Picci, Piero; Ferrari, Stefano; Aglietta, Massimo

    2015-01-01

    Results of previous study showed promising but short-lived activity of sorafenib in the treatment of patients with unresectable advanced and metastatic osteosarcoma. This treatment failure has been attributed to the mTOR pathway and might therefore be overcome with the addition of mTOR inhibitors. We aimed to investigate the activity of sorafenib in combination with everolimus in patients with inoperable high-grade osteosarcoma progressing after standard treatment. We did this non-randomised phase 2 trial in three Italian Sarcoma Group centres. We enrolled adults (≥18 years) with relapsed or unresectable osteosarcoma progressing after standard treatment (methotrexate, cisplatin, and doxorubicin, with or without ifosfamide). Patients received 800 mg sorafenib plus 5 mg everolimus once a day until disease progression or unacceptable toxic effects. The primary endpoint was 6 month progression-free survival (PFS). All analyses were intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT01804374. We enrolled 38 patients between June 16, 2011, and June 4, 2013. 17 (45%; 95% CI 28-61) of 38 patients were progression free at 6 months. Toxic effects led to dose reductions, or short interruptions, or both in 25 (66%) of 38 patients and permanent discontinuation for two (5%) patients. The most common grade 3-4 adverse events were lymphopenia and hypophosphataemia each in six (16%) patients, hand and foot syndrome in five (13%), thrombocytopenia in four (11%), and fatigue, oral mucositis, diarrhoea, and anaemia each in two (5%). One patient (3%) had a grade 3 pneumothorax that required trans-thoracic drainage, and that recurred at the time of disease progression. This was reported as a serious adverse event related to the study drugs in both instances. No other serious adverse events were reported during the trial. There were no treatment-related deaths. Although the combination of sorafenib and everolimus showed activity as a further-line treatment

  17. Sodium fluxes in sweet pepper exposed to varying sodium concentrations

    NARCIS (Netherlands)

    Blom-Zandstra, M.; Vogelzang, S.A.; Veen, B.W.

    1998-01-01

    The sodium transport and distribution of sweet pepper (Capsicum annuum L.) under saline conditions were studied after transferring the plants to a sodium-free nutrient solution. Sodium stress up to 60 mM did not affect the growth of sweet pepper, as it appears able to counteract the unfavourable

  18. Sodium hydride precipitation in sodium cold traps

    International Nuclear Information System (INIS)

    McPheeters, C.C.; Raue, D.J.

    1979-10-01

    A series of experiments have been performed to test a calculational model for precipitation of NaH in sodium cold traps. The calculational model, called ACTMODEL, is a computer simulation that uses the system geometry and operating conditions as input to calculate a mass transfer coefficient and the distribution of NaH in a cold trap. The ACTMODEL was tested using an analytical cold trap (ACT) that is simple and essentially one-dimensional. The ACT flow and temperature profile may be controlled at any desired condition. The ACT was analyzed destructively after each test to measure the actual NaH distribution. Excellent agreement was obtained between the ACTMODEL simulations and the experiments

  19. Sodium hydride precipitation in sodium cold traps

    International Nuclear Information System (INIS)

    McPheeters, C.C.; Raue, D.J.

    1980-06-01

    A series of experiments have been performed to test a calculational model for precipitation of NaH in sodium cold traps. The calculational model, called ACTMODEL, is a computer simulation that uses the system geometry and operating conditions as input to calculate a mass-transfer coefficient and the distribution of NaH in a cold trap. The ACTMODEL was tested using an analytical cold trap (ACT) that is simple and essentially one-dimensional. The ACT flow and temperature profile can be controlled at any desired condition. The ACT was analyzed destructively after each test to measure the actual NaH distribution. Excellent agreement was obtained between the ACTMODEL simulations and the experiments. Mass-transfer coefficients ranging upward from 6 x 10 -5 m/s were measured in both packless and packed traps. As much as a fourfold increase in precipitation surface area was observed with increasing amount of NaH deposited. 11 figures, 2 tables

  20. Thermophysical properties of sodium

    International Nuclear Information System (INIS)

    Harant, M.

    1978-01-01

    Substitution, inverse and substitution inverse relations in form of regression polynomials were used in calculating saturation pressure and density for thermodynamic and transport properties determination of sodium. Program UNISOAUT/A3 was used in calculating regression polynomials coefficients. (J.P.)

  1. Extinction of sodium fires

    International Nuclear Information System (INIS)

    Malet, J.C.; Spagna, F.

    1989-01-01

    This paper presents how, starting from a knowledge of sodium ignition and burning, principles for extinction (smothering catch trays, leak recuperation systems, powders) can be developed. These techniques applied in Superphenix 1 and PEC reactors have been tested in the ESMERALDA experimental program which is a joint French/Italian project. (author)

  2. Decomposition of Sodium Tetraphenylborate

    International Nuclear Information System (INIS)

    Barnes, M.J.

    1998-01-01

    The chemical decomposition of aqueous alkaline solutions of sodium tetraphenylborate (NaTPB) has been investigated. The focus of the investigation is on the determination of additives and/or variables which influence NaTBP decomposition. This document describes work aimed at providing better understanding into the relationship of copper (II), solution temperature, and solution pH to NaTPB stability

  3. Sodium purification in Rapsodie

    International Nuclear Information System (INIS)

    Giraud, B.

    1968-01-01

    This report is one of a series of publications presenting the main results of tests carried out during the start-up of the first french fast neutron reactor: Rapsodie. The article presents the sodium purification techniques used in the reactor cooling circuits both from the constructional point of view and with respect to results obtained during the first years working. (author) [fr

  4. The medical sodium chloride

    International Nuclear Information System (INIS)

    Mirsaidov, U.M.

    2002-01-01

    In the institute was investigated the chemical composition of rock salt of some deposits of Tajikistan and was show the presence in it admixture of ions of Ca 2 + , Mg 2 + a nd SO 2 - a nd absence of heavy metals, ammonium salts, iron, potassium and arsenic. Was elaborated the fundamental instrument-technologic scheme of sodium chloride receiving

  5. Creep in sodium

    International Nuclear Information System (INIS)

    Charnock, W.; Cordwell, J.E.

    1978-03-01

    Available information on the creep of austenitic, ferritic and Alloy-800 type steels in liquid sodium is critically reviewed. Creep properties of stainless steels can be affected by element transfer and corrosion. At reactor structural component temperatures environmental effects are likely to be less important than changes due to thermal ageing. At high clad temperatures (700 0 C) decarburisation may cause the loss of strength and ductility in unstabilised steels while cavity formation may cause embrittlement in stabilised steels. The properties of Alloy 800 are, in some experiments, found to deteriorate while in others they are enhanced. This may be a consequence of the metallurgical complexity of the material or arise from the nature of the various techniques employed. Low alloy ferritic steels tend to decarburise in sodium at temperatures greater than 500 0 C and this leads to loss of strength and an increase in ductility. High alloy ferritics are immune to this effect and appear to be able to tolerate a degree of carburisation. Although intergranular cracking may be enhanced in liquid sodium the mechanical consequences are not significant and evidence for the existence of an embrittlement effect not associated with element transfer or corrosion is weak. Stress and strain may enhance element transfer at crack tips. However in real cracks the gettering or supply action of the crack faces conditions the chemistry of the cracks in sodium and protects the crack tip from element transfer. Thus creep crack extension rates should be independent of changes in bulk coolant chemistry. (author)

  6. Technology for sodium purity control

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Ji Young; Kim, B. H.; Kim, T. J. [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-10-01

    When sodium is used as heat transfer fluid, the plugging in coolant flow, the corrosion of structure material and the transfer of radioactive material caused by the impurities in sodium are worth considerable. Accordingly, these impurities must be monitored and controlled continuously by sodium purification devices in the heat transfer system which sodium is used as coolant. Sodium purification loop was constructed for the purpose of accumulating the technology for purity control of the coolant, developing and verifying further efficient instruments for sodium purification. The plugging meter and the cold trap is used as the implement for measuring and controlling the oxygen and the hydrogen, the main impurities in sodium coolant. They are capable of excellent performance as the implements which could detect and monitor the impurities to the concentration limit required for nuclear reactor. Sodium purification loop could be used variably according to the experimental purpose. 18 refs., 34 figs., 8 tabs. (Author)

  7. Slicing sodium from bakery products

    NARCIS (Netherlands)

    Noort, M.

    2012-01-01

    The need for sodium reduction in our diet is clear to consumers, dieticians and food manufacturers. As sodium concentration has a strengthening effect on gluten, sodium reduction decreases dough mixing tolerance, dough resistance and induces dough stickiness. In particular, the latter may cause

  8. Safety measuring for sodium handling

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Ji Young; Jeong, K C; Kim, T J; Kim, B H; Choi, J H

    2001-09-01

    This is the report for the safety measures of sodium handling. These contents are prerequisites for the development of sodium technology and thus the workers participate in sodium handling and experiments have to know them perfectly. As an appendix, the relating parts of the laws are presented.

  9. Comparison of Outcomes in Patients With Versus Without Diabetes Mellitus After Revascularization With Everolimus- and Sirolimus-Eluting Stents (from the SORT OUT IV Trial)

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Junker, Anders

    2012-01-01

    Diabetes is associated with increased risk of major adverse cardiac events (MACEs) after percutaneous coronary intervention. The purpose of this substudy of the SORT OUT IV trial was to compare clinical outcomes in patients with and without diabetes mellitus treated with everolimus-eluting stents...... (EESs) or sirolimus-eluting stents (SESs). In total 2,774 patients (390 with diabetes, 14.1%) were randomized to stent implantation with EESs (n = 1,390, diabetes in 14.0%) or SESs (n = 1,384, diabetes in 14.2%). Randomization was stratified by presence/absence of diabetes. The primary end point...... was MACEs, a composite of cardiac death, myocardial infarction, definite stent thrombosis, or target vessel revascularization within 18 months. MACEs were higher in diabetic than in nondiabetic patients (13.1% vs 6.4%, hazard ratio [HR] 2.08, 95% confidence interval [CI] 1.51 to 2.86). In diabetic patients...

  10. An everolimus-eluting stent versus a paclitaxel-eluting stent in small vessel coronary artery disease: a pooled analysis from the SPIRIT II and SPIRIT III trials.

    Science.gov (United States)

    Bartorelli, Antonio L; Serruys, Patrick W; Miquel-Hébert, Karine; Yu, Shui; Pierson, Wes; Stone, Gregg W

    2010-07-01

    To evaluate the safety and efficacy of the XIENCE V everolimus-eluting stent compared to the TAXUS paclitaxel-eluting stent in small vessels. The XIENCE V everolimus-eluting stent (EES) has been shown to improve angiographic and clinical outcomes after percutaneous myocardial revascularization, but its performance in small coronary arteries has not been investigated. In this pooled analysis, we studied a cohort of 541 patients with small coronary vessels (reference diameter SPIRIT II and SPIRIT III studies. TAXUS Express (73% of lesions) and TAXUS Liberté (27% of lesions) paclitaxel-eluting stents (PES) were used as controls in SPIRIT II. In SPIRIT III, Taxus Express(2) PES was the control. Mean angiographic in-stent and in-segment late loss was significantly less in the EES group compared with the PES group, (0.15 +/- 0.37 mm vs. 0.30 +/- 0.44 mm; P = 0.011 for in-stent; 0.10 +/- 0.38 mm vs. 0.21 +/- 0.34 mm; P = 0.034 for in-segment). EES also resulted in a significant reduction in composite major adverse cardiac events at 1 year (19/366 [5.2%] vs. 17/159 [10.7%]; P = 0.037), due to fewer non-Q-wave myocardial infarctions and target lesion revascularizations. At 1 year, the rate of non-Q-wave myocardial infarction was significantly lower in the EES group compared with that of the PES group (6/366 [1.6%] vs. 8/159 [5.0%]; P = 0.037). In patients with small vessel coronary arteries, the XIENCE V EES was superior to the TAXUS PES. (c) 2010 Wiley-Liss, Inc.

  11. Serial optical coherence tomography assessment of malapposed struts after everolimus-eluting stent implantation. A subanalysis from the HEAL-EES study

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Kohki [Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona (Spain); Otsuki, Shuji [Division of Cardiology, Teikyo University Hospital, Tokyo (Japan); Giacchi, Giuseppe; Ortega-Paz, Luis [Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona (Spain); Shiratori, Yoshitaka [Division of Cardiology, Teikyo University Hospital, Tokyo (Japan); Freixa, Xavier; Martín-Yuste, Victoria; Masotti, Mónica; Sabaté, Manel [Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona (Spain); Brugaletta, Salvatore, E-mail: sabrugal@clinic.ub.es [Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona (Spain)

    2017-01-15

    Background: Incomplete stent apposition (ISA) is related to stent thrombosis, which is a serious adverse event. We aim to assess the time-course of ISA after 2nd generation everolimus-eluting stent (EES) implantation. Methods: In HEAL-EES study, we enrolled 36 patients who underwent percutaneous coronary intervention (PCI) with EES. OCT imaging was performed at baseline and follow-up. Patients were randomized 1:1:1 into 3 groups according to the time in which follow-up was performed: group A (6-month), group B (9-month), and group C (12-month). In this subanalysis, patients who had ISA segments at baseline and/or follow-up OCT were analyzed. Result: At baseline, among 41 lesions in 36 patients, 20 lesions in 18 patients had ISA segments and were analyzed. At baseline, there were 3.0% ISA struts in group A (n = 8), 2.8% in group B (n = 4), and 4.5% in group C (n = 8). At follow-up, ISA struts were present in 0.09%, 0.16% and 0.64%; respectively in groups A, B, and C. At follow-up, there was a significant decrease in the frequency of ISA: group A 3.0% vs. 0.09% (p < 0.001), group B 2.8% vs. 0.16% (p < 0.001), and group C 4.5% vs. 0.64% (p < 0.001). In group A, there was one late acquired ISA at follow-up. Conclusions: In patients undergoing 2nd generation EES implantation, area of acute ISA assessed by OCT, was almost resolved at 6-month follow-up. - Highlights: • Time-course of incomplete stent apposition of everolimus-eluting stent was assessed. • Serial optical coherence tomography images at baseline and follow-up were evaluated. • Acute incomplete stent apposition was almost resolved as early as at 6 months.

  12. Overtime evaluation of the vascular HEALing process after everolimus-eluting stent implantation by optical coherence tomography. The HEAL-EES study

    Energy Technology Data Exchange (ETDEWEB)

    Otsuki, Shuji; Brugaletta, Salvatore, E-mail: sabrugal@clinic.ub.es; Sabaté, Manel; Shiratori, Yoshitaka; Gomez-Monterrosas, Omar; Scalone, Giancarla; Romero-Villafañe, Sebastian; Hernández-Enríquez, Marco; Freixa, Xavier; Martín-Yuste, Victoria; Masotti, Mónica

    2016-06-15

    Purpose: Second-generation drug-eluting stent (DES) have shown a better safety and efficacy as compared to first generation DES due to an improved vascular healing process. This process has not been so far evaluated in vivo in an overtime fashion by optical coherent tomography (OCT). We sought to evaluate the vascular healing process after everolimus-eluting stent (EES) implantation at 6, 9 and 12 months, by OCT. Methods: Consecutive 36 patients undergoing percutaneous coronary intervention with EES were randomized 1:1:1 to receive OCT imaging at 6 (group A), 9 (group B) or 12-month follow-up (group C). One patient from group C was excluded because of target lesion revascularization at 1-month, whereas 5 patients withdraw the informed consent. Finally, 30 patients were analyzed. Results: Neointimal thickness was not different between 3 groups (group A: 99.50 [94.06–127.79] μm, group B: 107.26 [83.48–133.59] μm, group C: 127.67 [102.51–138.49] μm; p = 0.736). Although the percentage of “uncovered struts” was significantly higher in group A as compared to the other groups (8.0% vs. 4.4% vs. 2.9%, respectively; p = 0.180), the ratio of uncovered to total struts per section < 30% was similar between 3 groups (0.3% vs. 0.3% vs. 0%, respectively; p = 1.000). Conclusion: Healing process following EES implantation seems almost completed at 6-month follow-up. These data, which need to be confirmed in a larger study, may support the decision to shorten dual antiplatelet therapy. - Highlights: • Healing process following everolimus-eluting stent implantation is complete at 6-month • There are no difference in RUTTS > 30% between 6, 9 and 12 months analyses. • This finding may support to shorten dual antiplatelet therapy in this context.

  13. Specialists' meeting on sodium fires

    Energy Technology Data Exchange (ETDEWEB)

    Kozlov, F A; Kuznetsova, R I [eds.

    1989-07-01

    The four sessions of the meeting covered the following topics: 1. general approach to fast reactor safety, standards of fire safety, maximum design basis accidents for sodium leaks and fires, status of sodium fires in different countries; 2. physical and chemical processes during combustion of sodium and its interaction with structural and technological materials and methods for structural protection; 3. methods of sodium fires extinguishing and measures for localizing aerosol combustion products, organization of fire fighting procedures, instruction and training of fire personnel; 4. elimination of the consequences of sodium fires.

  14. Specialists' meeting on sodium fires

    International Nuclear Information System (INIS)

    Kozlov, F.A.; Kuznetsova, R.I.

    1989-01-01

    The four sessions of the meeting covered the following topics: 1. general approach to fast reactor safety, standards of fire safety, maximum design basis accidents for sodium leaks and fires, status of sodium fires in different countries; 2. physical and chemical processes during combustion of sodium and its interaction with structural and technological materials and methods for structural protection; 3. methods of sodium fires extinguishing and measures for localizing aerosol combustion products, organization of fire fighting procedures, instruction and training of fire personnel; 4. elimination of the consequences of sodium fires

  15. Development of Sodium Technology

    International Nuclear Information System (INIS)

    Choi, Jong Hyun; Nam, H. Y.; Kim, T. J.; Jeong, K. C.; Park, J. H.; Kim, B. H.; Jeong, J. Y.; Kim, J. M.; Choi, B. H.; Kim, B. S.

    2003-02-01

    The basic P and ID and fabrication method for IHTS simplification experiment were prepared for the experimental apparatus. In order to investigate the later phase of a SWR event, an experimental apparatus was designed and manufactured. The 620 data set have been obtained in the experiment of free surface fluctuation and an experimental correlation for the critical gas entertainment condition is additionally developed. For development of water into sodium leak detection technology, the properties from leak noises were extracted, and the tools for analyzing acoustic noises were constructed. The state-of-the-art on the flow and differential pressure measuring techniques in the piping system is investigated to develop new techniques which are applicable to high temperature sodium flow environment. The plan for the minimization of errors in temperature measurement was drawn up by analysing the error factors in temperature measurement. And the countermeasures for the minimization of errors in temperature measurement due to complex heat transfer were prepared

  16. Sodium conducting polymer electrolytes

    Energy Technology Data Exchange (ETDEWEB)

    Skaarup, S.; West, K. (eds.)

    1989-04-01

    This section deals with the aspects of ionic conduction in general as well as specific experimental results obtained for sodium systems. The conductivity as a function of temperature and oxygen/metal ratio are given for the systems NaI, NaCF/sub 3/SO/sub 3/ and NaClO/sub 4/ plus polyethylene oxide. Attempts have been made to produce mixed phase solid electrolytes analogous to the lithium systems that have worked well. These consist of mixtures of polymer and a solid electrolyte. The addition of both nasicon and sodium beta alumina unexpectedly decreases the ionic conductivity in contrast to the lithium systems. Addition of the nonconducting silica AEROSIL in order to increase the internal surface area has the effect of retarding the phase transition at 60 deg. C, but does not enhance the conductivity. (author) 23 refs.

  17. Prevention of everolimus-related stomatitis in women with hormone receptor-positive, HER2-negative metastatic breast cancer using dexamethasone mouthwash (SWISH): a single-arm, phase 2 trial.

    Science.gov (United States)

    Rugo, Hope S; Seneviratne, Lasika; Beck, J Thaddeus; Glaspy, John A; Peguero, Julio A; Pluard, Timothy J; Dhillon, Navneet; Hwang, Leon Christopher; Nangia, Chaitali; Mayer, Ingrid A; Meiller, Timothy F; Chambers, Mark S; Sweetman, Robert W; Sabo, J Randy; Litton, Jennifer K

    2017-05-01

    Stomatitis is a class effect associated with the inhibition of mTOR and is associated with everolimus therapy for breast cancer. Topical steroids might reduce stomatitis incidence and severity, and the need for dose reductions and interruptions of everolimus. Anecdotal use of topical steroid oral prophylaxis has been reported in patients with breast cancer. We aimed to assess dexamethasone-based mouthwash for prevention of stomatitis in patients with breast cancer. This US-based, multicentre, single-arm, phase 2 prevention study enrolled women aged 18 years and older with postmenopausal status who had histologically or cytologically confirmed metastatic hormone receptor-positive, HER2-negative breast cancer. Beginning on day 1 of cycle 1, patients received everolimus 10 mg plus exemestane 25 mg daily, with 10 mL of alcohol-free dexamethasone 0·5 mg per 5 mL oral solution (swish for 2 min and spit, four times daily for 8 weeks). After 8 weeks, dexamethasone mouthwash could be continued for up to eight additional weeks at the discretion of the clinician and patient. The primary endpoint was incidence of grade 2 or worse stomatitis by 8 weeks assessed in the full analysis set (patients who received at least one dose of everolimus and exemestane and at least one confirmed dose of dexamethasone mouthwash) versus historical controls from the BOLERO-2 trial (everolimus and exemestane treatment in patients with hormone receptor-positive advanced breast cancer who were not given dexamethasone mouthwash for prevention of stomatitis). This trial is registered at ClinicalTrials.gov, number NCT02069093. Between May 28, 2014, and Oct 8, 2015, we enrolled 92 women; 85 were evaluable for efficacy. By 8 weeks, the incidence of grade 2 or worse stomatitis was two (2%) of 85 patients (95% CI 0·29-8·24), versus 159 (33%) of 482 patients (95% CI 28·8-37·4) for the duration of the BOLERO-2 study. Overall, 83 (90%) of 92 patients had at least one adverse event. The most frequently

  18. Intimal hyperplasia and vascular remodeling after everolimus-eluting and sirolimus-eluting stent implantation in diabetic patients the randomized diabetes and drug-eluting stent (DiabeDES) IV intravascular ultrasound trial

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Maeng, Michael; Thayssen, Per

    2013-01-01

    OBJECTIVE: To evaluate the effects of the everolimus-eluting Xience™/Promus™ stent (EES) and the sirolimus-eluting Cypher™ stent (SES) on intimal hyperplasia (IH) in diabetic patients. BACKGROUND: Patients with diabetes mellitus have increased risk of in-stent restenosis after coronary stent...... implantation due to intimal hyperplasia (IH). METHODS: In a sub study of the Randomized Comparison of Everolimus-Eluting and Sirolimus-Eluting Stents in Patients Treated with Percutaneous Coronary Intervention (SORT OUT IV trial), serial intravascular ultrasound (IVUS) 10-month follow-up data were available...... in 88 patients, including 48 EES and 40 SES treated patients. IVUS endpoints included IH volume, in-stent % volume obstruction and changes in external elastic membrane (EEM) volume. RESULTS: Compared with the SES group, IH volume was increased in the EES group [median (interquartile range): 2.8 mm(3) (0...

  19. Activation of phosphoinositide 3-kinase/Akt/mechanistic target of rapamycin pathway and response to everolimus in endocrine receptor-positive metastatic breast cancer – A retrospective pilot analysis and viewpoint

    Directory of Open Access Journals (Sweden)

    Jyoti Bajpai

    2017-01-01

    Full Text Available Introduction: Biomarkers predictive of response to mechanistic target of rapamycin (mTOR inhibitor, everolimus, in endocrine receptor (ER-positive metastatic breast cancer (MBC are a work in progress. We evaluated the feasibility of directly measuring mTOR activity and phosphatase and tensin homolog (PTEN expression and correlating their expression with response and survival. Materials and Methods: MBC patients who received everolimus with endocrine therapy (ET after progression on an aromatase inhibitor and had adequate tissue preservation for estimation of mTOR activity and PTEN expression were selected for analysis from a prospectively maintained database. Progression-free survival (PFS and overall survival (OS were estimated by Kaplan–Meier method, and correlation between mTOR activity and PTEN expression with survival was done by log-rank test. Results: Thirteen ER-positive MBC patients were available for analysis. PTEN expression was lost in 11/13 (84.6% patients and retained in 2/13 patients (15.4%. mTOR activity was absent in four patients (30.7%, weak in six patients (46.1%, and moderate in 3 patients (23.2%. Median PFS for the entire population was 2.5 months while median OS was not reached. Patients with an absent mTOR activity showed a longer PFS (5 vs. 1.5 vs. 2 months than those with weak and moderate activity, respectively (P = 0.043. There was no correlation between loss of PTEN expression and PFS. Conclusions: Measurement of direct mTOR activity in patients with MBC receiving everolimus/ET combination appears feasible. Absent mTOR activity may predict for longer PFS with everolimus-ET combination and requires further study.

  20. Patient-reported outcomes in a phase iii study of everolimus versus placebo in patients with metastatic carcinoma of the kidney that has progressed on vascular endothelial growth factor receptor tyrosine kinase inhibitor therapy.

    Science.gov (United States)

    Beaumont, Jennifer L; Butt, Zeeshan; Baladi, Jeanfrancois; Motzer, Robert J; Haas, Tomas; Hollaender, Norbert; Kay, Andrea; Cella, David

    2011-01-01

    A phase III, randomized, double-blind, placebo-controlled trial was conducted in patients with metastatic renal cell carcinoma. The focus of this paper is to evaluate the patient-reported outcomes. Patients were randomly assigned (2:1) to receive oral everolimus 10 mg once daily or placebo. The Functional Assessment of Cancer Therapy Kidney Symptom Index-Disease-Related Symptoms (FKSI-DRS) and European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30 were administered before randomization and on day 1 of each cycle. The FKSI-DRS and the EORTC QLQ-C30 Physical Functioning and Global Quality of Life scores were the primary endpoints examined. Longitudinal models were used to compare treatment arms. Sensitivity analyses were conducted to explore the impact of missing data assumptions. Longitudinal trends for FKSI-DRS scores did not differ by treatment arm. Taking nonignorable missing data into account, there were significant differences between treatment arms in the trend over time for physical functioning and global quality of life, with the everolimus arm exhibiting greater decreases. All three of these measures of health-related quality of life were significantly related to progression-free survival. There was no evidence of a difference between everolimus and placebo in longitudinal patterns of disease-related symptoms, and little difference between the arms in physical functioning or global quality of life trends. This supports the conclusion that delay in tumor progression demonstrated by everolimus is associated with minimal impact on symptoms, physical functioning, or quality of life, as reported by patients.

  1. A study on sodium-concrete reaction

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Heum; Min, Byong Hun [Suwon University, Suwon (Korea, Republic of)

    1997-07-01

    A small sodium-concrete reaction facility was designed, manufactured and installed. this facility has been operated under inert gas(N{sub 2}) with different experimental variables such as sodium injection temperature, injection amount of sodium, aging period of concrete, sodium reservoir temperature. As a result, it was found that sodium injection temperature and injected amount of sodium has little effect on sodium-concrete reaction. However, sodium reservoir temperature and aging period of concrete has relatively high impact on sodium-concrete reaction. Sodium-concrete reaction model has also been developed and compared with experimental results. (Author) 51 refs., 16 tabs., 64 figs.

  2. Sodium characterization during the starting period of a sodium loop

    International Nuclear Information System (INIS)

    Lievens, F.; Parmentier, C.; Soenen, M.

    1976-01-01

    A sodium loop for analytical chemistry studies has been built by S.C.K./C.E.N. at Mol Belgium. Its first working period was used to test analytical methods, to characterize the sodium and to define the operating parameters of the loop. This report covers the working parameters of the loop, the characterization of the filling sodium and its purity evolution during the first working period of the loop

  3. Intravitreal flomoxef sodium in rabbits.

    Science.gov (United States)

    Mochizuki, K; Torisaki, M; Yamashita, Y; Komatsu, M; Tanahashi, T

    1993-01-01

    We studied the intraocular concentration of flomoxef sodium in nonvitrectomized and vitrectomized eyes of albino rabbits after intravenous administration of 100 mg/kg flomoxef sodium. The concentration of flomoxef sodium in the vitreous body was undetectable (flomoxef sodium was investigated with ophthalmoscopy, electroretinography (ERG) and light microscopy after intravitreal injection of 200, 500, 1,000 and 2,000 micrograms flomoxef sodium in albino and pigmented rabbits. No ERG changes were induced with 200 micrograms. Other higher doses caused transient ERG changes. After the 200-micrograms injection, the intravitreal concentration decreased exponentially, the half-life being 4.4 h. The antibacterial activity, broad coverage and low intravitreal toxicity of flomoxef sodium suggest that this compound may be used to treat bacterial endophthalmitis.

  4. Double sodium rubidium molybdates

    International Nuclear Information System (INIS)

    Mokhoseev, M.V.; Khal'baeva, K.M.; Khajkina, E.G.; Ogurtsov, A.M.

    1990-01-01

    According to ceramic technique double sodium-rubidium molybdates of the compositions Rb 2-x Na x MoO 4 (0.5≤x≤0.67) and Na 3 Rb(MoO 4 ) 2 have been prepared. It is ascertained that Rb 2-x Na x MoO 4 is crystallized in glaserite structural type (trigonal crystal system, sp.gr. P3m1, Z=2) and melts incongruently at 640 deg C. Na 3 Rb(MoO 4 ) 2 at room temperature is unstable and gradually decomposes into Na 2 MoO 4 and Rb 2-x Na x MoO 4

  5. Safety and efficacy of everolimus in Chinese patients with metastatic renal cell carcinoma resistant to vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy: an open-label phase 1b study

    International Nuclear Information System (INIS)

    Guo, Jun; Straub, Patrick; Pirotta, Nicoletta; Gogov, Sven; Huang, Yiran; Zhang, Xu; Zhou, Fangjian; Sun, Yinghao; Qin, Shukui; Ye, Zhangqun; Wang, Hui; Jappe, Annette

    2013-01-01

    In China, there are currently no approved therapies for the treatment of metastatic renal cell carcinoma (mRCC) following progression with vascular endothelial growth factor (VEGF)-targeted agents. In the phase 3 RECORD-1 trial, the mammalian target of rapamycin (mTOR) inhibitor everolimus afforded clinical benefit with good tolerability in Western patients with mRCC whose disease had progressed despite VEGF receptor-tyrosine kinase inhibitor (VEGFr-TKI) therapy. This phase 1b study was designed to further evaluate the safety and efficacy of everolimus in VEGFr-TKI-refractory Chinese patients with mRCC. An open-label, multicenter phase 1b study enrolled Chinese patients with mRCC who were intolerant to, or progressed on, previous VEGFr-TKI therapy (N = 64). Patients received everolimus 10 mg daily until objective tumor progression (according to RECIST, version 1.0), unacceptable toxicity, death, or study discontinuation for any other reason. The final data analysis cut-off date was November 30, 2011. A total of 64 patients were included in the study. Median age was 52 years (range, 19–75 years) and 69% of patients were male. Median duration of everolimus therapy was 4.1 months (range, 0.0-16.1 months). Expected known class-effect toxicities related to mTOR inhibitor therapy were observed, including anemia (64%), hypertriglyceridemia (55%), mouth ulceration (53%), hyperglycemia (52%), hypercholesterolemia (50%), and pulmonary events (31%). Common grade 3/4 adverse events were anemia (20%), hyperglycemia (13%), increased gamma-glutamyltransferase (11%), hyponatremia (8%), dyspnea (8%), hypertriglyceridemia (6%), and lymphopenia (6%). Median PFS was 6.9 months (95% CI, 3.7-12.5 months) and the overall tumor response rate was 5% (95% CI, 1-13%). The majority of patients (61%) had stable disease as their best overall tumor response. Safety and efficacy results were comparable to those of the RECORD-1 trial. Everolimus is generally well tolerated and provides clinical

  6. Five-year clinical and functional multislice computed tomography angiographic results after coronary implantation of the fully resorbable polymeric everolimus-eluting scaffold in patients with de novo coronary artery disease: the ABSORB cohort A trial.

    Science.gov (United States)

    Onuma, Yoshinobu; Dudek, Dariusz; Thuesen, Leif; Webster, Mark; Nieman, Koen; Garcia-Garcia, Hector M; Ormiston, John A; Serruys, Patrick W

    2013-10-01

    This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California). Multimodality imaging of the first-in-humans trial using a ABSORB BVS scaffold demonstrated at 2 years the bioresorption of the device while preventing restenosis. However, the long-term safety and efficacy of this therapy remain to be documented. In the ABSORB cohort A trial (ABSORB Clinical Investigation, Cohort A [ABSORB A] Everolimus-Eluting Coronary Stent System Clinical Investigation), 30 patients with a single de novo coronary artery lesion were treated with the fully resorbable everolimus-eluting Absorb scaffold at 4 centers. As an optional investigation in 3 of the 4 centers, the patients underwent multislice computed tomography (MSCT) angiography at 18 months and 5 years. Acquired MSCT data were analyzed at an independent core laboratory (Cardialysis, Rotterdam, the Netherlands) for quantitative analysis of lumen dimensions and was further processed for calculation of fractional flow reserve (FFR) at another independent core laboratory (Heart Flow, Redwood City, California). Five-year clinical follow-up is available for 29 patients. One patient withdrew consent after 6 months, but the vital status of this patient remains available. At 46 days, 1 patient experienced a single episode of chest pain and underwent a target lesion revascularization with a slight troponin increase after the procedure. At 5 years, the ischemia-driven major adverse cardiac event rate of 3.4% remained unchanged. Clopidogrel was discontinued in all but 1 patient. Scaffold thrombosis was not observed in any patient. Two noncardiac deaths were reported, 1 caused by duodenal perforation and the other from Hodgkin's disease. At 5 years, 18 patients underwent MSCT angiography. All scaffolds were patent, with a median minimal lumen area of 3

  7. The various sodium purification techniques

    International Nuclear Information System (INIS)

    Courouau, J.L.; Masse, F.; Rodriguez, G.; Latge, C.; Redon, B.

