Effects of everolimus on macrophage-derived foam cell behavior

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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

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

Regression of Cardiac Rhabdomyomas in a Neonate after Everolimus Treatment

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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.

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

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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...

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

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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....

Everolimus Implicated in Case of Severe Gastrointestinal Hemorrhage

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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.

Everolimus initiation and early calcineurin inhibitor withdrawal in heart transplant recipients

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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...

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

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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.

Research and innovation in the development of everolimus for oncology.

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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.

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

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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...

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

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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.

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

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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

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

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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.

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

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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.

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

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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.

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

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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

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...

Adjuvant Everolimus for Resected Kidney Cancer

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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.

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

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

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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.

Everolimus for Primary Intestinal Lymphangiectasia With Protein-Losing Enteropathy.

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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.

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

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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....

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

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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.

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

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

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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

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

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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.

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.

Everolimus Alleviates Obstructive Hydrocephalus due to Subependymal Giant Cell Astrocytomas.

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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.

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

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

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

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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

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...

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....

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

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

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.

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

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.

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

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

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.

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...

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.

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

[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.

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...

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.

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

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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

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

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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

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

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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...

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

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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

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

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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.

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

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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

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

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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

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

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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.

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

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

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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

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

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.

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

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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....

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

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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

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

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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.

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...

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.

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

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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.

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

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

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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...

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.

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

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

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

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

Future immunosuppressive agents in solid-organ transplantation.

Science.gov (United States)

Gabardi, Steven; Cerio, Jeffrey

2004-06-01

To review the pharmacology, pharmacokinetics, efficacy, and safety of mycophenolate sodium, everolimus, and FTY720. Clinical trials and abstracts evaluating mycophenolate sodium, everolimus, and FTY720 in solid-organ transplantation were considered for evaluation. English-language studies and published abstracts were selected for inclusion. Mycophenolate sodium has recently been approved by the Food and Drug Adminstration for marketing in the United States; everolimus and FTY720 are immunosuppressive agents that may soon be available in the United States. These agents have proven efficacy in reducing the incidence of acute rejection in solid-organ transplantation. Clinical trials have shown that these newer agents are relatively well tolerated. The most common adverse events associated with these agents were gastrointestinal and hematologic effects (mycophenolate sodium); hyperlipidemia, increased serum creatinine, and hematologic effects (everolimus): and gastrointestinal effects, headache, and bradycardia (FTY720). Mycophenolate sodium has been approved in some European countries and the United States. Everolimus has been approved in some European countries and a new drug application has been submitted to the Food and Drug Administration. FTY720 is currently in phase III clinical trials and submission to the Food and Drug Administration for approval is a few years away. The approval of these agents will furnish the transplant practitioner with even more options for immunosuppression.

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

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

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)....

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

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

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

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

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.

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

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...

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.

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

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...

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.

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.

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

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

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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.

[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.

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...

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.

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...

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

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.

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

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

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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.

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

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

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.

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

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

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...

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.

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.

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

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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.

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

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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.

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....

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.

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

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.

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

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

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...

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

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.

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

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

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.

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

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

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.

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)....

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

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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.

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

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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

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

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

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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

Recommendations of everolimus use in liver transplant.

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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.

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

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.

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.

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)....

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.

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

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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

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.

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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

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.

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....

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.

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.

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

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

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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.

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.

Z-drug for schizophrenia: A systematic review and meta-analysis.

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Kishi, Taro; Inada, Ken; Matsui, Yuki; Iwata, Nakao

2017-10-01

No systematic reviews and meta-analyses on the use of Z-drug for schizophrenia are available. Randomized, placebo-controlled, or non-pharmacological intervention-controlled trials published before 03/20/2017 were retrieved from major healthcare databases and clinical trial registries. A meta-analysis including only randomized, placebo-controlled trials was performed. Efficacy outcomes were measured as improvement in overall schizophrenia symptoms, total sleep time, and wake after sleep onset. Safety/acceptability outcomes were discontinuation rate and individual adverse events. Four trials [1 alpidem placebo-controlled study (n=66), 2 eszopiclone placebo-controlled studies (n=60), and 1 eszopiclone, shallow needling-controlled study (n=96)] were identified. The meta-analysis showed no significant differences in any outcome between pooled Z-drug and placebo treatment groups. For individual studies, alpidem was superior to placebo in improving the overall schizophrenia symptoms. One of the eszopiclone studies showed that eszopiclone was superior to placebo in improving the Insomnia Severity Index scores. Another eszopiclone study showed that eszopiclone did not differ from shallow needling therapy in improving both schizophrenia- and insomnia-related symptoms. Although this study failed to show significant benefits for the use of Z-drug in the treatment of schizophrenia, it showed that short-term use of eszopiclone is an acceptable method for treating persistent insomnia among these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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.

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

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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.

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

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

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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

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.

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...

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...

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。

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...

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

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.

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.

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

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.

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...

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

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.

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.

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.

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

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 ...

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.

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.

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

3-Year Clinical Follow-Up of the RIBS IV Clinical Trial: A Prospective Randomized Study of Drug-Eluting Balloons Versus Everolimus-Eluting Stents in Patients With In-Stent Restenosis in Coronary Arteries Previously Treated With Drug-Eluting Stents.

Science.gov (United States)

Alfonso, Fernando; Pérez-Vizcayno, María José; Cuesta, Javier; García Del Blanco, Bruno; García-Touchard, Arturo; López-Mínguez, José Ramón; Masotti, Mónica; Zueco, Javier; Cequier, Angel; Velázquez, Maite; Moreno, Raúl; Mainar, Vicente; Domínguez, Antonio; Moris, Cesar; Molina, Eduardo; Rivero, Fernando; Jiménez-Quevedo, Pilar; Gonzalo, Nieves; Fernández-Pérez, Cristina

2018-05-28

This study sought to compare the long-term safety and efficacy of drug-eluting balloons (DEB) and everolimus-eluting stents (EES) in patients with in-stent restenosis (ISR) of drug-eluting stents (DES). Treatment of patients with DES-ISR remains a challenge. The RIBS IV (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloons vs Everolimus-Eluting Stents) trial is a prospective multicenter randomized clinical trial comparing DEB and EES in patients with DES-ISR. The pre-specified comparison of the 3-year clinical outcomes obtained with these interventions is the main objective of the present study. A total of 309 patients with DES-ISR were randomized to DEB (n = 154) or EES (n = 155). At angiographic follow-up, the in-segment minimal lumen diameter was larger in the EES arm (2.03 ± 0.7 mm vs. 1.80 ± 0.6 mm; p 1 year) target lesion revascularization (2.6% vs. 4%) and target vessel revascularization (4% vs. 6.6%) was similar in the 2 arms. Rates of cardiac death (3.9% vs. 3.2%), myocardial infarction (2.6% vs. 4.5%), and stent thrombosis (1.3% vs. 2.6%) at 3 years were also similar in both arms. The 3-year clinical follow-up of this randomized clinical trial demonstrates that in patients with DES-ISR, EES reduce the need for repeat interventions compared with DEB. (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloons vs Everolimus-Eluting Stents [RIBS IV]; NCT01239940). Published by Elsevier Inc.

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 ...

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)

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.

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)

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)

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.

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

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...

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

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 ...

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...

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.)

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

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

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, ...

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...

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)

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.

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.

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

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.)

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.

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

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

Assessment of flow induced vibration in a sodium-sodium heat exchanger

Energy Technology Data Exchange (ETDEWEB)

Prakash, V. [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamil Nadu (India)], E-mail: prakash@igcar.gov.in; Thirumalai, M.; Prabhakar, R.; Vaidyanathan, G. [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamil Nadu (India)

2009-01-15

The 500 MWe Prototype Fast Breeder Reactor (PFBR) is under construction at Kalpakkam. It is a liquid metal sodium cooled pool type fast reactor with all primary components located inside a sodium pool. The heat produced due to fission in the core is transported by primary sodium to the secondary sodium in a sodium to sodium Intermediate Heat Exchanger (IHX), which in turn is transferred to water in the steam generator. PFBR IHX is a shell and tube type heat exchanger with primary sodium on shell side and secondary sodium in the tube side. Since IHX is one of the critical components placed inside the radioactive primary sodium, trouble-free operation of the IHX is very much essential for power plant availability. To validate the design and the adequacy of the support system provided for the IHX, flow induced vibration (FIV) experiments were carried out in a water test loop on a 60 deg. sector model. This paper discusses the flow induced vibration measurements carried out in 60 deg. sector model of IHX, the modeling criteria, the results and conclusion.

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.

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.)

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)

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...

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

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

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.

Effect of sodium lactate /sodium diacetate in combination with sodium nitrite on physiochemical, microbial properties and sensory evaluation of cow sausage

Directory of Open Access Journals (Sweden)

Habib Sedghi

2014-11-01

Full Text Available Sodium nitrite has been always considered as one of the common additives due to its antibacterial effects on Clostridium botulinum and meat products' color, however it produces cancer creating nitrosamine. Recently, organic acids and their salts such as lactates have been employed as antimicrobial compounds. Lactates also improve organileptic properties including color, texture and taste and antioxidant properties. Sodium lactate causes to more reduction of anaerobic spore former bacteria than nitrite, inhibits botulin produced by Clostridium botulinum. Sodium lactate produces a permanent reddish pink color through reduction of deoxymygloboline and producing deoxymyoglobuline. In this study, the decrease of sodium nitrite amount from 120ppm to 15ppm by adding sodium lactate / sodium diacetate led to achieve an acceptable product. The best results revealed through adding 3.0625% of sodium lactate / sodium diacetate in combination with 30ppm sodium nitrite. Results also exhibited more reduction of pathogens' growth than nitrite, enhanced flavor slightly, but unable to produce reddish pink color as produced by nitrite. Results also exhibited that sodium lactate / diacetate cause to retard in microbial growth, reducing chemical change, enhance sensory properties, partially improvement in taste and texture. Although inappropriate color demonstrated sodium lactate / diacetate's inability in red pink color production in 4th sample (contains 15 ppm nitrite, its synergy effect in combination with sodium nitrite on nitroso myoglobuline production has been proven, led to sodium nitrite reduction in sausages.