    1997-01-01

    In the framework of sodium waste treatment, the sodium purification phase plays an essential role in the chain of operations leading to the transformation of the active sodium, considered as waste, into a stable sodium salt. The objectives of the purification operations are: To keep a low impurity level, particularly a low concentration in oxygen and hydrogen, in order to allow its transfer to a processing plant, and in order to avoid risks of plugging and/or corrosion in sodium facilities; To reduce the sodium activity in order to limit the dose rate close to the facilities, and in order to reduce the activity of the liquid and gaseous effluents. After a recall of the different kind of impurities that can be present in sodium, and of the different purification methods that could be associated with, the following points are highlighted: (i) Oxygen and hydrogen purification needs, and presentation of some selection criteria for a purification unit adapted to a sodium processing plant, as well as 2 cold trap concepts that are in accordance with these criteria: PSICHOS and PIRAMIDE. (ii) Tritium reduction in a bulk of liquid sodium by swamping, isotopic exchange, or permeation throughout a membrane. (iii) Caesium trapping on carbonaceous matrix. The main matrices used at present are R.V.C. (Reticulated Vitreous Carbon) and Actitex/Pica products. Tests in the laboratory and on an experimental device have demonstrated the performances of these materials, which are able to reduce sodium activity in Cs 134 and Cs 137 to very low values. The sodium purification processes as regards to the hydrogen, oxygen and caesium, that are aimed at facilitating the subsequent treatment of sodium, are therefore mastered operations. Regarding the operations associated with the reduction of the tritium activity, the methods are in the process of being qualified, or to be qualified. (author)

  8. Physical properties of liquid sodium

    International Nuclear Information System (INIS)

    Alberdi Primicia, J.; Martinez Piquer, T.A.

    1977-01-01

    The molten sodium has been the more accepted coolant for the first generation of FBR, by this reason the knowledge of its technology is needed for the development of the next LMFBR. A series of necessary data for designing sodium liquid systems are given. Tables and graphics about the most important physical sodium properties between 1200-1400 degC are gathered. The results have been obtained from equations that relate the properties with temperature using a Fortran IV program. (author) [es

  9. Carbon transport in sodium systems

    International Nuclear Information System (INIS)

    Martin Espigares, M.; Lapena, J.; La Torre, M. de

    1983-01-01

    Carbon activities in dynamic non isothermal sodium system are determined using an equilibratium method. Foils of Fe-18 w% Cr-8 W% Ni alloy with low carbon content (in the as received condition) are exposed to dynamic liquid sodium in the temperature range between 450 0 C and 700 0 C. The analysis was used to evaluate the carburization-decarburization behaviour of type 304 stainless steel exposed to sodium. (author)

  10. Sodium waste technology: A summary report

    International Nuclear Information System (INIS)

    Abrams, C.S.; Witbeck, L.C.

    1987-01-01

    The Sodium Waste Technology (SWT) Program was established to resolve long-standing issues regarding disposal of sodium-bearing waste and equipment. Comprehensive SWT research programs investigated a variety of approaches for either removing sodium from sodium-bearing items, or disposal of items containing sodium residuals. The most successful of these programs was the design, test, and the production operation of the Sodium Process Demonstration Facility at ANL-W. The technology used was a series of melt-drain-evaporate operations to remove nonradioactive sodium from sodium-bearing items and then converting the sodium to storable compounds

  11. Effects of topical flurbiprofen sodium, diclofenac sodium, ketorolac ...

    African Journals Online (AJOL)

    To evaluate corneal sensitivity by using the Cochet-Bonnet® esthesiometer in normal canine eyes at different time points following instillation of three different topical non-steroidal anti-inflammatory drugs (flurbiprofen sodium 0.03%, diclofenac sodium 0.1% and ketorolac tromethamine 0.5%) and benzalkonium chloride ...

  12. A Simple Quantitative Synthesis: Sodium Chloride from Sodium Carbonate.

    Science.gov (United States)

    Gold, Marvin

    1988-01-01

    Describes a simple laboratory procedure for changing sodium carbonate into sodium chloride by adding concentrated HCl to cause the reaction and then evaporating the water. Claims a good stoichiometric yield can be obtained in one three-hour lab period. Suggests using fume hood for the reaction. (ML)

  13. Cavitation erosion in sodium flow, sodium cavitation tunnel testing

    International Nuclear Information System (INIS)

    Courbiere, Pierre.

    1981-04-01

    The high-volume sodium flows present in fast neutron reactors are liable to induce cavitation phenomena in various portion of the sodium lines and pumps. The absence of sufficient data in this area led the C.E.A. to undertake an erosion research program in cavitating sodium flow. This paper discusses the considerations leading to the definition and execution of sodium cavitation erosion tests, and reviews the tests run with 400 0 C sodium on various steel grades: 316, 316 L, 316 Ti (Z8CNDT17-12), Poral (Z3CND18-12), 304 L and LN2 - clad 316 L (Ni coating-clad 316 L). Acoustic detection and signal processing methods were used with an instrument package designed and implemented at the Cadarache Nuclear Research Center

  14. The experimental sodium facility NAVA

    International Nuclear Information System (INIS)

    Langenbrunner, H.; Grunwald, G.; May, R.

    1976-01-01

    Within the framework of preparations for the introduction of sodium cooled fast breeder reactors an experimental sodium facility was installed at the Central Institute of Nuclear Research at Rossendorf. Design, engineering aspects and operation of this facility are described; operating experience is briefly discussed. (author)

  15. Sodium as a reactor coolant

    International Nuclear Information System (INIS)

    Cesar, S.B.G.

    1989-01-01

    This work is related to the use of sodium as a reactor coolant, to the advantages and problems related to its use, its mechanical, thermophysics, eletronical, magnetic and nuclear properties. It is mainly a bibliographic review, with the aim of gathering the necessary information to persons initiating in the study of sodium and also as reference source. (author) [pt

  16. Recent progress in sodium technology

    Energy Technology Data Exchange (ETDEWEB)

    Hallett, W. J.

    1963-10-15

    Progress over the past year in U. S. laboratories studying some of the materials and engineering problems that must be resolved in bringing the technology of sodium to an economically and technically attractive point is reviewed. The status of sodium cooled power reactors in the U. S. is described. (P.C.H.)

  17. Method of processing waste sodium

    International Nuclear Information System (INIS)

    Shimoyashiki, Shigehiro; Takahashi, Kazuo.

    1982-01-01

    Purpose: To enable safety store of waste sodium in the form of intermetallic compounds. Method: Waste sodium used in a reactor is mixed with molten metal under an inert gas atmosphere and resulted intermetallic compounds are stored in a closely sealed container to enable quasi-permanent safety store as inert compound. Used waste sodium particularly, waste sodium in the primary system containing radioactive substances is charged in a waste sodium melting tank having a heater on the side, the tank is evacuated by a vacuum pump and then sealed with gaseous argon supplied from a gaseous argon tank, and waste sodium is melted under heating. The temperature and the amount of the liquid are measured by a thermometer and a level meter respectively. While on the other hand, molten metal such as Sn, Pb and Zn having melting point above 300 0 C are charged in a metal melting tank and heated by a heater. The molten sodium and the molten metals are charged into a mixing tank and agitated to mix by an induction type agitator. Sodium vapors in the tank are collected by traps. The air in the tank is replaced with gaseous argon. The molten mixture is closely sealed in a drum can and cooled to solidify for safety storage. (Seki, T.)

  18. Techniques for extinguishing sodium fires

    International Nuclear Information System (INIS)

    Raju, Chander; Kale, R.D.

    1979-02-01

    The experimental work done to evaluate the performance of commercially available fire extinguishants and powders for sodium fires is described. Dry chemical powder with sodium bicarbonate base was found very effective. Another effective method of extinghishing fire by using perforated covered tray is also discussed. (auth.)

  19. Friction and wear in sodium

    International Nuclear Information System (INIS)

    Hoffman, N.J.; Droher, J.J.

    1973-01-01

    In the design of a safe and reliable sodium-cooled reactor one of the more important problem areas is that of friction and wear of components immersed in liquid sodium or exposed to sodium vapor. Sodium coolant at elevated temperatures may severely affect most oxide-bearing surface layers which provide corrosion resistance and, to some extent, lubrication and surface hardness. Consequently, accelerated deterioration may be experienced on engaged-motion contact surfaces, which could result in unexpected reactor shutdown from component malfunction or failure due to galling and seizure. An overall view of the friction and wear phenomena encountered during oscillatory rubbing of surfaces in high-temperature, liquid-sodium environments is presented. Specific data generated at the Liquid Metal Engineering Center (LMEC) on this subject is also presented. (U.S.)

  20. Sodium sampling and impurities determination

    International Nuclear Information System (INIS)

    Docekal, J.; Kovar, C.; Stuchlik, S.

    1980-01-01

    Samples may be obtained from tubes in-built in the sodium facility and further processed or they are taken into crucibles, stored and processed later. Another sampling method is a method involving vacuum distillation of sodium, thus concentrating impurities. Oxygen is determined by malgamation, distillation or vanadium balance methods. Hydrogen is determined by the metal diaphragm extraction, direct extraction or amalgamation methods. Carbon is determined using dry techniques involving burning a sodium sample at 1100 degC or using wet techniques by dissolving the sample with an acid. Trace amounts of metal impurities are determined after dissolving sodium in ethanol. The trace metals are concentrated and sodium excess is removed. (M.S.)

  1. Toxicology of plutonium-sodium

    International Nuclear Information System (INIS)

    Hackett, P.L.

    1982-01-01

    Scenarios for liquid-metal fast breeder reactor (LMFBR) accidents predict the loss of sodium coolant, with subsequent core melt-down and release of mixed sodium-fuel aerosols [Na-(PuU)O 2 ] into the environment. Studies in other laboratories demonstrated that mixed aerosols of Na 2 O-PuO 2 were more readily transported from the lung than PuO 2 aerosols. We therefore devised a continuous aerosol-generating system for animal exposures in which laser-generated fuel aerosols were swept through sodium vapor to form sodium-fuel aerosols. These fuel and sodium-fuel aerosols were compared with regard to their physicochemical properties and their biological behavior following inhalation studies in rats and dogs

  2. Leak detector of liquid sodium

    International Nuclear Information System (INIS)

    Himeno, Yoshiaki.

    1975-01-01

    Object: To arrange a cable core connected to a leakage current detector on the outer wall of piping for liquid sodium, devices or the like and apply a voltage to said core and outer wall to quickly and securely detect the leakage of liquid sodium. Structure: A cable, which is composed of metal coating formed of metal material (copper, steel, stainless, etc.) which is apt to be corroded by reaction products of liquid sodium with water and oxygen in air, and metal oxide (such as magnesium oxide, beryllium oxide, aluminum oxide) as an electric insulator is arranged on the outer wall of pipes or devices. In the event sodium is leaked from the pipes or devices, said metal coating and the insulator are corroded, and the leakage of sodium is sensed by a leakage current detector through the core in the cable. (Kamimura, M.)

  3. Sodium ionization detector and sensor

    International Nuclear Information System (INIS)

    Hrizo, J.; Bauerle, J.E.

    1979-01-01

    Work conducted on a basic technology development effort with the Westinghouse Sodium Ionization Detector (SID) sensor is reported. Included are results obtained for three task areas: (1) On-line operational response testing - in-situ calibration techniques; (2) Performance-reliability characteristics of aged filaments; and (3) Evaluation of chemical interference effects. The results showed that a calibrator filament coated with a sodium compound, when activated, does supply the necessary sodium atoms to provide a valid operational in-situ test. The life time of new Cr 2 0 3 -protected SID sensor filaments can be extended by operating at a reduced temperature. However, there also is a reduction in the sensitivity. Non-sodium species, such as products from a smoldering fire and organic aerosols, produce an interference response from the sensor comparable to a typical sodium response

  4. Targeting sodium channels in cardiac arrhythmia

    NARCIS (Netherlands)

    Remme, Carol Ann; Wilde, Arthur A. M.

    2014-01-01

    Cardiac voltage-gated sodium channels are responsible for proper electrical conduction in the heart. During acquired pathological conditions and inherited sodium channelopathies, altered sodium channel function causes conduction disturbances and ventricular arrhythmias. Although the clinical,

  5. Synthesis and characterization of sodium alkoxides

    Indian Academy of Sciences (India)

    Unknown

    technique and IR spectroscopy. The elemental ... for maintenance or disposal, need to be cleaned free of sodium for the ... scenario on sodium removal using different alcohols are ... ethoxide and sodium n-propoxide by KBr pellet method.

  6. Evolutionary primacy of sodium bioenergetics

    Directory of Open Access Journals (Sweden)

    Wolf Yuri I

    2008-04-01

    Full Text Available Abstract Background The F- and V-type ATPases are rotary molecular machines that couple translocation of protons or sodium ions across the membrane to the synthesis or hydrolysis of ATP. Both the F-type (found in most bacteria and eukaryotic mitochondria and chloroplasts and V-type (found in archaea, some bacteria, and eukaryotic vacuoles ATPases can translocate either protons or sodium ions. The prevalent proton-dependent ATPases are generally viewed as the primary form of the enzyme whereas the sodium-translocating ATPases of some prokaryotes are usually construed as an exotic adaptation to survival in extreme environments. Results We combine structural and phylogenetic analyses to clarify the evolutionary relation between the proton- and sodium-translocating ATPases. A comparison of the structures of the membrane-embedded oligomeric proteolipid rings of sodium-dependent F- and V-ATPases reveals nearly identical sets of amino acids involved in sodium binding. We show that the sodium-dependent ATPases are scattered among proton-dependent ATPases in both the F- and the V-branches of the phylogenetic tree. Conclusion Barring convergent emergence of the same set of ligands in several lineages, these findings indicate that the use of sodium gradient for ATP synthesis is the ancestral modality of membrane bioenergetics. Thus, a primitive, sodium-impermeable but proton-permeable cell membrane that harboured a set of sodium-transporting enzymes appears to have been the evolutionary predecessor of the more structurally demanding proton-tight membranes. The use of proton as the coupling ion appears to be a later innovation that emerged on several independent occasions. Reviewers This article was reviewed by J. Peter Gogarten, Martijn A. Huynen, and Igor B. Zhulin. For the full reviews, please go to the Reviewers' comments section.

  7. Methods in the treatment of sodium wastes

    International Nuclear Information System (INIS)

    Rodriguez, G.

    1997-01-01

    In the domain of sodium waste processing, we have followed a logical route that has enabled us to propose a global method with respect to sodium wastes. This approach has led to: The choice of only those sodium processes using water; The development of sodium purification methods; The development of methods for cutting metallic wastes soiled by or filled with sodium; The transformation of the resulting sodium hydroxide into ultimate solid wastes for surface storage. (author)

  8. Tables of thermodynamic properties of sodium

    International Nuclear Information System (INIS)

    Fink, J.K.

    1982-06-01

    The thermodynamic properties of saturated sodium, superheated sodium, and subcooled sodium are tabulated as a function of temperature. The temperature ranges are 380 to 2508 K for saturated sodium, 500 to 2500 K for subcooled sodium, and 400 to 1600 K for superheated sodium. Tabulated thermodynamic properties are enthalpy, heat capacity, pressure, entropy, density, instantaneous thermal expansion coefficient, compressibility, and thermal pressure coefficient. Tables are given in SI units and cgs units

  9. Evaluation of chemical stability of polymers of XIENCE everolimus-eluting coronary stents in vivo by pyrolysis-gas chromatography/mass spectrometry.

    Science.gov (United States)

    Kamberi, Marika; Pinson, David; Pacetti, Stephen; Perkins, Laura E L; Hossainy, Syed; Mori, Hiroyoshi; Rapoza, Richard J; Kolodgie, Frank; Virmani, Renu

    2017-09-07

    The polymers poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) and poly(n-butyl methacrylate) (PBMA) are employed in manufacturing the XIENCE family of coronary stents. PBMA serves as a primer and adheres to both the stent and the drug coating. PVDF-HFP is employed in the drug matrix layer to hold the drug everolimus on the stent and control its release. Chemical stability of the polymers of XIENCE stents in the in-vivo environment was evaluated by pyrolysis-gas chromatography with mass spectrometry (Py-GC/MS) detection. For this evaluation, XIENCE stents explanted from porcine coronary arteries and from human coronary artery specimens at autopsy after 2-4 and 5-7 years of implantation, respectively, were compared to freshly manufactured XIENCE stents (controls). The comparison of pyrograms of explanted stent samples and controls showed identical fragmentation fingerprints of polymers, indicating that PVDF-HFP and PBMA maintained their chemical integrity after multiple years of XIENCE coronary stent implantation. The findings of the present study demonstrate the chemical stability of PVDF-HFP and PBMA polymers of the XIENCE family of coronary stents in the in-vivo environment, and constitute a further proof of the suitability of PVDF-HFP as a drug carrier for the drug eluting stent applications. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2017. © 2017 Wiley Periodicals, Inc.

  10. Everolimus plus exemestane as first-line therapy in HR⁺, HER2⁻ advanced breast cancer in BOLERO-2.

    Science.gov (United States)

    Beck, J Thaddeus; Hortobagyi, Gabriel N; Campone, Mario; Lebrun, Fabienne; Deleu, Ines; Rugo, Hope S; Pistilli, Barbara; Masuda, Norikazu; Hart, Lowell; Melichar, Bohuslav; Dakhil, Shaker; Geberth, Matthias; Nunzi, Martina; Heng, Daniel Y C; Brechenmacher, Thomas; El-Hashimy, Mona; Douma, Shyanne; Ringeisen, Francois; Piccart, Martine

    2014-02-01

    The present exploratory analysis examined the efficacy, safety, and quality-of-life effects of everolimus (EVE) + exemestane (EXE) in the subgroup of patients in BOLERO-2 whose last treatment before study entry was in the (neo)adjuvant setting. In BOLERO-2, patients with hormone-receptor-positive (HR(+)), human epidermal growth factor receptor-2-negative (HER2(-)) advanced breast cancer recurring/progressing after a nonsteroidal aromatase inhibitor (NSAI) were randomly assigned (2:1) to receive EVE (10 mg/day) + EXE (25 mg/day) or placebo (PBO) + EXE. The primary endpoint was progression-free survival (PFS) by local assessment. Overall, 137 patients received first-line EVE + EXE (n = 100) or PBO + EXE (n = 37). Median PFS by local investigator assessment nearly tripled to 11.5 months with EVE + EXE from 4.1 months with PBO + EXE (hazard ratio = 0.39; 95 % CI 0.25-0.62), while maintaining quality of life. This was confirmed by central assessment (15.2 vs 4.2 months; hazard ratio = 0.32; 95 % CI 0.18-0.57). The marked PFS improvement in patients receiving EVE + EXE as first-line therapy for disease recurrence during or after (neo)adjuvant NSAI therapy supports the efficacy of this combination in the first-line setting. Furthermore, the results highlight the potential benefit of early introduction of EVE + EXE in the management of HR(+), HER2(-) advanced breast cancer in postmenopausal patients.

  11. Enteric-coated mycophenolate sodium.

    Science.gov (United States)

    Gabardi, Steven; Tran, Jennifer L; Clarkson, Michael R

    2003-11-01

    To review the pharmacology, pharmacokinetics, efficacy, and safety of mycophenolate sodium. Primary literature was obtained via a MEDLINE search (1966-June 2003). Abstracts were obtained from the manufacturer and included in the analysis. All studies and abstracts evaluating mycophenolate sodium in solid organ transplantation were considered for inclusion. English-language studies and abstracts were selected for inclusion, but were limited to those consisting of human subjects. Mycophenolate sodium, a mycophenolic acid prodrug, is an inhibitor of T-lymphocyte proliferation. Mycophenolic acid reduces the incidence of acute rejection in renal transplantation. Mycophenolate sodium is enteric coated and has been suggested as a potential method to reduce the gastrointestinal adverse events seen with mycophenolate mofetil. Both mycophenolate mofetil and mycophenolate sodium have been shown to be therapeutically equivalent at decreasing the incidence of allograft rejection and loss. The frequency of adverse events is similar between both compounds, with the most common events being diarrhea and leukopenia. Mycophenolate sodium is effective in preventing acute rejection in renal transplant recipients. At doses of 720 mg twice daily, the efficacy and safety profiles are similar to those of mycophenolate mofetil 1000 mg twice daily. Mycophenolate sodium has been approved in Switzerland; approval in the US is pending.

  12. Water simulation of sodium reactors

    International Nuclear Information System (INIS)

    Grewal, S.S.; Gluekler, E.L.

    1981-01-01

    The thermal hydraulic simulation of a large sodium reactor by a scaled water model is examined. The Richardson Number, friction coefficient and the Peclet Number can be closely matched with the water system at full power and the similarity is retained for buoyancy driven flows. The simulation of thermal-hydraulic conditions in a reactor vessel provided by a scaled water experiment is better than that by a scaled sodium test. Results from a correctly scaled water test can be tentatively extrapolated to a full size sodium system

  13. Sodium diffusion in boroaluminosilicate glasses

    DEFF Research Database (Denmark)

    Smedskjaer, Morten M.; Zheng, Qiuju; Mauro, John C.

    2011-01-01

    of isothermal sodium diffusion in BAS glasses by ion exchange, inward diffusion, and tracer diffusion experiments. By varying the [SiO2]/[Al2O3] ratio of the glasses, different structural regimes of sodium behavior are accessed. We show that the mobility of the sodium ions decreases with increasing [SiO2]/[Al2O......Understanding the fundamentals of alkali diffusion in boroaluminosilicate (BAS) glasses is of critical importance for advanced glass applications, e.g., the production of chemically strengthened glass covers for personal electronic devices. Here, we investigate the composition dependence...

  14. Analytical study of sodium combustion phenomena under sodium leak accidents

    International Nuclear Information System (INIS)

    Kim, Byung Ho; Jeong, J. Y.; Jeong, K. C.; Kim, T. J.; Choi, J. H.

    2001-12-01

    The rise of temperature and pressure, the release of aerosol in the buildings as a result of sodium fire must be considered for the safety measures of LMR. Therefore for the safety of the LMR, it is necessary to understand the characteristics of sodium fire, resulting from the various type of leakage. ASSCOPS(Analysis of Simultaneous Sodium Combustion in Pool and Spray) is the computer code for the analysis of the thermal consequence of sodium leak and fire in LMR that has been developed by Japan Nuclear Cycle Development Institute(JNC) in Japan. In this study, a preliminary analysis of sodium leak and fire accidents in S/G building of KALIMER is made by using ASSCOPS code. Various phenomena of interest are spray and pool burning, peak pressure, temperature change, local structure temperature, aerosol behavior, drain system into smothering tank, ventilation characteristics at each cell with the safety venting system and nitrogen injection system. In this calculation, the dimension of the S/G building was chosen in accordance with the selected options of LMR name KALIMER(Korea). As a result of this study, it was shown that subsequent effect of sodium fire depended upon whether the sodium continued to leak from the pipe or not, whether the ventilation system was running, whether the inert gas injection system was provided, whether the sodium on floor was drained into the smothering tank or not, whether the building was sealed or not, etc. Specially the excessive rise of pressure into each cell was prevented by installing the pressure release plates on wall of the building

  15. In situ Microscopic Observation of Sodium Deposition/Dissolution on Sodium Electrode

    OpenAIRE

    Yuhki Yui; Masahiko Hayashi; Jiro Nakamura

    2016-01-01

    Electrochemical sodium deposition/dissolution behaviors in propylene carbonate-based electrolyte solution were observed by means of in situ light microscopy. First, granular sodium was deposited at pits in a sodium electrode in the cathodic process. Then, the sodium particles grew linearly from the electrode surface, becoming needle-like in shape. In the subsequent anodic process, the sodium dissolved near the base of the needles on the sodium electrode and the so-called ?dead sodium? broke a...

  16. Parametric Effect of Sodium Hydroxide and Sodium Carbonate on the Potency of a Degreaser

    OpenAIRE

    Babatope Abimbola Olufemi

    2016-01-01

    Experimental and statistical analysis was carried out on the comparative effect of sodium hydroxide and sodium carbonate on the potency of a laboratory produced degreaser in this work. The materials used include; octadecyl benzene sulphonic acid, sodium hydroxide, sodium carbonate, sodium metasilicate, carboxyl methyl cellulose (C.M.C), formadelhyde, perfume, colourant and distilled water. Different samples of degreaser were produced with varying composition of sodium hydroxide and sodium car...

  17. Sodium concrete reaction - Structural considerations

    International Nuclear Information System (INIS)

    Ferskakis, G.N.

    1984-01-01

    An overview of the sodium concrete reaction phenomenon, with emphasis on structural considerations, is presented. Available test results for limestone, basalt, and magnetite concrete with various test article configurations are reviewed. Generally, tests indicate reaction is self limiting before all sodium is used. Uncertainties, however, concerning the mechanism for penetration of sodium into concrete have resulted in different theories about a reaction model. Structural behavior may be significant in the progression of the reaction due to thermal-structuralchemical interactions involving tensile cracking, compressive crushing, or general deterioration of concrete and the exposure of fresh concrete surfaces to react with sodium. Structural behavior of test articles and potential factors that could enhance the progression of the reaction are discussed

  18. Borocaptate sodium (BSH) toxicity issues

    International Nuclear Information System (INIS)

    LaHann, T.

    1995-01-01

    ISU's Center for Toxicology Research has been conducting toxicity testing of borocaptate sodium (BSH) to aid in assessing if proposed human studies of BSH are likely to be acceptably safe. This report describes BSH interactions with other biological agents

  19. Ultrasonic imaging in liquid sodium

    Energy Technology Data Exchange (ETDEWEB)

    Lubeigt, E. [CEA Cadarache, DEN/DTN/STCP/LIET, 13108 Saint-Paul-Lez-Durance Cedex (France); Laboratoire de Mecanique et d' Acoustique, CNRS UPR 7051, 13402 Marseille Cedex 20 (France); Mensah, S.; Chaix, J.F.; Rakotonarivo, S. [Laboratoire de Mecanique et d' Acoustique, CNRS UPR 7051, 13402 Marseille Cedex 20 (France); Gobillot, G. [CEA Cadarache, DEN/DTN/STCP/LIET, 13108 Saint-Paul-Lez-Durance Cedex (France)

    2015-07-01

    The fourth generation of nuclear reactor can use liquid sodium as the core coolant. When the reactor is operating, sodium temperatures can reach up to 600 deg. C. During maintenance periods, when the reactor is shut down, the coolant temperature is reduced to 200 deg. C. Because molten sodium is optically opaque, ultrasonic imaging techniques are developed for maintenance activities. Under-sodium imaging aims at i) checking the health of immersed structures. It should also allow ii) to assess component degradation or damage as cracks and shape defects as well as iii) the detection of lost objects. The under-sodium imaging system has to sustain high temperature (up to 300 deg. C) and hostility of the sodium environment. Furthermore, specific constraints such as transducers characteristics or the limited sensor mobility in the reactor vessel have to be considered. This work focuses on developing a methodology for detecting damages such as crack defects with ultrasound devices. Surface-breaking cracks or deep cracks are sought in the weld area, as welds are more subject to defects. Traditional methods enabled us to detect emerging cracks of submillimeter size with sodium-compatible high-temperature transducer. The presented approach relies on making use of prior knowledge about the environment through the implementation of differential imaging and time-reversal techniques. Indeed, this approach allows to detect a change by comparison with a reference measurement and by focusing back to any change in the environment. It is a means of analysis and understanding of the physical phenomena making it possible to design more effective inspection strategies. Difference between the measured signals reveals the acoustic field scattered by a perturbation (a crack for instance), which may occur between periodical measurements. The imaging method relies on the adequate combination of two computed ultrasonic fields, one forward and one adjoint. The adjoint field, which carries the

  20. Ultrasonic imaging in liquid sodium

    International Nuclear Information System (INIS)

    Lubeigt, E.; Mensah, S.; Chaix, J.F.; Rakotonarivo, S.; Gobillot, G.

    2015-01-01

    The fourth generation of nuclear reactor can use liquid sodium as the core coolant. When the reactor is operating, sodium temperatures can reach up to 600 deg. C. During maintenance periods, when the reactor is shut down, the coolant temperature is reduced to 200 deg. C. Because molten sodium is optically opaque, ultrasonic imaging techniques are developed for maintenance activities. Under-sodium imaging aims at i) checking the health of immersed structures. It should also allow ii) to assess component degradation or damage as cracks and shape defects as well as iii) the detection of lost objects. The under-sodium imaging system has to sustain high temperature (up to 300 deg. C) and hostility of the sodium environment. Furthermore, specific constraints such as transducers characteristics or the limited sensor mobility in the reactor vessel have to be considered. This work focuses on developing a methodology for detecting damages such as crack defects with ultrasound devices. Surface-breaking cracks or deep cracks are sought in the weld area, as welds are more subject to defects. Traditional methods enabled us to detect emerging cracks of submillimeter size with sodium-compatible high-temperature transducer. The presented approach relies on making use of prior knowledge about the environment through the implementation of differential imaging and time-reversal techniques. Indeed, this approach allows to detect a change by comparison with a reference measurement and by focusing back to any change in the environment. It is a means of analysis and understanding of the physical phenomena making it possible to design more effective inspection strategies. Difference between the measured signals reveals the acoustic field scattered by a perturbation (a crack for instance), which may occur between periodical measurements. The imaging method relies on the adequate combination of two computed ultrasonic fields, one forward and one adjoint. The adjoint field, which carries the

  1. ELEVATE: an innovative study design to assess the efficacy, safety, and evolution of cardiovascular parameters in de novo kidney transplant recipients after early conversion from a calcineurin inhibitor to everolimus

    Directory of Open Access Journals (Sweden)

    van der Giet M

    2014-03-01

    Full Text Available Markus van der Giet,1 Josep M Cruzado,2 Johan W de Fijter,3 Hallvard Holdaas,4 Zailong Wang,5 Antonio Speziale,6 Guido Junge61Department of Nephrology, Campus Benjamin Franklin, Charite'-Universitätsmedizin, Berlin, Germany; 2Department of Nephrology, University Hospital of Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; 3Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; 4Section of Nephrology, Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 5Biometrics and Statistical Science, Novartis Pharmaceuticals, East Hanover, NJ, USA; 6Research and Development, Novartis Pharma AG, Basel, SwitzerlandAbstract: Progressive decline in allograft function and cardiovascular mortality after kidney transplantation remain major clinical challenges that can potentially be addressed by the mammalian target of rapamycin (mTOR inhibitors, everolimus and sirolimus. mTOR inhibitors maintain immunosuppressive efficacy after minimization of calcineurin inhibitor (CNI therapy and can achieve significant long-term improvements in renal function. Recently, data have accumulated that suggest mTOR inhibitors may offer cardioprotective effects. In animal models, inhibition of mTOR leads to regression of cardiac hypertrophy, and the limited data consistently point to a remodeling benefit following heart transplantation. Experimentally, mTOR inhibitors restrict atherogenesis, confirmed clinically by intravascular ultrasound data demonstrating lower rates of transplant vasculopathy in heart transplant recipients on everolimus. Lastly, mTOR inhibitors appear to ameliorate arterial stiffness, a known risk factor for post-transplant cardiovascular events, but data remain sparse. The ELEVATE study will examine the renal effect of early conversion from CNI therapy to everolimus after kidney transplantation. Key secondary endpoints include the change in left ventricular mass index, the first time

  2. Too Much Sodium PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.

  3. Characterization of Sodium Spray Aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, C. T.; Koontz, R. L.; Silberberg, M. [Atomics International, North American Rockwell Corporation, Canoga Park, CA (United States)

    1968-12-15

    The consequences of pool and spray fires require evaluation in the safety analysis of liquid metal-cooled fast breeder reactors. Sodium spray fires are characterized by high temperature and pressure, produced during the rapid combustion of sodium in air. Following the initial energy release, some fraction of the reaction products are available as aerosols which follow the normal laws of agglomeration, growth, settling, and plating. An experimental study is underway at Atomics International to study the characteristics of high concentration sprays of liquid sodium in reduced oxygen atmospheres and in air. The experiments are conducted in a 31.5 ft{sup 3} (2 ft diam. by 10 ft high) vessel, certified for a pressure of 100 lb/in{sup 2} (gauge). The spray injection apparatus consists of a heated sodium supply pot and a spray nozzle through which liquid sodium is driven by nitrogen pressure. Spray rate and droplet size can be varied by the injection velocity (nozzle size, nitrogen pressure, and sodium temperature). Aerosols produced in 0, 4, and 10 vol. % oxygen environments have been studied. The concentration and particle size distribution of the material remaining in the air after the spray injection and reaction period are measured. Fallout rates are found to be proportional to the concentration of aerosol which remains airborne following the spray period. (author)

  4. Sodium voiding analysis in Kalimer

    International Nuclear Information System (INIS)

    Chang, Won-Pyo; Jeong, Kwan-Seong; Hahn, Dohee

    2001-01-01

    A sodium boiling model has been developed for calculations of the void reactivity feedback as well as the fuel and cladding temperatures in the KALIMER core after onset of sodium boiling. The sodium boiling in liquid metal reactors using sodium as coolant should be modeled because of phenomenon difference observed from that in light water reactor systems. The developed model is a multiple -bubble slug ejection model. It allows a finite number of bubbles in a channel at any time. Voiding is assumed to result from formation of bubbles that fill the whole cross section of the coolant channel except for liquid film left on the cladding surface. The vapor pressure, currently, is assumed to be uniform within a bubble. The present study is focused on not only demonstration of the sodium voiding behavior predicted by the developed model, but also confirmation on qualitative acceptance for the model. In results, the model catches important phenomena for sodium boiling, while further effort should be made for the complete analysis. (author)

  5. 21 CFR 522.460 - Cloprostenol sodium.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Cloprostenol sodium. 522.460 Section 522.460 Food... Cloprostenol sodium. (a)(1) Specifications. Each milliliter of the aqueous solution contains 263 micrograms of cloprostenol sodium (equivalent to 250 micrograms of cloprostenol) in a sodium citrate, anhydrous citric acid...

  6. Are Reductions in Population Sodium Intake Achievable?

    Directory of Open Access Journals (Sweden)

    Jessica L. Levings

    2014-10-01

    Full Text Available The vast majority of Americans consume too much sodium, primarily from packaged and restaurant foods. The evidence linking sodium intake with direct health outcomes indicates a positive relationship between higher levels of sodium intake and cardiovascular disease risk, consistent with the relationship between sodium intake and blood pressure. Despite communication and educational efforts focused on lowering sodium intake over the last three decades data suggest average US sodium intake has remained remarkably elevated, leading some to argue that current sodium guidelines are unattainable. The IOM in 2010 recommended gradual reductions in the sodium content of packaged and restaurant foods as a primary strategy to reduce US sodium intake, and research since that time suggests gradual, downward shifts in mean population sodium intake are achievable and can move the population toward current sodium intake guidelines. The current paper reviews recent evidence indicating: (1 significant reductions in mean population sodium intake can be achieved with gradual sodium reduction in the food supply, (2 gradual sodium reduction in certain cases can be achieved without a noticeable change in taste or consumption of specific products, and (3 lowering mean population sodium intake can move us toward meeting the current individual guidelines for sodium intake.

  7. The dismantling of fast reactors: sodium processing

    International Nuclear Information System (INIS)

    Rodriguez, G.; Berte, M.; Serpante, J.P.

    1999-01-01

    Fast reactors require a coolant that does not slow down neutrons so water can not be used. Metallic sodium has been chosen because of its outstanding neutronic and thermal properties but sodium reacts easily with air and water and this implies that sodium-smeary components can not be considered as usual nuclear wastes. A stage of sodium neutralizing is necessary in the processing of wastes from fast reactors. Metallic sodium is turned into a chemically stable compound: soda, carbonates or sodium salts. This article presents several methods used by Framatome in an industrial way when dismantling sodium-cooled reactors. (A.C.)

  8. A Patient with MSUD: Acute Management with Sodium Phenylacetate/Sodium Benzoate and Sodium Phenylbutyrate

    OpenAIRE

    K?se, Melis; Canda, Ebru; Kagnici, Mehtap; U?ar, Sema Kalkan; ?oker, Mahmut

    2017-01-01

    In treatment of metabolic imbalances caused by maple syrup urine disease (MSUD), peritoneal dialysis, and hemofiltration, pharmacological treatments for elimination of toxic metabolites can be used in addition to basic dietary modifications. Therapy with sodium phenylacetate/benzoate or sodium phenylbutyrate (NaPB) in urea-cycle disorder cases has been associated with a reduction in branched-chain amino acid (BCAA) concentrations when the patients are on adequate dietary protein intake. Moreo...

  9. Sodium Velocity Maps on Mercury

    Science.gov (United States)

    Potter, A. E.; Killen, R. M.

    2011-01-01

    The objective of the current work was to measure two-dimensional maps of sodium velocities on the Mercury surface and examine the maps for evidence of sources or sinks of sodium on the surface. The McMath-Pierce Solar Telescope and the Stellar Spectrograph were used to measure Mercury spectra that were sampled at 7 milliAngstrom intervals. Observations were made each day during the period October 5-9, 2010. The dawn terminator was in view during that time. The velocity shift of the centroid of the Mercury emission line was measured relative to the solar sodium Fraunhofer line corrected for radial velocity of the Earth. The difference between the observed and calculated velocity shift was taken to be the velocity vector of the sodium relative to Earth. For each position of the spectrograph slit, a line of velocities across the planet was measured. Then, the spectrograph slit was stepped over the surface of Mercury at 1 arc second intervals. The position of Mercury was stabilized by an adaptive optics system. The collection of lines were assembled into an images of surface reflection, sodium emission intensities, and Earthward velocities over the surface of Mercury. The velocity map shows patches of higher velocity in the southern hemisphere, suggesting the existence of sodium sources there. The peak earthward velocity occurs in the equatorial region, and extends to the terminator. Since this was a dawn terminator, this might be an indication of dawn evaporation of sodium. Leblanc et al. (2008) have published a velocity map that is similar.

  10. Some techniques for sodium removal in CIAE

    International Nuclear Information System (INIS)

    Yuan Waimai; Ding Dejun; Guo Huanfang; Hong Shuzhang; Zhou Shuxia; Shen Fenyang; Yang Zhongmin; Xu Yongxing

    1997-01-01

    In this paper the experiment and application on sodium removal and sodium disposal are presented. Steam-nitrogen process was used in CIAE for cleaning cold traps, sodium vapor traps, a sodium tank. Atomized water-nitrogen process was used for cleaning dummy fuel assembly for CEFR and a sintered stainless steel filter. Sprinkle process was used for cleaning some tubes. Bultylcellosolve was used for cleaning sintered stainless steel filter and sodium flow measurement device. Ethanol alcohol was used for cleaning electromagnetic pump. Paraffin, transformer-oil or their mixture was used for cleaning sodium valves, a sodium vapor trap and sodium-potassium alloy absorber. A small sintered stainless steel filter was distillated in vacuum. A simple sodium disposal device has been served for several years in CIA.E. It can dispose about 10 Kg sodium each time and the disposal process is no-aerosol. It operates in open air for non-radioactive sodium. In recent years a small sodium cleaning plant has been built. It can use atomized water, steam or organic alcohol to removal of sodium. The LAVEL cleaning plant and SLAPSO cleaning plant were introduced from Italy. And CEFR preliminary design on sodium cleaning for spent fuel assembly and on sodium removal-decontamination for large reactor components is introduced. Vapour-nitrogen process is planned to use in them. (author)

  11. The REMEDEE-OCT Study: An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody-Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical Coherence Tomography Imaging Analysis

    NARCIS (Netherlands)

    Jaguszewski, Milosz; Aloysius, Romila; Wang, Wei; Bezerra, Hiram G.; Hill, Jonathan; de Winter, Robbert J.; Karjalainen, Pasi P.; Verheye, Stefan; Wijns, William; Lüscher, Thomas F.; Joner, Michael; Costa, Marco; Landmesser, Ulf

    2017-01-01

    The aim of the present study was to evaluate vascular healing of the bioengineered COMBO Dual Therapy Stent compared with a cobalt-chromium (CoCr) everolimus-eluting stent (EES) as assessed by optical coherence tomography in patients with acute coronary syndromes. CD34+ cells promote endothelial

  12. Bioresorbable Everolimus-Eluting Vascular Scaffold for Patients With Peripheral Artery Disease (ESPRIT I): 2-Year Clinical and Imaging Results.

    Science.gov (United States)

    Lammer, Johannes; Bosiers, Marc; Deloose, Koen; Schmidt, Andrej; Zeller, Thomas; Wolf, Florian; Lansink, Wouter; Sauguet, Antoine; Vermassen, Frank; Lauwers, Geert; Scheinert, Dierk; Popma, Jeffrey J; McGreevy, Robert; Rapoza, Richard; Schwartz, Lewis B; Jaff, Michael R

    2016-06-13

    This is the first-in-human study of a drug-eluting bioresorbable vascular scaffold (BVS) for treatment of peripheral artery disease (PAD) involving the external iliac artery (EIA) and superficial femoral artery (SFA). Drug-eluting BVS has shown promise in coronary arteries. The ESPRIT BVS system is a device-drug combination consisting of an everolimus-eluting poly-l-lactide scaffold. Safety and performance were evaluated in 35 subjects with symptomatic claudication. Lesions were located in the SFA (88.6%) and EIA (11.4%). Mean lesion length was 35.7 ± 16.0 mm. The study device was successfully deployed in 100% of cases, without recoil. Procedure-related minor complications were observed in 3 patients (groin hematoma, dissection). Within 2 years there was 1 unrelated death, but no patients in this cohort had an amputation. At 1 and 2 years, the binary restenosis rates were 12.1% and 16.1%, respectively, and target lesion revascularization was performed in 3 of 34 patients (8.8%) and 4 of 32 patients (11.8%), respectively. The ankle brachial index 0.75 ± 0.14 improved from pre-procedure to 0.96 ± 0.16 at 2 years' follow-up. At 2 years, 71.0% of the patients were Rutherford-Becker 0, and 93.5% achieved a maximum walking distance of 1,500 feet. The safety of the ESPRIT BVS was demonstrated with no procedure or device-related deaths or amputations within 2 years. The low occurrence of revascularizations was consistent with duplex-ultrasonography showing sustained patency at 2-years. (A Clinical Evaluation of the Abbott Vascular ESPRIT BVS [Bioresorbable Vascular Scaffold] System [ESPRIT I]; NCT01468974). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen.

    Directory of Open Access Journals (Sweden)

    Gianluigi Zaza

    Full Text Available The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined.We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group, and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group.A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05. Flagellar motor switch protein (fliNY and type IV pilus assembly protein pilM (pilM were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity.Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this objective.

  14. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen.

    Science.gov (United States)

    Zaza, Gianluigi; Dalla Gassa, Alessandra; Felis, Giovanna; Granata, Simona; Torriani, Sandra; Lupo, Antonio

    2017-01-01

    The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined. We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group), and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group). A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity) at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05). Flagellar motor switch protein (fliNY) and type IV pilus assembly protein pilM (pilM) were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA) was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity. Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this objective.

  15. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen

    Science.gov (United States)

    Dalla Gassa, Alessandra; Felis, Giovanna; Granata, Simona; Torriani, Sandra; Lupo, Antonio

    2017-01-01

    Background The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined. Methods We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group), and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group). Results A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity) at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05). Flagellar motor switch protein (fliNY) and type IV pilus assembly protein pilM (pilM) were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA) was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity. Conclusions Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this

  16. Paclitaxel-eluting stents versus everolimus-eluting coronary stents in a diabetic population: two-year follow-up of the TUXEDO-India trial.

    Science.gov (United States)

    Kaul, Upendra; Bhagwat, Ajit; Pinto, Brian; Goel, Praveen K; Jagtap, Prashant; Sathe, Shireesh; Wander, Gurpreet S; Arambam, Priyadarshini; Bangalore, Sripal

    2017-11-20

    The aim of this study was to report whether the superiority of the everolimus-eluting stent (EES) vs. the paclitaxel-eluting stent (PES) at one-year follow-up in the Taxus Element versus Xience Prime in a Diabetic Population (TUXEDO)-India trial was sustained at longer-term follow-up. One thousand eight hundred and thirty (1,830) patients with diabetes mellitus and coronary artery disease were randomised to EES vs. PES. Follow-up data up to two years were available in 1,701 (92.9%) patients. The primary endpoint was target vessel failure (TVF), defined as the composite of cardiac death, target vessel myocardial infarction (TV-MI), or ischaemia-driven target vessel revascularisation (TVR). Treatment with EES had a lower two-year rate of TVF (4.3% vs. 6.6%, p=0.03). Of the secondary endpoints, EES significantly reduced any MI (1.6% vs. 3.5%, p=0.01), TV-MI (0.7% vs. 3.1%, p=0.0001), ST (0.4% vs. 2.2%, p=0.001), cardiac death or target vessel MI (2.9% vs. 4.8%, p=0.04) and TLR (1.9% vs. 3.7%, p=0.02), compared with PES. Between one year and two years, no significant differences in the clinical outcomes were observed (pinteraction >0.05). In this adequately powered trial, the benefits of EES vs. PES in a diabetic population seen at one year were maintained at two years.

  17. A process for assessing the feasibility of a network meta-analysis: a case study of everolimus in combination with hormonal therapy versus chemotherapy for advanced breast cancer.

    Science.gov (United States)

    Cope, Shannon; Zhang, Jie; Saletan, Stephen; Smiechowski, Brielan; Jansen, Jeroen P; Schmid, Peter

    2014-06-05

    The aim of this study is to outline a general process for assessing the feasibility of performing a valid network meta-analysis (NMA) of randomized controlled trials (RCTs) to synthesize direct and indirect evidence for alternative treatments for a specific disease population. Several steps to assess the feasibility of an NMA are proposed based on existing recommendations. Next, a case study is used to illustrate this NMA feasibility assessment process in order to compare everolimus in combination with hormonal therapy to alternative chemotherapies in terms of progression-free survival for women with advanced breast cancer. A general process for assessing the feasibility of an NMA is outlined that incorporates explicit steps to visualize the heterogeneity in terms of treatment and outcome characteristics (Part A) as well as the study and patient characteristics (Part B). Additionally, steps are performed to illustrate differences within and across different types of direct comparisons in terms of baseline risk (Part C) and observed treatment effects (Part D) since there is a risk that the treatment effect modifiers identified may not explain the observed heterogeneity or inconsistency in the results due to unexpected, unreported or unmeasured differences. Depending on the data available, alternative approaches are suggested: list assumptions, perform a meta-regression analysis, subgroup analysis, sensitivity analyses, or summarize why an NMA is not feasible. The process outlined to assess the feasibility of an NMA provides a stepwise framework that will help to ensure that the underlying assumptions are systematically explored and that the risks (and benefits) of pooling and indirectly comparing treatment effects from RCTs for a particular research question are transparent.

  18. Percutaneous coronary intervention with second-generation paclitaxel-eluting stents versus everolimus-eluting stents in United States contemporary practice (REWARDS TLX Trial).

    Science.gov (United States)

    Waksman, Ron; Ghali, Magdi; Goodroe, Randy; Ryan, Thomas; Turco, Mark; Ring, Michael; McGarry, Thomas; Dobies, David; Shammas, Nicolas; Steinberg, Daniel H; Swymelar, Stacy; Kaneshige, Kimberly; Torguson, Rebecca

    2012-10-15

    Registry Experience at the Washington Hospital Center, DES - Taxus Liberte Versus Xience V (REWARDS TLX) is a physician-initiated, retrospective, real-world, multicenter, observational study for all patients >18 years of age subjected to percutaneous coronary intervention with everolimus-eluting stents (EESs) or paclitaxel-eluting stents (PESs). Outcomes of patients receiving a TAXUS Liberté or XIENCE V drug-eluting stent were compared. Baseline clinical, procedural, and follow-up data at 12 months were collected from 10 clinical centers by an electronic data capture system. The study's primary end point was major adverse cardiac events: a composite of all-cause death, Q-wave myocardial infarction, target vessel revascularization, and stent thrombosis. The trial is registered with http://www.clinicaltrials.gov (NCT01134159). Data were entered for 1,195 patients (PES, n = 595; EES, n = 600). Baseline clinical characteristics were similar except for higher dyslipidemia, systemic hypertension, and family history of coronary artery disease in the EES group. In-hospital outcome was similar between groups, with an overall in-hospital stent thrombosis rate of 0.2%. The primary end point at 12 months was similar (EES 7.8% vs 10.8%, p = 0.082). Overall stent thrombosis rate was lower in the EES group (0.3% vs 1.2%, respectively, p = 0.107); however, target lesion revascularization was similar (PES, hazard ratio 1.46, 95% confidence interval 0.98 to 2.19, p = 0.064). There was no difference in overall mortality between groups. In conclusion, second-generation EESs and PESs demonstrated similar efficacy and safety profiles for broadened patient and lesion subsets compared to a selected population from the pivotal trials. However, for composite efficacy and safety end points, EESs outperformed second-generation PESs. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Efficacy of everolimus with exemestane versus exemestane alone in Asian patients with HER2-negative, hormone-receptor-positive breast cancer in BOLERO-2.

    Science.gov (United States)

    Noguchi, Shinzaburo; Masuda, Norikazu; Iwata, Hiroji; Mukai, Hirofumi; Horiguchi, Jun; Puttawibul, Puttisak; Srimuninnimit, Vichien; Tokuda, Yutaka; Kuroi, Katsumasa; Iwase, Hirotaka; Inaji, Hideo; Ohsumi, Shozo; Noh, Woo-Chul; Nakayama, Takahiro; Ohno, Shinji; Rai, Yoshiaki; Park, Byeong-Woo; Panneerselvam, Ashok; El-Hashimy, Mona; Taran, Tetiana; Sahmoud, Tarek; Ito, Yoshinori

    2014-11-01

    The addition of mTOR inhibitor everolimus (EVE) to exemestane (EXE) was evaluated in an international, phase 3 study (BOLERO-2) in patients with hormone-receptor-positive (HR(+)) breast cancer refractory to letrozole or anastrozole. The safety and efficacy of anticancer treatments may be influenced by ethnicity (Sekine et al. in Br J Cancer 99:1757-62, 2008). Safety and efficacy results from Asian versus non-Asian patients in BOLERO-2 are reported. Patients were randomized (2:1) to 10 mg/day EVE + EXE or placebo (PBO) + EXE. Primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival, response rate, clinical benefit rate, and safety. Of 143 Asian patients, 98 received EVE + EXE and 45 received PBO + EXE. Treatment with EVE + EXE significantly improved median PFS versus PBO + EXE among Asian patients by 38 % (HR = 0.62; 95 % CI, 0.41-0.94). Median PFS was also improved among non-Asian patients by 59 % (HR = 0.41; 95 % CI, 0.33-0.50). Median PFS duration among EVE-treated Asian patients was 8.48 versus 4.14 months for PBO + EXE, and 7.33 versus 2.83 months, respectively, in non-Asian patients. The most common grade 3/4 adverse events (stomatitis, anemia, elevated liver enzymes, hyperglycemia, and dyspnea) occurred at similar frequencies in Asian and non-Asian patients. Grade 1/2 interstitial lung disease occurred more frequently in Asian patients. Quality of life was similar between treatment arms in Asian patients. Adding EVE to EXE provided substantial clinical benefit in both Asian and non-Asian patients with similar safety profiles. This combination represents an improvement in the management of postmenopausal women with HR(+)/HER2(-) advanced breast cancer progressing on nonsteroidal aromatase inhibitors, regardless of ethnicity.

  20. Safety and efficacy of everolimus-eluting stents compared with first-generation drug-eluting stents in patients undergoing primary percutaneous coronary intervention

    Energy Technology Data Exchange (ETDEWEB)

    Escárcega, Ricardo O.; Baker, Nevin C.; Magalhaes, Marco A.; Lipinski, Michael J.; Minha, Sa’ar; Torguson, Rebecca; Satler, Lowell F.; Pichard, Augusto D.; Suddath, William O.; Waksman, Ron, E-mail: ron.waksman@medstar.net

    2014-09-15

    Objective: To assess the safety and efficacy everolimus-eluting stents (EES) compared with first-generation drug-eluting stents (DES) in patients with acute myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI). Background: EES have been associated with improved clinical outcomes compared to paclitaxel-eluting stents (PES) and with similar outcomes compared to sirolimus-eluting stents (SES). Methods: A total of 520 patients who presented with ST-elevation myocardial infarction (STEMI) from 2003 to 2013, who underwent primary PCI with DES, were retrospectively analyzed. Of these, 247 received SES, 136 PES, and 137 EES. Patients were followed up to 2 years for major adverse cardiac events (MACE). Univariate and multivariate models detected correlates to outcome. Results: EES implantation, compared with PES and SES, resulted in comparable rates of MACE (8.8% vs. 16.2%, p = 0.06 and 8.8% vs. 12.6%, respectively, p = 0.26), stent thrombosis, MI, and target lesion revascularization. Patients who received EES had lower rates of all-cause mortality (3.7% vs. 12.6% vs. 9.4%, p = 0.03) at 1-year follow up. However, in the univariate and multivariate analyses, stent type was not independently associated with the primary outcome or with all-cause mortality. Diabetes mellitus and number of stents implanted were independently associated with the primary outcome. Conclusion: While EES seem to be associated with better outcome when compared to PES, the main correlates of STEMI patients are the presence of diabetes and number of stents implanted, and not the type of stent used for intervention.

  1. Everolimus plus exemestane versus bevacizumab-based chemotherapy for second-line treatment of hormone receptor-positive metastatic breast cancer in Greece: An economic evaluation study.

    Science.gov (United States)

    Kourlaba, Georgia; Rapti, Vasiliki; Alexopoulos, Athanasios; Relakis, John; Koumakis, Georgios; Chatzikou, Magdalini; Maniadakis, Nikos; Georgoulias, Vassilis

    2015-08-05

    The objective of our study was to conduct a cost-effectiveness (CE) study of combined everolimus (EVE) and exemestane (EXE) versus the common clinical practice in Greece for the treatment of postmenopausal women with HR+/HER2- advanced breast cancer (BC) progressing on nonsteroidal aromatase inhibitors (NSAI). The combinations of bevacizumab (BEV) plus paclitaxel (PACL) and BEV plus capecitabine (CAPE) were selected as comparators. A Markov model, consisting of three health states, was used to describe disease progression and evaluate the CE of the comparators from a third-party payer perspective over a lifetime horizon. Efficacy and safety data as well as utility values considered in the model were extracted from the relevant randomized Phase III clinical trials and other published studies. Direct medical costs referring to the year 2014 were incorporated in the model. A probabilistic sensitivity analysis was conducted to account for uncertainty and variation in the parameters of the model. Primary outcomes were patient survival (life-years), quality-adjusted life years (QALYs), total direct costs and incremental cost-effectiveness ratios (ICER). The discounted quality-adjusted survival of patients treated with EVE plus EXE was greater by 0.035 and 0.004 QALYs, compared to BEV plus PACL and BEV plus CAPE, respectively. EVE plus EXE was the least costly treatment in terms of drug acquisition, administration, and concomitant medications. The total lifetime cost per patient was estimated at €55,022, €67,980, and €62,822 for EVE plus EXE, BEV plus PACL, and BEV plus CAPE, respectively. The probabilistic analysis confirmed the deterministic results. Our results suggest that EVE plus EXE may be a dominant alternative relative to BEV plus PACL and BEV plus CAPE for the treatment of HR+/HER2- advanced BC patients failing initial therapy with NSAIs.

  2. Safety and efficacy of everolimus with exemestane vs. exemestane alone in elderly patients with HER2-negative, hormone receptor-positive breast cancer in BOLERO-2.

    Science.gov (United States)

    Pritchard, Kathleen I; Burris, Howard A; Ito, Yoshinori; Rugo, Hope S; Dakhil, Shaker; Hortobagyi, Gabriel N; Campone, Mario; Csöszi, Tibor; Baselga, José; Puttawibul, Puttisak; Piccart, Martine; Heng, Daniel; Noguchi, Shinzaburo; Srimuninnimit, Vichien; Bourgeois, Hugues; Gonzalez Martin, Antonio; Osborne, Karen; Panneerselvam, Ashok; Taran, Tetiana; Sahmoud, Tarek; Gnant, Michael

    2013-12-01

    Postmenopausal women with hormone receptor-positive (HR(+)) breast cancer in whom disease progresses or there is recurrence while taking a nonsteroidal aromatase inhibitor (NSAI) are usually treated with exemestane (EXE), but no single standard of care exists in this setting. The BOLERO-2 trial demonstrated that adding everolimus (EVE) to EXE improved progression-free survival (PFS) while maintaining quality of life when compared with EXE alone. Because many women with HR(+) advanced breast cancer are elderly, the tolerability profile of EVE plus EXE in this population is of interest. BOLERO-2, a phase III randomized trial, compared EVE (10 mg/d) and placebo (PBO), both plus EXE (25 mg/d), in 724 postmenopausal women with HR(+) advanced breast cancer recurring/progressing after treatment with NSAIs. Safety and efficacy data in elderly patients are reported at 18-month median follow-up. Baseline disease characteristics and treatment histories among the elderly subsets (≥ 65 years, n = 275; ≥ 70 years, n = 164) were generally comparable with younger patients. The addition of EVE to EXE improved PFS regardless of age (hazard ratio, 0.59 [≥ 65 years] and 0.45 [≥ 70 years]). Adverse events (AEs) of special interest (all grades) that occurred more frequently with EVE than with PBO included stomatitis, infections, rash, pneumonitis, and hyperglycemia. Elderly EVE-treated patients had similar incidences of these AEs as did younger patients but had more on-treatment deaths. Adding EVE to EXE offers substantially improved PFS over EXE and was generally well tolerated in elderly patients with HR(+) advanced breast cancer. Careful monitoring and appropriate dose reductions or interruptions for AE management are recommended during treatment with EVE in this patient population. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Absorb bioresorbable vascular scaffold versus everolimus-eluting metallic stent in ST-segment elevation myocardial infarction: 1-year results of a propensity score matching comparison: the BVS-EXAMINATION Study (bioresorbable vascular scaffold-a clinical evaluation of everolimus eluting coronary stents in the treatment of patients with ST-segment elevation myocardial infarction).

    Science.gov (United States)

    Brugaletta, Salvatore; Gori, Tommaso; Low, Adrian F; Tousek, Petr; Pinar, Eduardo; Gomez-Lara, Josep; Scalone, Giancarla; Schulz, Eberhard; Chan, Mark Y; Kocka, Viktor; Hurtado, Jose; Gomez-Hospital, Juan Antoni; Münzel, Thomas; Lee, Chi-Hang; Cequier, Angel; Valdés, Mariano; Widimsky, Petr; Serruys, Patrick W; Sabaté, Manel

    2015-01-01

    The purpose of this study was to compare the 1-year outcome between bioresorbable vascular scaffold (BVS) and everolimus-eluting metallic stent (EES) in ST-segment elevation myocardial infarction (STEMI) patients. The Absorb BVS (Abbott Vascular, Santa Clara, California) is a polymeric scaffold approved for treatment of stable coronary lesions. Limited and not randomized data are available on its use in ST-segment elevation myocardial infarction (STEMI) patients. This study included 290 consecutive STEMI patients treated by BVS, compared with either 290 STEMI patients treated with EES or 290 STEMI patients treated with bare-metal stents (BMS) from the EXAMINATION (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-segment Elevation Myocardial Infarction) trial, by applying propensity score matching. The primary endpoint was a device-oriented endpoint (DOCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization, at 1-year follow-up. Device thrombosis, according to the Academic Research Consortium criteria, was also evaluated. The cumulative incidence of DOCE did not differ between the BVS and EES or BMS groups either at 30 days (3.1% vs. 2.4%, hazard ratio [HR]: 1.31 [95% confidence interval (CI): 0.48 to 3.52], p = 0.593; vs. 2.8%, HR: 1.15 [95% CI: 0.44 to 2.30], p = 0.776, respectively) or at 1 year (4.1% vs. 4.1%, HR: 0.99 [95% CI: 0.23 to 4.32], p = 0.994; vs. 5.9%, HR: 0.50 [95% CI: 0.13 to 1.88], p = 0.306, respectively). Definite/probable BVS thrombosis rate was numerically higher either at 30 days (2.1% vs. 0.3%, p = 0.059; vs. 1.0%, p = 0.324, respectively) or at 1 year (2.4% vs. 1.4%, p = 0.948; vs. 1.7%, p = 0.825, respectively), as compared with EES or BMS. At 1-year follow-up, STEMI patients treated with BVS showed similar rates of DOCE compared with STEMI patients treated with EES or BMS, although rate of scaffolds thrombosis, mostly clustered in the early phase

  4. Biodegradable Polymer Biolimus-Eluting Stents Versus Durable Polymer Everolimus-Eluting Stents in Patients With Coronary Artery Disease: Final 5-Year Report From the COMPARE II Trial (Abluminal Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent).

    Science.gov (United States)

    Vlachojannis, Georgios J; Smits, Pieter C; Hofma, Sjoerd H; Togni, Mario; Vázquez, Nicolás; Valdés, Mariano; Voudris, Vassilis; Slagboom, Ton; Goy, Jean-Jaques; den Heijer, Peter; van der Ent, Martin

    2017-06-26

    This analysis investigates the 5-year outcomes of the biodegradable polymer biolimus-eluting stent (BP-BES) and durable polymer everolimus-eluting stent (DP-EES) in an all-comers population undergoing percutaneous coronary intervention. Recent 1- and 3-year results from randomized trials have indicated similar safety and efficacy outcomes of BP-BES and DP-EES. Whether benefits of the biodegradable polymer device arise over longer follow-up is unknown. Moreover, in-depth, prospective, long-term follow-up data on metallic drug-eluting stents with durable or biodegradable polymers are scarce. The COMPARE II trial (Abluminal Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent) was a prospective, randomized, multicenter, all-comers trial in which 2,707 patients were randomly allocated (2:1) to BP-BES or DP-EES. The pre-specified endpoint at 5 years was major adverse cardiac events, a composite of cardiac death, nonfatal myocardial infarction, or target vessel revascularization. Five-year follow-up was available in 2,657 patients (98%). At 5 years, major adverse cardiac events occurred in 310 patients (17.3%) in the BP-BES group and 142 patients (15.6%) in the DP-EES group (p = 0.26). The rate of the combined safety endpoint all-cause death or myocardial infarction was 15.0% in the BP-BES group versus 14.8% in the DP-EES group (p = 0.90), whereas the efficacy measure target vessel revascularization was 10.6% versus 9.0% (p = 0.18), respectively. Interestingly, definite stent thrombosis rates did not differ between groups (1.5% for BP-BES vs. 0.9% for DP-EES; p = 0.17). The 5-year analysis comparing biodegradable polymer-coated BES and the durable polymer-coated EES confirms the initial early- and mid-term results regarding similar safety and efficacy outcomes in this all-comers percutaneous coronary intervention population. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

  5. Methods to Compose Sodium Fire Extinguishing Equipment on Sodium Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    Kim, B H; Kim, J M; Jeong, J Y; Choi, B H

    2008-06-15

    Sodium fire is graded 'D' and it is difficult to extinguish sodium fire. In this report, the characteristics of sodium fire and the methods composing the suitable fire extinguishing systems to suppress fire effectively were described.

  6. Methods to Compose Sodium Fire Extinguishing Equipment on Sodium Test Facility

    International Nuclear Information System (INIS)

    Kim, B. H.; Kim, J. M.; Jeong, J. Y.; Choi, B. H.

    2008-06-01

    Sodium fire is graded 'D' and it is difficult to extinguish sodium fire. In this report, the characteristics of sodium fire and the methods composing the suitable fire extinguishing systems to suppress fire effectively were described

  7. Sodium aerosol formation in an argon flow over hot sodium

    International Nuclear Information System (INIS)

    Clement, C.F.; Dolias, M.J.; UKAEA Atomic Energy Research Establishment, Harwell. Thermal Hydraulics Div.)

    1987-01-01

    Vapour evaporation, which partly forms aerosol, occurs when a cold gas flows over a hot liquid. A previous well-mixed model is extended to predict the final vapour plus aerosol content of such a flow in terms of its initial and final temperatures. The predictions are compared to results of the Copacabana II experiment in which argon passed over a sodium pool. Agreement is obtained for the final sodium density at moderate flow rates, and physical reasons are given as to why deviations occur at low and high flow rates. (author)

  8. Outcome of everolimus eluting bioabsorbable vascular scaffold (BVS) compared to non BVS drug eluting stent in the management of ST-segment elevation myocardial infarction (STEMI) — A comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Chakraborty, Rabin; Patra, Soumya, E-mail: dr_soumyapatra@rediffmail.com; Banerjee, Suvro; Pande, Arindam; Khan, Aftab; Mandol, Prakash Chandra; Ghosh, Debashish; De, Swapan Kumar; Das, Sankha Subhro; Nag, Raja

    2016-04-15

    Background: The safety and efficacy of everolimus eluting bioabsorbable vascular scaffold (BVS) in the management of “ST” segment elevation myocardial infarction (STEMI) are yet to be established. Aims: To evaluate immediate and short term safety and efficacy of the everolimus-eluting ABSORB BVS compared with non BVS drug eluting stent (DES) in patients with STEMI. Methods: From December 2013 to December 2014, 220 patients with STEMI were included in this study. Among them, 35 patients treated with BVS were compared with a control group composed of 180 patients who underwent non BVS DES implantation in the same time period. The incidence of major adverse cardiac events (MACE: stent thrombosis: death, non-fatal myocardial infarction, or target vessel/lesion revascularization) before discharge and up to six months was evaluated. Results: 1 vessel disease was more frequent whereas, 2 and 3 vessel disease was less frequent in BVS group. Procedural characteristics were also similar between groups, except for the use of post dilation (p = 0.04). Procedural success, in-hospital, and up to six-month MACE rates were similar between both groups. Definite or probable stent thrombosis did not occur (according to the ARC criteria) in BVS patients, though two patients during the index admission and another two patients in the first month after DES implantation had stent thrombosis. Conclusion: The use of the ABSORB BVS for STEMI is feasible and associated with good procedural safety, and angiographic success rate.

  9. Outcome of everolimus eluting bioabsorbable vascular scaffold (BVS) compared to non BVS drug eluting stent in the management of ST-segment elevation myocardial infarction (STEMI) — A comparative study

    International Nuclear Information System (INIS)

    Chakraborty, Rabin; Patra, Soumya; Banerjee, Suvro; Pande, Arindam; Khan, Aftab; Mandol, Prakash Chandra; Ghosh, Debashish; De, Swapan Kumar; Das, Sankha Subhro; Nag, Raja

    2016-01-01

    Background: The safety and efficacy of everolimus eluting bioabsorbable vascular scaffold (BVS) in the management of “ST” segment elevation myocardial infarction (STEMI) are yet to be established. Aims: To evaluate immediate and short term safety and efficacy of the everolimus-eluting ABSORB BVS compared with non BVS drug eluting stent (DES) in patients with STEMI. Methods: From December 2013 to December 2014, 220 patients with STEMI were included in this study. Among them, 35 patients treated with BVS were compared with a control group composed of 180 patients who underwent non BVS DES implantation in the same time period. The incidence of major adverse cardiac events (MACE: stent thrombosis: death, non-fatal myocardial infarction, or target vessel/lesion revascularization) before discharge and up to six months was evaluated. Results: 1 vessel disease was more frequent whereas, 2 and 3 vessel disease was less frequent in BVS group. Procedural characteristics were also similar between groups, except for the use of post dilation (p = 0.04). Procedural success, in-hospital, and up to six-month MACE rates were similar between both groups. Definite or probable stent thrombosis did not occur (according to the ARC criteria) in BVS patients, though two patients during the index admission and another two patients in the first month after DES implantation had stent thrombosis. Conclusion: The use of the ABSORB BVS for STEMI is feasible and associated with good procedural safety, and angiographic success rate.