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.

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.

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.)

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

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

Reaction velocity of sodium hydration in humid air and sodium carbonation in humid carbon dioxide atmosphere. Fundamental study on sodium carbonate process in FBR bulk sodium coolant disposal technology

International Nuclear Information System (INIS)

Tadokoro, Yutaka; Yoshida, Eiichi

1999-11-01

A sodium carbonate processing method, which changes sodium to sodium carbonate and/or sodium bicarbonate by humid carbon dioxide, has been examined and about to be applied to large test loops dismantling. However, that the basic data regarding the progress of the reaction is insufficient on the other hand, is a present condition. The present report therefore aims at presenting basic data regarding the reaction velocity of sodium hydration in humid air and sodium carbonation in humid carbon dioxide atmosphere, and observing the reaction progress, for the application to large test loops dismantling. The test result is summarized as follows. (1) Although the reaction velocity of sodium varied with sodium specimen sizes and velocity measurement methods, the reaction velocity of sodium hydration was in about 0.16 ∼ 0.34 mmh -1 (0.016 ∼ 0.033g cm -2 h -1 , 6.8x10 -4 ∼ 1.4x10 -3 mol cm -2 h -1 ) and that of sodium carbonation was in about 0.16 ∼ 0.27mmh -1 (0.016 ∼ 0.023g cm -2 h -1 , 6.8x10 -4 ∼ 1.1x10 -3 mol cm -2 h -1 ) (26 ∼ 31degC, RH 100%). (2) The reaction velocity of sodium in carbon dioxide atmosphere was greatly affected by vapor partial pressure (absolutely humidity). And the velocity was estimated in 0.08 ∼ 0.12mmh -1 (0.008 ∼ 0.012g cm -2 h -1 , 3.4x10 -4 ∼ 5.2x10 -4 mol cm -2 h -1 ) in the carbon dioxide atmosphere, whose temperature of 20degC and relative humidity of 80% are assumed real sodium carbonate process condition. (3) By the X-ray diffraction method, NaOH was found in humid air reaction product. Na 2 CO 3 , NaHCO 3 were found in carbon dioxide atmosphere reaction product. It was considered that Sodium changes to NaOH, and subsequently to NaHCO 3 through Na 2 CO 3 . (4) For the application to large test loops dismantling, it is considered possible to change sodium to a target amount of sodium carbonate (or sodium bicarbonate) by setting up gas supply quantity and also processing time appropriately according to the surface area

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.

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...

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 ...

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.

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

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

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.)

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

Final report on the safety assessment of sodium sulfite, potassium sulfite, ammonium sulfite, sodium bisulfite, ammonium bisulfite, sodium metabisulfite and potassium metabisulfite.

Science.gov (United States)

Nair, Bindu; Elmore, Amy R

2003-01-01

Sodium Sulfite, Ammonium Sulfite, Sodium Bisulfite, Potassium Bisulfite, Ammonium Bisulfite, Sodium Metabisulfite, and Potassium Metabisulfite are inorganic salts that function as reducing agents in cosmetic formulations. All except Sodium Metabisulfite also function as hair-waving/straightening agents. In addition, Sodium Sulfite, Potassium Sulfite, Sodium Bisulfite, and Sodium Metabisulfite function as antioxidants. Although Ammonium Sulfite is not in current use, the others are widely used in hair care products. Sulfites that enter mammals via ingestion, inhalation, or injection are metabolized by sulfite oxidase to sulfate. In oral-dose animal toxicity studies, hyperplastic changes in the gastric mucosa were the most common findings at high doses. Ammonium Sulfite aerosol had an acute LC(50) of >400 mg/m(3) in guinea pigs. A single exposure to low concentrations of a Sodium Sulfite fine aerosol produced dose-related changes in the lung capacity parameters of guinea pigs. A 3-day exposure of rats to a Sodium Sulfite fine aerosol produced mild pulmonary edema and irritation of the tracheal epithelium. Severe epithelial changes were observed in dogs exposed for 290 days to 1 mg/m(3) of a Sodium Metabisulfite fine aerosol. These fine aerosols contained fine respirable particle sizes that are not found in cosmetic aerosols or pump sprays. None of the cosmetic product types, however, in which these ingredients are used are aerosolized. Sodium Bisulfite (tested at 38%) and Sodium Metabisulfite (undiluted) were not irritants to rabbits following occlusive exposures. Sodium Metabisulfite (tested at 50%) was irritating to guinea pigs following repeated exposure. In rats, Sodium Sulfite heptahydrate at large doses (up to 3.3 g/kg) produced fetal toxicity but not teratogenicity. Sodium Bisulfite, Sodium Metabisulfite, and Potassium Metabisulfite were not teratogenic for mice, rats, hamsters, or rabbits at doses up to 160 mg/kg. Generally, Sodium Sulfite, Sodium

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

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)

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.)

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.)

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.

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)

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

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 ...

Investigation of Plugging of Narrow Sodium Channels by Sodium and Carbon Dioxide Interaction

Energy Technology Data Exchange (ETDEWEB)

Park, Sun Hee; Wi, Myung-Hwan; Min, Jae Hong; Kim, Tae-joon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2014-10-15

The supercritical CO{sub 2} Brayton cycle system is known to be a promising power conversion system for improving the efficiency and preventing the sodium water reaction (SWR) of the current SFR concept using a Rankine steam cycle. PCHEs are known to have potential for reducing the volume occupied by the sodium-to-CO{sub 2} exchangers as well as the heat exchanger mass relative to traditional shell-and-tube heat exchangers. Here, we report a study on a plugging test by the interaction of sodium and CO{sub 2} to investigate design parameters of sodium channels in the realistic operating conditions. We investigated a plugging test by an interaction of sodium and CO{sub 2} with different cross sectional areas of the sodium channels. It was found that the flow rate of sodium decreased earlier and faster with a narrower cross sectional area compared to a wider one. Our experimental results are expected to be used for determining the sodium channel areas of PCHEs.

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)

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)

Investigation for the sodium leak Monju. Sodium fire test-II

International Nuclear Information System (INIS)

Uchiyama, Naoki; Takai, Toshihide; Nishimura, Masahiro; Miyahara, Shinya; Miyake, Osamu; Tanabe, Hiromi

2000-08-01

As a part of the work for investigating the sodium leak accident which occurred in the Monju reactor (hereinafter referred to as Monju), sodium fire test-II was carried out using the SOLFA-1 (Sodium Leak, Fire and Aerosol) facility at OEC/PNC. In the test, the piping, ventilation duct, grating and floor liner were all full-sized and arranged in a rectangular concrete cell in the same manner as in Monju. The main objectives of the test were to confirm the leak and burning behavior of sodium from the damaged thermometer, and the effects of the sodium fire on the integrity of the surrounding structure. The main conclusions obtained from the test are shown below: (1) Burning Behavior of Leaked Sodium : Images taken with a cameras in the test reveal that in the early stages of the sodium leak, the sodium dropped down out of the flexible tube in drips. (2) Damage to the Ventilation Duct and Grating : The temperature of the ventilation duct's inner surface fluctuated between approximately 600degC and 700degC. The temperature of the grating began rising at the outset of the test, then fluctuated between roughly 600degC and 900degC. The maximum temperature was about 1000degC. After the test, damage to the ventilation duct and the grating was found. Damage to the duct was greater than that at Monju. (3) Effects on the Floor Liner : The temperature of the floor liner under the leak point exceed 1,000degC at 3 hours and 20 minutes into the test. A post test inspection of the liner revealed five holes in an area about 1m x 1m square under the leak point. There was also a decrease of the liner thickness on the north and west side of the leak point. (4) Effects on Concrete : The post test inspection revealed no surface damage on either the concrete side walls or the ceiling. However, the floor concrete was eroded to a maximum depth 8 cm due to a sodium-concrete reaction. The compressive strength of the concrete was not degraded in spite of the thermal effect. (5) Chemical

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

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.)

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

Final report on the safety assessment of potassium silicate, sodium metasilicate, and sodium silicate.

Science.gov (United States)

Elmore, Amy R

2005-01-01

Potassium Silicate, Sodium Metasilicate, and Sodium Silicate combine metal cations with silica to form inorganic salts used as corrosion inhibitors in cosmetics. Sodium Metasilicate also functions as a chelating agent and Sodium Silicate as a buffering and pH adjuster. Sodium Metasilicate is currently used in 168 formulations at concentrations ranging from 13% to 18%. Sodium Silicate is currently used in 24 formulations at concentrations ranging from 0.3% to 55%. Potassium Silicate and Sodium Silicate have been reported as being used in industrial cleaners and detergents. Sodium Metasilicate is a GRAS (generally regarded as safe) food ingredient. Aqueous solutions of Sodium Silicate species are a part of a chemical continuum of silicates based on an equilibrium of alkali, water, and silica. pH determines the solubility of silica and, together with concentration, determines the degree of polymerization. Sodium Silicate administered orally is readily absorbed from the alimentary canal and excreted in the urine. The toxicity of these silicates has been related to the molar ratio of SiO2/Na2O and the concentration being used. The Sodium Metasilicate acute oral LD50 ranged from 847 mg/kg in male rats to 1349.3 mg/kg in female rats and from 770 mg/kg in female mice to 820 mg/kg in male mice. Gross lesions of variable severity were found in the oral cavity, pharynx, esophagus, stomach, larynx, lungs, and kidneys of dogs receiving 0.25 g/kg or more of a commercial detergent containing Sodium Metasilicate; similar lesions were also seen in pigs administered the same detergent and dose. Male rats orally administered 464 mg/kg of a 20% solution containing either 2.0 or 2.4 to 1.0 ratio of sodium oxide showed no signs of toxicity, whereas doses of 1000 and 2150 mg/kg produced gasping, dypsnea, and acute depression. Dogs fed 2.4 g/kg/day of Sodium Silicate for 4 weeks had gross renal lesions but no impairment of renal function. Dermal irritation of Potassium Silicate, Sodium

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.

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)

Development of a sodium ionization detector for sodium-to-gas leaks

International Nuclear Information System (INIS)

Swaminathan, K.; Elumalai, G.

1984-01-01

A sensitive sodium-to-gas leak detector has been indigenously developed for use in liquid metal cooled fast breeder reactor. The detector relies on the relative ease with which sodium vapour or its aerosols including its oxides and hydroxides can be thermally ionized compared with other possible constituents such as nitrogen, oxygen, water vapour etc. in a carrier gas and is therefore called sodium ionization detector (SID). The ionization current is a measure of sodium concentration in the carrier gas sampled through the detector. Different sensor designs using platinum and rhodium as filament materials in varying sizes were constructed and their responses to different sodium aerosol concentrations in the carrier gas were investigated. Nitrogen was used as the carrier gas. Both the background current and speed of response were found to depend on the diameter of the filament. There was also a particular collector voltage which yielded maximum sensitivity of the detector. The sensor was therefore optimised considering influence of above factors and a detector has been built which demonstrates a sensitivity better than 0.3 nanogram of sodium per cubic centimetre of carrier gas for a signal to background ratio of 1:1. Its usefulness in detecting sodium fires in experimental area was also demonstrated. Currently efforts are under way to improve the life time of the filament used in the above detector. (author)

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.

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...

Preliminary Plugging tests in Narrow Sodium Channels by Sodium and Carbon Dioxide reaction

Energy Technology Data Exchange (ETDEWEB)

Park, Sun Hee; Wi, Myung-Hwan; Min, Jae Hong [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-05-15

This report is on the investigation of the physical/chemical phenomena that a slow loss of CO{sub 2} inventory into sodium after the sodium-CO{sub 2} boundary failure in PCHEs in realistic operating conditions. The first phenomenon is potential channel plugging inside the narrow PCHE channel. Unlike a conventional shell and- tube type HXs, failures in a PCHE are expected to be small cracks. If the faulted channel is blocked, it may have a positive function for plant safety because the pressure boundary would automatically recover due to this self-plugging. The other one is damage propagation on pressure boundary, which is referred to as potential wastage with combined corrosion/erosion effect. Physical/chemical phenomena that a slow loss of CO{sub 2} inventory into sodium after the sodium-CO{sub 2} boundary failure in printed circuit heat exchangers (PCHEs) were investigated. Our preliminary experimental results of plugging show that sodium flow immediately stopped as CO{sub 2} was injected through the nozzle at 300-400 .deg. C in 3 mm sodium channels, whereas sodium flow stopped about 60 min after CO{sub 2} injection in 5 mm sodium channels.

Corrosion behaviors of ceramics against liquid sodium. Sodium corrosion characteristics of sintering additives

International Nuclear Information System (INIS)

Tachi, Yoshiaki; Kano, Shigeki; Hirakawa, Yasushi; Yoshida, Eiichi

1998-01-01

It has been progressed as the Frontier Materials Research to research and develop ceramics to apply for several components of fast breeder reactor using liquid sodium as coolant instead of metallic materials. Grain boundary of ceramics has peculiar properties compared with matrix because most of ceramics are produced by hardening and firing their raw powders. Some previous researchers indicated that ceramics were mainly corroded at grain boundaries by liquid sodium, and ceramics could not be used under corrosive environment. Thus, it is the most important for the usage of ceramics in liquid sodium to improve corrosion resistance of grain boundaries. In order to develop the advanced ceramics having good sodium corrosion resistance among fine ceramics, which have recently been progressed in quality and characteristics remarkably, sodium corrosion behaviors of typical sintering additives such as MgO, Y 2 O 3 and AlN etc. have been examined and evaluated. As a result, the followings have been clarified and some useful knowledge about developing advanced ceramics having good corrosion resistance against liquid sodium has been obtained. (1) Sodium corrosion behavior of MgO depended on Si content. Samples containing large amount of Si were corroded severely by liquid sodium, whereas others with low Si contents showed good corrosion resistance. (2) Both Y 2 O 3 and AlN, which contained little Si, showed good sodium corrosion resistance. (3) MgO, Y 2 O 3 and AlN are thought to be corroded by liquid sodium, if they contain some SiO 2 . Therefore, in order to improve sodium corrosion resistance, it is very important for these ceramics to prevent the contamination of matrix with SiO 2 through purity control of their raw powders. (author)

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

Parametric study of sodium aerosols in the cover-gas space of sodium-cooled reactors

International Nuclear Information System (INIS)

Sheth, A.

1975-03-01

A mathematical model has been developed to describe the behavior of sodium aerosols in the cover-gas space of a sodium-cooled reactor. A review of the literature was first made to examine methods of aerosol generation, mathematical expressions representing aerosol behavior, and pertinent experimental investigations of sodium aerosols. In the development of the model, some terms were derived from basic principles and other terms were estimated from available correlations. The model was simulated on a computer, and important parameters were studied to determine their effects on the overall behavior of sodium aerosols. The parameters studied were sodium pool temperature, source and initial size of particles, film thickness at the sodium pool/cover gas interface, wall plating parameters, cover-gas flow rate, and type of cover gas (argon and helium). The model satisfactorily describes the behavior of sodium aerosol in argon, but not in helium. Possible reasons are given for the failure of the model with helium, and further experimental work is recommended. The mathematical model, with appropriate modifications to describe the behavior of sodium aerosols in helium, would be very useful in designing traps to remove aerosols from the cover gas of sodium-cooled reactors. (U.S.)

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)

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.

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.

[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.

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)

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

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

Gateways to clinical trials.

Science.gov (United States)

Tomillero, A; Moral, M A

2009-05-01

(-)-Gossypol; Abacavir sulfate/lamivudine, ACAM-1000, ACE-011, Agomelatine, AGS-004, Alemtuzumab, Alvocidib hydrochloride, AMG-317, Amlodipine, Aripiprazole, Atazanavir sulfate, Azacitidine; Becatecarin, Belinostat, Bevacizumab, BMS-387032, BMS-690514, Bortezomib; Casopitant mesylate, Cetuximab, Choline fenofibrate, CK-1827452, Clofarabine, Conivaptan hydrochloride; Dabigatran etexilate, DADMe-Immucillin-H, Darbepoetin alfa, Darunavir, Dasatinib, DC-WT1, Decitabine, Deferasirox, Degarelix acetate, Denenicokin, Denosumab, Dienogest, Duloxetine hydrochloride; Ecogramostim, Eculizumab, Edoxaban tosilate, Elacytarabine, Elesclomol, Eltrombopag olamine, Enfuvirtide, Enzastaurin hydrochloride, Eribulin mesilate, Erlotinib hydrochloride, Escitalopram oxalate, Eszopiclone, Etravirine; Flibanserin, Fludarabine, Fondaparinux sodium, Fosamprenavir calcium; Gefitinib, Genistein; I-131-L19-SIP, Idrabiotaparinux sodium, Imatinib mesylate, IMGN-901, Ipilimumab; Laromustine, Lenalidomide, Liposomal cisplatin, Liraglutide, Lisdexamfetamine mesilate, Lopinavir, Lopinavir/ritonavir; Maraviroc, MDV-3100, Mecasermin rinfabate, MP-470, Mycophenolic acid sodium salt; Naproxcinod, NB-002, Nesiritide, Nilotinib hydrochloride monohydrate, NK-012; Palonosetron hydrochloride, Panobinostat, Pegfilgrastim, Peginterferon alfa-2a, Pitavastatin calcium, PL-3994, Plerixafor hydrochloride, Plitidepsin, PM-10450; Raltegravir potassium, Recombinant human soluble thrombomodulin, ReoT3D, RHAMM R3 peptide, Rivaroxaban, Romiplostim, Rosuvastatin calcium, Rozrolimupab; Sabarubicin hydrochloride, Salinosporamide A, Sirolimus-eluting stent, Smallpox (Vaccinia) Vaccine, Live, Sorafenib; Tenofovir disoproxil fumarate, Tenofovir disoproxil fumarate/emtricitabine, Teriparatide, Tipifarnib, Tipranavir, Trabectedin, Trifluridine/TPI; Vardenafil hydrochloride hydrate, Vinflunine, Volociximab, Vorinostat; Ximelagatran; Yttrium 90 (90Y) ibritumomab tiuxetan; Ziprasidone hydrochloride, Zoledronic acid monohydrate

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.