  10. Inhibitin: a specific inhibitor of sodium/sodium exchange in erythrocytes.

    OpenAIRE

    Morgan, K; Brown, R C; Spurlock, G; Southgate, K; Mir, M A

    1986-01-01

    An inhibitor of ouabain-insensitive sodium/sodium exchange in erythrocytes has been isolated from leukemic promyelocytes. To explore the specific effects of this inhibitor, named inhibitin, sodium transport experiments were carried out in human erythrocytes. Inhibitin reduced ouabain-insensitive bidirectional sodium transport. It did not change net sodium fluxes, had no significant effect on rubidium influx, and did not inhibit sodium-potassium-ATPase activity. The inhibitory effect of inhibi...

  11. LMFBR safety and sodium boiling

    Energy Technology Data Exchange (ETDEWEB)

    Hinkle, W.D.; Tschamper, P.M.; Fontana, M.H.; Henry, R.E.; Padilla, A. Jr.

    1978-01-01

    Within the U.S. Fast Breeder Reactor Safety R and D Work Breakdown Structure for Line of Assurance 2, Limit Core Damage, the influence of sodium boiling upon the progression and termination of accidents is being studied in loss of flow, transient overpower, loss of piping integrity, loss of shutdown heat removal system and local fault situations. The pertinent analytical and experimental results of this research to date are surveyed and compared with the requirements for demonstrating the effectiveness of this line of assurance. A discussion of specific technical issues concerned with sodium boiling and the need for future development work is also presented.

  12. Neutronic spectrometry measurements in sodium

    International Nuclear Information System (INIS)

    Perlini, G.; Acerbis, S.

    1987-01-01

    Measurements were made of neutronic penetration in sodium, which could serve as a reference and as a benchmark for computer codes. The model employed consisted of an assembly of 7 containers full of sodium for a total of 10 tons and a useful length of almost 4 metres. Measurements were performed at various depths along the central axis of the structure with proton recoil proportional counters. The energy band explored was between 100 and 650 keV. Here we report not only the original spectra of the impulses but also the neutronic spectra found by unfolding with the SPEC-4 code

  13. Too Much Sodium PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-02-07

    This 60 second PSA is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.  Created: 2/7/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/7/2012.

  14. Urinary Sodium and Potassium Excretion and Dietary Sources of Sodium in Maputo, Mozambique

    Directory of Open Access Journals (Sweden)

    Ana Queiroz

    2017-08-01

    Full Text Available This study aimed to evaluate the urinary excretion of sodium and potassium, and to estimate the main food sources of sodium in Maputo dwellers. A cross-sectional evaluation of a sample of 100 hospital workers was conducted between October 2012 and May 2013. Sodium and potassium urinary excretion was assessed in a 24-h urine sample; creatinine excretion was used to exclude unlikely urine values. Food intake in the same period of urine collection was assessed using a 24-h dietary recall. The Food Processor Plus® was used to estimate sodium intake corresponding to naturally occurring sodium and sodium added to processed foods (non-discretionary sodium. Salt added during culinary preparations (discretionary sodium was computed as the difference between urinary sodium excretion and non-discretionary sodium. The mean (standard deviation urinary sodium excretion was 4220 (1830 mg/day, and 92% of the participants were above the World Health Organization (WHO recommendations. Discretionary sodium contributed 60.1% of total dietary sodium intake, followed by sodium from processed foods (29.0% and naturally occurring sodium (10.9%. The mean (standard deviation urinary potassium excretion was 1909 (778 mg/day, and 96% of the participants were below the WHO potassium intake recommendation. The mean (standard deviation sodium to potassium molar ratio was 4.2 (2.4. Interventions to decrease sodium and increase potassium intake are needed in Mozambique.

  15. High-pressure sodium lamp

    NARCIS (Netherlands)

    1996-01-01

    A high pressure sodium lamp of the invention is provided with a discharge vessel (20) which is enclosed with intervening space (1) by an outer bulb (10), which space contains a gas-fill with at least 70 mol. % nitrogen gas. Electrodes (30a, 30b) are positioned in the discharge vessel (20) and are

  16. Cavitation problems in sodium valves

    International Nuclear Information System (INIS)

    Elie, X.

    1976-01-01

    Cavitation poses few problems for sodium valves, in spite of the fact that the loops are not pressurized. This is no doubt due to the low flow velocities in the pipes. For auxiliary loop valves we are attempting to standardize performances with respect to cavitation. For economic reasons cavitation thresholds are approached with large diameter valves. (author)

  17. Structure of sodium perbromate monohydrate

    International Nuclear Information System (INIS)

    Blackburn, A.C.; Gallucci, J.C.; Gerkin, R.E.; Reppart, W.J.

    1992-01-01

    NaBrO 4 .H 2 O, M r =184.90, monoclinic, C2/c, a=15.7575(19), b=5.7373(15), c=11.3390(19) A, β=111.193(10)deg. In this structure, there are two inequivalent Na ions, each coordinated by six O atoms. In each of the two types of distorted octahedra, there are three inequivalent Na-O distances; the average Na(1)-O and Na(2)-O distances are 2.379(10) and 2.405(23) A, respectively. The perbromate ion in this structure displays very nearly regular tetrahedral geometry, although it is subject to no symmetry constraints; the average observed Br-O distance is 1.601(4) A, while the average observed O-Br-O angle is 109.5(9)deg. These values agree well with previously reported values. The perbromate ion, but neither of the sodium coordination polyhedra, shows rigid-body behavior. The average rigid-body corrected Br-O distance in the perbromate ion is 1.624(3) A. Refinement of the two inequivalent H atoms permitted detailed analysis of the hydrogen bonding, which is slightly different from that reported for the isomorphic sodium perchlorate monohydrate. Dynamic disordering of the H atoms as detailed by magnetic resonance methods for sodium perchlorate monohydrate is not clearly indicated in our X-ray study of sodium perbromate monohydrate. (orig./GSCH)

  18. Comparison of sodium aerosol codes

    International Nuclear Information System (INIS)

    Dunbar, I.H.; Fermandjian, J.; Bunz, H.; L'homme, A.; Lhiaubet, G.; Himeno, Y.; Kirby, C.R.; Mitsutsuka, N.

    1984-01-01

    Although hypothetical fast reactor accidents leading to severe core damage are very low probability events, their consequences are to be assessed. During such accidents, one can envisage the ejection of sodium, mixed with fuel and fission products, from the primary circuit into the secondary containment. Aerosols can be formed either by mechanical dispersion of the molten material or as a result of combustion of the sodium in the mixture. Therefore considerable effort has been devoted to study the different sodium aerosol phenomena. To ensure that the problems of describing the physical behaviour of sodium aerosols were adequately understood, a comparison of the codes being developed to describe their behaviour was undertaken. The comparison consists of two parts. The first is a comparative study of the computer codes used to predict aerosol behaviour during a hypothetical accident. It is a critical review of documentation available. The second part is an exercise in which code users have run their own codes with a pre-arranged input. For the critical comparative review of the computer models, documentation has been made available on the following codes: AEROSIM (UK), MAEROS (USA), HAARM-3 (USA), AEROSOLS/A2 (France), AEROSOLS/B1 (France), and PARDISEKO-IIIb (FRG)

  19. CDC Vital Signs: Where's the Sodium?

    Science.gov (United States)

    ... in medical costs. Problem Not all foods are created equal Understanding sodium in foods can be confusing ... for lower sodium choices. About 25% comes from restaurants and it can be hard for a person ...

  20. ELTA: Cita{sup trademark}: Sodium measurement

    Energy Technology Data Exchange (ETDEWEB)

    Mauvais, O. [Water Analysis Line Mgr, ELTA (France)

    2002-07-01

    ELTA is pleased to present its last model of Sodium analyzers: CITA 2340: Automatically controlled sodium meter, integrating more automation and performances results respecting costs and wastes reduction. (authors)

  1. Normal range of human dietary sodium intake

    DEFF Research Database (Denmark)

    McCarron, David A; Kazaks, Alexandra G; Geerling, Joel C

    2013-01-01

    The recommendation to restrict dietary sodium for management of hypertensive cardiovascular disease assumes that sodium intake exceeds physiologic need, that it can be significantly reduced, and that the reduction can be maintained over time. In contrast, neuroscientists have identified neural...... circuits in vertebrate animals that regulate sodium appetite within a narrow physiologic range. This study further validates our previous report that sodium intake, consistent with the neuroscience, tracks within a narrow range, consistent over time and across cultures....

  2. 49 CFR 173.189 - Batteries containing sodium or cells containing sodium.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Batteries containing sodium or cells containing sodium. 173.189 Section 173.189 Transportation Other Regulations Relating to Transportation PIPELINE AND... Than Class 1 and Class 7 § 173.189 Batteries containing sodium or cells containing sodium. (a...

  3. 21 CFR 556.620 - Sulfabromomethazine sodium.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sulfabromomethazine sodium. 556.620 Section 556... Tolerances for Residues of New Animal Drugs § 556.620 Sulfabromomethazine sodium. Tolerances for residues of sulfabromomethazine sodium in food are established as follows: (a) In the uncooked edible tissues of cattle at 0.1...

  4. Clinical impact of nonosmotic sodium storage

    NARCIS (Netherlands)

    Olde Engberink, R.H.G.

    2017-01-01

    High sodium intake is associated with hypertension and increased cardiovascular and renal risk. In this thesis we assessed whether these negative effects of sodium can be neutralised by glycosaminoglycans in the endothelial surface layer (i.e. nonosmotic sodium storage). Also, we investigate the

  5. 21 CFR 558.60 - Arsanilate sodium.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Arsanilate sodium. 558.60 Section 558.60 Food and... in Animal Feeds § 558.60 Arsanilate sodium. (a) Appprovals. Type A medicated articles: 20, 50, or 100...) Arsanilate sodium may be used in accordance with the provisions of this section in the combinations provided...

  6. 21 CFR 522.1145 - Hyaluronate sodium.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Hyaluronate sodium. 522.1145 Section 522.1145 Food... Hyaluronate sodium. (a)(1) Specifications. Each milliliter of sterile aqueous solution contains 10 milligrams of hyaluronate sodium. (2) Sponsor. See 000009 in § 510.600(c). (3) Conditions of use—(i) Amount...

  7. Sodium Fire Demonstration Facility Design and Operation

    International Nuclear Information System (INIS)

    Cho, Youngil; Kim, Jong-Man; Lee, Jewhan; Hong, Jonggan; Yeom, Sujin; Cho, Chungho; Jung, Min-Hwan; Gam, Da-Young; Jeong, Ji-Young

    2014-01-01

    Although sodium has good characteristics such as high heat transfer rate and stable nuclear property, it is difficult to manage because of high reactivity. Sodium is solid at the room temperature and it easily reacts with oxygen resulting in fire due to the reaction heat. Thus, sodium must be stored in a chemically stable place, i.e., an inert gas-sealed or oil filled vessel. When a sodium fire occurs, the Na 2 O of white fume is formed. It is mainly composed of Na 2 O 2 , NaOH, and Na 2 CO 3 , ranging from 0.1 to several tens of micrometers in size. It is known that the particle size increases by aggregation during floating in air. Thus, the protection method is important and should be considered in the design and operation of a sodium system. In this paper, sodium fire characteristics are described, and the demonstration utility of outbreak of sodium fire and its extinguishing is introduced. In this paper, sodium fire characteristics and a demonstration facility are described. The introduced sodium fire demonstration facility is the only training device used to observe a sodium fire and extinguish it domestically. Furthermore, the type of sodium fire will be diversified with the enhancement of the utility. It is expected that this utility will contribute to experience in the safe treatment of sodium by the handlers

  8. Sodium Bicarbonate mouth rinse: An Uncommon Complication

    OpenAIRE

    Fatih Mehmet Coskunses

    2012-01-01

    Sodium bicarbonate is a natural buffer that maintains a healthy pH in mouth to promote a clean and fresh oral environment. Sodium-bicarbonate rinse is empirically suggested to patients by dentist and people around, and may prove to be harmful. In this short communication, we present chemical burn of oral mucosa because of sodium-bicarbonate rinse after misfit dental impression.

  9. 21 CFR 582.1748 - Sodium caseinate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sodium caseinate. 582.1748 Section 582.1748 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1748 Sodium caseinate. (a) Product. Sodium caseinate. (b) Conditions of use. This substance...

  10. 21 CFR 182.1748 - Sodium caseinate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Sodium caseinate. 182.1748 Section 182.1748 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR... Substances § 182.1748 Sodium caseinate. (a) Product. Sodium caseinate. (b) Conditions of use. This substance...

  11. 21 CFR 184.1742 - Sodium carbonate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Sodium carbonate. 184.1742 Section 184.1742 Food... Specific Substances Affirmed as GRAS § 184.1742 Sodium carbonate. (a) Sodium carbonate (Na2CO3, CAS Reg. No... ore calcined to impure soda ash and then purified; or (3) synthesized from limestone by the Solvay...

  12. Sodium fires and nuclear power station safety

    International Nuclear Information System (INIS)

    Ivanenko, V.N.; Zubin, A.; Drobyshev, A.V.

    1986-01-01

    The danger of sodium aerosol release at a design basis accident (DBA) of a sodium-cooled fast reactor that involves coolant leakage and burning, is being analyzed. It has been shown that radioactive and toxic releases at DBA do not exceed permissible values. Some means of sodium fire fighting are described. (author)

  13. 21 CFR 582.1742 - Sodium carbonate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sodium carbonate. 582.1742 Section 582.1742 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1742 Sodium carbonate. (a) Product. Sodium carbonate. (b) Conditions of use. This substance...

  14. Mixed Solvent Reactive Recrystallization of Sodium Carbonate

    NARCIS (Netherlands)

    Gaertner, R.S.

    2005-01-01

    Investigation of the reactive recrystallization of trona (sodium sesquicarbonate) and sodium bicarbonate to sodium carbonate (soda) in a mixed solvent led to the design of several alternative, less energy consumptive, economically very attractive process routes for the production of soda from all

  15. Sodium purification in Rapsodie; La purification du sodium a Rapsodie

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, B [Commissariat a l' Energie Atomique, Dir. des Piles Atomiques, Cadarache (France). Centre d' Etudes Nucleaires

    1968-07-01

    This report is one of a series of publications presenting the main results of tests carried out during the start-up of the first french fast neutron reactor: Rapsodie. The article presents the sodium purification techniques used in the reactor cooling circuits both from the constructional point of view and with respect to results obtained during the first years working. (author) [French] Ce rapport fait partie d'une serie de publications presentant l'essentiel des resultats des essais effectues a l'occasion du demarrage du premier reacteur francais a neutrons rapides: RAPSODIE. Cet article expose les techniques de la purification du sodium utilise dans les circuits de refroidissement du reacteur tant au point de vue de leur realisation technologique, que des resultats obtenus pendant la premiere annee de fonctionnement. (auteur)

  16. Zotarolimus-eluting Resolute Integrity versus everolimus-eluting Xience Xpedition stents in the management of very long (>30 mm) de novo coronary artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Patra, Soumya, E-mail: dr_soumyapatra@rediffmail.com; Chakraborty, Rabindra Nath; Pande, Arindam; Banerjee, Suvro; Jena, Manabhanjan; Mandal, Prakash Chandra; De, Swapan Kumar; Khan, Aftab; Das, Sankha Suvro; Ghosh, Debashish; Nag, Raja

    2017-04-15

    Background: Procedural and clinical outcomes in patients with very long (>30 mm) coronary lesions who underwent stent-based percutaneous coronary interventions are still unfavorable. Therefore, we compared the relative efficacy and safety of resolute zotarolimus-eluting stents (R-ZES) and Xpedition everolimus-eluting stents (X-EES) for patients with de novo very long coronary lesions. Methods: This comparative single-centre, retrospective study compared long R-ZES and X-EES in consecutive patients admitted with very long (≥30 mm) native ACC/AHA type C coronary lesions in 2014. All patients were followed up clinically at 1, 3, 6 and 12 months. In this study, only symptom-driven angiogram was advised. The study end point was to evaluate immediate procedural success and one-year rate of target lesion failure (TLF), which is a composite of cardiac death, target lesion myocardial infarction, or target lesion revascularization (TLR). Results: Total number of patients enrolled in this study was 185 (R-ZES = 107; X-EES = 78). The baseline characteristics and post procedural success rate were similar between R-ZES and X-EES groups, including the post stenting lesion lengths (36.6 ± 1.92 mm vs 40.71 ± 6.175 mm, P = 0.09). At 12-month follow-up, there were no significant between-group differences in the rate of adverse clinical events (death, myocardial infarction, stent thrombosis, target lesion revascularization, and composite outcomes). Procedural success was achieved in 94% in R-ZES group and 93% in X-EES group (P = 0.24). The incidence of TLF was 5% in R-ZES and 4% in X-EES groups (HR-1.25; 95% CI-0.86-5.6; P = 0.19). Conclusion: Patients with de novo long coronary artery disease, R-ZES implantation showed similar clinical outcome as compared with X-EES implantation. - Highlights: • This is the first study comparing between R-ZES (Resolute Integrity) and X-EES (Xience Xpedition) used in PCI for long coronary artery disease. Here, single stent length of more than 30

  17. Quality-of-Life After Everolimus-Eluting Stents or Bypass Surgery for Left-Main Disease: Results From the EXCEL Trial.

    Science.gov (United States)

    Baron, Suzanne J; Chinnakondepalli, Khaja; Magnuson, Elizabeth A; Kandzari, David E; Puskas, John D; Ben-Yehuda, Ori; van Es, Gerrit-Anne; Taggart, David P; Morice, Marie-Claude; Lembo, Nicholas J; Brown, W Morris; Banning, Adrian; Simonton, Charles A; Kappetein, A Pieter; Sabik, Joseph F; Serruys, Patrick W; Stone, Gregg W; Cohen, David J

    2017-12-26

    The EXCEL (Evaluation of Xience Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial compared outcomes in patients with unprotected left main coronary artery disease (LMCAD) treated with coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) using everolimus-eluting stents. Whereas rates of death, stroke, and myocardial infarction were similar at 36 months, event timing and repeat revascularization rates differed by treatment group. To understand the effects of revascularization strategy from the patient's perspective, a prospective quality of life (QoL) substudy was performed alongside the EXCEL trial. Between September 2010 and March 2014, 1,905 patients with LMCAD were randomized to undergo CABG or PCI, of whom 1,788 participated in the QoL substudy. QoL was assessed at baseline and 1, 12, and 36 months using the Seattle Angina Questionnaire, the 12-Item Short Form Health Survey, the Rose Dyspnea Scale, the Patient Health Questionnaire-8, and the EQ-5D. Differences between PCI and CABG were assessed using longitudinal random-effect growth curve models. Over 36 months, both PCI and CABG were associated with significant improvements in QoL compared with baseline. At 1 month, PCI was associated with better QoL than CABG. By 12 months though, these differences were largely attenuated, and by 36 months, there were no significant QoL differences between PCI and CABG. Among selected patients with LMCAD, both PCI and CABG result in similar QoL improvement through 36 months, although a greater early benefit is seen with PCI. Taken together with the 3-year clinical results of EXCEL, these findings suggest that PCI and CABG provide similar intermediate-term outcomes for patients with LMCAD. (Evaluation of Xience Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier

  18. Biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents for primary percutaneous coronary revascularisation of acute myocardial infarction.

    Science.gov (United States)

    Pilgrim, Thomas; Piccolo, Raffaele; Heg, Dik; Roffi, Marco; Tüller, David; Vuilliomenet, André; Muller, Olivier; Cook, Stéphane; Weilenmann, Daniel; Kaiser, Christoph; Jamshidi, Peiman; Khattab, Ahmed A; Taniwaki, Masanori; Rigamonti, Fabio; Nietlispach, Fabian; Blöchlinger, Stefan; Wenaweser, Peter; Jüni, Peter; Windecker, Stephan

    2016-12-10

    Our aim was to compare the safety and efficacy of a novel, ultrathin strut, biodegradable polymer sirolimus-eluting stent (BP-SES) with a thin strut, durable polymer everolimus-eluting stent (DP-EES) in a pre-specified subgroup of patients with acute ST-segment elevation myocardial infarction (STEMI) enrolled in the BIOSCIENCE trial. The BIOSCIENCE trial is an investigator-initiated, single-blind, multicentre, randomised non-inferiority trial (NCT01443104). Randomisation was stratified according to the presence or absence of STEMI. The primary endpoint, target lesion failure (TLF), is a composite of cardiac death, target vessel myocardial infarction, and clinically indicated target lesion revascularisation within 12 months. Between February 2012 and May 2013, 407 STEMI patients were randomly assigned to treatment with BP-SES or DP-EES. At one year, TLF occurred in seven (3.4%) patients treated with BP-SES and 17 (8.8%) patients treated with DP-EES (RR 0.38, 95% CI: 0.16-0.91, p=0.024). Rates of cardiac death were 1.5% in the BP-SES group and 4.7% in the DP-EES group (RR 0.31, 95% CI: 0.08-1.14, p=0.062); rates of target vessel myocardial infarction were 0.5% and 2.6% (RR 0.18, 95% CI: 0.02-1.57, p=0.082), respectively, and rates of clinically indicated target lesion revascularisation were 1.5% in the BP-SES group versus 2.1% in the DP-EES group (RR 0.69, 95% CI: 0.16-3.10, p=0.631). There was no difference in the risk of definite stent thrombosis. In this pre-specified subgroup analysis, BP-SES was associated with a lower rate of target lesion failure at one year compared to DP-EES in STEMI patients. These findings require confirmation in a dedicated STEMI trial.

  19. Health-related quality of life and disease symptoms in postmenopausal women with HR(+), HER2(-) advanced breast cancer treated with everolimus plus exemestane versus exemestane monotherapy.

    Science.gov (United States)

    Campone, Mario; Beck, J Thaddeus; Gnant, Michael; Neven, Patrick; Pritchard, Kathleen I; Bachelot, Thomas; Provencher, Louise; Rugo, Hope S; Piccart, Martine; Hortobagyi, Gabriel N; Nunzi, Martina; Heng, Daniel Y C; Baselga, José; Komorowski, Anna; Noguchi, Shinzaburo; Horiguchi, Jun; Bennett, Lee; Ziemiecki, Ryan; Zhang, Jie; Cahana, Ayelet; Taran, Tetiana; Sahmoud, Tarek; Burris, Howard A

    2013-11-01

    Everolimus (EVE)+exemestane (EXE; n = 485) more than doubled median progression-free survival versus placebo (PBO) + EXE (n = 239), with a manageable safety profile and no deterioration in health-related quality-of-life (HRQOL) in patients with hormone-receptor-positive (HR(+)) advanced breast cancer (ABC) who recurred or progressed on/after nonsteroidal aromatase inhibitor (NSAI) therapy. To further evaluate EVE + EXE impact on disease burden, we conducted additional post-hoc analyses of patient-reported HRQOL. HRQOL was assessed using EORTC QLQ-C30 and QLQ-BR23 questionnaires at baseline and every 6 weeks thereafter until treatment discontinuation because of disease progression, toxicity, or consent withdrawal. Endpoints included the QLQ-C30 Global Health Status (QL2) scale, the QLQ-BR23 breast symptom (BRBS), and arm symptom (BRAS) scales. Between-group differences in change from baseline were assessed using linear mixed models with selected covariates. Sensitivity analysis using pattern-mixture models determined the effect of study discontinuation on/before week 24. Treatment arms were compared using differences of least squares mean (LSM) changes from baseline and 95% confidence intervals (CIs) at each timepoint and overall. Clinicaltrials.gov: NCT00863655. Progression-free survival, survival, response rate, safety, and HRQOL. Linear mixed models (primary model) demonstrated no statistically significant overall difference between EVE + EXE and PBO + EXE for QL2 (LSM difference = -1.91; 95% CI = -4.61, 0.78), BRBS (LSM difference = -0.18; 95% CI = -1.98, 1.62), or BRAS (LSM difference = -0.42; 95% CI = -2.94, 2.10). Based on pattern-mixture models, patients who dropped out early had worse QL2 decline on both treatments. In the expanded pattern-mixture model, EVE + EXE-treated patients who did not drop out early had stable BRBS and BRAS relative to PBO + EXE. HRQOL data were not collected after disease progression. These analyses confirm

  20. Effect of visceral metastases on the efficacy and safety of everolimus in postmenopausal women with advanced breast cancer: subgroup analysis from the BOLERO-2 study.

    Science.gov (United States)

    Campone, Mario; Bachelot, Thomas; Gnant, Michael; Deleu, Ines; Rugo, Hope S; Pistilli, Barbara; Noguchi, Shinzaburo; Shtivelband, Mikhail; Pritchard, Kathleen I; Provencher, Louise; Burris, Howard A; Hart, Lowell; Melichar, Bohuslav; Hortobagyi, Gabriel N; Arena, Francis; Baselga, José; Panneerselvam, Ashok; Héniquez, Aurelia; El-Hashimyt, Mona; Taran, Tetiana; Sahmoud, Tarek; Piccart, Martine

    2013-08-01

    Everolimus (EVE; an inhibitor of mammalian target of rapamycin [mTOR]) enhances treatment options for postmenopausal women with hormone-receptor-positive (HR(+)), human epidermal growth factor receptor-2-negative (HER2(-)) advanced breast cancer (ABC) who progress on a non-steroidal aromatase inhibitor (NSAI). This is especially true for patients with visceral disease, which is associated with poor prognosis. The BOLERO-2 (Breast cancer trial of OraLEveROlimus-2) trial showed that combination treatment with EVE and exemestane (EXE) versus placebo (PBO)+EXE prolonged progression-free survival (PFS) by both investigator (7.8 versus 3.2 months, respectively) and independent (11.0 versus 4.1 months, respectively) central assessment in postmenopausal women with HR(+), HER2(-) ABC recurring/progressing during/after NSAI therapy. The BOLERO-2 trial included a substantial proportion of patients with visceral metastases (56%). Prespecified exploratory subgroup analysis conducted to evaluate the efficacy and safety of EVE+EXE versus PBO+EXE in a prospectively defined subgroup of patients with visceral metastases. At a median follow-up of 18 months, EVE+EXE significantly prolonged median PFS compared with PBO+EXE both in patients with visceral metastases (N=406; 6.8 versus 2.8 months) and in those without visceral metastases (N=318; 9.9 versus 4.2 months). Improvements in PFS with EVE+EXE versus PBO+EXE were also observed in patients with visceral metastases regardless of Eastern Cooperative Oncology Group performance status (ECOG PS). Patients with visceral metastases and ECOG PS 0 had a median PFS of 6.8 months with EVE+EXE versus 2.8 months with PBO+EXE. Among patients with visceral metastases and ECOG PS ≥1, EVE+EXE treatment more than tripled median PFS compared with PBO+EXE (6.8 versus 1.5 months). Adding EVE to EXE markedly extended PFS by ≥4 months among patients with HR(+) HER2(-) ABC regardless of the presence of visceral metastases. Copyright © 2013 The

  1. UV-visible spectroscopy as an alternative to liquid chromatography for determination of everolimus in surfactant-containing dissolution media: a useful approach based on solid-phase extraction.

    Science.gov (United States)

    Kamberi, Marika; Tran, Thu-Ngoc

    2012-11-01

    High-throughput 96-well solid phase extraction (SPE) plate with C-18 reversed phase sorbent followed by UV-visible (UV-Vis) microplate reader was applied to the analysis of hydrophobic drugs in surfactant-containing dissolution media, which are often used to evaluate the in-vitro drug release of drug eluting stents (DES). Everolimus and dissolution medium containing Triton X-405 were selected as representatives, and the appropriate SPE conditions (adsorption, washing and elution) were investigated to obtain a practical and reliable sample clean-up. It was shown that the developed SPE procedure was capable of removing interfering components (Triton X-405 and its impurities), allowing for an accurate automated spectrophotometric analysis to be performed. The proposed UV-Vis spectrophotometric method yielded equivalent results compared to a classical LC analysis method. Linear regression analysis indicated that both methods have the ability to obtain test results that are directly proportional to the concentration of analyte in the sample within the selected range of 1.0-10 μg/ml for everolimus, with a coefficient of correlation (r(2)) value of >0.998 and standard deviation of the residuals (Syx) of UV-Vis spectrophotometric method and from 98 to 102 for the HPLC method, respectively. The 95% CI of the mean recovery for the UV-Vis spectrophotometric method was 99-102% and for the HPLC method was 99-101%. No statistical difference was found between the mean recoveries of the methods (p=0.42). Hence the methods are free from interference due to Triton and other chemicals present in the dissolution medium. The variation in the amount of everolimus estimated by UV-Vis spectrophotometric and HPLC methods was ≤3.5%, and the drug release profiles obtained by both methods were found to be equivalent by evaluation with two-one-sided t-test (two-tailed, p=0.62; mean of differences, 0.17; 95% CI, 0.62-0.96) and similarity factor f2 (f2 value, 87). The excellent conformity of

  2. Economic Outcomes of Bioresorbable Vascular Scaffolds Versus Everolimus-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention: 1-Year Results From the ABSORB III Trial.

    Science.gov (United States)

    Baron, Suzanne J; Lei, Yang; Chinnakondepalli, Khaja; Vilain, Katherine; Magnuson, Elizabeth A; Kereiakes, Dean J; Ellis, Stephen G; Stone, Gregg W; Cohen, David J

    2017-04-24

    The purpose of this study was to evaluate the economic impact of the Absorb bioresorbable vascular scaffold compared with the Xience everolimus-eluting stent in patients undergoing percutaneous coronary intervention. The ABSORB III trial (Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease) demonstrated that the Absorb scaffold was noninferior to the Xience stent with respect to target lesion failure at 1 year. Whether health care costs differ between the Absorb scaffold and the Xience stent is unknown. We performed a prospective health economic study alongside the ABSORB III trial, in which patients undergoing percutaneous coronary intervention for stable or unstable angina were randomized to receive the Absorb scaffold (n = 1,322) or Xience stent (n = 686). Resource use data were collected through 1 year of follow-up. Costs were assessed using resource-based accounting (for procedures), MedPAR data (for other index hospitalization costs), and Medicare reimbursements (for follow-up costs and physician fees). Initial procedural costs were higher with the Absorb scaffold than the Xience stent ($6,316 ± 1,892 vs. $6,103 ± 1,895; p = 0.02), driven mainly by greater balloon catheter use and the higher cost of the scaffold in the Absorb group. Nonetheless, index hospitalization costs ($15,035 ± 2,992 for Absorb vs. $14,903 ± 3,449 for Xience; p = 0.37) and total 1-year costs ($17,848 ± 6,110 for Absorb vs. $17,498 ± 7,411 for Xience; p = 0.29) were similar between the 2 groups. Although initial procedural costs were higher with the Absorb scaffold, there were no differences in total 1-year health care costs between the 2 cohorts. Longer term follow-up is needed to determine whether meaningful cost savings emerge after scaffold resorption. (A Clinical Evaluation of Absorb™ BVS, the Everolimus-Eluting Bioresorbable Vascular Scaffold in the Treatment of Subjects With de Novo Native Coronary Artery Lesions; NCT01751906). Copyright © 2017

  3. Long-term forecasting and comparison of mortality in the Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial: prospective validation of the SYNTAX Score II.

    Science.gov (United States)

    Campos, Carlos M; van Klaveren, David; Farooq, Vasim; Simonton, Charles A; Kappetein, Arie-Pieter; Sabik, Joseph F; Steyerberg, Ewout W; Stone, Gregg W; Serruys, Patrick W

    2015-05-21

    To prospectively validate the SYNTAX Score II and forecast the outcomes of the randomized Evaluation of the Xience Everolimus-Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) Trial. Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization is a prospective, randomized multicenter trial designed to establish the efficacy and safety of percutaneous coronary intervention (PCI) with the everolimus-eluting stent compared with coronary artery bypass graft (CABG) surgery in subjects with unprotected left-main coronary artery (ULMCA) disease and low-intermediate anatomical SYNTAX scores (EXCEL, the SYNTAX Score II was prospectively applied to predict 4-year mortality in the CABG and PCI arms. The 95% prediction intervals (PIs) for mortality were computed using simulation with bootstrap resampling (10 000 times). For the entire study cohort, the 4-year predicted mortalities were 8.5 and 10.5% in the PCI and CABG arms, respectively [odds ratios (OR) 0.79; 95% PI 0.43-1.50). In subjects with low (≤22) anatomical SYNTAX scores, the predicted OR was 0.69 (95% PI 0.34-1.45); in intermediate anatomical SYNTAX scores (23-32), the predicted OR was 0.93 (95% PI 0.53-1.62). Based on 4-year mortality predictions in EXCEL, clinical characteristics shifted long-term mortality predictions either in favour of PCI (older age, male gender and COPD) or CABG (younger age, lower creatinine clearance, female gender, reduced left ventricular ejection fraction). The SYNTAX Score II indicates at least an equipoise for long-term mortality between CABG and PCI in subjects with ULMCA disease up to an intermediate anatomical complexity. Both anatomical and clinical characteristics had a clear impact on long-term mortality predictions and decision making between CABG and PCI. Published on behalf of the European Society of Cardiology. All rights reserved. © The

  4. Long-Term Results of Everolimus-Eluting Stents Versus Drug-Eluting Balloons in Patients With Bare-Metal In-Stent Restenosis: 3-Year Follow-Up of the RIBS V Clinical Trial.