Investigation for the sodium leak in Monju. Sodium leak and fire test-1

International Nuclear Information System (INIS)

Kawata, Koji; Ohno, Shuji; Miyahara, Shinya; Miyake, Osamu; Tanabe, Hiromi

2000-08-01

As a part of the work for investigating the sodium leak accident which occurred in the Monju reactor (hereinafter referred to as Monju) on December 8, 1995, three tests, (1) a sodium leak test, (2) a sodium leak and fire test-1, and (3) a sodium leak and fire test-II, were carried out at OEC/PEC. The main objectives of these tests were to confirm the leak and burning behavior of sodium from the damaged thermometer, and the effects of the sodium fire on the integrity of the surrounding structure. This report describes the results of the sodium fire test-I carried out as a preliminary test. The test was performed using the SOLFA-2 (Sodium Leak, Fire and Aerosol) facility on April 8, 1996. In this test, sodium heated to 480degC was leaked for approximately 1.5 hours from a leak simulating apparatus and caused to drop onto a ventilation duct and a grating with the same dimensions and layout as those in Monju. The main conclusions obtained from the test are shown below: 1) Observation from video cameras in the test revealed that in the early stages of the sodium leak, sodium dripped out of the flexible tube of the thermometer. This dripping and burning expanded in range as the sodium splashed on the duct. 2) No damage to the duct itself was detected. However, the aluminum louver frame of the ventilation duct's lower inlet was damaged. Its machine screws came off, leaving half of the grill (on the grating side) detached. 3) No large hole, like the one seen at Monju, was found when the grating was removed from the testing system for inspection, although the area centered on the point were the sodium dripped was damaged in a way indicating the first stages of grating failure. The 5mm square lattice was corroded through in some parts, and numerous blades (originally 3.2 mm thick) had become sharpened like the blade of a knife. 4) The burning pan underside thermocouple near the leak point measured 700degC in within approximately 10 minutes, and for the next hour remained

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...

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.

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)

Sodium intake and dietary sources of sodium in a sample of undergraduate students from Novi Sad, Serbia.

Science.gov (United States)

2017-07-01

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. 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. 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. 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.

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)

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 ...

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)

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)

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 ...

Assessment of sodium status in large ruminants by measuring the sodium-to-potassium ratio in muzzle secretions.

Science.gov (United States)

Singh, S P; Rani, D

1999-09-01

To develop a simple diagnostic test to assess sodium status in large ruminants on the basis of the sodium-to-potassium ratio (Na:K) and to determine its relevance. 7 buffalo heifers and 21 lactating, pregnant, and nonpregnant dairy cows and heifers. Buffalo heifers were subjected in 2 experiments to variable dietary sodium intake or sodium depletion and changes in sodium and potassium concentrations; Na:K was simultaneously monitored in various body fluids to study its value for indicating sodium status. Validity of the muzzle secretion test was assessed. Muzzle secretion and urinary Na:K and sodium concentration, but not serum electrolyte concentrations, reflected the sodium status of buffalo heifers in response to the widely variable intake of sodium (0.03 to 0.16% of dry matter [DM]). Progressive sodium depletion during an 11-day period, using saliva deprivation caused reciprocal changes in sodium and potassium concentrations in saliva and muzzle secretion, but not in urine. Decreasing urine sodium concentration was associated with decreasing urine potassium concentration. Saliva, urine, and muzzle secretion Na:K closely reflected the degree of sodium deficit. Buffaloes or dairy cows maintained on optimal sodium intake had muzzle secretion and urine Na:K > 0.30. Muzzle secretion or urine Na:K muzzle secretion Na:K, and to a large extent urine Na:K, may be used as a convenient diagnostic tool to assess sodium status in large ruminants. It has accuracy similar to that of saliva Na:K.

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.

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

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)

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.

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)

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 ...

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

Sodium removal disassembly and examination of the Fermi secondary sodium pump

International Nuclear Information System (INIS)

Maffei, H.P.; Funk, C.W.; Ballif, J.L.

1974-01-01

The Fermi secondary pump is a centrifugal single stage design. The pump had been operated more than 42,000 hours between 450 and 800 0 F. Sodium was drained from the pump in 1973 and the system was back filled with carbon dioxide. The pump was fabricated for 2.25 Cr-1 Mo Croloy steel. Prior to cleaning the pump was inerted and heated with 150 0 F nitrogen using the pump casing as the containment vessel. The water-vapor-nitrogen process was used in three increasing stages of water concentration. The hydrogen concentration in the discharge line was followed as an indicator of the sodium-water reaction rate. Upon completion of the hydrogen evolution, the pump was rinsed several times with hot water. Six pounds of sodium were removed from the pump during a process cycle of 79 hours including rinsing. The maximum pump temperature recorded was 175 0 F with no variation exceeding 10 0 F. The hydrogen concentration in the effluent provided a very satisfactory index for control of the reaction by adjustment of the water-vapor concentration feed to the system. Rinsing effectiveness was limited by a pool of water in the volute that was not drainable with the available system hook up. Sodium and its compounds were removed from all internal surfaces that could be observed by the first stage of disassembly. All such surfaces were coated with a black deposit. Areas above the sodium liquid level were coated with a vermillion colored oxide. Sodium was found on the (1) threads of the impeller nut lock screw, (2) impeller nut-tapered shaft interface, and (3) vapor deposited sodium was found in the oil seal

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

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.

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...

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

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.

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

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

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.

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)

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...

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.

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)

Sodium intake in US ethnic subgroups and potential impact of a new sodium reduction technology: NHANES Dietary Modeling.

Science.gov (United States)

Fulgoni, Victor L; Agarwal, Sanjiv; Spence, Lisa; Samuel, Priscilla

2014-12-18

Because excessive dietary sodium intake is a major contributor to hypertension, a reduction in dietary sodium has been recommended for the US population. Using the National Health and Nutrition Examination Survey (NHANES) 2007-2010 data, we estimated current sodium intake in US population ethnic subgroups and modeled the potential impact of a new sodium reduction technology on sodium intake. NHANES 2007-2010 data were analyzed using The National Cancer Institute method to estimate usual intake in population subgroups. Potential impact of SODA-LO® Salt Microspheres sodium reduction technology on sodium intake was modeled using suggested sodium reductions of 20-30% in 953 foods and assuming various market penetrations. SAS 9.2, SUDAAN 11, and NHANES survey weights were used in all calculations with assessment across age, gender and ethnic groups. Current sodium intake across all population subgroups exceeds the Dietary Guidelines 2010 recommendations and has not changed during the last decade. However, sodium intake measured as a function of food intake has decreased significantly during the last decade for all ethnicities. "Grain Products" and "Meat, Poultry, Fish, & Mixtures" contribute about 2/3rd of total sodium intake. Sodium reduction, using SODA-LO® Salt Microspheres sodium reduction technology (with 100% market penetration) was estimated to be 185-323 mg/day or 6.3-8.4% of intake depending upon age, gender and ethnic group. Current sodium intake in US ethnic subgroups exceeds the recommendations and sodium reduction technologies could potentially help reduce dietary sodium intake among those groups.

Effects of dietary sodium on metabolites: the Dietary Approaches to Stop Hypertension (DASH)-Sodium Feeding Study.

Science.gov (United States)

Derkach, Andriy; Sampson, Joshua; Joseph, Justin; Playdon, Mary C; Stolzenberg-Solomon, Rachael Z

2017-10-01

Background: High sodium intake is known to increase blood pressure and is difficult to measure in epidemiologic studies. Objective: We examined the effect of sodium intake on metabolites within the DASH (Dietary Approaches to Stop Hypertension Trial)-Sodium Trial to further our understanding of the biological effects of sodium intake beyond blood pressure. Design: The DASH-Sodium Trial randomly assigned individuals to either the DASH diet (low in fat and high in protein, low-fat dairy, and fruits and vegetables) or a control diet for 12 wk. Participants within each diet arm received, in random order, diets containing high (150 nmol or 3450 mg), medium (100 nmol or 2300 mg), and low (50 nmol or 1150 mg) amounts of sodium for 30 d (crossover design). Fasting blood samples were collected at the end of each sodium intervention. We measured 531 identified plasma metabolites in 73 participants at the end of their high- and low-sodium interventions and in 46 participants at the end of their high- and medium-sodium interventions ( N = 119). We used linear mixed-effects regression to model the relation between each log-transformed metabolite and sodium intake. We also combined the resulting P values with Fisher's method to estimate the association between sodium intake and 38 metabolic pathways or groups. Results: Six pathways were associated with sodium intake at a Bonferroni-corrected threshold of 0.0013 (e.g., fatty acid, food component or plant, benzoate, γ-glutamyl amino acid, methionine, and tryptophan). Although 82 metabolites were associated with sodium intake at a false discovery rate ≤0.10, only 4-ethylphenylsufate, a xenobiotic related to benzoate metabolism, was significant at a Bonferroni-corrected threshold ( P Sodium intake is associated with changes in circulating metabolites, including gut microbial, tryptophan, plant component, and γ-glutamyl amino acid-related metabolites. This trial was registered at clinicaltrials.gov as NCT00000608. © 2017

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.

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

Sodium and cover gas chemistry in the high temperature sodium facility

International Nuclear Information System (INIS)

McCown, J.J.; Duncan, H.C.

1976-01-01

The equipment and procedures used in following sodium and cover gas chemistry changes in the High Temperature Sodium Facility are presented. The methods of analysis and results obtained are given. Impurity trends which have been measured during the facility operations are discussed

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.)