    Science.gov (United States)

    Alfonso, Fernando; Pérez-Vizcayno, María José; García Del Blanco, Bruno; Otaegui, Imanol; Masotti, Mónica; Zueco, Javier; Veláquez, Maite; Sanchís, Juan; García-Touchard, Arturo; Lázaro-García, Rosa; Moreu, José; Bethencourt, Armando; Cuesta, Javier; Rivero, Fernando; Cárdenas, Alberto; Gonzalo, Nieves; Jiménez-Quevedo, Pilar; Fernández, Cristina

    2016-06-27

    The aim of this study was to compare the long-term efficacy of everolimus-eluting stents (EES) and drug-eluting balloons (DEB) in patients with bare-metal stent in-stent restenosis (ISR). The relative long-term clinical efficacy of current therapeutic modalities in patients with ISR remains unknown. The 3-year clinical follow-up (pre-specified endpoint) of patients included in the RIBS V (Restenosis Intra-Stent of Bare-Metal Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent Implantation) randomized clinical trial was analyzed. All patients were followed yearly using a pre-defined structured questionnaire. A total of 189 patients with bare-metal stent ISR were allocated to either EES (n = 94) or DEB (n = 95). Clinical follow-up at 1, 2, and 3 years was obtained in all patients (100%). Compared with patients treated with DEB, those treated with EES obtained better angiographic results, including larger minimal luminal diameter at follow-up (primary study endpoint; 2.36 ± 0.6 mm vs. 2.01 ± 0.6 mm; p 1 year) target vessel (3 [3.2%] vs. 3 [3.2%]; p = 0.95) and target lesion (1 [1%] vs. 2 [2.1%]; p = 0.54) revascularization was low and similar in the 2 arms. Rates of definite or probable stent thrombosis (1% vs. 0%) were also similar in the 2 arms. The 3-year clinical follow-up of the RIBS V clinical trial confirms the sustained safety and efficacy of EES and DEB in patients treated for bare-metal stent ISR. In this setting, EES reduce the need for target lesion revascularization at very long-term follow-up. (RIBS V [Restenosis Intra-Stent of Bare Metal Stents: Paclitaxel-Eluting Balloon vs Everolimus-Eluting Stent] [RIBS V]; NCT01239953). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Transformation of sodium from the Rapsodie fast breeder reactor into sodium hydroxide

    International Nuclear Information System (INIS)

    Roger, J.; Latge, C.; Rodriguez, G.

    1994-01-01

    One of the major problems raised by decommissioning a fast breeder reactor (FBR) concerns the disposal of the sodium coolant. The Desora operation was undertaken to eliminate the Rapsodie primary sodium as part of the partial decommissioning program, and to develop an operational sodium treatment unit for other needs. The process involves reacting small quantities of sodium in water inside a closed vessel, producing aqueous sodium hydroxide and hydrogen gas. It is described in this work. (O.L.). 4 figs

  6. Distributed temperature sensor testing in liquid sodium

    Energy Technology Data Exchange (ETDEWEB)

    Gerardi, Craig; Bremer, Nathan; Lisowski, Darius; Lomperski, Stephen

    2017-02-01

    Rayleigh-backscatter-based distributed fiber optic sensors were immersed in sodium to obtain high-resolution liquid-sodium temperature measurements. Distributed temperature sensors (DTSs) functioned well up to 400°C in a liquid sodium environment. The DTSs measured sodium column temperature and the temperature of a complex geometrical pattern that leveraged the flexibility of fiber optics. A single Ø 360 lm OD sensor registered dozens of temperatures along a length of over one meter at 100 Hz. We also demonstrated the capability to use a single DTS to simultaneously detect thermal interfaces (e.g. sodium level) and measure temperature.

  7. Sodium-concrete reaction model development

    International Nuclear Information System (INIS)

    Nguyen, D.H.; Muhlestein, L.D.; Postma, A.K.

    1982-07-01

    Major observations have been formulated after reviewing test results for over 100 sodium-concrete reaction tests. The observations form the basis for developing a mechanistic model to predict the transient behavior of sodium-concrete reactions. The major observations are listed. Mechanisms associated with sodium and water transport to the reaction zone are identified, and represented by appropriate mathematical expressions. The model attempts to explain large-scale, long-term (100 h) test results were sodium-concrete reactions terminated even in the presence of unreacted sodium and concrete

  8. C-Scan Performance Test of Under-Sodium ultrasonic Waveguide Sensor in Sodium

    International Nuclear Information System (INIS)

    Joo, Young Sang; Bae, Jin Ho; Kim, Jong Bum

    2011-01-01

    Reactor core and in-vessel structures of a sodium-cooled fast (SFR) are submerged in opaque liquid sodium in the reactor vessel. The ultrasonic inspection techniques should be applied for observing the in-vessel structures under hot liquid sodium. Ultrasonic sensors such as immersion sensors and rod-type waveguide sensors have developed in order to apply under-sodium viewing of the in-vessel structures of SFR. Recently the novel plate-type ultrasonic waveguide sensor has been developed for the versatile application of under-sodium viewing in SFR. In previous studies, the ultrasonic waveguide sensor module was designed and manufactured, and the feasibility study of the ultrasonic waveguide sensor was performed. To improve the performance of the ultrasonic waveguide sensor in the under-sodium application, a new concept of ultrasonic waveguide sensors with a Be coated SS304 plate is suggested for the effective generation of a leaky wave in liquid sodium and the non-dispersive propagation of A 0 -mode Lamb wave in an ultrasonic waveguide sensor. In this study, the C-scan performance of the under-sodium ultrasonic waveguide sensor in sodium has been investigated by the experimental test in sodium. The under-sodium ultrasonic waveguide sensor and the sodium test facility with a glove box system and a sodium tank are designed and manufactured to carry out the performance test of under-sodium ultrasonic waveguide sensor in sodium environment condition

  9. Auger recombination in sodium iodide

    Science.gov (United States)

    McAllister, Andrew; Kioupakis, Emmanouil; Åberg, Daniel; Schleife, André

    2014-03-01

    Scintillators are an important tool used to detect high energy radiation - both in the interest of national security and in medicine. However, scintillator detectors currently suffer from lower energy resolutions than expected from basic counting statistics. This has been attributed to non-proportional light yield compared to incoming radiation, but the specific mechanism for this non-proportionality has not been identified. Auger recombination is a non-radiative process that could be contributing to the non-proportionality of scintillating materials. Auger recombination comes in two types - direct and phonon-assisted. We have used first-principles calculations to study Auger recombination in sodium iodide, a well characterized scintillating material. Our findings indicate that phonon-assisted Auger recombination is stronger in sodium iodide than direct Auger recombination. Computational resources provided by LLNL and NERSC. Funding provided by NA-22.

  10. Sodium vapor charge exchange cell

    International Nuclear Information System (INIS)

    Hiddleston, H.R.; Fasolo, J.A.; Minette, D.C.; Chrien, R.E.; Frederick, J.A.

    1976-01-01

    An operational sequential charge-exchange ion source yielding a 50 MeV H - current of approximately 8 mA is planned for use with the Argonne 500 MeV booster synchrotron. We report on the progress for development of a sodium vapor charge-exchange cell as part of that planned effort. Design, fabrication, and operating results to date are presented and discussed. (author)

  11. Distributed temperature sensor testing in liquid sodium

    Energy Technology Data Exchange (ETDEWEB)

    Gerardi, Craig, E-mail: cgerardi@anl.gov; Bremer, Nathan; Lisowski, Darius; Lomperski, Stephen

    2017-02-15

    Highlights: • Distributed temperature sensors measured high-resolution liquid-sodium temperatures. • DTSs worked well up to 400 °C. • A single DTS simultaneously detected sodium level and temperature. - Abstract: Rayleigh-backscatter-based distributed fiber optic sensors were immersed in sodium to obtain high-resolution liquid-sodium temperature measurements. Distributed temperature sensors (DTSs) functioned well up to 400 °C in a liquid sodium environment. The DTSs measured sodium column temperature and the temperature of a complex geometrical pattern that leveraged the flexibility of fiber optics. A single Ø 360 μm OD sensor registered dozens of temperatures along a length of over one meter at 100 Hz. We also demonstrated the capability to use a single DTS to simultaneously detect thermal interfaces (e.g. sodium level) and measure temperature.

  12. Combustion suppressing device for leaked sodium

    International Nuclear Information System (INIS)

    Ooto, Akihiro.

    1985-01-01

    Purpose: To suppress the atmospheric temperature to secure the building safety and shorten the recovery time after the leakage in a chamber for containing sodium leaked from coolant circuit equipments or pipeways of LMFBR type rector by suppressing the combustion of sodium contained in the chamber. Constitution: To the inner wall of a chamber for containing sodium handling equipments, are vertically disposed a panel having a coolant supply port at the upper portion and a coolant discharge port at the lower portion thereof and defined with a coolant flowing channel and a panel for sucking the coolant discharged from the abovementioned panel and exhausting the same externally. Further, a corrugated combustion suppressing plate having apertures for draining the condensated leaked sodium is disposed near the sodium handling equipments. If ruptures are resulted to the sodium handling equipments or pipeway, leaked sodium is passed through the drain apertures in the suppressing plate and stored at the bottom of the containing chamber. (Horiuchi, T.)

  13. Development of the immersed sodium flowmeter

    International Nuclear Information System (INIS)

    Chen Daolong

    1994-09-01

    An immersed sodium flowmeter of the range 3 m 3 /h is developed. It is a flowmeter of entire-sealed construction, it can be operated in sodium. Its construction, the theoretical calculation of the calibration characteristic and the pressure loss, the test facility and the calibration test are presented in detail. It analytical expression of the calibration characteristic in the temperature limit 200∼600 degree C and the error analysis are given. The basic error of this immersed sodium flowmeter is below +-2.3% of the measuring range. The immersed sodium flowmeter can be used to resolve the sodium flowrate measuring problems of the in-reactor component of LMFBR, for example, the flowrate measuring of the in-reactor sodium purification loop, the flowrate measuring of the immersed sodium pump and the flowrate measuring of the in-reactor test component

  14. Sodium bicarbonate improves swimming performance.

    Science.gov (United States)

    Lindh, A M; Peyrebrune, M C; Ingham, S A; Bailey, D M; Folland, J P

    2008-06-01

    Sodium bicarbonate ingestion has been shown to improve performance in single-bout, high intensity events, probably due to an increase in buffering capacity, but its influence on single-bout swimming performance has not been investigated. The effects of sodium bicarbonate supplementation on 200 m freestyle swimming performance were investigated in elite male competitors. Following a randomised, double blind counterbalanced design, 9 swimmers completed maximal effort swims on 3 separate occasions: a control trial (C); after ingestion of sodium bicarbonate (SB: NaHCO3 300 mg . kg (-1) body mass); and after ingestion of a placebo (P: CaCO3 200 mg . kg (-1) body mass). The SB and P agents were packed in gelatine capsules and ingested 90 - 60 min prior to each 200 m swim. Mean 200 m performance times were significantly faster for SB than C or P (1 : 52.2 +/- 4.7; 1 : 53.7 +/- 3.8; 1 : 54.0 +/- 3.6 min : ss; p bicarbonate were all elevated pre-exercise in the SB compared to C and P trials (p < 0.05). Post-200 m blood lactate concentrations were significantly higher following the SB trial compared with P and C (p < 0.05). It was concluded that SB supplementation can improve 200 m freestyle performance time in elite male competitors, most likely by increasing buffering capacity.

  15. Sodium fires in nuclear facilities

    International Nuclear Information System (INIS)

    Menzenhauer, P.

    1974-01-01

    The work deals with the behaviour of liquid sodium when it comes into contact with air, especially in the course of fires in technical plants. The most important fire procedures are constructed as realistically as possible, that is to say that the fires were not only carried out on a laboratory scale but with quantities of up to 200 kg sodium at temperatures of up to 800 0 C. The following was investigated: 1) the course of the fire in rooms, 2) restriction of the fire, 3) removal of the burnt remains, 4) protection measures. The fire was varied in its most important physical appearance such as surface fire, spurt fire and fire on isolated pipe lines. The fires were checked by precautionary, contructive measures - it was not necessary to place persons at the site of the fire - and by active measures such as for example by covering with extinguishing powder. All important test phases were captured in film and slides series. Visible material is thus available for the operation team of sodium plants and fire brigades who might possibly be called upon. (orig./LH) [de

  16. A study of atomic interaction between suspended nanoparticles and sodium atoms in liquid sodium

    International Nuclear Information System (INIS)

    Saito, Jun-ichi; Ara, Kuniaki

    2010-01-01

    A feasibility study of suppression of the chemical reactivity of sodium itself using an atomic interaction between nanoparticles and sodium atoms has been carried out. We expected that the atomic interaction strengthens when the nanoparticle metal is the transition element which has a major difference in electronegativity from sodium. We also calculated the atomic interaction between nanoparticle and sodium atoms. It became clear that the atomic bond between the nanoparticle atom and the sodium atom is larger than that between sodium atoms, and the charge transfer takes place to the nanoparticle atom from the sodium atom. Using sodium with suspended nanoparticles, the fundamental physical properties related to the atomic interaction were investigated to verify the atomic bond. The surface tension of sodium with suspended nanoparticles increased, and the evaporation rate of sodium with suspended nanoparticles also decreased compared with that of sodium. Therefore the presence of the atomic interaction between nanoparticles and sodium was verified from these experiments. Because the fundamental physical property changes by the atomic interaction, we expected changes in the chemical reactivity characteristics. The chemical reaction properties of sodium with suspended nanoparticles with water were investigated experimentally. The released reaction heat and the reaction rate of sodium with suspended nanoparticles were reduced than those of sodium. The influence of the charge state of nanoparticle on the chemical process with water was theoretically investigated to speculate on the cause of reaction suppression. The potential energy in both primary and side reactions changed by the charge transfer, and the free energy of activation of the reaction with water increased. Accordingly, the reaction barrier also increased. This suggests there is a possibility of the reduction in the reaction of sodium by the suspension of nanoparticles. Consequently the possibility of the

  17. Sodium setpoint and gradient in bicarbonate hemodialysis.

    Science.gov (United States)

    Basile, Carlo; Libutti, Pasquale; Lisi, Piero; Vernaglione, Luigi; Casucci, Francesco; Losurdo, Nicola; Teutonico, Annalisa; Lomonte, Carlo

    2013-01-01

    The demonstration of an individual osmolar setpoint in hemodialysis (HD) is crucial to individualize dialysate sodium concentrations. Furthermore, the diffusive gradient between plasma and dialysate sodium is important in the "fine tuning" of the intradialytic sodium mass balance (MB). The design of this study included part A: a retrospective analysis of predialysis plasma sodium concentrations extracted from a 6-year database in our HD population (147 prevalent white anuric patients); and part B: study of intradialytic sodium kinetics in 48 patients undergoing one 4-hour bicarbonate HD session. Direct potentiometry with an ion-selective electrode was used for sodium measurements. Study part A: the mean number of plasma sodium measurements per patient was 16.06 ± 14.03 over a mean follow-up of 3.55 ± 1.76 years. The mean of the averaged plasma sodium concentrations was 136.7 ± 2.1 mmol/L, with a low mean intraindividual coefficient of variation (1.39 ± 0.4). Study part B: mean predialysis and postdialysis plasma sodium concentrations were 135.8 ± 0.9 and 138.0 ± 0.9 mmol/L (p<0.001). Mean inlet dialyzer sodium concentration was 138.7 ± 1.1 mmol/L; the hourly diffusion concentration gradients showed a statistically significant transfer from dialysate to plasma (Wilks ? <0.0001). A statistically significant relationship was found between sodium MB and diffusion gradient (p<0.02), and between sodium MB and ultrafiltration volume (p<0.01). A relatively "fixed" and individual osmolar setpoint in HD patients was shown for the first time in a long-term follow-up. A dialysate sodium concentration of 140 mmol/L determined a dialysate to plasma sodium gradient.

  18. Intelligent type sodium instrumentations for LMFR

    International Nuclear Information System (INIS)

    Daolong Chen

    1996-01-01

    The constructions and their performances of a lot of newly developed intelligent type sodium instrumentations that consist of the intelligent type sodium flowmeter, the intelligent type immersed sodium flowmeter, the intelligent type sodium manometer and the intelligent type sodium level gauge are described. The graduation characteristic equations for corresponding transducer using the medium temperature as the parameter are given. Because the operating temperature limit of measured medium (sodium) is wide, so the on-line compensation of the temperature effect of their graduation characteristics much be considered. The tests show that these intelligent type sodium instrumentations possess of good linearity. The accurate sodium process parameter (flowrate, pressure and level) measurement data can be obtained by means of their on-line compensation function of the temperature effect. Moreover, these intelligent type sodium instrumentations possess of the self-inspection, the electric shutoff protection, the setting of full-scale, the setting of alarm limits (two upper limits and two lower limits alarms), the thermocouple breaking alarm, each other isolative the 0-10V direct-current analogue output and CENTRONICS standard digital output, and the alarm relay contact output. These intelligent type sodium instrumentations are suitable particularly for the instrument, control and protective systems of LMFR by means of these excellent functions based on microprocessor. The basic error of the intelligent type sodium flowmeter, immersed sodium flowmeter, sodium manometer and sodium level gauge is respectively ±2%, ±2.3%, ±0.3% and ±1.9% of measuring range. (author). 4 refs, 9 figs

  19. A sirolimus-eluting bioabsorbable polymer-coated stent (MiStent) versus an everolimus-eluting durable polymer stent (Xience) after percutaneous coronary intervention (DESSOLVE III): a randomised, single-blind, multicentre, non-inferiority, phase 3 trial.

    Science.gov (United States)

    de Winter, Robbert J; Katagiri, Yuki; Asano, Taku; Milewski, Krzysztof P; Lurz, Philipp; Buszman, Pawel; Jessurun, Gillian A J; Koch, Karel T; Troquay, Roland P T; Hamer, Bas J B; Ophuis, Ton Oude; Wöhrle, Jochen; Wyderka, Rafał; Cayla, Guillaume; Hofma, Sjoerd H; Levesque, Sébastien; Żurakowski, Aleksander; Fischer, Dieter; Kośmider, Maciej; Goube, Pascal; Arkenbout, E Karin; Noutsias, Michel; Ferrari, Markus W; Onuma, Yoshinobu; Wijns, William; Serruys, Patrick W

    2018-02-03

    MiStent is a drug-eluting stent with a fully absorbable polymer coating containing and embedding a microcrystalline form of sirolimus into the vessel wall. It was developed to overcome the limitation of current durable polymer drug-eluting stents eluting amorphous sirolimus. The clinical effect of MiStent sirolimus-eluting stent compared with a durable polymer drug-eluting stents has not been investigated in a large randomised trial in an all-comer population. We did a randomised, single-blind, multicentre, phase 3 study (DESSOLVE III) at 20 hospitals in Germany, France, Netherlands, and Poland. Eligible participants were any patients aged at least 18 years who underwent percutaneous coronary intervention in a lesion and had a reference vessel diameter of 2·50-3·75 mm. We randomly assigned patients (1:1) to implantation of either a sirolimus-eluting bioresorbable polymer stent (MiStent) or an everolimus-eluting durable polymer stent (Xience). Randomisation was done by local investigators via web-based software with random blocks according to centre. The primary endpoint was a non-inferiority comparison of a device-oriented composite endpoint (DOCE)-cardiac death, target-vessel myocardial infarction, or clinically indicated target lesion revascularisation-between the groups at 12 months after the procedure assessed by intention-to-treat. A margin of 4·0% was defined for non-inferiority of the MiStent group compared with the Xience group. All participants were included in the safety analyses. This trial is registered with ClinicalTrials.gov, number NCT02385279. Between March 20, and Dec 3, 2015, we randomly assigned 1398 patients with 2030 lesions; 703 patients with 1037 lesions were assigned to MiStent, of whom 697 received the index procedure, and 695 patients with 993 lesions were asssigned to Xience, of whom 690 received the index procedure. At 12 months, the primary endpoint had occurred in 40 patients (5·8%) in the sirolimus-eluting stent group and in 45

  20. Instrumentation for Sodium Circuits; Instrumentation des Circuits de Sodium

    Energy Technology Data Exchange (ETDEWEB)

    Cambillard, E. [CEA, Centre d' Etudes Nucleaires de Fontenay-aux-Roses (France); Lions, N. [CEA, Centre d' Etudes Nucleaires de Cadarache (France)

    1967-06-15

    Electromagnetic flow meters, level gauges and differential pressure gauges are among the main measurement instruments designed and tested at the Commissariat a l'Energie Atomique (CEA) for sodium reactors. The main characteristics of the flow meters used with RAPSODIE are indicated. The instruments used in this connection are of the permanent -magnet or electromagnet type (in the primary circuits). A description is given of the calibration methods employed - use is made of diaphragms or Venturi tubes as standard flow meters - and information is given on the results measured for maximum sodium flows of 400 m{sup 3}/h. Three types of continuous level gauge have been studied. Resistance gauge. Two varieties used for the 1 - and 10-MW test circuits of RAPSODIE are described. In one there is a compensation resistance along the whole height of the measuring element (the continuous gauges used with the RAPSODIE reactor are at present of this type). In the other type of gauge a device is incorporated to heat the measurement element and prevent the formation of conducting deposits (prototype sodium tests have been completed). Induction gauge. This type has two coupled coils and is fitted with a device to compensate for temperature effects. A description is given of a prototype which has been built and the results obtained in the course of sodium tests are described. Ultrasonic gauge. With this type, a transmitter is fitted on top of the outside of the sodium container; there is also a vertical wave guide, the bottom of which is immersed in the liquid metal and possesses a reflector system which returns the ultrasonic beam towards the surface. Fixed reference marks provide a permanent means of calibration and the whole apparatus is welded. This type of gauge is now being constructed. The differential pressure gauges that have been built, and used in particular with Venturi tube flow meters, are modified versions of the devices employed with the 1 - and 10-MW test circuits of

  1. Efficacy and Safety of the Absorb Everolimus-Eluting Bioresorbable Scaffold for Treatment of Patients With Diabetes Mellitus: Results of the Absorb Diabetic Substudy.

    Science.gov (United States)

    Kereiakes, Dean J; Ellis, Stephen G; Kimura, Takeshi; Abizaid, Alexandre; Zhao, Weiying; Veldhof, Susan; Vu, Minh-Thien; Zhang, Zhen; Onuma, Yoshinobu; Chevalier, Bernard; Serruys, Patrick W; Stone, Gregg W

    2017-01-09

    The study sought to evaluate the efficacy and safety of the Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) (Abbott Vascular, Abbott Park, Illinois) in patients with diabetes mellitus. Randomized, controlled trials have demonstrated comparable clinical outcomes following percutaneous coronary intervention with either Absorb BVS or metallic Xience everolimus-eluting stent. However, these trials lack power required to provide reliable treatment effect estimates in this high-risk population. In a pre-specified, powered analysis, patients with diabetes who received ≥1 Absorb were pooled from the ABSORB II, III, and JAPAN randomized trials and from the single arm ABSORB EXTEND registry. The study composite primary endpoint was target lesion failure (TLF) at 1 year following Absorb BVS compared with a performance goal of 12.7%. Among 754 diabetic patients included in analysis (27.3% insulin treated), the 1-year TLF rate was 8.3% (upper 1-sided 95% confidence limit: 10.1%; p = 0.0001 vs. performance goal). Scaffold thrombosis (definite or probable) was observed in 2.3% of patients. Multivariable regression identified older age, insulin treatment, and smaller pre-procedure reference vessel diameter as significant independent predictors of 1-year TLF. The Absorb diabetic substudy suggests efficacy and safety of the Absorb BVS for treatment of patients with diabetes mellitus. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. A Patient with MSUD: Acute Management with Sodium Phenylacetate/Sodium Benzoate and Sodium Phenylbutyrate

    Directory of Open Access Journals (Sweden)

    Melis Köse

    2017-01-01

    Full Text Available In treatment of metabolic imbalances caused by maple syrup urine disease (MSUD, peritoneal dialysis, and hemofiltration, pharmacological treatments for elimination of toxic metabolites can be used in addition to basic dietary modifications. Therapy with sodium phenylacetate/benzoate or sodium phenylbutyrate (NaPB in urea-cycle disorder cases has been associated with a reduction in branched-chain amino acid (BCAA concentrations when the patients are on adequate dietary protein intake. Moreover, NaPB in treatment of MSUD patients is also associated with reduction of BCAA levels in a limited number of cases. However, there are not enough studies in the literature about application and efficacy of this treatment. Our case report sets an example of an alternative treatment’s efficacy when extracorporeal procedures are not available due to technical difficulties during attack period of the disease.

  3. A Patient with MSUD: Acute Management with Sodium Phenylacetate/Sodium Benzoate and Sodium Phenylbutyrate.

    Science.gov (United States)

    Köse, Melis; Canda, Ebru; Kagnici, Mehtap; Uçar, Sema Kalkan; Çoker, Mahmut

    2017-01-01

    In treatment of metabolic imbalances caused by maple syrup urine disease (MSUD), peritoneal dialysis, and hemofiltration, pharmacological treatments for elimination of toxic metabolites can be used in addition to basic dietary modifications. Therapy with sodium phenylacetate/benzoate or sodium phenylbutyrate (NaPB) in urea-cycle disorder cases has been associated with a reduction in branched-chain amino acid (BCAA) concentrations when the patients are on adequate dietary protein intake. Moreover, NaPB in treatment of MSUD patients is also associated with reduction of BCAA levels in a limited number of cases. However, there are not enough studies in the literature about application and efficacy of this treatment. Our case report sets an example of an alternative treatment's efficacy when extracorporeal procedures are not available due to technical difficulties during attack period of the disease.

  4. Sodium vapor deposition onto a horizontal flat plate above liquid sodium surface, (3)

    International Nuclear Information System (INIS)

    Kudo, Kazuhiko; Hirata, Masaru.

    1978-01-01

    Sodium vapour and sodium mist in the cover gas of a sodium system of a fast breeder reactor cause various problems. In this report, with the results of measurements of sodium mist concentration, the distribution of sodium mist diameter in cover gas was analytically obtained. The analysis was made by using the different nucleus model B. The measurement of the concentration of sodium mist was carried out with a sodium mist pot designed by the author. The experiment was done at the sodium temperature of 400 and 500 degree centigrade. The relations among sodium temperature, upper wall temperature, and the sodium mist concentration in cover gas were obtained. Evaluation of effective condensed nuclear radius in the cover gas was made by the comparison of analysis and experimental results. The results of this evaluation shows the following conclusions. It is impossible to express the distribution of sodium mist diameter by normal distribution or logarithmic normal distribution. Drop of sodium temperature results in the decrease of weight mean radius of generated sodium mist. Drop of upper wall temperature causes the decrease of weight mean radius, and increases sodium mist concentration. (Kato, T.)

  5. Sodium-sodium intermediate heat exchangers design problems

    International Nuclear Information System (INIS)

    Chandramohan, R.

    1975-01-01

    This paper deals briefly with the calculation methods adapted, in working-out the stresses due to fluid pressures (normal as well as transient), weights, piping-reactions, vibration in the tube-bundle and also the thermal stresses during normal and transient conditions, for the mechanical design of intermediate heat-exchanger. The thermal stress evaluation of the tube-sheet is given particular emphasis. A brief outline of the design problems connected with the Na-Na exchangers of large size sodium cooled fast reactor plants is also given. (author)

  6. Cleaning of Sodium in the Cold Trap

    International Nuclear Information System (INIS)

    Kim, Byung Ho; Jeong, Ji Young; Kim, Jong Man; Choi, Byung Hae; Nam, Ho Yun

    2005-01-01

    The purpose of a cleaning process is to remove the residual sodium adhering to the component walls once it has been properly drained. It is necessary to clean and decontaminate a component, especially the large components of the primary coolant system; such as the intermediate heat exchangers and the primary pump. Improper and inadequate cleaning has in a number of cases resulted in problems in the storage, handling, and reuse of components. Several types of failures due to improper cleaning procedures have been defined in the past. Inadequate and incomplete removal of sodium results in residues which may contain metallic sodium and alkaline compounds such as sodium hydroxide, sodium oxide, sodium carbonate, and various types of alcoholates. Reinsertion of components containing these compounds into a high-temperature sodium system can result in either the intergranular penetration characteristic of a high- oxygen sodium or an accelerated corrosion due to oxygen. The methods used for cleaning sodium equipment depend on the condition and types of equipment to be cleaned and whether the equipment is to be reused. Cleaning methods are needed that will avoid a deleterious local overheating, material surface degradation or deposits, chemical, physical, or mechanical damage, and external effects. This paper discusses a steam-nitrogen gas cleaning method for the routine applications that permits the reuse of the cold trap in sodium

  7. Wireless sensor network for sodium leak detection

    International Nuclear Information System (INIS)

    Satya Murty, S.A.V.; Raj, Baldev; Sivalingam, Krishna M.; Ebenezer, Jemimah; Chandran, T.; Shanmugavel, M.; Rajan, K.K.

    2012-01-01

    Highlights: ► Early detection of sodium leak is mandatory in any reactor handling liquid sodium. ► Wireless sensor networking technology has been introduced for detecting sodium leak. ► We designed and developed a wireless sensor node in-house. ► We deployed a pilot wireless sensor network for handling nine sodium leak signals. - Abstract: To study the mechanical properties of Prototype Fast Breeder Reactor component materials under the influence of sodium, the IN Sodium Test (INSOT) facility has been erected and commissioned at Indira Gandhi Centre for Atomic Research. Sodium reacts violently with air/moisture leading to fire. Hence early detection of sodium leak if any is mandatory for such plants and almost 140 sodium leak detectors are placed throughout the loop. All these detectors are wired to the control room for data collection and monitoring. To reduce the cost, space and maintenance that are involved in cabling, the wireless sensor networking technology has been introduced in the sodium leak detection system of INSOT. This paper describes about the deployment details of the pilot wireless sensor network and the measures taken for the successful deployment.

  8. Containment Sodium Chemistry Models in MELCOR.

    Energy Technology Data Exchange (ETDEWEB)

    Louie, David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Humphries, Larry L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Denman, Matthew R [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-04-01

    To meet regulatory needs for sodium fast reactors’ future development, including licensing requirements, Sandia National Laboratories is modernizing MELCOR, a severe accident analysis computer code developed for the U.S. Nuclear Regulatory Commission (NRC). Specifically, Sandia is modernizing MELCOR to include the capability to model sodium reactors. However, Sandia’s modernization effort primarily focuses on the containment response aspects of the sodium reactor accidents. Sandia began modernizing MELCOR in 2013 to allow a sodium coolant, rather than water, for conventional light water reactors. In the past three years, Sandia has been implementing the sodium chemistry containment models in CONTAIN-LMR, a legacy NRC code, into MELCOR. These chemistry models include spray fire, pool fire and atmosphere chemistry models. Only the first two chemistry models have been implemented though it is intended to implement all these models into MELCOR. A new package called “NAC” has been created to manage the sodium chemistry model more efficiently. In 2017 Sandia began validating the implemented models in MELCOR by simulating available experiments. The CONTAIN-LMR sodium models include sodium atmosphere chemistry and sodium-concrete interaction models. This paper presents sodium property models, the implemented models, implementation issues, and a path towards validation against existing experimental data.

  9. Sodium intake and dietary sources of sodium in undergraduate students from Novi Sad, Serbia

    Directory of Open Access Journals (Sweden)

    Jovičić-Bata Jelena

    2016-01-01

    Full Text Available Background/Aim. Data on sodium intake and sources of sodium in the diet in Serbia are limited. The aim of this study was to estimate the sodium intake and identify the sources of sodium in the diet of undergraduate students attending the University of Novi Sad. Methods. Students completed a questionnaire to gather data on their gender, age and university faculty attended, and then a 24 h dietary recall. The sodium intake of the students was calculated using the dietary recall data and data on the sodium content of foods. The contribution of different food groups as well as of specific foodstuffs to the total sodium intake was calculated. Results. The mean estimated sodium intake of the students was 3,938.5 ± 1,708.1 mg/day. The sodium intake of 89.1% of the surveyed students exceeded the guideline for sodium intake, the majority of the sodium coming from processed foods (78.9% of the total sodium intake. The food groups that contributed the most to the total sodium intake of the students were meat and meat products (21.7% and cereals and cereal-based products (18.6%. Bread and other bakery products were responsible for 13.1% of the total sodium intake. Conclusion. High sodium intake in students of the University of Novi Sad puts them at high risk of developing high blood pressure. The food industry should work towards reformulating products with high sodium content, especially bread and other bakery products. Efforts should be taken to reduce sodium intake among undergraduate students in Novi Sad.

  10. Improving the Corrosion Inhibitive Strength of Sodium Sulphite in Hydrogen Cyanide Solution Using Sodium Benzoate

    Directory of Open Access Journals (Sweden)

    Muhammed Olawale Hakeem AMUDA

    2008-12-01

    Full Text Available The improvement in the inhibitive strength of sodium sulphite on corrosion of mild steel in hydrogen cyanide by adding sodium benzoate in regulated volume was investigated using the fundamental weight loss measurement.500 ppm concentration inhibitive mixtures of sodium benzoate and sodium sulphite in three different volume ratios (5/15, 10/10, 15/5 were formulated and studied for corrosion rate in 200ml hydrogen cyanide fluid. Result obtained indicates that the corrosion rate of mild steel in hydrogen cyanide in the presence of sodium benzoate/sodium sulphite inhibitive mixtures range 0.322mmpy to 1.1269mmpy across the three volumetric ratios considered. The 15ml5ml sodium benzoatesodium sulphite mixture had the best average corrosion rate of 0.5123mmpy.The corrosion rate followed reducing pattern after the first 200 hours of immersion. The average corrosion rate in the sodium benzoate / sodium sulphite mixture is less than the rate in sodium sulphite and the mixture is only effective after long time exposure.It is concluded that adding sodium benzoate to sodium sulphite in the volumetric ratio 155ml improves the inhibitive strength of sodium sulphite on the corrosion of mild steel in hydrogen cyanide environment.

  11. Reduced Dietary Sodium Intake Increases Heart Rate

    DEFF Research Database (Denmark)

    Graudal, Niels A; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2016-01-01

    Reduced dietary sodium intake (sodium reduction) increases heart rate in some studies of animals and humans. As heart rate is independently associated with the development of heart failure and increased risk of premature death a potential increase in heart rate could be a harmful side......-effect of sodium reduction. The purpose of the present meta-analysis was to investigate the effect of sodium reduction on heart rate. Relevant studies were retrieved from an updated pool of 176 randomized controlled trials (RCTs) published in the period 1973-2014. Sixty-three of the RCTs including 72 study...... populations reported data on heart rate. In a meta-analysis of these data sodium reduction increased heart rate with 1.65 beats per minute [95% CI: 1.19, 2.11], p heart rate. This effect was independent of baseline blood pressure. In conclusion sodium reduction...

  12. Apparatus for detecting leakage of liquid sodium

    Science.gov (United States)

    Himeno, Yoshiaki

    1978-01-01

    An apparatus for detecting the leakage of liquid sodium includes a cable-like sensor adapted to be secured to a wall of piping or other equipment having sodium on the opposite side of the wall, and the sensor includes a core wire electrically connected to the wall through a leak current detector and a power source. An accidental leakage of the liquid sodium causes the corrosion of a metallic layer and an insulative layer of the sensor by products resulted from a reaction of sodium with water or oxygen in the atmospheric air so as to decrease the resistance between the core wire and the wall. Thus, the leakage is detected as an increase in the leaking electrical current. The apparatus is especially adapted for use in detecting the leakage of liquid sodium from sodium-conveying pipes or equipment in a fast breeder reactor.

  13. Interaction of oil and paraffin with sodium

    Energy Technology Data Exchange (ETDEWEB)

    Kozlov, F A; Zagorulko, Yu I; Kovalev, Yu P; Lamykin, E V; Alekseev, V V; Sergeev, G P [Institute of Physics and Power Engineering, Obninsk (USSR)

    1980-05-01

    This report presents the investigation results on the kinetics of a gaseous oil pyrolysis product composition change in the presence of sodium under static conditions at 350 deg. C, 550 deg. C and 700 deg. C as well as the behaviour of oil and paraffin within the sodium circulating loops. The calculated estimations of the critical oil physical state parameters in sodium flows are given. (author)

  14. Interaction of oil and paraffin with sodium

    International Nuclear Information System (INIS)

    Kozlov, F.A.; Zagorulko, Yu.I.; Kovalev, Yu.P.; Lamykin, E.V.; Alekseev, V.V.; Sergeev, G.P.

    1980-01-01

    This report presents the investigation results on the kinetics of a gaseous oil pyrolysis product composition change in the presence of sodium under static conditions at 350 deg. C, 550 deg. C and 700 deg. C as well as the behaviour of oil and paraffin within the sodium circulating loops. The calculated estimations of the critical oil physical state parameters in sodium flows are given. (author)

  15. Summary of HEDL sodium fire tests

    Energy Technology Data Exchange (ETDEWEB)

    Hilliard, R K [Hanford Engineering Development Laboratory, Richland, WA (United States)

    1979-03-01

    The sodium fire test program and related studies at the Hanford Engineering Development Laboratory (HEDL), covering the period from 1972 to 1978, are described. The program is analytical and experimental in scope, with computer code development and experimental verification. Tests have ranged in size from gram quantity laboratory tests to 1600-kg sodium spills. The experimental work is performed in two facilities: the Large Sodium Fire Facility (LSFF) and the Containment Systems Test Facility (CSTF). The facilities are described and the experimental results summarized. Sodium fire extinguishment tests which verified the Fast Flux Test Facility (FFTF) secondary sodium fire protection system are described and related information on sodium burning rates and smoke release rates are correlated. The burning rates are compared to theoretical predictions based on heat and mass transfer analogy, with good agreement. Comparisons with the SOFIRE-II code are also made. Sodium combustion aerosol properties are defined as to chemical and physical nature, settling in closed vessels and effect of added water vapor. The HAA-38 aerosol behaviour computer code is compared to tests in the 850-m{sup 3} CSTF containment vessel. Sodium spray tests in the CSTF are compared with the SPRAY computer code. An air cleaning program is described, which has the objective of removing high mass concentration sodium combustion aerosols from vented cells and containment buildings. The aerosol mass holding capacity of commercial filters was measured and an aqueous scrubber system is described. The effects of sodium spills on cell structures were investigated, including water release from heated concrete, the reaction of sodium with concrete, the formation and spontaneous recombination of hydrogen, and the ability of steel cell liners to withstand large spills of high temperature sodium without leaking. (author)

  16. Summary of HEDL sodium fire tests

    International Nuclear Information System (INIS)

    Hilliard, R.K.

    1979-01-01

    The sodium fire test program and related studies at the Hanford Engineering Development Laboratory (HEDL), covering the period from 1972 to 1978, are described. The program is analytical and experimental in scope, with computer code development and experimental verification. Tests have ranged in size from gram quantity laboratory tests to 1600-kg sodium spills. The experimental work is performed in two facilities: the Large Sodium Fire Facility (LSFF) and the Containment Systems Test Facility (CSTF). The facilities are described and the experimental results summarized. Sodium fire extinguishment tests which verified the Fast Flux Test Facility (FFTF) secondary sodium fire protection system are described and related information on sodium burning rates and smoke release rates are correlated. The burning rates are compared to theoretical predictions based on heat and mass transfer analogy, with good agreement. Comparisons with the SOFIRE-II code are also made. Sodium combustion aerosol properties are defined as to chemical and physical nature, settling in closed vessels and effect of added water vapor. The HAA-38 aerosol behaviour computer code is compared to tests in the 850-m 3 CSTF containment vessel. Sodium spray tests in the CSTF are compared with the SPRAY computer code. An air cleaning program is described, which has the objective of removing high mass concentration sodium combustion aerosols from vented cells and containment buildings. The aerosol mass holding capacity of commercial filters was measured and an aqueous scrubber system is described. The effects of sodium spills on cell structures were investigated, including water release from heated concrete, the reaction of sodium with concrete, the formation and spontaneous recombination of hydrogen, and the ability of steel cell liners to withstand large spills of high temperature sodium without leaking. (author)

  17. Summary of HEDL sodium fire tests

    International Nuclear Information System (INIS)

    Hillard, R.K.

    1978-10-01

    The sodium fire test program and related studies at the Hanford Engineering Development Laboratory (HEDL) are described. The program is analytical and experimental in scope, with computer code development and experimental verification. Tests have ranged in size from gram quantity laboratory tests to 1600-kg sodium spills. The experimental work is performed in two facilities: the Large Sodium Fire Facility (LSFF) and the Containment Systems Test Facility (CSTF). Sodium fire extinguishment tests which verified the Fast Flux Test Facility (FFTF) secondary sodium fire protection system are described and related informaion on sodium burning rates and smoke release rates are correlated. The burning rates are compared to theoretical predictions based on heat and mass transfer analogy, with good agreement. Comparisons with the SOFIRE-II code are also made. Sodium combustion aerosol properties are defined as to chemical and physical nature, settling in closed vessels and effect of added water vapor. The HAA-3B aerosol behavior computer code is compared to tests in the 850-m 3 CSTF containment vessel. Sodium spray tests in the CSTF are compared with the SPRAY computer code. An air cleaning program is described, which has the objective of removing high mass concentration sodium combustion aerosols from vented cells and containment buildings. The aerosol mass holding capacity of commercial filters was measured and an aqueous scrubber system is described. The effects of sodium spills on cell structures were investigated, including water release from heated concrete, the reaction of sodium with concrete, the formation and spontaneous recombination of hydrogen, and the ability of steel cell liners to withstand large spills of high temperature sodium without leaking

  18. Chemistry of carbon in dynamic sodium

    International Nuclear Information System (INIS)

    Lievens, F.; Casteels, F.

    1980-01-01

    The chemistry of carbon in sodium is described by its chemical activity measurements using alloy monitor foils, by its behaviour in the heat exchanger of the Na 2 sodium loop after 60,000 hours of operation, and by measurements with on-line meters. Efforts toward the identification of the carbon chemical states present in dynamic sodium, and responsible for the carbon chemical activity, are described. (author)

  19. Cosmic ray produced sodium and its applications

    International Nuclear Information System (INIS)

    Goncalves Barbosa, A.

    1981-07-01

    The following topics were presented: calculations of the theoretical production rate of sodium-22 in the atmosphere in order to estimate its activity in rain water; description of the method of chemical separation of sodium and of counting of various radionuclide samples; results obtained for 22 Na, 137 Cs, 144 Ce, 7 Be and 210 Pb and seasonal variations of these radionuclides in rain and river waters; seasonal variations of natural elements, sodium, potassium and uranium in rain and river waters [fr

  20. Chemistry of carbon in dynamic sodium

    Energy Technology Data Exchange (ETDEWEB)

    Lievens, F; Casteels, F [SCK/CEN, Mol (Belgium)

    1980-05-01

    The chemistry of carbon in sodium is described by its chemical activity measurements using alloy monitor foils, by its behaviour in the heat exchanger of the Na 2 sodium loop after 60,000 hours of operation, and by measurements with on-line meters. Efforts toward the identification of the carbon chemical states present in dynamic sodium, and responsible for the carbon chemical activity, are described. (author)

  1. Sodium cleaning from sodium contaminated components and operation for experimental equipment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, B. H.; Kim, J. M.; Kim, T. J.; Nam, H. Y.; Jeong, J. Y.; Choi, B. H.; Choi, J. H

    2007-11-15

    An objective of washing technology development for sodium contaminated equipment is to clean and reuse safely and effectively the used equipment through a washing and maintenance, and recovery of the sodium wastes generated during washing.

  2. Sodium pool fire analysis of sodium-cooled fast reactor by calculation

    International Nuclear Information System (INIS)

    Yu Hong; Xu Mi; Jin Degui

    2002-01-01

    Theoretical models were established according to the characteristic of sodium pool fire, and the SPOOL code was created independently. Some transient processes in sodium pool fire were modeled, including chemical reaction of sodium and oxygen; sodium combustion heat transfer modes in several kids of media; production, deposition and discharge of sodium aerosol; mass and energy exchange between different media in different ventilating conditions. The important characteristic parameters were calculated, such as pressure and temperature of gas, temperature of building materials, mass concentration of sodium aerosol, and so on. The SPOOL code, which provided available safety analysis tool for sodium pool fire accidents in sodium-cooled fast reactor, was well demonstrated with experimental data

  3. Electrolytic process to produce sodium hypochlorite using sodium ion conductive ceramic membranes

    Science.gov (United States)

    Balagopal, Shekar; Malhotra, Vinod; Pendleton, Justin; Reid, Kathy Jo

    2012-09-18

    An electrochemical process for the production of sodium hypochlorite is disclosed. The process may potentially be used to produce sodium hypochlorite from seawater or low purity un-softened or NaCl-based salt solutions. The process utilizes a sodium ion conductive ceramic membrane, such as membranes based on NASICON-type materials, in an electrolytic cell. In the process, water is reduced at a cathode to form hydroxyl ions and hydrogen gas. Chloride ions from a sodium chloride solution are oxidized in the anolyte compartment to produce chlorine gas which reacts with water to produce hypochlorous and hydrochloric acid. Sodium ions are transported from the anolyte compartment to the catholyte compartment across the sodium ion conductive ceramic membrane. Sodium hydroxide is transported from the catholyte compartment to the anolyte compartment to produce sodium hypochlorite within the anolyte compartment.

  4. Measurement of carbon thermodynamic activity in sodium

    Energy Technology Data Exchange (ETDEWEB)

    Kozlov, F A; Zagorulko, Yu I; Kovalev, Yu P; Alekseev, V V [Institute of Physics and Power Engineering, Obninsk (USSR)

    1980-05-01

    The report presents the brief outline on system of carbon activity detecting system in sodium (SCD), operating on the carbon-permeable membrane, of the methods and the results of testing it under the experimental circulating loop conditions. The results of carbon activity sensor calibration with the use of equilibrium samples of XI8H9, Fe -8Ni, Fe -12Mn materials are listed. The behaviour of carbon activity sensor signals in sodium under various transitional conditions and hydrodynamic perturbation in the circulating loop, containing carbon bearing impurities in the sodium flow and their deposits on the surfaces flushed by sodium, are described. (author)

  5. Excess Sodium Tetraphenylborate and Intermediates Decomposition Studies

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, M.J.

    1998-12-07

    The stability of excess amounts of sodium tetraphenylborate (NaTPB) in the In-Tank Precipitation (ITP) facility depends on a number of variables. Concentration of palladium, initial benzene, and sodium ion as well as temperature provide the best opportunities for controlling the decomposition rate. This study examined the influence of these four variable on the reactivity of palladium-catalyzed sodium tetraphenylborate decomposition. Also, single effects tests investigated the reactivity of simulants with continuous stirring and nitrogen ventilation, with very high benzene concentrations, under washed sodium concentrations, with very high palladium concentrations, and with minimal quantities of excess NaTPB.

  6. Experience on sodium removal from various components

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, M; Kanbe, M; Yagisawa, H; Sasaki, S; Kataoka, H; Fukada, T; Ishii, Y; Saito, R; Mimoto, Y [O-arai Engineering Centre, PNC, Ibaraki-ken, Tokio (Japan)

    1978-08-01

    Since 1970, OEC (O-arai Engineering Center) has been Investigating the following methods for removal of sodium from the components of sodium plants: steam cleaning for the 50 MW Steam Generator, secondary proto-type pump of 'JOYO' and Dummy fuel assembly of 'JOYO', alcohol cleaning for Sector Model of Intermediate Heat Exchanger (IHX) of 'JOYO', a sector model of Sodium-to-Air cooler of 'JOYO' and a proto-type isolation valve of 'JOYO' and cleaning by vacuumization at high temperature for Regenerative Heat Exchanger. This report describes the outline of the Sodium Disposal Facility and experience of sodium removal processing on the 50 MW Steam Generator, the crevices of the experimental sub-assemblies, the Fuel Handling Machine of 'MONJU' and the Regenerative Heat Exchanger of the Sodium Flow Test Facility. Through these experiences it was noted that, (1) Removal of sodium from crevices such as in bolted joints are very difficult. (2) Consideration is needed in the removal process where material damage might occur from the generation of hydro-oxides. (3) Some detection device to tell the completion of sodium removal as well as the end of reaction is required. (4) Requalification rules should be clarified. Efforts in this direction have been made in the case of a 'JOYO' prototype pump by reinstalling it after sodium removal five times. (author)

  7. Dissolution of LMFBR fuel-sodium aerosols

    International Nuclear Information System (INIS)

    Allen, M.D.; Moss, O.R.

    1979-01-01

    Plutonium dioxide, normally insoluble in biological fluids, becomes much more soluble when mixed with sodium as the aerosol is formed. Sodium-fuel aerosols are approximately 20 times less soluble in simulated lung fluid than in distilled water. Solubility of sodium-fuel aerosols increases when Na 2 CO 3 are added to the distilled-water dissolution fluid. Mixed-oxide fuel aerosols without sodium present are relatively insoluble in distilled water, simulated lung fluid, and distilled water with Na 2 CO 3 and NaHCO 3 added

  8. Sodium-blood pressure interrelationship in pregnancy.

    Science.gov (United States)

    Franx, A; Steegers, E A; de Boo, T; Thien, T; Merkus, J M

    1999-03-01

    In non-pregnant individuals, a strong positive association of sodium intake with blood pressure has been established, but the relationship between sodium intake and blood pressure in human pregnancy remains obscure up to date. The aim of this prospective observational cohort study was to assess the relationship between urinary sodium excretion (as a measure for intake) and blood pressure from the early second trimester onwards throughout pregnancy. The study group consisted of 667 low-risk women with singleton pregnancies, of whom 350 were nulliparous and 317 parous. Blood pressure was measured in a standardised fashion at predetermined intervals from the first antenatal visit prior to 16 weeks gestation until delivery. Urinary sodium excretion was measured in 24-h urine collections on at least four occasions between 16 and 38 weeks gestation. Main outcome measures were the coefficients of correlation between changes in urinary sodium output and changes in blood pressure during six different gestational epochs. No significant correlations were found between changes in urinary sodium output and changes in blood pressure. Correlation coefficients were alike for nulliparous and parous women and for different gestational intervals. Prior to 32 weeks gestation, no differences were observed in sodium excretion between women who remained normotensive and those who developed gestational hypertension. These results suggest that changes in sodium intake are not associated with blood pressure changes in low-risk pregnant women. Blood pressure increases as observed in the second half of normotensive and hypertensive pregnancies are unlikely to be caused by changes in renal sodium handling.

  9. Methods and means of sodium fire fighting

    International Nuclear Information System (INIS)

    Zemskij, G.T.

    1985-01-01

    Methods and means for coaling sodium fire fighting are analyzed. Their advantages and drawbacks are considered. Comparative data on sodium fire fighting using some of considered compositions are presented. High efficiency of self-expanding compositions (Grafeks SK-23 and RS) is noted. Properties of MGS new composition for sodium fire fighting are considered. High fighting ability of the composition independent of burning metal layer width is shown. It is noted that fire fighting MGS efficiency decreases with growth of time of free fire burning which affects fire fighting methods. Technical means of powder delivery to burning sodium are reported

  10. Intelligent type sodium instrumentations for LMFBR

    International Nuclear Information System (INIS)

    Chen Daolong

    1996-07-01

    The constructions and performances of lots of newly developed intelligent type sodium instrumentations are described. The graduation characteristic equations for corresponding transducer using the medium temperature as the parameter are given. These intelligent type sodium instrumentations are possessed of good linearity. The accurate measurement data of sodium process parameters (flowrate, pressure and level) can be obtained by means of their on-line compensation function of the temperature effect. Moreover, these intelligent type sodium instrumentations are possessed of the self-inspection, the electric shutoff protection, the setting of full-scale, the setting of alarm limits (two upper limits and two lower limits alarms), the thermocouple breaking alarm, mutual isolative the 0∼10 V direct-current analogue output and the CENTRONICS standard digital output, and the alarm relay contact output. Theses intelligent type sodium instrumentations are suitable particularly for the instrument, control and protective systems of LMFBR by means of these excellent functions based on microprocessor. The basic errors of the intelligent type sodium flowmeter, immersed sodium flowmeter, sodium manometer and sodium level gauge are +-2%, +-2.3%, +-0.3% and +-1.9% of measuring ranges respectively. (9 figs.)

  11. Experience on sodium removal from various components

    International Nuclear Information System (INIS)

    Kamei, M.; Kanbe, M.; Yagisawa, H.; Sasaki, S.; Kataoka, H.; Fukada, T.; Ishii, Y.; Saito, R.; Mimoto, Y.

    1978-01-01

    Since 1970, OEC (O-arai Engineering Center) has been Investigating the following methods for removal of sodium from the components of sodium plants: steam cleaning for the 50 MW Steam Generator, secondary proto-type pump of 'JOYO' and Dummy fuel assembly of 'JOYO', alcohol cleaning for Sector Model of Intermediate Heat Exchanger (IHX) of 'JOYO', a sector model of Sodium-to-Air cooler of 'JOYO' and a proto-type isolation valve of 'JOYO' and cleaning by vacuumization at high temperature for Regenerative Heat Exchanger. This report describes the outline of the Sodium Disposal Facility and experience of sodium removal processing on the 50 MW Steam Generator, the crevices of the experimental sub-assemblies, the Fuel Handling Machine of 'MONJU' and the Regenerative Heat Exchanger of the Sodium Flow Test Facility. Through these experiences it was noted that, (1) Removal of sodium from crevices such as in bolted joints are very difficult. (2) Consideration is needed in the removal process where material damage might occur from the generation of hydro-oxides. (3) Some detection device to tell the completion of sodium removal as well as the end of reaction is required. (4) Requalification rules should be clarified. Efforts in this direction have been made in the case of a 'JOYO' prototype pump by reinstalling it after sodium removal five times. (author)

  12. Experience on sodium removal from various components

    International Nuclear Information System (INIS)

    Kamei, M.; Kanbe, M.; Yagisawa, H.; Sasaki, S.; Kataoka, H.

    1978-02-01

    Since 1970, OEC (O-arai Engineering Center) has been investigating the following methods for removal of sodium from the components of sodium plants: steam cleaning for the 50 MW Steam Generator, secondary proto-type pump of ''JOYO'' and Dummy fuel assembly of ''JOYO'', alcohol cleaning for Sector Model of Intermediate Heat Exchanger (IHX) of ''JOYO'', a sector model of Sodium-to-Air cooler of ''JOYO'' and a proto-type Isolation valve of ''JOYO'' and cleaning by vacuumization at high temperature for Regenerative Heat Exchanger. This report describes the outline of the Sodium Disposal Facility and experience of sodium removal processing on the 50 MW Steam Generator, the crevices of the experimental subassemblies, the Fuel Handling Machine of ''MONJU'' and the Regenerative Heat Exchanger of the Sodium Flow Test Facility. Through these experiences it was noted that, (1) Removal of Sodium from crevices such as in bolted joints are very difficult. (2) Consideration is needed in the removal process where material damage might occur from the generation of hydro-oxides. (3) Some detection device to tell the completion of sodium removal as well as the end of reaction is required. (4) Requalification rules should be clarified. Efforts in this direction have been made in the case of a ''JOYO'' prototype pump by reinstalling it after sodium removal five times. (author)

  13. Method for processing radioactive wastes containing sodium

    International Nuclear Information System (INIS)

    Kubota, Takeshi.

    1975-01-01

    Object: To bake, solidify and process even radioactive wastes highly containing sodium. Structure: H and or NH 4 zeolites of more than 90g per chemical equivalent of sodium present in the waste is added to and left in radioactive wastes containing sodium, after which they are fed to a baker such as rotary cylindrical baker, spray baker and the like to bake and solidify the wastes at 350 to 800 0 C. Thereby, it is possible to bake and solidify even radioactive wastes highly containing sodium, which has been impossible to do so previously. (Kamimura, M.)

  14. Sodium-cooled nuclear reactor

    International Nuclear Information System (INIS)

    Hammers, H.W.

    1982-01-01

    The invention concerns a sodium-cooled nuclear reactor, whose reactor tank contains the primary circuit, shielding surrounding the reactor core and a primary/secondary heat exchanger, particularly a fast breeder reactor on the module principle. In order to achieve this module principle it is proposed to have electromagnetic circulating pumps outside the reactor tank, where the heat exchanger is accomodated in an annular case above the pumps. This case has several openings at the top end to the space above the reactor core, some smaller openings in the middle to the same space and is connected at the bottom to an annular space between the tank wall and the reactor core. As a favoured variant, it is proposed that the annular electromagnetic pumps should be arranged concentrically to the reactor tank, where there is an annual duct on the inside of the reactor tank. In this way the sodium-cooled nuclear reactor is made suitable as a module with a large number of such elements. (orig.) [de

  15. Operating experience with sodium valves in the TNO-sodium test facilities

    International Nuclear Information System (INIS)

    Gasselt, M.L.G. van

    1974-01-01

    The development of sodium components for the SNR-300 in Holland has reached the stage where full scale testing in sodium has almost been finished and construction is at its height. It is against this background that a review is given of the weaknesses in one area or the other of the commercially available types of sodium valves used in TNO's smaller test facilities at Apeldoorn and TNO's 50 MW sodium components test facility at Hengelo. (U.S.)

  16. Improving the Corrosion Inhibitive Strength of Sodium Sulphite in Hydrogen Cyanide Solution Using Sodium Benzoate

    OpenAIRE

    Muhammed Olawale Hakeem AMUDA; Olusegun Olusoji SOREMEKUN; Olakunle Wasiu SUBAIR; Atinuke OLADOYE

    2008-01-01

    The improvement in the inhibitive strength of sodium sulphite on corrosion of mild steel in hydrogen cyanide by adding sodium benzoate in regulated volume was investigated using the fundamental weight loss measurement.500 ppm concentration inhibitive mixtures of sodium benzoate and sodium sulphite in three different volume ratios (5/15, 10/10, 15/5) were formulated and studied for corrosion rate in 200ml hydrogen cyanide fluid. Result obtained indicates that the corrosion rate of mild steel i...

  17. Sodium Carbonate is Saltier Than Sodium Chloride to Sodium-Depleted Rats.

    Science.gov (United States)

    St John, Steven J; McBrayer, Anya M; Krauskopf, Erin E

    2017-10-01

    In a series of behavioral experiments in the 1960s, G.R. Morrison identified several unique features of the taste of Na2CO3 to rats; namely, it is 1) considerably more intense than NaCl at isomolar concentrations, 2) avoided at 10 times lower concentrations than NaCl to thirsty rats, 3) preferred at 10 times lower concentrations than NaCl in sodium-depleted rats. He also demonstrated its qualitatively similarity to NaCl. In Experiment 1, we confirmed and extended many of Morrison's observations. Rats were injected with furosemide on 3 occasions to stimulate a sodium appetite. After each depletion, rats were given a brief-access taste test in a lickometer presenting, in random order, water and 7 concentrations of salt. One test used NaCl (0.028-0.89 M, quarter log steps), another used Na2CO3, and the third used Na2CO3, but at a tenfold lower concentration range (0.0028-0.089 M). Rats licked NaCl in an inverted-U shaped concentration-response function peaking at 0.158-0.281 M. As Morrison's results predicted, rats licked Na2CO3 in nearly identical fashion, but at a tenfold lower concentration range (peak at 0.0158-0.028 M). In a second experiment, furosemide-treated rats were repeatedly tested with the lower Na2CO3 range but mixed in the epithelial sodium channel blocker amiloride at various concentrations (3-300 μM, half log steps). Amiloride reduced licking for Na2CO3 and shifted the peak response rightward up to about half a log unit. Thus, this "super-saltiness" of Na2CO3 to rats is at least partly amiloride-dependent. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality

    DEFF Research Database (Denmark)

    Graudal, Niels; Jürgens, Gesche; Baslund, Bo

    2014-01-01

    BACKGROUND: The effect of sodium intake on population health remains controversial. The objective was to investigate the incidence of all-cause mortality (ACM) and cardiovascular disease events (CVDEs) in populations exposed to dietary intakes of low sodium (<115 mmol), usual sodium (low usual so...

  19. Control of sodium fires and sodium-water reactions in breeder reactors

    International Nuclear Information System (INIS)

    Foerster, K.; Ruloff, G.; Voss, J.

    1985-01-01

    The excellent neutronic and thermodynamic properties of sodium as a fast-reactor coolant are somewhat counterbalanced by its high oxygen affinity. Because incidents like sodium fires and sodium-water reactions cannot be absolutely excluded, their effects and preventive measures have to be investigated. Characteristics and counter-measures are discussed. (orig.) [de

  20. Sodium ordering and the control of magnetism in sodium cobaltate

    International Nuclear Information System (INIS)

    Morris, D.J.P.; Roger, M.; Tennant, D.A.; Goff, J.P.; Gutmann, M.J.; Hoffmann, J.-U.; Prabhakaran, D.; Shannon, N.; Lake, B.; Deen, P.P.

    2007-01-01

    The long-range three-dimensional ordering of Na + ions was studied in a sample of composition Na 0.75 CoO 2 using single-crystal neutron diffraction. Large-scale numerical simulations reveal the ordering principle for this system, the formation of multi-vacancy charged droplets then order long range, and the structure factors from these defect clusters are in good agreement with the observed neutron diffraction intensities. The electrostatic potential is found to be the dominant factor in determining the sodium ordering and its associated distortion field. The superstructures induce a periodic potential in the CoO 2 , giving potential wells that are larger than the single-particle hopping frequency and so able to localize holes. The results readily explain many of the observed electrical and magnetic properties, including the three dimensionality of the magnetic excitations

  1. 21 CFR 172.822 - Sodium lauryl sulfate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Sodium lauryl sulfate. 172.822 Section 172.822 Food... Multipurpose Additives § 172.822 Sodium lauryl sulfate. The food additive sodium lauryl sulfate may be safely... specifications: (1) It is a mixture of sodium alkyl sulfates consisting chiefly of sodium lauryl sulfate [CH2(CH2...

  2. Sodium fires. Progress achieved in research and experimental results

    International Nuclear Information System (INIS)

    Malet, J.C.; Duverger de Cuy, G.; Casselman, C.; Charpenel, J.; Natta, M.; Devillers, C.

    1979-08-01

    This paper describes the sodium fire programs undertaken by the CEA's Nuclear Safety Department. Experimental results concerning sodium ignition and combustion, sodium fire suppression, sodium aerosol filtration and sodium-concrete contact reactions are given and the applications of these results in the Super-Phenix reactor is discussed

  3. Tumorigenicity of sodium ascorbate in male rats.

    Science.gov (United States)

    Cohen, S M; Anderson, T A; de Oliveira, L M; Arnold, L L

    1998-06-15

    Sodium ascorbate, like other sodium salts such as saccharin, glutamate, and bicarbonate, produces urinary alterations when fed at high doses to rats, which results in mild superficial urothelial cytotoxicity and regeneration but not tumors in a standard 2-year bioassay. Sodium saccharin was shown to produce a low incidence of bladder tumors in rats if administered in a two-generation bioassay. In the present study, we evaluated sodium ascorbate in a two-generation bioassay that involved feeding to the male and female parental F344 rats for 4 weeks before mating, feeding the dams during gestation and lactation, and then feeding the weaned (at 28 days of age) male F1 generation rats for the remainder of their lifetime (up to 128 weeks of the experiment). Dietary levels of 1.0, 5.0, and 7.0% sodium ascorbate were tested. At 5.0 and 7.0% sodium ascorbate, there was an increase in urinary bladder urothelial papillary and nodular hyperplasia and the induction of a few papillomas and carcinomas. There was a dose-responsive increase in renal pelvic calcification and hyperplasia and inhibition of the aging nephropathy of rats even at the level of 1% sodium ascorbate. Because the short-term urothelial effects of sodium ascorbate in rats are inhibited by treatments producing urinary acidification to pH sodium ascorbate to evaluate the long-term effects. The combination of 7.0% sodium ascorbate plus 2.78% NH4Cl in the diet was toxic, and the group was terminated early during the course of the experiment. The group fed 5.0% sodium ascorbate plus 2.04% NH4Cl showed complete inhibition of the urothelial effects of sodium ascorbate and significant inhibition of its renal effects. We also demonstrated the presence of a calcium phosphate-containing urinary precipitate in rats fed sodium ascorbate at all doses, in a dose-responsive manner. The formation of the precipitate was inhibited by coadministration with NH4Cl. The proliferative effects of sodium ascorbate on the male rat

  4. Combustion of sodium in the open atmosphere

    Energy Technology Data Exchange (ETDEWEB)

    Morewith, H A; Johnson, R P; Nelson, C T; Otter, J M [Energy System Group, Rockwell International, Rockwell (United States)

    1979-03-01

    A series of sodium fire tests has been conducted in ambient air at a meteorological test site. This test series was designed to simulate hypothetical accidents which might occur in the heat transport system of an LMFBR. Measurements of concentration, agglomeration, fallout, and chemical species of the sodium combustion products were made as a function of downwind distance. In each of the first two tests, {approx}23 kg of 540 deg. C sodium was sprayed as a fan of 250-{mu}m sodium drops across the wind, from heights of 5 or 6 m. Each release took a few minutes. A dense sodium combustion product aerosol was formed, and quickly agglomerated to large (100 to 660 {mu}m) diameter particles. More than 50% of the aerosol mass fell out within several hundred meters of the release point. Two additional tests were performed by releasing sodium through 9.5-mm diameter jets at a height of 30 m. In each test, the sodium jet was aimed horizontally across the wind, and followed a downward parabolic trajectory, releasing burning sodium drops along its track. Again, close-in fallout due to large agglomerates was observed. A substantial amount of unburned sodium fell 30 m to the ground, where it burned. In a third type of test, sodium was burned for 60 min as pool in a 1.5m{sup 2} burn pan at 9 m/s wind velocity. Approximately 30% of the combustion products became airborne. Large agglomerates fell out as they moved downwind, depositing 1 kg/m{sup 2} at 1 m downwind from the edge of the pan. Chemical analysis of the samples indicated that the sodium fires produced mainly Na{sub 2}O, and that the conversion of NaOH was slow. Comparison were made with COMRADEX-IV code models, which are appropriate for calculating deposition and concentrations for downwind distances between 10{sup 2} and 10{sup 4} m. (author)

  5. Combustion of sodium in the open atmosphere

    International Nuclear Information System (INIS)

    Morewith, H.A.; Johnson, R.P.; Nelson, C.T.; Otter, J.M.

    1979-01-01

    A series of sodium fire tests has been conducted in ambient air at a meteorological test site. This test series was designed to simulate hypothetical accidents which might occur in the heat transport system of an LMFBR. Measurements of concentration, agglomeration, fallout, and chemical species of the sodium combustion products were made as a function of downwind distance. In each of the first two tests, ∼23 kg of 540 deg. C sodium was sprayed as a fan of 250-μm sodium drops across the wind, from heights of 5 or 6 m. Each release took a few minutes. A dense sodium combustion product aerosol was formed, and quickly agglomerated to large (100 to 660 μm) diameter particles. More than 50% of the aerosol mass fell out within several hundred meters of the release point. Two additional tests were performed by releasing sodium through 9.5-mm diameter jets at a height of 30 m. In each test, the sodium jet was aimed horizontally across the wind, and followed a downward parabolic trajectory, releasing burning sodium drops along its track. Again, close-in fallout due to large agglomerates was observed. A substantial amount of unburned sodium fell 30 m to the ground, where it burned. In a third type of test, sodium was burned for 60 min as pool in a 1.5m 2 burn pan at 9 m/s wind velocity. Approximately 30% of the combustion products became airborne. Large agglomerates fell out as they moved downwind, depositing 1 kg/m 2 at 1 m downwind from the edge of the pan. Chemical analysis of the samples indicated that the sodium fires produced mainly Na 2 O, and that the conversion of NaOH was slow. Comparison were made with COMRADEX-IV code models, which are appropriate for calculating deposition and concentrations for downwind distances between 10 2 and 10 4 m. (author)

  6. Atmospheric dispersion of sodium aerosol due to a sodium leak in a fast breeder reactor complex

    International Nuclear Information System (INIS)

    Punitha, G.; Sudha, A. Jasmin; Kasinathan, N.; Rajan, M.