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)

Impact Of Sodium Oxalate, Sodium Aluminosilicate, and Gibbsite/Boehmite on ARP Filter Performance

Energy Technology Data Exchange (ETDEWEB)

Poirier, M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Burket, P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2015-11-01

The Savannah River Site (SRS) is currently treating radioactive liquid waste with the Actinide Removal Process (ARP) and the Modular Caustic Side Solvent Extraction Unit (MCU). Recently, the low filter flux through the ARP of approximately 5 gallons per minute has limited the rate at which radioactive liquid waste can be treated. Salt Batch 6 had a lower processing rate and required frequent filter cleaning. Savannah River Remediation (SRR) has a desire to understand the causes of the low filter flux and to increase ARP/MCU throughput. SRR requested SRNL to conduct bench-scale filter tests to evaluate whether sodium oxalate, sodium aluminosilicate, or aluminum solids (i.e., gibbsite and boehmite) could be the cause of excessive fouling of the crossflow or secondary filter at ARP. The authors conducted the tests by preparing slurries containing 6.6 M sodium Salt Batch 6 supernate, 2.5 g MST/L slurry, and varying concentrations of sodium oxalate, sodium aluminosilicate, and aluminum solids, processing the slurry through a bench-scale filter unit that contains a crossflow primary filter and a dead-end secondary filter, and measuring filter flux and transmembrane pressure as a function of time. Among the conclusions drwn from this work are the following: (1) All of the tests showed some evidence of fouling the secondary filter. This fouling could be from fine particles passing through the crossflow filter. (2) The sodium oxalate-containing feeds behaved differently from the sodium aluminosilicate- and gibbsite/boehmite-containing feeds.

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

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.

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.

Sodium fire test at broad ranges of temperature and oxygen concentration. 4. Low temperature sodium spray fire tests

International Nuclear Information System (INIS)

Kawata, Koji; Miyahara, Shinya

2005-08-01

Sodium spray fire tests at the initial sodium temperature of 250degC were conducted under the atmospheric conditions of air and 3% oxygen containing nitrogen to determine the sodium burning rate and the aerosol release fraction and compare them with the test results at the initial sodium temperature of 500degC in air atmosphere. In the tests, sodium was supplied using a commercial spray nozzle into a stainless steel vessel of 100 m 3 volume (SOLFA-2). The sodium burning rate was calculated from two independent methods: the consumption rate of oxygen in the vessel and the enthalpy change of vessel components during the test. The aerosol release fraction was determined from the comparison between the measured aerosol concentrations and the calculated ones by the ABC-INTG code. The main conclusions were as follows, (1) In air atmosphere, a) sodium droplets ignited instantaneously and the spray fire was observed, and b) the sodium burning rate was about 440 g-Na/s and the fraction of supplied sodium was about 70%. (2) In 3% oxygen containing nitrogen, a) ignition of sodium droplets was not observed, and b) the sodium burning rate was about 44 g-Na/s and the fraction of supplied sodium was less than 10%. (author)

Hemodialysis for near-fatal sodium phosphate toxicity in a child receiving sodium phosphate enemas.

Science.gov (United States)

Becknell, Brian; Smoyer, William E; O'Brien, Nicole F

2014-11-01

This study aimed to demonstrate the importance of considering hemodialysis as a treatment option in the management of sodium phosphate toxicity. This is a case report of a 4-year-old who presented to the emergency department with shock, decreased mental status, seizures, and tetany due to sodium phosphate toxicity from sodium phosphate enemas. Traditional management of hyperphosphatemia with aggressive hydration and diuretics was insufficient to reverse the hemodynamic and neurological abnormalities in this child. This is the first report of the use of hemodialysis in a child without preexisting renal failure for the successful management of near-fatal sodium phosphate toxicity. Hemodialysis can safely be used as an adjunctive therapy in sodium phosphate toxicity to rapidly reduce serum phosphate levels and increase serum calcium levels in children not responding to conventional management.

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.)

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)

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...

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

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.)

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.

Urinary Sodium Excretion and Dietary Sources of Sodium Intake in Chinese Postmenopausal Women with Prehypertension

Science.gov (United States)

Liu, Zhao-min; Ho, Suzanne C.; Tang, Nelson; Chan, Ruth; Chen, Yu-ming; Woo, Jean

2014-01-01

Background Reducing salt intake in communities is one of the most effective and affordable public health strategies to prevent hypertension, stroke and renal disease. The present study aimed to determine the sodium intake in Hong Kong Chinese postmenopausal women and identify the major food sources contributing to sodium intake and urine excretion. Methods This was a cross-sectional study among 655 Chinese postmenopausal women with prehypertension who were screened for a randomized controlled trial. Data collection included 24 h urine collection for the measurement of sodium, potassium and creatinine, 3-day dietary records, anthropometric measures and questionnaire survey on demographic data and dietary habits. Results The average salt intake estimated from urinary excretion was 7.8±3.2 g/d with 82.1% women above WHO recommendation of 5 g/day. Food groups as soup (21.6%), rice and noodles (13.5%), baked cereals (12.3%), salted/preserved foods (10.8%), Chinese dim sum (10.2%) and sea foods (10.1%) were the major contributors of non-discretionary salt. Discretionary salt use in cooking made a modest contribution to overall intake. Vegetable and fruit intake, age, sodium intake from salted foods, sea foods and soup were the independent determinants of urinary sodium excretion. Conclusions Our data revealed a significant room for reduction of the sodium intake. Efforts to reduce sodium from diets in Hong Kong Chinese postmenopausal women should focus on both processed foods and discretionary salt during cooking. Sodium reduction in soup and increase in fruit intake would be potentially effective strategy for reducing sodium. PMID:25083775

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...

Effect of sodium ascorbate and sodium nitrite on protein and lipid oxidation in dry fermented sausages.

Science.gov (United States)

Berardo, A; De Maere, H; Stavropoulou, D A; Rysman, T; Leroy, F; De Smet, S

2016-11-01

The effects of sodium nitrite and ascorbate on lipid and protein oxidation were studied during the ripening process of dry fermented sausages. Samples were taken at day 0, 2, 8, 14, 21 and 28 of ripening to assess lipid (malondialdehyde) and protein (carbonyls and sulfhydryl groups) oxidation. Sodium ascorbate and nitrite were separately able to reduce the formation of malondialdehyde. Their combined addition resulted in higher amounts of carbonyl compounds compared to their separate addition or the treatment without any of both compounds. Moreover, sodium nitrite limited the formation of γ-glutamic semialdehyde whereas sodium ascorbate showed a pro-oxidant effect. A loss of thiol groups was observed during ripening, which was not affected by the use of sodium ascorbate nor sodium nitrite. In conclusion, sodium nitrite and ascorbate affected protein and lipid oxidation in different manners. The possible pro-oxidant effect of their combined addition on carbonyl formation might influence the technological and sensory properties of these products. Copyright © 2016 Elsevier Ltd. All rights reserved.

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...

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)

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

Methodology for sodium fire vulnerability assessment of sodium cooled fast reactor based on the Monte-Carlo principle

Energy Technology Data Exchange (ETDEWEB)

Song, Wei [Nuclear and Radiation Safety Center, P. O. Box 8088, Beijing (China); Wu, Yuanyu [ITER Organization, Route de Vinon-sur-Verdon, 13115 Saint-Paul-lès-Durance (France); Hu, Wenjun [China Institute of Atomic Energy, P. O. Box 275(34), Beijing (China); Zuo, Jiaxu, E-mail: zuojiaxu@chinansc.cn [Nuclear and Radiation Safety Center, P. O. Box 8088, Beijing (China)

2015-11-15

Highlights: • Monte-Carlo principle coupling with fire dynamic code is adopted to perform sodium fire vulnerability assessment. • The method can be used to calculate the failure probability of sodium fire scenarios. • A calculation example and results are given to illustrate the feasibility of the methodology. • Some critical parameters and experience are shared. - Abstract: Sodium fire is a typical and distinctive hazard in sodium cooled fast reactors, which is significant for nuclear safety. In this paper, a method of sodium fire vulnerability assessment based on the Monte-Carlo principle was introduced, which could be used to calculate the probabilities of every failure mode in sodium fire scenarios. After that, the sodium fire scenario vulnerability assessment of primary cold trap room of China Experimental Fast Reactor was performed to illustrate the feasibility of the methodology. The calculation result of the example shows that the conditional failure probability of key cable is 23.6% in the sodium fire scenario which is caused by continuous sodium leakage because of the isolation device failure, but the wall temperature, the room pressure and the aerosol discharge mass are all lower than the safety limits.

Methodology for sodium fire vulnerability assessment of sodium cooled fast reactor based on the Monte-Carlo principle

International Nuclear Information System (INIS)

Song, Wei; Wu, Yuanyu; Hu, Wenjun; Zuo, Jiaxu

2015-01-01

Highlights: • Monte-Carlo principle coupling with fire dynamic code is adopted to perform sodium fire vulnerability assessment. • The method can be used to calculate the failure probability of sodium fire scenarios. • A calculation example and results are given to illustrate the feasibility of the methodology. • Some critical parameters and experience are shared. - Abstract: Sodium fire is a typical and distinctive hazard in sodium cooled fast reactors, which is significant for nuclear safety. In this paper, a method of sodium fire vulnerability assessment based on the Monte-Carlo principle was introduced, which could be used to calculate the probabilities of every failure mode in sodium fire scenarios. After that, the sodium fire scenario vulnerability assessment of primary cold trap room of China Experimental Fast Reactor was performed to illustrate the feasibility of the methodology. The calculation result of the example shows that the conditional failure probability of key cable is 23.6% in the sodium fire scenario which is caused by continuous sodium leakage because of the isolation device failure, but the wall temperature, the room pressure and the aerosol discharge mass are all lower than the safety limits.

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

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

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)

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)

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 ...