    2008-01-01

    Liquid sodium at high temperatures (470 K to 825 K) is used as the primary and secondary coolant in Liquid Metal cooled Fast Breeder Reactors (LMFBR). In the event of a postulated sodium leak in the Steam Generator Building (SGB) of a LMFBR, sodium readily combusts in the ambient air, especially at temperatures above 523 K. Intense sodium fire results and sodium oxide fumes are released as sodium aerosols. Sodium oxides are readily converted to sodium hydroxide in air due to the presence of moisture in it. Hence, sodium aerosols are invariably in the form of particulate sodium hydroxide. These aerosols damage not only the equipment and instruments due to their corrosive nature but also pose health hazard to humans. Hence, it is essential to estimate the concentration of sodium aerosols within the plant boundary for a sodium leak event. The Gaussian Plume Dispersion Model can obtain the atmospheric dispersion of sodium aerosols in an open terrain. However, this model dose not give accurate results for dispersion in spaces close to the point of release and with buildings in between. The velocity field due to the wind is altered to a large extent by the intervening buildings and structures. Therefore, a detailed 3-D estimation of the velocity field and concentration has to be obtained through rigorous computational fluid dynamics (CFD) approach. PHOENICS code has been employed to determine concentration of sodium aerosols at various distances from the point of release. The dispersion studies have been carried out for the release of sodium aerosols at different elevations from the ground and for different wind directions. (author)

  7. Drug Monographs: Atezolizumab and Everolimus.

    Science.gov (United States)

    Green, Matthew A; Waddell, J Aubrey; Solimando, Dominic A

    2016-11-01

    The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr., President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, email: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net. The authors are not employees of, under contract to, recipients of funding to review products from, or in any other way affiliated with either Genentech, Inc. or Novartis Pharmaceuticals Corporation. The information presented in this review is based on published data and clinical expertise and includes information not included in the product labeling. Incorporation of such published data provides a more robust assessment of the drugs and assists pharmacists in evaluation of orders for off-label use of these agents.

  8. Formulation of Sodium Alginate Nanospheres Containing ...

    African Journals Online (AJOL)

    Purpose: The aim of this work was to formulate sodium alginate nanospheres of amphotericin B by controlled gellification method and to evaluate the role of the nanospheres as a “passive carrier” in targeted antifungal therapy. Methods: Sodium alginate nanospheres of amphotericin B were prepared by controlled ...

  9. Assessment of sodium conductor distribution cable

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-06-01

    The study assesses the barriers and incentives for using sodium conductor distribution cable. The assessment considers environmental, safety, energy conservation, electrical performance and economic factors. Along with all of these factors considered in the assessment, the sodium distribution cable system is compared to the present day alternative - an aluminum conductor system. (TFD)

  10. Development of industrial utilization of metallic sodium

    International Nuclear Information System (INIS)

    Yuhara, Shunichi

    1995-01-01

    Sodium exists in large quantity, being ranked to 6th in the existence proportion of elements, and takes 2.83% of the matters composing earth crust. Sodium is an alkali metal which is light weight, chemically very active and a strong reducing substance. It is excellent in the compatibility with iron and steel materials, and it possesses good heat conduction and flow characteristics and stable nuclear characteristics. Since the industrial production of sodium became practical, its utilization was developed as the reducing agent and catalyst in chemical industry, the core coolant and heat transport medium for nuclear reactors, the material composing the secondary batteries for storing electric power, and the auxiliaries for metal refining and so on. The industrial production of metallic sodium is carried out by the electrolysis of melted salt, namely Downs process. The production of metallic sodium in Japan is 3000-6000 t yearly, and its import is 300-350 t. Its main use is for organic chemical industry including dye production. The grades of metallic sodium products and their uses are shown. The utilization of sodium for large fast reactors, the utilization of NaK as the heat transport and cooling medium for space use nuclear reactors and deep sea fast reactor system, and the utilization of sodium as the catalyst in dye production, for silicon carbide fiber production and for agricultural and medical chemical production are reported. (K.I.)

  11. 21 CFR 172.175 - Sodium nitrite.

    Science.gov (United States)

    2010-04-01

    ... preservative and color fixative, with sodium nitrate, in meat-curing preparations for the home curing of meat and meat products (including poultry and wild game), with directions for use which limit the amount of sodium nitrite to not more than 200 parts per million in the finished meat product, and the amount of...

  12. 21 CFR 172.170 - Sodium nitrate.

    Science.gov (United States)

    2010-04-01

    ... finished product. (2) As a preservative and color fixative, with or without sodium nitrite, in meat-curing preparations for the home curing of meat and meat products (including poultry and wild game), with directions... finished meat product and the amount of sodium nitrite to not more than 200 parts per million in the...

  13. Eclampsia despite strict dietary sodium restriction.

    NARCIS (Netherlands)

    Delemarre, F.M.C.; Steegers, E.A.P.; Berendes, J.N.

    2001-01-01

    The classic indication for prescribing dietary sodium restriction in pregnancy has been the prevention of eclampsia. We describe a case of intrapartum eclampsia in a 24-year-old nulliparous woman. A strongly sodium restricted diet was prescribed because of pre-eclampsia. Compliance to the diet was

  14. PG BN 1600 sodium fire protection system

    International Nuclear Information System (INIS)

    Bar, J.; Urbancik, L.

    1978-12-01

    A design was developed of a fire protection system for steam generator of a 1600 MW sodium cooled fast reactor (BN-1600). Chemical reactions are described of liquid sodium with atmospheric components and solid materials coming into contact with sodium in its release from the steam generator, and in safeguarding protection against sodium fires. The requirements for the purity of nitrogen as an atmosphere inert to liquid sodium are given. Characteristics and basic parameters are shown of level and spray fires, elementary terms are explained concerning the properties of aerosols formed during fires, the methods and means of release signalling and fire alarm are described as are fire precautions using fire-fighting equipment, modifying the support tank and the cell bottom and building sewage pits. The design of the system comprises an alarm system for liquid sodium using point and line electric contact sensors and flame photometer based aerosol sensors as well as a fire-fighting system based on the system of channelling liquid sodium into emergency discharge tanks filled with an inert gas, a set of fire extinguishers and other fire fighting material, and measures for the elimination of sodium fire consequences. (J.B.)

  15. Visualizing individual sodium channels on the move.

    Science.gov (United States)

    Heinemann, Stefan H

    2012-07-27

    Visualization of voltage-gated sodium channels at work is an important requirement for the understanding of rapid electrical signaling in nerve cells. In this issue of Chemistry & Biology, Ondrus and colleagues have mastered this challenge by chemical synthesis of a fluorescent antagonist and by monitoring single sodium channels in living cells with unprecedented optical resolution. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Sodium MR imaging of human brain neoplasms

    International Nuclear Information System (INIS)

    Kobayashi, Shu; Yoshikawa, Kohki; Takakura, Kintomo; Iio, Masahiro

    1988-01-01

    We reported the experience of the sodium magnetic resonance imaging of 5 patients with brain tumors (4 astrocytomas and 1 craniopharyngioma), using a Siemens 1.5 Tesla superconductive magnet. We used two-dimensional Fourier imaging with a spin-echo scanning sequence (and with the repetition time of 140 msec and the echo time of 11 - 14 msec). The radiofrequency was maintained at 17 MHz. Sodium MR imaging was achieved with a 64 x 64 data acquisition (30 mm slice thickness) in 19.1 min. On the sodium MRI, all four astrocytomas, along with the eye balls and the cerebrospinal fluid spaces, appeared as high-intensity areas. Peritumoral edema is also visualized as highly intense, so that it is difficult to discriminate tumor extent from the surrounding edema. Our comparative studies with malignant glioma cases using the same equipment are needed to clarify the relationship between sodium signal intensities and the malignancy of gliomas, and to evaluate the potential clinical utility of sodium MRI. A craniopharyngioma than contained a yellowish cystic fluid with a sodium concentration as high as CSF was shown on sodium MRI as a mass with highly intense signals. The ability to differentiate extracellular from intracellular sodium, that has been studied by several investigators, would greatly augment the clinical specificity of MR imaging. (author)

  17. The Sodium Tail of the Moon

    Science.gov (United States)

    Matta, M.; Smith, S.; Baumgardner, J.; Wilson, J.; Martinis, C.; Mendillo, M.

    2009-01-01

    During the few days centered about new Moon, the lunar surface is optically hidden from Earth-based observers. However, the Moon still offers an observable: an extended sodium tail. The lunar sodium tail is the escaping "hot" component of a coma-like exosphere of sodium generated by photon-stimulated desorption, solar wind sputtering and meteoroid impact. Neutral sodium atoms escaping lunar gravity experience solar radiation pressure that drives them into the anti-solar direction forming a comet-like tail. During new Moon time, the geometry of the Sun, Moon and Earth is such that the anti-sunward sodium flux is perturbed by the terrestrial gravitational field resulting in its focusing into a dense core that extends beyond the Earth. An all-sky camera situated at the El Leoncito Observatory (CASLEO) in Argentina has been successfully imaging this tail through a sodium filter at each lunation since April 2006. This paper reports on the results of the brightness of the lunar sodium tail spanning 31 lunations between April 2006 and September 2008. Brightness variability trends are compared with both sporadic and shower meteor activity, solar wind proton energy flux and solar near ultra violet (NUV) patterns for possible correlations. Results suggest minimal variability in the brightness of the observed lunar sodium tail, generally uncorrelated with any single source, yet consistent with a multi-year period of minimal solar activity and non-intense meteoric fluxes.

  18. Sodium removal, storage, and requalification of components

    International Nuclear Information System (INIS)

    Gallegos, A.; Shimazaki, T.; Oliva, R.M.

    1974-01-01

    The objectives of this program are to devise, develop, test, and evaluate techniques for sodium removal and storage of test specimens and components, and to expand and refine, by test and analysis, the sodium removal and storage techniques and procedures for use in processing typical LMFBR components

  19. 21 CFR 582.1736 - Sodium bicarbonate.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sodium bicarbonate. 582.1736 Section 582.1736 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS SUBSTANCES GENERALLY RECOGNIZED AS SAFE General Purpose Food Additives § 582.1736 Sodium bicarbonate. (a) Product....

  20. Sodium nitrate combustion limit tests

    International Nuclear Information System (INIS)

    Beitel, G.A.

    1976-04-01

    Sodium nitrate is a powerful solid oxidant. Energetically, it is capable of exothermically oxidizing almost any organic material. Rate-controlling variables such as temperature, concentration of oxidant, concentration of fuel, thermal conductivity, moisture content, size, and pressure severely limit the possibility of a self-supported exothermic reaction (combustion). The tests reported in this document were conducted on one-gram samples at atmospheric pressure. Below 380 0 C, NaNO 3 was stable and did not support combustion. At moisture concentrations above 22 wt percent, exothermic reactions did not propagate in even the most energetic and reactive compositions. Fresh resin and paraffin were too volatile to enable a NaNO 2 -supported combustion process to propagate. Concentrations of NaNO 3 above 95 wt percent or below 35 wt percent did not react with enough energy release to support combustion. The influence of sample size and confining pressure, both important factors, was not investigated in this study

  1. Sodium technology at EBR-II

    International Nuclear Information System (INIS)

    Holmes, J.T.; Smith, C.R.F.; Olson, W.H.

    1976-01-01

    Since the installation of purity monitoring systems in 1967, the control of the purity of the primary and secondary sodium and cover gas systems at the Experimental Breeder Reactor II (EBR-II) has been excellent. A rigorous monitoring program is being used to assure that operating limits for more than 25 chemical and radioactive impurities are not exceeded. The program involves the use of sophisticated sampling and analysis techniques and on-line monitors for both sodium and cover gas systems. Sodium purity control is accomplished by essentially continuous cold trapping of a small side stream of the total circulating sodium. The cold traps have been found to be very effective for the removal of the major chemical impurities (oxygen and hydrogen) and tritium but are almost ineffective for 131 I and 137 Cs that enter the sodium from fuel cladding breaks. Purging with pure argon maintains the cover gas purity

  2. Sodium hypochlorite-induced acute kidney injury

    Directory of Open Access Journals (Sweden)

    Brandon W Peck

    2014-01-01

    Full Text Available Sodium hypochlorite (bleach is commonly used as an irrigant during dental proce-dures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI. In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

  3. Destruction of mechanical structures by sodium fires

    International Nuclear Information System (INIS)

    Cherdron, W.

    1992-01-01

    With respect to pipe ruptures and leakages in liquid-metal fast breeder reactors, it can be assumed that relatively large amounts of liquid sodium will be poured or sprayed into an oxygen-containing atmosphere. Under reactor conditions, the sodium will burn immediately, leading to temperature and pressure rises in the containment, and the strong aerosol release may influence ventilation and filter systems. In addition to these consequences, which are well known, it must be taken into account that the sodium fire also attacks mechanical structures like steel and concrete. In the frame work of the sodium fire research program (FAUNA) at Kernforschungszentrum Karlsruhe, extensive experiments were performed to investigate the consequences of sodium pool, spray, and combined fires

  4. Sodium evaporation into a forced argon flow

    International Nuclear Information System (INIS)

    Kumada, Toshiaki; Kasahara, Fumio; Ishiguro, Ryoji

    1975-01-01

    Evaporation from a rectangular sodium free surface into an argon flow was measured. Tests were carried out with varying sodium temperature, argon velocity and argon temperature respectively under conditions of fog formation being possible. In order to clarify the enhancement of evaporation by fog formation, convection heat transfer from a plate of the same geometry into an air flow was also measured. The evaporation rate and Sherwood number were compared with those predicted by both the heat transfer experiment and the theory proposed by Hill and Szekely, and also a comparison was run with the previously reported experimental results of sodium evaporation. As a result it was shown that the sodium evaporation rate in this experiment is at least four times as large as that predicted by the heat transfer experiment and varies almost linearly with the heat transfer rate and the sodium vapour pressure. (auth.)

  5. The role of sodium in the body

    Directory of Open Access Journals (Sweden)

    Munteanu Constantin

    2011-05-01

    Full Text Available Sodium is a metallic element with the symbol Na , in the same group with Li, K, Rb, Cs; is widespread in nature in the form of salts (nitrates, carbonates, chlorides, atomic number 11 and atomic weight 22,9898 . It,s a soft metal, reactive and with a low melting point , with a relative density of 0,97 at 200C (680 F. From the commercial point of view, sodium is the most important of all the alkaline metals. Elemental sodium was first isolated by Humpry Davy in 1807 by passing an electric current through molten sodium hydroxide. Elemental sodium does not occur naturally on earth, because it quickly oxidizes in air and is violently reactive with water, so it must be stored in a non-oxidizing medium, such as liquid hydrocarbon . The free metal is used for some chemical synthesis, analysis, and heat transfer applications .

  6. Adiabatic flame temperature of sodium combustion and sodium-water reaction

    International Nuclear Information System (INIS)

    Okano, Y.; Yamaguchi, A.

    2001-01-01

    In this paper, background information of sodium fire and sodium-water reaction accidents of LMFBR (liquid metal fast breeder reactor) is mentioned at first. Next, numerical analysis method of GENESYS is described in detail. Next, adiabatic flame temperature and composition of sodium combustion are analyzed, and affect of reactant composition, such oxygen and moisture, is discussed. Finally, adiabatic reaction zone temperature and composition of sodium-water reaction are calculated, and affects of reactant composition, sodium vaporization, and pressure are stated. Chemical equilibrium calculation program for generic chemical system (GENESYS) is developed in this study for the research on adiabatic flame temperature of sodium combustion and adiabatic reaction zone temperature of sodium-water reaction. The maximum flame temperature of the sodium combustion is 1,950 K at the standard atmospheric condition, and is not affected by the existence of moisture. The main reaction product is Na 2 O (l) , and in combustion in moist air, with NaOH (g) . The maximum reaction zone temperature of the sodium-water reaction is 1,600 K, and increases with the system pressure. The main products are NaOH (g) , NaOH (l) and H2 (g) . Sodium evaporation should be considered in the cases of sodium-rich and high pressure above 10 bar

  7. Sodium-NaK engineering handbook. Volume III. Sodium systems, safety, handling, and instrumentation. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Foust, O J [ed.

    1978-01-01

    The handbook is intended for use by present and future designers in the Liquid Metals Fast Breeder Reactor (LMFBR) Program and by the engineering and scientific community performing other type investigation and exprimentation requiring high-temperature sodium and NaK technology. The arrangement of subject matter progresses from a technological discussion of sodium and sodium--potassium alloy (NaK) to discussions of varius categories and uses of hardware in sodium and NaK systems. Emphasis is placed on sodium and NaK as heat-transport media. Sufficient detail is included for basic understanding of sodium and NaK technology and of technical aspects of sodium and NaK components and instrument systems. Information presented is considered adequate for use in feasibility studies and conceptual design, sizing components and systems, developing preliminary component and system descriptions, identifying technological limitations and problem areas, and defining basic constraints and parameters.

  8. Low Blood Sodium in Older Adults: A Concern?

    Science.gov (United States)

    ... sodium in older adults: A concern? Why is low blood sodium a health concern for older adults? ... treated? Answers from Paul Y. Takahashi, M.D. Low blood sodium (hyponatremia) occurs when you have an ...

  9. Development of sodium disposal technology. Experiment of sodium compound solidification process

    International Nuclear Information System (INIS)

    Matsumoto, Toshiyuki; Ohura, Masato; Yatoh, Yasuo

    2007-07-01

    A large amount of sodium containing radioactive waste will come up at the time of final shutdown/decommission of FBR plant. The radioactive waste is managed as solid state material in a closed can in Japan. As for the sodium, there is no established method to convert the radioactive sodium to solid waste. Further, the sodium is highly reactive. Thus, it is recommended to convert the sodium to a stable substance before the solidification process. One of the stabilizing methods is conversion of sodium into sodium hydroxide solution. These stabilization and solidification processes should be safe, economical, and efficient. In order to develop such sodium disposal technology, nonradioactive sodium was used and a basic experiment was performed. Waste-fluid Slag Solidification method was employed as the solidification process of sodium hydroxide solution. Experimental parameters were mixing ratio of the sodium hydroxide and the slag solidification material, temperature and concentration of the sodium hydroxide. The best parameters were obtained to achieve the maximum filling ratio of the sodium hydroxide under a condition of enough high compressive strength of the solidified waste. In a beaker level test, the solidified waste was kept in a long term and it was shown that there was no change of appearance, density, and also the compressive strength was kept at a target value. In a real scale test, homogeneous profiles of the density and the compressive strength were obtained. The compressive strength was higher than the target value. It was shown that the Waste-fluid Slag Solidification method can be applied to the solidification process of the sodium hydroxide solution, which was produced by the stabilization process. (author)

  10. The influence of sodium fires on LMFBRs safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Justin, F [DSN/Centre de Fontenay-aux-Roses, Fontenay-aux-Roses (France)

    1979-03-01

    In a sodium cooled reactor, sodium fires are accidental conditions to be taken into account in safety analysis. For the various sodium categories, fire conditions, associated risks, safety analysis objectives and detailed corresponding issues are indicated, An experimental research program can be deduced from these considerations. This report covers the following: safety analysis methodology; primary sodium fires; secondary sodium fires; auxiliary sodium fires, and related experimental research programs.

  11. Experimental and Numerical Simulation towards Sodium Safety in SFR

    International Nuclear Information System (INIS)

    Ponraju, D.; Rao, Hemanth; Das, Sanjay Kumar; Punitha; Nashine, B.K.; Chellapandi, P.

    2013-01-01

    Summary and future program on sodium fire: Past - Design verification of LCT by experiments; Small scale experiments on sodium resistant concrete; Small sodium spray: - Fire senario; - particle distribution. Current activities - Containment code development; Demonstration of LCT system, effective LCT design; Qualification of extinguishers and sodium resistant contrete; LBB justification; Aerosol distribution. Future - Sodium school; HR development in handing sodium systems; Collaboration with AERB, IRSN, CEA and other International Organizations; Design guidelines

  12. Process for the production of sodium carbonate anhydrate

    OpenAIRE

    Oosterhof, H.; Van Rosmalen, G.M.; Witkamp, G.J.; De Graauw, J.

    2000-01-01

    The invention is directed to a process for the production of sodium carbonate-anhydrate having a bulk density of at least 800 kg/m, said process comprising: providing a suspension of solid sodium carbonate and/or solid sodium bicarbonate and/or solid double salts at least comprising one of sodium carbonate and sodium bicarbonate, in a mixture containing water and an organic, water miscible or partly water miscible solvent, which solvent influences the transition temperature below which sodium...

  13. The influence of sodium fires on LMFBRs safety analysis

    International Nuclear Information System (INIS)

    Justin, F.

    1979-01-01

    In a sodium cooled reactor, sodium fires are accidental conditions to be taken into account in safety analysis. For the various sodium categories, fire conditions, associated risks, safety analysis objectives and detailed corresponding issues are indicated, An experimental research program can be deduced from these considerations. This report covers the following: safety analysis methodology; primary sodium fires; secondary sodium fires; auxiliary sodium fires, and related experimental research programs

  14. Scientific Opinion on the safety evaluation of the active substances, sodium carbonate peroxyhydrate coated with sodium carbonate and sodium silicate, bentonite, sodium chloride, sodium carbonate for use in active food contact materials

    OpenAIRE

    EFSA Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF)

    2013-01-01

    This scientific opinion of the Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids deals with the safety evaluation of the powder mixture of the active substances sodium carbonate peroxyhydrate coated with sodium carbonate and sodium silicate (FCM substance No 1009), bentonite (CAS No 1302-78-9, FCM No 393), sodium chloride (CAS No 7647-14-5, FCM No 985), sodium carbonate (CAS No 497-19-8, FCM No 1008) which are intended to be used as combined oxygen generator and carbon...

  15. Sodium-metal halide and sodium-air batteries.

    Science.gov (United States)

    Ha, Seongmin; Kim, Jae-Kwang; Choi, Aram; Kim, Youngsik; Lee, Kyu Tae

    2014-07-21

    Impressive developments have been made in the past a few years toward the establishment of Na-ion batteries as next-generation energy-storage devices and replacements for Li-ion batteries. Na-based cells have attracted increasing attention owing to low production costs due to abundant sodium resources. However, applications of Na-ion batteries are limited to large-scale energy-storage systems because of their lower energy density compared to Li-ion batteries and their potential safety problems. Recently, Na-metal cells such as Na-metal halide and Na-air batteries have been considered to be promising for use in electric vehicles owing to good safety and high energy density, although less attention is focused on Na-metal cells than on Na-ion cells. This Minireview provides an overview of the fundamentals and recent progress in the fields of Na-metal halide and Na-air batteries, with the aim of providing a better understanding of new electrochemical systems. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Simulation of sodium boiling experiments with THERMIT sodium version

    International Nuclear Information System (INIS)

    Huh, K.Y.

    1982-05-01

    Natural and forced convection experiments (SBTF and French) are simulated with the sodium version of the thermal-hydraulic computer code THERMIT. Simulation is done for the test section with the pressure-velocity boundary condition and subsequently extended to the whole loop. For the test section simulation, a steady-state and transient calculations are performed and compared with experimental data. For the loop simulation, two methods are used, a simulated 1-D loop and an actual 1-D loop. In the simulated 1-D loop analysis, the vapor density is increased by one hundred and two hundred times to avoid the code failure and the results still showed some of the important characteristics of the two-phase flow oscillation in a loop. A mathematical model is suggested for the two-phase flow oscillation. In the actual 1-D loop, only the single phase calculation was performed and turned out to be nearly the same as the simulated 1-D loop single phase results

  17. A randomized multicenter comparison of hybrid sirolimus-eluting stents with bioresorbable polymer versus everolimus-eluting stents with durable polymer in total coronary occlusion: rationale and design of the Primary Stenting of Occluded Native Coronary Arteries IV study

    Directory of Open Access Journals (Sweden)

    Teeuwen Koen

    2012-12-01

    Full Text Available Abstract Background Percutaneous recanalization of total coronary occlusion (TCO was historically hampered by high rates of restenosis and reocclusions. The PRISON II trial demonstrated a significant restenosis reduction in patients treated with sirolimus-eluting stents compared with bare metal stents for TCO. Similar reductions in restenosis were observed with the second-generation zotarolimus-eluting stent and everolimus-eluting stent. Despite favorable anti-restenotic efficacy, safety concerns evolved after identifying an increased rate of very late stent thrombosis (VLST with drug-eluting stents (DES for the treatment of TCO. Late malapposition caused by hypersensitivity reactions and chronic inflammation was suggested as a probable cause of these VLST. New DES with bioresorbable polymer coatings were developed to address these safety concerns. No randomized trials have evaluated the efficacy and safety of the new-generation DES with bioresorbable polymers in patients treated for TCO. Methods/Design The prospective, randomized, single-blinded, multicenter, non-inferiority PRISON IV trial was designed to evaluate the safety, efficacy, and angiographic outcome of hybrid sirolimus-eluting stents with bioresorbable polymers (Orsiro; Biotronik, Berlin, Germany compared with everolimus-eluting stents with durable polymers (Xience Prime/Xpedition; Abbott Vascular, Santa Clara, CA, USA in patients with successfully recanalized TCOs. In total, 330 patients have been randomly allocated to each treatment arm. Patients are eligible with estimated duration of TCO ≥4 weeks with evidence of ischemia in the supply area of the TCO. The primary endpoint is in-segment late luminal loss at 9-month follow-up angiography. Secondary angiographic endpoints include in-stent late luminal loss, minimal luminal diameter, percentage of diameter stenosis, in-stent and in-segment binary restenosis and reocclusions at 9-month follow-up. Additionally, optical coherence

  18. Optical coherence tomography findings after chronic total occlusion interventions: Insights from the “AngiographiC evaluation of the everolimus-eluting stent in chronic Total occlusions” (ACE-CTO) study (NCT01012869)

    Energy Technology Data Exchange (ETDEWEB)

    Sherbet, Daniel P.; Christopoulos, Georgios; Karatasakis, Aris; Danek, Barbara Anna; Kotsia, Anna; Navara, Rachita; Michael, Tesfaldet T.; Roesle, Michele; Rangan, Bavana V.; Haagen, Donald [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States); Garcia, Santiago [Minneapolis VA Healthcare System and University of Minnesota, Minneapolis, MN (United States); Maniu, Calin [Bon Secours Health System, Suffolk, VA (United States); Pershad, Ashish [Banner Good Samaritan Medical Center, Phoenix, AZ (United States); Abdullah, Shuaib M.; Hastings, Jeffrey L.; Kumbhani, Dharam J.; Luna, Michael; Addo, Tayo; Banerjee, Subhash [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States); Brilakis, Emmanouil S., E-mail: esbrilakis@gmail.com [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States)

    2016-10-15

    Background: There is limited information on optical coherence tomography (OCT) findings after percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs). OCT allows high resolution imaging that can enhance understanding of the vascular response after stenting of chronically occluded vessels. Methods: The Angiographic Evaluation of the Everolimus-Eluting Stent in Chronic Total Occlusions (ACE-CTO) study collected angiographic and clinical outcomes from 100 patients undergoing CTO PCI with the everolimus-eluting stent (EES). OCT was performed 8-months post stenting in 62 patients. Every third frame was analyzed throughout the course of the stented arterial segment. Lumen contours were semi-automatically traced and stent struts were manually delineated, with automatic measurement of the strut to lumen distance. Struts on the luminal side of the lumen contour were classified as malapposed if the distance to the lumen contour exceeded 0.108 mm. Results: A total of 44,450 struts in 6047 frames were analyzed, of which 4113 9.3%, 95% confidence intervals [CI] 9.0% to 9.5%) were malapposed and 1230 (2.8%, 95% CI 2.6% to 2.9%) were uncovered. Fifty-five of 62 patients (88.7%, 95% CI 78.5% to 98.4%) had at least one malapposed stent strut and 50 patients (80.7%, 95% CI 69.2% to 88.6%) had at least one uncovered stent strut. Mean strut-intimal thickness of the apposed and malapposed struts was 0.126 ± 0.140 mm and − 0.491 ± 0.440 mm, respectively. Conclusion: High rates of stent strut malapposition and incomplete stent strut coverage were observed after CTO PCI using EES, highlighting unique challenges associated with stent implantation in CTOs. - Highlights: • Percutaneous coronary intervention with drug-eluting stents for chronic total occlusion is associated with a 40% rate of binary in-stent restenosis at 8 months • Of patients who receive a drug eluting stent for a chronic total occlusion 88.7% will have stent strut malapposition and 80.7% will

  19. First principle study of sodium decorated graphyne

    Energy Technology Data Exchange (ETDEWEB)

    Sarkar, Utpal, E-mail: utpalchemiitkgp@yahoo.com [Assam University, Silchar (India); Bhattacharya, Barnali [Assam University, Silchar (India); Seriani, Nicola [The Abdus Salam ICTP, Trieste (Italy)

    2015-11-05

    Highlights: • Presence of Na decreases the stability of the system. • Na-decorated graphyne compounds are metallic and might be used in electronics. • The sodium-adsorbed graphyne can be used as electrodes in Na-ion battery. - Abstract: We present first-principles calculations of the electronic properties of Na-decorated graphyne. This structure of the graphyne family is a direct band gap semiconductor with a band gap of 0.44 eV in absence of sodium, but Na-decorated graphyne compounds are metallic, and can then be employed as carbon-based conductors. Metallization is due to charge donation from sodium to carbon. Pristine graphyne is more stable than Na-decorated graphyne, therefore is seems probable that, if this material should be employed as electrode in Na-ion batteries, it would lead to the formation of metallic sodium rather than well dispersed sodium ions. On the other side, this property might be useful if graphyne is employed in water desalination. Finally, the abrupt change from a semiconducting to a metallic state in presence of a small amount of sodium might be exploited in electronics, e.g. for the production of smooth metal–semiconductor interfaces through spatially selective deposition of sodium.

  20. UK position paper on sodium fires

    Energy Technology Data Exchange (ETDEWEB)

    Vaughan, G J [National Nuclear Corporation Ltd., Risley, Warrington, Cheshire (United Kingdom); Glass, D [United Kingdom Atomic Energy Authority, Dounreay Nuclear Power Development Establishment, Thurso, Caithness (United Kingdom); Newman, R N [Central Electricity Generating Board, Berekely Nuclear Laboratory, Berkeley, Gloucestershire (United Kingdom); Ramsdale, S A [United Kingdom Atomic Energy Authority, Safety and Reliability Directorate, Culcheth, Cheshire (United Kingdom); Snelling, K W [United Kingdom Atomic Energy Authority, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1989-07-01

    The UK has over several years developed a philosophy for the prevention, mitigation and extinguishment of sodium fires. The systems which were developed for PFR have been continuously revised and modified and from these considerations systems were proposed for CDFR. The latest phases of this development are described with reference to the CDFR plant. The current analytical and experimental work on fires, aerosols and sodium concrete reactions is also discussed. The UK are developing codes to analyse the effects of a sodium fire in a building and to model aerosol behaviour following a fire. Experimental work on small scale fires, aerosol behaviour, filtration devices and sodium concrete reaction is being carried out on a laboratory scale. Techniques for aerosol measurement and characterisation have also been developed and used both In the laboratory and large scale tests. Larger scale tests of sodium fire extinguishment techniques have also been performed. Currently a programme of tests (SOFA) of large scale fires in the open to investigate the chemical and physical changes in the aerosol and its dispersion in the atmosphere are just beginning. The UK studies are intended to both assist in the development of prevention and mitigation systems for design base and beyond design base accidents in any building which contains sodium (or sodium potassium alloy) and also to provide methods for assessing the risks from such accidents. (author)

  1. A study on sodium-concrete reaction

    Energy Technology Data Exchange (ETDEWEB)

    Pae, Jae Huem; Min, Byung Hoon; Lee, Joon Sik; Lee, Choong Hui; Chung, Ki Hong; Keum, Choong Ki [Suwon University, Suwon (Korea, Republic of)

    1994-07-15

    Sodium is commonly used as a coolant in liquid metal reactor. A large amount of its leakage may be possible in hypothetical accidents, even though the possibility is very low. In case that the leaked hot sodium comes in direct contact with structural concrete of liquid metal reactor, the reactor`s integrity can be challenged by the rupture of structure materials, hydrogen generation and its explosion, and release of radioactive aerosols due to sodium-concrete reaction. The knowledge of sodium-concrete reaction is evaluated to be one of the important and indispensable technologies for the establishment of safety measure in liquid metal reactor. In this study, the experimental facility of sodium-concrete reaction is to be designed, constructed and operated. And the reaction phenomena of sodium-concrete reaction is also to be analyzed through the experimental results. The aim of this study is to establish the measure of safety and protection for sodium-related facilities and to secure one of the fundamental technologies of liquid metal reactor safety. 47 refs., 7 figs., 13 tab.

  2. A resting bottom sodium cooled fast reactor

    International Nuclear Information System (INIS)

    Costes, D.

    2012-01-01

    This follows ICAPP 2011 paper 11059 'Fast Reactor with a Cold Bottom Vessel', on sodium cooled reactor vessels in thermal gradient, resting on soil. Sodium is frozen on vessel bottom plate, temperature increasing to the top. The vault cover rests on the safety vessel, the core diagrid welded to a toric collector forms a slab, supported by skirts resting on the bottom plate. Intermediate exchangers and pumps, fixed on the cover, plunge on the collector. At the vessel top, a skirt hanging from the cover plunges into sodium, leaving a thin circular slit partially filled by sodium covered by argon, providing leak-tightness and allowing vessel dilatation, as well as a radial relative holding due to sodium inertia. No 'air conditioning' at 400 deg. C is needed as for hanging vessels, and this allows a large economy. The sodium volume below the slab contains isolating refractory elements, stopping a hypothetical corium flow. The small gas volume around the vessel limits any LOCA. The liner cooling system of the concrete safety vessel may contribute to reactor cooling. The cold resting bottom vessel, proposed by the author for many years, could avoid the complete visual inspection required for hanging vessels. However, a double vessel, containing support skirts, would allow introduction of inspecting devices. Stress limiting thermal gradient is obtained by filling secondary sodium in the intermediate space. (authors)

  3. UK position paper on sodium fires

    International Nuclear Information System (INIS)

    Vaughan, G.J.; Glass, D.; Newman, R.N.; Ramsdale, S.A.; Snelling, K.W.