Thermal analysis experiment for elucidating sodium-water chemical reaction mechanism in steam generator of sodium-cooled fast reactor

International Nuclear Information System (INIS)

Kikuchi, Shin; Kurihara, Akikazu; Ohshima, Hiroyuki

2012-01-01

For the purpose of elucidating the mechanism of the sodium-water surface reaction in a steam generator of sodium-cooled fast reactors, kinetic study of the sodium (Na)-sodium hydroxide (NaOH) reaction has been carried out by using Differential Thermal Analysis (DTA) technique. The parameters, including melting points of Na and NaOH, phase transition temperature of NaOH, Na-NaOH reaction temperature, and decomposition temperature of sodium hydride (NaH) have been identified from DTA curves. Based on the measured reaction temperature, rate constant of sodium monoxide (Na 2 O) generation was obtained. Thermal analysis results indicated that Na 2 O generation at the secondary overall reaction should be considered during the sodium-water reaction. (author)

Nutritional impact of sodium reduction strategies on sodium intake from processed foods

NARCIS (Netherlands)

Hendriksen, M.A.H.; Verkaik-Kloosterman, J.; Noort, M.W.; Raaij, J.M.A. van

2015-01-01

Background/objectives: Sodium intake in the Netherlands is substantially above the recommended intake of 2400 mg/day. This study aimed to estimate the effect of two sodium reduction strategies, that is, modification of the composition of industrially processed foods toward the technologically

Nutritional impact of sodium reduction strategies on sodium intake from processed foods

NARCIS (Netherlands)

Hendriksen, M.A.H.; Verkaik-Kloosterman, J.; Noort, M.W.J.; Raaij, van J.M.A.

2015-01-01

Background/objectives: Sodium intake in the Netherlands is substantially above the recommended intake of 2400¿mg/day. This study aimed to estimate the effect of two sodium reduction strategies, that is, modification of the composition of industrially processed foods toward the technologically

An effective method to screen sodium-based layered materials for sodium ion batteries

Science.gov (United States)

Zhang, Xu; Zhang, Zihe; Yao, Sai; Chen, An; Zhao, Xudong; Zhou, Zhen

2018-03-01

Due to the high cost and insufficient resource of lithium, sodium-ion batteries are widely investigated for large-scale applications. Typically, insertion-type materials possess better cyclic stability than alloy-type and conversion-type ones. Therefore, in this work, we proposed a facile and effective method to screen sodium-based layered materials based on Materials Project database as potential candidate insertion-type materials for sodium ion batteries. The obtained Na-based layered materials contains 38 kinds of space group, which reveals that the credibility of our screening approach would not be affected by the space group. Then, some important indexes of the representative materials, including the average voltage, volume change and sodium ion mobility, were further studied by means of density functional theory computations. Some materials with extremely low volume changes and Na diffusion barriers are promising candidates for sodium ion batteries. We believe that our classification algorithm could also be used to search for other alkali and multivalent ion-based layered materials, to accelerate the development of battery materials.

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.)

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.)

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

Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the American Heart Association Sodium Conference 2013 Planning Group.

Science.gov (United States)

Antman, Elliott M; Appel, Lawrence J; Balentine, Douglas; Johnson, Rachel K; Steffen, Lyn M; Miller, Emily Ann; Pappas, Antigoni; Stitzel, Kimberly F; Vafiadis, Dorothea K; Whitsel, Laurie

2014-06-24

A 2-day interactive forum was convened to discuss the current status and future implications of reducing sodium in the food supply and to identify opportunities for stakeholder collaboration. Participants included 128 stakeholders engaged in food research and development, food manufacturing and retail, restaurant and food service operations, regulatory and legislative activities, public health initiatives, healthcare, academia and scientific research, and data monitoring and surveillance. Presentation topics included scientific evidence for sodium reduction and public health policy recommendations; consumer sodium intakes, attitudes, and behaviors; food technologies and solutions for sodium reduction and sensory implications; experiences of the food and dining industries; and translation and implementation of sodium intake recommendations. Facilitated breakout sessions were conducted to allow for sharing of current practices, insights, and expertise. A well-established body of scientific research shows that there is a strong relationship between excess sodium intake and high blood pressure and other adverse health outcomes. With Americans getting >75% of their sodium from processed and restaurant food, this evidence creates mounting pressure for less sodium in the food supply. The reduction of sodium in the food supply is a complex issue that involves multiple stakeholders. The success of new technological approaches for reducing sodium will depend on product availability, health effects (both intended and unintended), research and development investments, quality and taste of reformulated foods, supply chain management, operational modifications, consumer acceptance, and cost. The conference facilitated an exchange of ideas and set the stage for potential collaboration opportunities among stakeholders with mutual interest in reducing sodium in the food supply and in Americans' diets. Population-wide sodium reduction remains a critically important component of

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)

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)

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

Sodium-carbonate co-substituted hydroxyapatite ceramics

Directory of Open Access Journals (Sweden)

Zoltan Z. Zyman

2013-12-01

Full Text Available Powders of sodium-carbonate co-substituted hydroxyapatite, having sodium content in the range of 0.25–1.5 wt.% with a 0.25 wt.% step, were prepared by a precipitation-solid state reaction route. Compacts of the powders were sintered in a CO2 flow (4 mL/min at 1100 °C for 2 h. The sintered ceramics contained sodium and carbonate ions in the ranges of 0–1.5 wt.% and 1.3–6 wt.%, respectively, which are typical impurity concentrations in biological apatite. A relationship between sodium and carbonate contents and the type of carbonate substitution was found. The total carbonate content progressively increased with the sodium content. The obtained ceramics showed an AB-type carbonate substitution. However, the substitution became more B-type as the sodium content increased. As a result, the carbonation was almost B-type (94 % for the highest sodium content (1.5 wt.%.

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.)

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...

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.

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 ...

Thermal performance tests on a sodium-to-sodium heat exchanger

International Nuclear Information System (INIS)

Prahlad, B.; Kale, R.D.; Rajan, K.K.

1990-01-01

Thermal performance of a 3 MW sodium-to-sodium intermediate heat exchanger (IHX) was evaluated under temperature conditions typical of a Fast Breeder Reactor IHX. A regenerative figure of eight loop was used with the heat exchanger at the cross over point, and a 500 kW heat source and an air cooled sink to maintain the desired test conditions. The overall heat transfer coefficient was found to vary from 4.02 to 4.87 kW/m 2 ·K for Peclet numbers varying from 37 to 112.5 on the shell side and 44.4 to 133.5 on the tube side respectively. The Peclet numbers were representative of low turbulent regime in this case. While the overall heat transfer coefficient was found close to predictions using Lubarsky's correlation, it was somewhat lower than that predicted by later correlations of Spukunsky and Borishansky. The reasons for the lower overall heat transfer coefficient have been explained in terms of possible maldistribution of shell side flow in low turbulent regime reducing the effective heat transfer area and increased thermal contact resistance. Based on their findings the authors feel that heat transfer in a sodium-to-sodium heat exchanger at low Peclet numbers is expected to differ from that obtained with large Peclet numbers. (author)

Selective sodium intercalation into sodium nickel-manganese sulfate for dual Na-Li-ion batteries.

Science.gov (United States)

Marinova, Delyana M; Kukeva, Rosica R; Zhecheva, Ekaterina N; Stoyanova, Radostina K

2018-04-26

Double sodium transition metal sulfates combine in themselves unique intercalation properties with eco-compatible compositions - a specific feature that makes them attractive electrode materials for lithium and sodium ion batteries. Herein, we examine the intercalation properties of novel double sodium nickel-manganese sulfate, Na2Ni1/2Mn1/2(SO4)2, having a large monoclinic unit cell, through electrochemical and ex situ diffraction and spectroscopic methods. The sulfate salt Na2Ni1/2Mn1/2(SO4)2 is prepared by thermal dehydration of the corresponding hydrate salt Na2Ni1/2Mn1/2(SO4)2·4H2O having a blödite structure. The intercalation reactions on Na2Ni1-xMnx(SO4)2 are studied in two model cells: half-ion cell versus Li metal anode and full-ion cell versus Li4Ti5O12 anode by using lithium (LiPF6 dissolved in EC/DMC) and sodium electrolytes (NaPF6 dissolved in EC:DEC). Based on ex situ XRD and TEM analysis, it is found that sodium intercalation into Na2Ni1/2Mn1/2(SO4)2 takes place via phase separation into the Ni-rich monoclinic phase and Mn-rich alluaudite phase. The redox reactions involving participation of manganese and titanium ions are monitored by ex situ EPR spectroscopy. It has been demonstrated that manganese ions from the sulfate salt are participating in the electrochemical reaction, while the nickel ions remain intact. As a result, a reversible capacity of about 65 mA h g-1 is reached. The selective intercalation properties determine sodium nickel-manganese sulfate as a new electrode material for hybrid lithium-sodium ion batteries that is thought to combine the advantages of individual lithium and sodium batteries.