    1989-01-01

    The UK has over several years developed a philosophy for the prevention, mitigation and extinguishment of sodium fires. The systems which were developed for PFR have been continuously revised and modified and from these considerations systems were proposed for CDFR. The latest phases of this development are described with reference to the CDFR plant. The current analytical and experimental work on fires, aerosols and sodium concrete reactions is also discussed. The UK are developing codes to analyse the effects of a sodium fire in a building and to model aerosol behaviour following a fire. Experimental work on small scale fires, aerosol behaviour, filtration devices and sodium concrete reaction is being carried out on a laboratory scale. Techniques for aerosol measurement and characterisation have also been developed and used both In the laboratory and large scale tests. Larger scale tests of sodium fire extinguishment techniques have also been performed. Currently a programme of tests (SOFA) of large scale fires in the open to investigate the chemical and physical changes in the aerosol and its dispersion in the atmosphere are just beginning. The UK studies are intended to both assist in the development of prevention and mitigation systems for design base and beyond design base accidents in any building which contains sodium (or sodium potassium alloy) and also to provide methods for assessing the risks from such accidents. (author)

  4. Installation for the suppression of sodium fires

    International Nuclear Information System (INIS)

    Newman, R.N.; Payne, J.F.B.; Lee, C.J.; Rowe, D.M.J.

    1979-01-01

    The basic operating principles are discussed of a passive baffle-catch tray fire suppression system for sodium fires. A new design is described incorporating increased compartmentalization of the collecting and drainage parts of the device. The burning and smoke generation rates from trays with varying aperture sizes were measured. From the experiments it was found that the burning rate and smoke generation rates could be related satisfactorily to the aperture areas. For the smallest aperture size ( 2 ) it was found that the smoke release was considerably less than that from a fire of the same area, because the smoke deposited on the underside of the baffle. A re-ignition problem was found, where pillars of sodium oxide (wicks) grow upward from the surface of the drained sodium and begin to burn when level with the baffle aperature. From a knowledge of the rate of growth of the wicks, trays may be made sufficiently deep to avoid the problem. Self acting valves were developed which allow the passage of sodium through the aperture and close when drainage is complete. These devices were shown to effect complete extinction of the drained sodium. Using the designs proposed it is possible to construct a system that will reduce the smoke emission from the drained sodium by a factor approaching 10 3 , without the use of valves, or with the self acting valves developed, reduce the emission from the drained sodium to approximately zero. (author)

  5. Under sodium ultrasonic imaging system for PFBR

    International Nuclear Information System (INIS)

    Patankar, V.H.; Lalwani, S.K.; Agashe, A.A.

    2014-01-01

    Under Sodium UltraSonic Scanner (USUSS) has been developed to detect the growth and protrusion of fuel sub-assemblies of PFBR, submerged in liquid sodium by using the ultrasonic imaging technique during reactor shut-down when liquid sodium is at 180 ℃. The imaging is carried out prior to every Fuel handling operation. Electronics Division, BARC has designed and developed an 8-Channel Ultrasonic Imaging System (UIS) which consists of 4 downward viewing and 4 side viewing ultrasonic transducers alongwith pulser-receiver, signal processing electronics hardware and software. An automated mechanical scanner developed by IGCAR houses sodium immersible transducers to image the fuel sub assemblies. The system has been successfully tested with dummy protruding and grown FSAs, submerged under liquid sodium. Such ultrasonic imaging systems are not available to India from international market. The USUSS developed indigenously has all the features available in similar systems developed by other countries. After every imaging campaign, the mechanical scanner containing ultrasonic transducers is stored in the Argon filled storage-pit. Before every campaign of USUSS, it is necessary to check the healthiness of the sodium immersible and contaminated ultrasonic transducers, as the under-sodium scanner is decontaminated once in five years. For this purpose, a novel Non Contact Ultrasonic Inspection System (NCUIS) has been designed and developed by Electronics Division, BARC to check the functionality of the high-temperature and contaminated transducers of USUSS, using air-coupled ultrasonic technique. (author)

  6. Iodine release from sodium pool combustion

    International Nuclear Information System (INIS)

    Sagawa, N.; Fukushima, Y.; Yokota, N.; Akagane, K.; Mochizuki, K.

    1979-01-01

    Iodine release associated with sodium pool combustion was determined by heating 20 gr sodium containing sodium iodide, which was labelled with 131 I and dissolved in the sodium in concentration of 1∼1,000 ppm, to burn on a nickel crucible in conditioned atmosphere in a closed vessel of 0.4 m 3 . Oxygen concentration was changed in 5∼21% and humidity in 0∼89% by mixing nitrogen gas and air. Combustion products were trapped by a Maypack filter composed of particle filters, copper screens and activated charcoal beds and by a glass beads pack cooled by liquid argon. Iodine collected on these filter elements was determined by radio-gas chromatography. When the sodium sample burned in the atmosphere of air at room temperature, the release fractions observed were 6∼33% for sodium and 1∼20% for iodine added in the sodium. The release iodine was present in aerosol at a ratio of 98%, and the remainder in the gas form. The release fraction of iodine trended to decrease as oxygen concentration and humidity in the atmosphere increased. No organic iodide was detected in the combustion products. (author)

  7. Computer simulation for sodium-concrete reactions

    International Nuclear Information System (INIS)

    Zhang Bin; Zhu Jizhou

    2006-01-01

    In the liquid metal cooled fast breeder reactors (LMFBRs), direct contacts between sodium and concrete is unavoidable. Due to sodium's high chemical reactivity, sodium would react with concrete violently. Lots of hydrogen gas and heat would be released then. This would harm the ignorantly of the containment. This paper developed a program to simualte sodium-conrete reactions across-the-board. It could give the reaction zone temperature, pool temperature, penetration depth, penetration rate, hydrogen flux and reaction heat and so on. Concrete was considered to be composed of silica and water only in this paper. The variable, the quitient of sodium hydroxide, was introduced in the continuity equation to simulate the chemical reactions more realistically. The product of the net gas flux and boundary depth was ably transformed to that of penetration rate and boundary depth. The complex chemical kinetics equations was simplified under some hypothesises. All the technique applied above simplified the computer simulation consumedly. In other words, they made the computer simulation feasible. Theoretics models that applied in the program and the calculation procedure were expatiated in detail. Good agreements of an overall transient behavior were obtained in the series of sodium-concrete reaction experiment analysis. The comparison between the analytical and experimental results showed the program presented in this paper was creditable and reasonable for simulating the sodium-concrete reactions. This program could be used for nuclear safety judgement. (authors)

  8. Removal of sodium from the component of the sodium purification loop

    International Nuclear Information System (INIS)

    Kim, Byung Ho; Jeong, Kyung Chai; Jeong, Ji Young; Kim, Jong Man; Choi, Byung Hae; Nam, Ho Yun

    2005-01-01

    The purpose of a cleaning process is to remove the residual sodium adhering to the component walls once it has been properly drained. It is necessary to clean and decontaminate a component, especially the large components of the primary coolant system; such as the intermediate heat exchangers and the primary pump. Improper and inadequate cleaning has in a number of cases resulted in problems in the storage, handling, and reuse of components. Several types of failures due to improper cleaning procedures have been defined in the past. Inadequate and incomplete removal of sodium results in residues which may contain metallic sodium and alkaline compounds such as sodium hydroxide, sodium oxide, sodium carbonate, and various types of alcoholates. Reinsertion of components containing these compounds into a high-temperature sodium system can result in either the intergranular penetration characteristic of a high-oxygen sodium or an accelerated corrosion due to oxygen. The methods used for cleaning sodium equipment depend on the condition and types of equipment to be cleaned and whether the equipment is to be reused. Cleaning methods are needed that will avoid a deleterious local overheating, material surface degradation or deposits, chemical, physical, or mechanical damage, and external effects. This paper discusses a steam-nitrogen gas cleaning method for the routine applications that permits the reuse of the cold trap in sodium

  9. Review of the sodium fire experiments including sodium-concrete-reactions and summary of the results

    International Nuclear Information System (INIS)

    Cherdron, W.

    1996-01-01

    In the technical and design concept of containment systems of sodium cooled breeder reactors it has to be considered, that leakages in sodium pipes lead to sodium fires. The temperature and pressure rise caused by sodium fires makes it indispensable to analyse these accidents to be able to assess the safety of the whole system. Generally sodium leakages may lead to three different types of fires with different consequences. The main influences are the geometry of the leakage, shape, size, location, and the sodium conditions, such as temperature, flow rate and velocity. It must be also considered the reaction of sodium with surfaces like concrete. The paper gives an overview over all the sodium fire experiments performed in the FAUNA-facility (220 m 3 ) of the Forschungszentrum Karlsruhe in the years 1979 to 1993. The experimental program started with the investigation of pool fires on burning areas between 2 and 12 m 2 with up to 500 kg of Sodium. The experiments had been continued with 3 combined fires and 40 experiments on spray fires. 7 experiments on sodium-concrete reactions completed the program. (author)

  10. Electrolyte transport in distal colon of sodium-depleted rats: Effect of sodium repletion

    International Nuclear Information System (INIS)

    Turnamian, S.G.; Binder, H.J.

    1988-01-01

    Dietary sodium depletion increases plasma aldosterone level and, as a result, induces amiloride-sensitive electrogenic sodium absorption and electrogenic potassium secretion and stimulates Na + -K + -ATPase activity in rat distal colon, while inhibiting electroneutral sodium chloride absorption. To assess the events that occur as the aldosterone-stimulated colon reverts to normal, unidirectional 22 Na and 36 Cl fluxes were measured under voltage-clamp conditions across isolated distal colonic mucosa of rats that were initially dietary sodium depleted for 7 days and then sodium repleted for varying periods of time before the study. Within 8 h of dietary sodium repletion, plasma aldosterone level and Na + -K + -ATPase activity declined to normal, amiloride-sensitive electrogenic sodium absorption decreased by >90%, and active electrogenic potassium secretion also decreased markedly. In contrast, electroneutral sodium chloride absorption did not completely return to levels seen in normal animals until ∼64-68 h. These results demonstrate that maintenance of electrogenic sodium absorption and potassium secretion are directly dependent on elevated plasma aldosterone levels. The inhibition of electroneutral sodium absorption, although initiated by excess aldosterone, persists after normalization of the plasma aldosterone level, thereby implying that the inhibition is dependent on additional factor(s)

  11. An investigation of sodium iodide solubility in sodium-stainless steel systems

    International Nuclear Information System (INIS)

    Sagawa, Norihiko; Tashiro, Suguru

    1996-01-01

    Sodium iodide and major constituents of stainless steel in sodium are determined by using the steel capsules to obtain a better understanding on contribution of the constituents to the apparent iodide solubility in sodium. The capsule loaded with 20 g sodium and 0.1 - 0.3 g powder of sodium iodide is heated at its upper part in a furnace and cooled at its bottom on brass plates to establish a large temperature gradient along the capsule tube. After a given period of equilibration, the iodide and constituents are fixed in solidified sodium by quick quenching of the capsules. Sodium samples are taken from the sectioned capsule tube and submitted to sodium dissolution by vaporized water for determination of the iodine and to vacuum distillation for determination of the metal elements. Iron and nickel concentrations are observed to be lower in the samples at higher iodine concentrations. Chromium and manganese concentrations are seen to be insensitive to the iodine concentrations. The observations can be interpreted by a model that sodium oxide combines with metal iodide in sodium to form a complex compound and with consideration that the compound will fall and deposit onto the bottom of the capsule by thermal diffusion. (author)

  12. Sodium vapor deposition onto a horizontal flat plate above liquid sodium surface, 2

    International Nuclear Information System (INIS)

    Kudo, Kazuhiko; Hirata, Masaru.

    1977-01-01

    The sodium vapor deposition onto a horizontal flat plate above liquid sodium surface was studied. The analysis was performed by assuming that the sodium mist is emitted into the main flow without condensation and then grows up in the main flow and drops on the sodium surface. The effects of growth of sodium mist to the system were investigated. The model of the phenomena is the sodium deposition onto a horizontal flat plate which is placed above the sodium surface with the medium cover gas. One-dimensional analysis can be done. The rate of deposition is greatly reduced when the temperature of the flat plate is lowered. For the analysis of this phenomena, it is assumed that the sodium mist grows by condensation. One of results is that the real state may be the state between the state that the condensation of mist is made in the boundary layer and the state that the mist is condensed in the main flow. Others are that there is no effect of sodium mist condensation on the rate of deposition, and that the rate of the vaporization of sodium is given by the original and the modified model. (Kato, T.)

  13. Dynamic thermal baffle on lower head of FBR sodium-sodium intermediate heat exchanger

    International Nuclear Information System (INIS)

    Charbonnel, A.; Foussat, C.

    1981-01-01

    The cover head of the heat exchanger is bathed on the one side by the primary sodium of the 'cold' header of the vessel and on the other side by the secondary sodium which feeds the heat exchange tube bank through the lower tubesheet. In the case of transient or permanent operating conditions at partial ratings, there are large temperature differences between the inner sodium (inlet temperature conditions of secondary sodium) and the outer sodium (mean temperature conditions in the primary sodium outlet port), hence the necessity of designing a thermal baffle which protects the head and its connection to the tubesheet. A 'static' thermal baffle consisting of a thick steel plate enclosing static sodium around the head proves inadequate during transient operating conditions. This is why a 'dynamic' thermal baffle is used whose design is based on the fact that the primary sodium in the lower part of the outlet port is always at a temperature close to that of the secondary sodium in the inlet header and the head. The primary sodium is taken from the bottom of the outlet port by a ring deflector and circulates in an annulus created by a double housing and the head. It flows out through openings in the lower part of the housing. (orig./GL)

  14. A Global Model of Meteoric Sodium

    Science.gov (United States)

    Marsh, Daniel R.; Janches, Diego; Feng, Wuhu; Plane, John M. C.

    2013-01-01

    A global model of sodium in the mesosphere and lower thermosphere has been developed within the framework of the National Center for Atmospheric Research's Whole Atmosphere Community Climate Model (WACCM). The standard fully interactive WACCM chemistry module has been augmented with a chemistry scheme that includes nine neutral and ionized sodium species. Meteoric ablation provides the source of sodium in the model and is represented as a combination of a meteoroid input function (MIF) and a parameterized ablation model. The MIF provides the seasonally and latitudinally varying meteoric flux which is modeled taking into consideration the astronomical origins of sporadic meteors and considers variations in particle entry angle, velocity, mass, and the differential ablation of the chemical constituents. WACCM simulations show large variations in the sodium constituents over time scales from days to months. Seasonality of sodium constituents is strongly affected by variations in the MIF and transport via the mean meridional wind. In particular, the summer to winter hemisphere flow leads to the highest sodium species concentrations and loss rates occurring over the winter pole. In the Northern Hemisphere, this winter maximum can be dramatically affected by stratospheric sudden warmings. Simulations of the January 2009 major warming event show that it caused a short-term decrease in the sodium column over the polar cap that was followed by a factor of 3 increase in the following weeks. Overall, the modeled distribution of atomic sodium in WACCM agrees well with both ground-based and satellite observations. Given the strong sensitivity of the sodium layer to dynamical motions, reproducing its variability provides a stringent test of global models and should help to constrain key atmospheric variables in this poorly sampled region of the atmosphere.

  15. Overflow type sodium sampler for FBTR circuits

    International Nuclear Information System (INIS)

    Muralidaran, P.; Ganesan, V.; Chandran, K.; Periaswami, G.

    1996-01-01

    Obtaining a representative sample is crucial for getting reliable results in sodium analysis. Sampling liquid sodium reliability is complicated since impurities segregate while cooling. Selective sorption of certain elements calls for use of different crucible materials for various sodium impurities. Sampling methods currently in use such as flow through sampling and dip sampling are not the proper methods as they can not take care of the above problems. An overflow type sampler where the entire sample contained in a crucible can be used for analysis thus obviating problems due to segregation has been developed for use in Fast Breeder Test Reactor (FBTR). This report describes the construction and operation of this sampler. (author)

  16. IAEA sodium void reactivity benchmark calculations

    International Nuclear Information System (INIS)

    Hill, R.N.; Finck, P.J.

    1992-01-01

    In this paper, the IAEA-1 992 ''Benchmark Calculation of Sodium Void Reactivity Effect in Fast Reactor Core'' problem is evaluated. The proposed design is a large axially heterogeneous oxide-fueled fast reactor as described in Section 2; the core utilizes a sodium plenum above the core to enhance leakage effects. The calculation methods used in this benchmark evaluation are described in Section 3. In Section 4, the calculated core performance results for the benchmark reactor model are presented; and in Section 5, the influence of steel and interstitial sodium heterogeneity effects is estimated

  17. Conceptural design of multipurpose sodium test loop

    International Nuclear Information System (INIS)

    Kim, W.C.; Lee, Y.W.; Nam, H.Y.; Chun, S.Y.; Kim, J.; Yuh, M.W.

    1982-01-01

    This report describes the conceptural design of the multipurpose sodium test loop (MSTL). This MSTL consists mainly of impurity control and measurement system, corrosion and masstransfer system and heat transfer system. Problems associated with liquid sodium coolant will be studied and operating experiences will be obtained by the use of this facility. This technology will be used to evaluate safety and reliability of large sodium facility in the future. The total cost excluding the cost of building construction is estimated to 175 thousand dollars. (Author)

  18. Calculation of thermophysical properties of sodium

    International Nuclear Information System (INIS)

    Fink, J.K.; Leibowitz, L.

    1981-01-01

    The thermodynamic properties of sodium previously recommended by Padilla have been updated. As much as possible, the approach described by Padilla has been used. For sodium in the states of saturated liquid and vapor, subcooled liquid and superheated vapor, the following thermodynamic properties were determined: enthalpy, heat capacity (constant pressure and constant volume), pressure, density, thermal-expansion coefficient, and compressibility (adiabatic and isothermal). In addition to the above properties, thermodynamic properties including heat of fusion, heat of vaporization, surface tension, speed of sound and transport properties of themal conductivity, thermal diffusivity, emissivity, and viscosity were determined for saturated sodium

  19. Interaction of theobromine with sodium benzoate

    Energy Technology Data Exchange (ETDEWEB)

    Nishijo, J.; Yonetani, I.

    1982-03-01

    The interaction of theobromine with sodium benzoate was investigated by PMR spectroscopy. The interaction of theobromine with pentadeuterated benzoic acid (benzoic acid-d5) was examined in the same manner but to a lesser degree. Chemical shifts of theobromine protons were determined as a function of sodium benzoate concentration in deuterium oxide at 30 and 15 degrees. Signals of both methyl groups of theobromine underwent significant upfield shifts when sodium benzoate was added to a theobromine solution. This fact suggests that a complex is formed by vertical stacking or plane-to-plane stacking. The same results were obtained for benzoic acid-d5.

  20. Radioimmunoassay of sodium cromoglycate in human plasma

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K; Gardner, J J; Lockley, W J.S.; Preston, J R; Wilkinson, D J [Fisons plc, Loughborough (UK). Pharmaceutical Div.

    1983-01-01

    A sensitive radioimmunoassay method for sodium cromoglycate in human plasma is described. The lowest quantifiable concentration of sodium cromoglycate is 0.93 nmol/l when 0.1 ml plasma samples are analysed. The range of the method is limited; both 0.01 and 0.1 ml volumes of plasma must be analysed to encompass the concentration range 0.93-139 nmol/l which may be encountered in plasma samples from patients and human volunteers. The method is specific for sodium cromoglycate as indicated by a low cross-reactivity of the anti-cromoglycate antiserum with a number of drugs.

  1. Hydrogen meter for service in liquid sodium

    International Nuclear Information System (INIS)

    McCown, J.J.

    1983-11-01

    This standard establishes the requirements for the design, materials, fabrication, quality assurance, examination, and acceptance testing of a hydrogen meter and auxiliary equipment for use in radioactive or nonradioactive liquid sodium service. The meter shall provide a continuous and accurate indication of the hydrogen impurity concentration over the range 0.03 to 10 ppM hydrogen in sodium at temperatures between 800 and 1000 0 F (427 and 538 0 C). The meter may also be used to rapidly monitor changes in hydrogen concentration, over the same concentration range, and, therefore can be used as a sensor for sodium-water reactions in LMFBR steam generators

  2. A method for the manufacture of nuclear-purity sodium

    International Nuclear Information System (INIS)

    Besson, Paul; Graff, Willy.

    1973-01-01

    Description is given of a method for the manufacture of sodium from the amalgam provided by sodium chloride aqueous electrolysis cells, comprising the steps of treating the sodium amalgam by a sodium polysulfide or a mixture of sodium polysulfide in anhydrous alcohol solution, then causing the thus obtained sodium monosulfide to react with a polysulfide or a mixture of polysulfides so as to obtain a mixture of sodium polysulfides with a higher sodium content, and finally separating sodium through the electrolysis of the sodium-rich polysulfides, the electrolysis being carried out in an electrolytic cell with β-alumina solid electrolyte operating at a temperature between 250 and 300 deg C, in which the polysulfide forms the anode compartment and sodium the cathode compartment [fr

  3. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride

    DEFF Research Database (Denmark)

    Graudal, Niels Albert; Hubeck-Graudal, Thorbjorn; Jurgens, Gesche

    2017-01-01

    Background: In spite of more than 100 years of investigations the question of whether a reduced sodium intake improves health is still unsolved. Objectives: To estimate the effects of low sodium intake versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum...... results: A total of 185 studies were included. The average sodium intake was reduced from 201 mmol/day (corresponding to high usual level) to 66 mmol/day (corresponding to the recommended level). The effect of sodium reduction on blood pressure (BP) was as follows: white people with normotension: SBP.......0005) and triglyceride (P sodium intake as compared with high sodium intake. All effects were stable in 125 study populations with a sodium intake below 250 mmol/day and a sodium reduction intervention of at least one week. Authors' conclusions: Sodium reduction from an average high usual sodium...

  4. Sodium: How to Tame Your Salt Habit

    Science.gov (United States)

    ... dogs, sausage and ham. Buy fresh or frozen poultry or meat that hasn't been injected with ... use of sodium-laden condiments. Soy sauce, salad dressings, sauces, dips, ketchup, mustard and relish all contain ...

  5. Ultrasonic sweep arm for sodium cooled reactors

    International Nuclear Information System (INIS)

    Rohrbacher, H.A.; Bartholomay, R.

    1975-05-01

    This report describes experience in the use of a new type of monitoring and testing device to be applied in conjunction with components under sodium. In the method outlined, ultrasonic pulses are used which are emitted into the sodium plenum of fast breeder reactors by newly developed high temperature transducers. The basic work was conducted under out-of-pile conditions in a sodium tank of the sodium tank facility of the Karlsruhe Institute for Reactor Development. The sensor development, which preceded this phase, resulted in the use of soldered lithium niobate crystals whose operating characteristics were improved by the preliminary treatment outlined in the report. Special materials and techniques suitable for sensor fabrication are proposed. An alternative to soldering is suggested for contacting the crystals with their diaphragms, i.e. a contact pressure concept for the range of application up to 2 MHz. (orig.) [de

  6. fibrin–chitosan–sodium alginate composite sheet

    Indian Academy of Sciences (India)

    sodium alginate composite (F–C–SA) in sheet form. F–C–SA composite was prepared and characterized for its physicochemical properties like water absorption capacity, surface morphology, FTIR spectra and mechanical properties.

  7. Antimicrobial efficacy of nanosilver, sodium hypochlorite and ...

    African Journals Online (AJOL)

    NS), chlorhexidine gluconate (CHX) and sodium hypochlorite (NaOCl) against Enterococcus faecalis. Two tests of minimum inhibitory concentration (MIC) and zone of inhibition were carried out using NS, NaOCl and CHX. 70-fold ...

  8. Filtration of sodium-fire aerosols

    International Nuclear Information System (INIS)

    Alexas, A.; Jordan, S.; Lindner, W.

    1979-01-01

    Different filter devices have been developed and tested with respect to their use in the off-gas system of liquid-metal fast breeder reactors to prevent the escape of sodium-fire aerosols that might be formed in case of an accident. The testing results have shown that the use of a multilayer sand bed filter is still the best method to filter limited amounts of sodium-fire aerosols over a long operating time. Efficiencies on the order of 99.98 and 98.8% were reached for loading capacities of 500 and 1000 g/m 2 , respectively. Unlimited amounts of sodium-fire aerosols can be filtered by wet scrubbers with an efficiency of 70% per scrubber stage. Fiberglas filters connot be used for the filtration of sodium-fire aerosols over a long operating time because the filter material can be destroyed after several days of operating

  9. Synthesis of deuterium-labelled diclofenac sodium

    International Nuclear Information System (INIS)

    Leroy, D.; Richard, J.; Godbillon, J.

    1993-01-01

    Dicolofenac sodium labelled with deuterium in the phenylacetic ring was prepared from [ 2 H 5 ]-bromobenzene in a six-step reaction. It was found to be suitable for use in pharmacokinetic and bioavailability studies in man. (Author)

  10. Monju secondary heat transport system sodium leak

    International Nuclear Information System (INIS)

    Suzuki, Takeo; Hiroi, Hiroshi; Usami, Shin; Iwata, Koji.

    1996-01-01

    On December 8, 1995, the sodium leakage from the secondary heat transport system (SHTS) occurred in the piping room of the reactor auxiliary building in Monju. The secondary sodium leaked through a temperature sensor, due to the breakaway of the tip of the well tube of the sensor installed near the outlet of the intermediate heat exchanger (IHX) in the C loop of SHTS. The reactor core remained cooled and thus, from the viewpoint of radiological hazards, the safety of the reactor was secured. There were no adverse effects for operating personnel or the surrounding environment. The cause of the well tube failure is considered to result from high cycle fatigue due to flow induced vibrations. Delay in draining the sodium from the leaking loop increased the consequential effects from sodium combustion products. (author)

  11. Small sodium valve design and operating experience

    International Nuclear Information System (INIS)

    Abramson, R.; Elie, X.; Vercasson, M.; Nedelec, J.

    1974-01-01

    Conventionally, valves for sodium pipes smaller than 125 mm in diameter are called ''small sodium valves''. However, this limit should rather be considered as the lower limit o ''large sodium valves''. In fact, both the largest sizes of small valves and the smallest of large valves can be found in the range of 125-300 mm in diameter. Thus what is said about small valves also applies, for a few valve types, above the 125 mm limit. Sodium valves are described here in a general manner, with no manufacturing details except when necessary for understanding valve behavior. Operating experience is pointed out wherever possible. Finally, some information is given about ongoing or proposed development plans. (U.S.)

  12. Formulation of Sodium Alginate Nanospheres Containing ...

    African Journals Online (AJOL)

    Patrick Erah

    controlled gellification method and to evaluate the role of the nanospheres as a ... method, and the particle size analysis was carried out by scanning electron ... capacity of sodium alginate was evaluated in terms of drug to polymer ratio.

  13. CRBRP sodium circulating pump design evaluation

    International Nuclear Information System (INIS)

    Marrujo, F.; Cook, M.; Manners, L.; Cothran, H.

    1977-12-01

    The following topics are discussed: (1) primary sodium pump design concept; (2) pump level control system; (3) resolution of design problems in stress analysis, dynamics analysis, and mechanical design; (4) model testing; (5) planned performance tests; and (6) fabrication status

  14. Parabrachial and hypothalamic interaction in sodium appetite

    Science.gov (United States)

    Dayawansa, S.; Peckins, S.; Ruch, S.

    2011-01-01

    Rats with bilateral lesions of the lateral hypothalamus (LH) fail to exhibit sodium appetite. Lesions of the parabrachial nuclei (PBN) also block salt appetite. The PBN projection to the LH is largely ipsilateral. If these deficits are functionally dependent, damaging the PBN on one side and the LH on the other should also block Na appetite. First, bilateral ibotenic acid lesions of the LH were needed because the electrolytic damage used previously destroyed both cells and axons. The ibotenic LH lesions produced substantial weight loss and eliminated Na appetite. Controls with ipsilateral PBN and LH lesions gained weight and displayed robust sodium appetite. The rats with asymmetric PBN-LH lesions also gained weight, but after sodium depletion consistently failed to increase intake of 0.5 M NaCl. These results dissociate loss of sodium appetite from the classic weight loss after LH damage and prove that Na appetite requires communication between neurons in the LH and the PBN. PMID:21270347

  15. Polymerization of sodium methacrylate induced by irradiation

    International Nuclear Information System (INIS)

    Galvan S, A.

    1998-01-01

    This work has two objectives, first: it is pretended to localize the lines of carbon links in its IR spectra, and second: following the polymerization of sodium methacrylate according to that it is irradiated with gamma rays. (Author)

  16. Sodium removal from Hallam Reactor components

    International Nuclear Information System (INIS)

    Huntsman, L.K.; Meservey, R.H.

    1979-08-01

    This report discussed the removal of sodium from major components of the Hallam Nuclear Power Facility. This facility contained the experimental ractor used to test the feasibility of sodium coolant. The Idaho Operations Office of the Department of Energy assigned EG and G Idaho, Inc., the task of carrying out this decontamination and decommissioning program at the Idaho National Engineering Laboratory (INEL). Since their shipment to the INEL from Lincoln, Nebraska in 1968, the Hallam Reactor components had been stored in inert nitrogen to prevent the sodium in the components from reacting with moisture in the air. The procedure used to react the sodium in the components and to decontaminate them is discussed. Problems and unusual occurrences in the decontamination and decommissioning process are also reported

  17. Sodium vapour aerosol formation and sodium deposition current work within the United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Hawtin, P [Chemical Engineering Division, Atomic Energy Research Establishment, Harwell, Didcot, Oxon (United Kingdom); Seed, G [Nuclear Power Company (Risley) Ltd, Risley, Warrington, Cheshire (United Kingdom)

    1977-01-01

    The significance to reactor operation of sodium transport through the cover gas of a sodium-cooled fast reactor and its subsequent deposition on cooled reactor surfaces is fully appreciated in the UK. A programme of work is therefore underway designed to understand the mechanism of sodium transport under these conditions. This paper described the work which has so far been completed, discussed the work presently in progress, and outlines future plans. (author)

  18. Apparatus for removing impurities in the sodium of sodium cooled reactors

    Energy Technology Data Exchange (ETDEWEB)

    Yamauchi, A

    1970-11-11

    An apparatus is provided for removing oxygen from liquid sodium flowing in a sodium cooled reactor. The removal of oxygen is complete with high efficiency. The liquid sodium to be purified is disposed outside a cylindrical wall and negatively charged, whereas sodium as a reducing material is disposed inside the same wall. The cylindrical wall is made of zirconia-calcia (ZrO/sub 2/)sub(0.87)(CaO)sub(0.13) solid electrolyte, the cylinder having a thickness of 2.5mm, a diameter of 3cm and a depth of 20cm under the sodium level. Electric resistance of the solid electrolyte is 2.3 ohm at 500/sup 0/C. A current of 1A by the application of 25 volts treats 0.3g of oxygen. Consequently, 1 liter or 1kg of liquid sodium containing 1,000ppm of oxygen can be purified for about 3 hours at an electrical consumption of 7.5 watt-hour. In one embodiment, a cylindrical electrolytic solid made of zirconia-calcia or zirconia-yttria was disposed in a container. Liquid sodium containing oxygen flowed outside of the cylinder. Liquid sodium as a reducing material was present inside the cylinder and the container and the cylinder were electrically insulated. An electrode was inserted at the center of the cylinder and a baffle plate at the upper portion of the electrode to shield heat and rising sodium vapor was provided. The space above the container was filled with an inert gas. The oxygen in the liquid sodium to be purified transferred through the wall of the cylinder into the interior of the cylinder so as to oxydize the reducing sodium material. The supersaturated sodium oxide inside the cylinder was deposited.

  19. Astrocyte Sodium Signalling and Panglial Spread of Sodium Signals in Brain White Matter.

    Science.gov (United States)

    Moshrefi-Ravasdjani, Behrouz; Hammel, Evelyn L; Kafitz, Karl W; Rose, Christine R

    2017-09-01

    In brain grey matter, excitatory synaptic transmission activates glutamate uptake into astrocytes, inducing sodium signals which propagate into neighboring astrocytes through gap junctions. These sodium signals have been suggested to serve an important role in neuro-metabolic coupling. So far, it is unknown if astrocytes in white matter-that is in brain regions devoid of synapses-are also able to undergo such intra- and intercellular sodium signalling. In the present study, we have addressed this question by performing quantitative sodium imaging in acute tissue slices of mouse corpus callosum. Focal application of glutamate induced sodium transients in SR101-positive astrocytes. These were largely unaltered in the presence of ionotropic glutamate receptors blockers, but strongly dampened upon pharmacological inhibition of glutamate uptake. Sodium signals induced in individual astrocytes readily spread into neighboring SR101-positive cells with peak amplitudes decaying monoexponentially with distance from the stimulated cell. In addition, spread of sodium was largely unaltered during pharmacological inhibition of purinergic and glutamate receptors, indicating gap junction-mediated, passive diffusion of sodium between astrocytes. Using cell-type-specific, transgenic reporter mice, we found that sodium signals also propagated, albeit less effectively, from astrocytes to neighboring oligodendrocytes and NG2 cells. Again, panglial spread was unaltered with purinergic and glutamate receptors blocked. Taken together, our results demonstrate that activation of sodium-dependent glutamate transporters induces sodium signals in white matter astrocytes, which spread within the astrocyte syncytium. In addition, we found a panglial passage of sodium signals from astrocytes to NG2 cells and oligodendrocytes, indicating functional coupling between these macroglial cells in white matter.

  20. Percutaneous Coronary Intervention of Left Main Disease: Pre- and Post-EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) Era.

    Science.gov (United States)

    Park, Duk-Woo; Park, Seung-Jung

    2017-06-01

    For nearly half a century, coronary artery bypass grafting has been the standard treatment for patients with obstructive left main coronary artery (LMCA) disease. However, there has been considerable evolution in the field of percutaneous coronary intervention, and especially, percutaneous coronary intervention for LMCA disease has been rapidly expanded with adoption of drug-eluting stents. Some, but not all randomized trials, have shown that percutaneous coronary intervention with drug-eluting stents might be a suitable alternative for selected patients with LMCA disease instead of bypass surgery. However, none of previous trials involving early-generation drug-eluting stents was sufficiently powered and comparative trials using contemporary drug-eluting stents were limited. Recently, primary results of 2 new trials of EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) were reported. However, these trials showed conflicting results, which might pose uncertainty on the optimal revascularization strategy for LMCA disease. In this article, with the incorporation of a key review on evolution of LMCA treatment, we summarize the similarity or disparity of the EXCEL and NOBLE trials, focus on how they relate to previous trials in the field, and finally speculate on how the treatment strategy may be changed or recommended for LMCA treatment. © 2017 American Heart Association, Inc.