Evaluation of steam-to-sodium leak detectors in the sodium components test installation (SCTI)

Energy Technology Data Exchange (ETDEWEB)

McKee, J M; Simmons, W R

1975-07-01

Two nickel diffusion-membrane type hydrogen detectors were installed in the secondary sodium system of the Sodium Components Test Installation and evaluated during the 12-month performance test of the Modular Steam Generator (MSG). Hydrogen in the expansion tank cover gas was monitored with a gas chromatograph. During this period, numerous steam and hydrogen injections were made, simulating steam leaks into the sodium of an LMFBR steam generator. The response of the detectors was evaluated for leak sizes ranging from 10{sup -6} to 10{sup -4} 1b H{sub 2}O/sec, injection periods of 0.5 to 300 min, secondary sodium flow rates of 0.2 x 10{sup 6} to 1.5 x 10{sup 6} 1b/hr, and sodium temperatures of 400 to 950 deg. F. The response of the leak detection system was influenced significantly by two regimes of sodium temperature. Below 600 deg. F, the cover gas hydrogen detector gave the largest response; this is attributed to the long dissolution time of hydrogen bubbles relative to the transit time of hydrogen to the expansion tank. Above 600 deg. F, the hydrogen apparently dissolved rapidly and the detectors were much more effective in the sodium than in the cover gas. At least 75% of the hydrogen and 50% of the oxygen content of injected steam appeared as detectable activity if the reaction products were dispersed in the sodium stream and the sodium was above 600 deg. F. Hydrogen injections into semi-stagnant sodium at the MSG tube sheets were detected with better sensitivity than steam injections into the main sodium stream. It appeared that high local concentrations of hydrogen were quickly carried to the nearest detector by upward currents created by the injected gas. The alarm system functioned as expected, 2.1 ppb/min being the smallest rate-of-rise in hydrogen concentration to give an automatic alarm. With more sensitive rate-of-rise alarm settings, leaks as small as 2 x 10{sup -5} 1b H{sub 2}O/sec could be detected in a system such as the Clinch River Breeder

Evaluation of steam-to-sodium leak detectors in the sodium components test installation (SCTI)

International Nuclear Information System (INIS)

McKee, J.M.; Simmons, W.R.

1975-01-01

Two nickel diffusion-membrane type hydrogen detectors were installed in the secondary sodium system of the Sodium Components Test Installation and evaluated during the 12-month performance test of the Modular Steam Generator (MSG). Hydrogen in the expansion tank cover gas was monitored with a gas chromatograph. During this period, numerous steam and hydrogen injections were made, simulating steam leaks into the sodium of an LMFBR steam generator. The response of the detectors was evaluated for leak sizes ranging from 10 -6 to 10 -4 1b H 2 O/sec, injection periods of 0.5 to 300 min, secondary sodium flow rates of 0.2 x 10 6 to 1.5 x 10 6 1b/hr, and sodium temperatures of 400 to 950 deg. F. The response of the leak detection system was influenced significantly by two regimes of sodium temperature. Below 600 deg. F, the cover gas hydrogen detector gave the largest response; this is attributed to the long dissolution time of hydrogen bubbles relative to the transit time of hydrogen to the expansion tank. Above 600 deg. F, the hydrogen apparently dissolved rapidly and the detectors were much more effective in the sodium than in the cover gas. At least 75% of the hydrogen and 50% of the oxygen content of injected steam appeared as detectable activity if the reaction products were dispersed in the sodium stream and the sodium was above 600 deg. F. Hydrogen injections into semi-stagnant sodium at the MSG tube sheets were detected with better sensitivity than steam injections into the main sodium stream. It appeared that high local concentrations of hydrogen were quickly carried to the nearest detector by upward currents created by the injected gas. The alarm system functioned as expected, 2.1 ppb/min being the smallest rate-of-rise in hydrogen concentration to give an automatic alarm. With more sensitive rate-of-rise alarm settings, leaks as small as 2 x 10 -5 1b H 2 O/sec could be detected in a system such as the Clinch River Breeder Reactor Plant. A preliminary

Environmental, health, and safety issues of sodium-sulfur batteries for electric and hybrid vehicles. Volume 3, Transport of sodium-sulfur and sodium-metal-chloride batteries

Energy Technology Data Exchange (ETDEWEB)

Hammel, C J

1992-09-01

This report examines the shipping regulations that govern the shipment of dangerous goods. Since the elemental sodium contained in both sodium-sulfur and sodium-metal-chloride batteries is classified as a dangerous good, and is listed on both the national and international hazardous materials listings, both national and international regulatory processes are considered in this report The interrelationships as well as the differences between the two processes are highlighted. It is important to note that the transport regulatory processes examined in this report are reviewed within the context of assessing the necessary steps needed to provide for the domestic and international transport of sodium-beta batteries. The need for such an assessment was determined by the Shipping Sub-Working Group (SSWG) of the EV Battery Readiness Working Group (Working Group), created in 1990. The Working Group was created to examine the regulatory issues pertaining to in-vehicle safety, shipping, and recycling of sodium-sulfur batteries, each of which is addressed by a sub-working group. The mission of the SSWG is to establish basic provisions that will ensure the safe and efficient transport of sodium-beta batteries. To support that end, a proposal to the UN Committee of Experts was prepared by the SSWG, with the goal of obtaining a proper shipping name and UN number for sodium-beta batteries and to establish the basic transport requirements for such batteries (see the appendix for the proposal as submitted). It is emphasized that because batteries are large articles containing elemental sodium and, in some cases, sulfur, there is no existing UN entry under which they can be classified and for which modal transport requirements, such as the use of packaging appropriate for such large articles, are provided for. It is for this reason that a specific UN entry for sodium-beta batteries is considered essential.

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

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,

Simultaneous HPLC method for determination of sodium trimethoprim phenylpropanol disulphonate and sodium sulfaquinoxaline in veterinary drugs

Directory of Open Access Journals (Sweden)

Puangkaew Lakkanatinaporn

2004-11-01

Full Text Available A simple HPLC method has been developed for the separation and determination of sodium trimethoprim phenylpropanol disulphonate and sodium sulfaquinoxaline in veterinary preparations. Both drugs were separated well on a Kromasil C18 column (5 µm, 150 × 4.6 mm using a mixture of acetonitrile and 0.5% triethylamine in 1% acetic acid, pH 3 (18:82, v/v as the mobile phase at the flow rate of 1.5 ml/ min. The presence of both substances was monitored by UV absorption detection at 271 nm. The retention times of sodium trimethoprim phenylpropanol disulphonate and sodium sulfaquinoxaline were 3.2 and 16.0 min, respectively. The performance of the developed method was tested. Linear responses of both drugs were achieved between 48-145% of labeled amount over the concentration ranges of 35-101 µg/ml and 102-306 µg/ ml for sodium trimethoprim phenylpropanol disulphonate and sodium sulfaquinoxaline with correlation coefficients (R2 of 0.9980 and 0.9998, respectively. Accuracy expressed in term of recoveries were 101.4± 1.21% (n=6 for sodium trimethoprim phenylpropanol disulphonate and 99.7±0.92% (n=6 for sodium sulfaquinoxaline. Precision of the method in terms of the relative standard deviation is not more than 2% in all cases. These figures of merit indicated the validity of the developed method.

SNL/JAEA Collaborations on Sodium Fire Benchmarking.

Energy Technology Data Exchange (ETDEWEB)

Clark, Andrew Jordan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Denman, Matthew R [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Takata, Takashi [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ohshima, Hiroyuki [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-11-01

Two sodium spray fire experiments performed by Sandia National Laboratories (SNL) were used for a code - to - code comparison between CONTAIN - LMR and SPHINCS. Both computer codes are used for modeling sodium accidents in sodium fast reactors. The comparison between the two codes provides insights into the ability of both codes to model sodium spray fires. The SNL T3 and T4 experiments are 20 kg sodium spray fires with sodium spray temperature s of 200 deg C and 500 deg C, respe ctively. Given the relatively low sodium temperature in the SNL T3 experiment, the sodium spray experienced a period of non - combustion. The vessel in the SNL T4 experiment experienced a rapid pressurization that caused of the instrumentation ports to fail during the sodium spray. Despite these unforeseen difficulties, both codes were shown in good agreement with the experiment s . The subsequent pool fire that develops from the unburned sodium spray is a significant characteristic of the T3 experiment. SPHIN CS showed better long - term agreement with the SNL T3 experiment than CONTAIN - LMR. The unexpected port failure during the SNL T4 experiment presented modelling challenges. The time at which the port failure occurred is unknown, but is believed to have occur red at about 11 seconds into the sodium spray fire. The sensitivity analysis for the SNL T4 experiment shows that with a port failure, the sodium spray fire can still maintain elevated pressures during the spray.

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.

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.

Reduced-Sodium Lunches Are Well-Accepted by Uninformed Consumers Over a 3-Week Period and Result in Decreased Daily Dietary Sodium Sodium Intakes: A Randomized Controlled Trial

NARCIS (Netherlands)

Janssen, A.M.; Kremer, S.; Stipriaan, van W.L.; Noort, M.W.J.; Vries, de J.H.M.; Temme, E.H.M.

2015-01-01

Background Processed foods are major contributors to excessive sodium intake in Western populations. We investigated the effect of food reformulation on daily dietary sodium intake. Objective To determine whether uninformed consumers accept reduced-sodium lunches and to determine the effect of

Salt craving: the psychobiology of pathogenic sodium intake.

Science.gov (United States)

Morris, Michael J; Na, Elisa S; Johnson, Alan Kim

2008-08-06

Ionic sodium, obtained from dietary sources usually in the form of sodium chloride (NaCl, common table salt) is essential to physiological function, and in humans salt is generally regarded as highly palatable. This marriage of pleasant taste and physiological utility might appear fortunate--an appealing taste helps to ensure that such a vital substance is ingested. However, the powerful mechanisms governing sodium retention and sodium balance are unfortunately best adapted for an environment in which few humans still exist. Our physiological and behavioral means for maintaining body sodium and fluid homeostasis evolved in hot climates where sources of dietary sodium were scarce. For many reasons, contemporary diets are high in salt and daily sodium intakes are excessive. High sodium consumption can have pathological consequences. Although there are a number of obstacles to limiting salt ingestion, high sodium intake, like smoking, is a modifiable behavioral risk factor for many cardiovascular diseases. This review discusses the psychobiological mechanisms that promote and maintain excessive dietary sodium intake. Of particular importance are experience-dependent processes including the sensitization of the neural systems underlying sodium appetite and the effects of sodium balance on hedonic state and mood. Accumulating evidence suggests that plasticity within the central nervous system as a result of experience with high salt intake, sodium depletion, or a chronic unresolved sodium appetite fosters enduring changes in sodium related appetitive and consummatory behaviors.

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.

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

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.)

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.

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.

Dog rose (Rosa canina L.) as a functional ingredient in porcine frankfurters without added sodium ascorbate and sodium nitrite.

Science.gov (United States)

Vossen, Els; Utrera, Mariana; De Smet, Stefaan; Morcuende, David; Estévez, Mario

2012-12-01

The effect of dog rose (Rosa canina L.; RC), rich in polyphenols and ascorbic acid, on lipid and protein oxidation, colour stability and texture of frankfurters was investigated. Four treatments were prepared: with 5 or 30 g/kg RC extract and without sodium ascorbate and sodium nitrite (5RC and 30RC, respectively), a positive control (with sodium ascorbate and sodium nitrite; PC) and a negative control (without sodium ascorbate, sodium nitrite or RC extract; NC). Hexanal values were much higher throughout storage in NC compared to RC and PC frankfurters (Prose can act as a natural antioxidant in frankfurters, but not as full replacer for sodium nitrite. Copyright © 2012 Elsevier Ltd. All rights reserved.

Delaminated sodium nonatitanate and a method for producing delaminated sodium nonatitanate

Science.gov (United States)

Nyman, May D.

2016-02-02

A hydrothermal synthesis method of making a delaminated titanate is disclosed. The delaminated titanate has a unique structure or morphology. The delaminated titanate is first formed by forming at a low temperature a layered sodium nonatitanate (SNT), which may be referred to as layered sodium titanate. The layered SNT has a unique morphology. The layered SNT is then synthesized into a delaminated titanate having a unique morphology.

Effects of sodium fires on structures and materials. Practical experience with sodium leakage accidents

International Nuclear Information System (INIS)

Freudenstein, K.F.

1989-01-01

A few sodium leakage, incidents happened in SNR 300 nuclear power plant during pre-nuclear operation which were of minor importance with respect to sodium fires. The most important sodium fire accident in the past happened in the Almeria Solar platform in Spain during the attempt to repair a valve while leaving accidentally the circuit under 4 bar overpressure. Considerable damage to pipes, valves, its insulation and its support structures was observed in the influence zone of the fire. Post accident analysis gave a leaked mass of about 14 m 3 , at a sodium temperature of 225 deg. C, the leakage lasting approximately half an hour, and burning under convective heat exchange with the external air in a section of 40 m 2 up to a height of 6 m down to the catch pans. Some local temperatures were determined by metallurgical means, integral support temperatures estimated from mechanical deformation observed. From these temperatures it was concluded that a massive spray type fire must have happened. The results fall in the interpretation range of sodium-spray fire test results. (author)

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

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

Characterization of ion distributions near the surface of sodium-containing and sodium-depleted calcium aluminosilicate glass melts

International Nuclear Information System (INIS)

Corrales, Louis R.; Du, Jincheng

2006-01-01

The distribution of cation and anion components of sodium containing calcium aluminosilicate glass was studied by classical molecular dynamics simulations in a high temperature melt in the bulk and at the vacuum-melt interface. A significant redistribution of the sodium and non-bridging oxygen ions was observed. Subsequently, a sodium depleted calcium aluminosilicate glass melt was simulated to determine the sensitivity of the redistribution of ions near the vacuum-melt interface to the presence of sodium ions. It is found that the thermodynamic equilibrium condition near a surface favors the enrichment of non-bridging oxygen ions that is closely associated with enrichment of the sodium ions

Under-Sodium-Viewing as one technique for periodic inspections in sodium-cooled fast reactors-- possibilities and limits

International Nuclear Information System (INIS)

Weiss, H.

1979-07-01

Periodic inspections are gaining increasingly technical importance for fast sodium cooled reactors. Among others the reactor tank and its internals have to be inspected, whereby licensing experts partly are requesting the standards of Light Water Reactors. This leads to difficulties in sodium cooled reactors because of the non-transparent coolant sodium and their compact structure. In order to avoid the complete dumping of the sodium, the under sodium viewing shall be applied besides other inspection methods. Since this is a new method, which is still in its development phase, this report presents and discusses the technical and physical basis and outlines possibilities and limits [de

Spot urine sodium measurements do not accurately estimate dietary sodium intake in chronic kidney disease12

Science.gov (United States)

Dougher, Carly E; Rifkin, Dena E; Anderson, Cheryl AM; Smits, Gerard; Persky, Martha S; Block, Geoffrey A; Ix, Joachim H

2016-01-01

Background: Sodium intake influences blood pressure and proteinuria, yet the impact on long-term outcomes is uncertain in chronic kidney disease (CKD). Accurate assessment is essential for clinical and public policy recommendations, but few large-scale studies use 24-h urine collections. Recent studies that used spot urine sodium and associated estimating equations suggest that they may provide a suitable alternative, but their accuracy in patients with CKD is unknown. Objective: We compared the accuracy of 4 equations [the Nerbass, INTERSALT (International Cooperative Study on Salt, Other Factors, and Blood Pressure), Tanaka, and Kawasaki equations] that use spot urine sodium to estimate 24-h sodium excretion in patients with moderate to advanced CKD. Design: We evaluated the accuracy of spot urine sodium to predict mean 24-h urine sodium excretion over 9 mo in 129 participants with stage 3–4 CKD. Spot morning urine sodium was used in 4 estimating equations. Bias, precision, and accuracy were assessed and compared across each equation. Results: The mean age of the participants was 67 y, 52% were female, and the mean estimated glomerular filtration rate was 31 ± 9 mL · min–1 · 1.73 m–2. The mean ± SD number of 24-h urine collections was 3.5 ± 0.8/participant, and the mean 24-h sodium excretion was 168.2 ± 67.5 mmol/d. Although the Tanaka equation demonstrated the least bias (mean: −8.2 mmol/d), all 4 equations had poor precision and accuracy. The INTERSALT equation demonstrated the highest accuracy but derived an estimate only within 30% of mean measured sodium excretion in only 57% of observations. Bland-Altman plots revealed systematic bias with the Nerbass, INTERSALT, and Tanaka equations, underestimating sodium excretion when intake was high. Conclusion: These findings do not support the use of spot urine specimens to estimate dietary sodium intake in patients with CKD and research studies enriched with patients with CKD. The parent data for this

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

Designing solid-liquid interphases for sodium batteries

KAUST Repository

Choudhury, Snehashis

2017-10-06

Secondary batteries based on earth-abundant sodium metal anodes are desirable for both stationary and portable electrical energy storage. Room-temperature sodium metal batteries are impractical today because morphological instability during recharge drives rough, dendritic electrodeposition. Chemical instability of liquid electrolytes also leads to premature cell failure as a result of parasitic reactions with the anode. Here we use joint density-functional theoretical analysis to show that the surface diffusion barrier for sodium ion transport is a sensitive function of the chemistry of solid–electrolyte interphase. In particular, we find that a sodium bromide interphase presents an exceptionally low energy barrier to ion transport, comparable to that of metallic magnesium. We evaluate this prediction by means of electrochemical measurements and direct visualization studies. These experiments reveal an approximately three-fold reduction in activation energy for ion transport at a sodium bromide interphase. Direct visualization of sodium electrodeposition confirms large improvements in stability of sodium deposition at sodium bromide-rich interphases.

Sodium leak at Monju (II): Sodium leak, burning and aerosol behavior

International Nuclear Information System (INIS)

Funada, T.; Yamagishi, Y.

1996-01-01

The amount of leaked sodium was estimated as approximately 640 kg during the 220 minute leak. The ventilation duct and the walkway grating under the leak site were severely damaged by Na-Fe-O reaction, but the floor liner and the concrete wall were not. A total 100 kg of sodium aerosol was deposited in the reactor auxiliary building and 230 kg was released to the atmosphere. The sodium concentration at the site boundary was calculated as 0.05 mg/m 3 , NaOH equivalent, which was low in comparison with the permitted level of 2 mg/m 3 . The tritium quantity released was estimated as 4.4 x 10 7 Bq, which was about 0.03% of the average released value per month for a LWR. (author)

Mapping of sodium void worth and doppler effect for sodium-cooled fast reactor - 15458

International Nuclear Information System (INIS)

Krepel, J.; Pelloni, S.; Bortot, S.; Panadero, A.L.; Mikityuk, K.

2015-01-01

The sodium-cooled fast reactor (SFR) represents the reference and the most technologically mastered system among the Generation-IV reactors. Nevertheless, the sodium void worth in the fuel regions of SFR is usually positive. To overcome this safety drawback, low-void sodium-cooled fast spectrum core (CFV) was proposed by CEA. Such a CFV core is used in the frame of WP6 'Core safety' of the FP7 Euratom ESNII+ project as a reference SFR design. The overall sodium void effect is negative for the CFV core. Nevertheless, locally it is positive in the fuel region and negative in the sodium plenum. Similarly, also the Doppler effect is spatially dependent and it varies between the inner and outer fuel regions and between the middle and lower blankets. Accordingly, knowledge of the local distributions or actually mappings of the two safety-related parameters will be necessary, before safety assessment and transient analysis can be done. In this study these maps have been produced using the deterministic code ERANOS. The obtained mapping shows strong local dependency of both safety-related effects. A sensitivity of the void effect to the sodium plenum modeling was also demonstrated. The results may serve as an input for the transient analysis of the CFV core or as a cross-check for the Monte Carlo method based maps. (authors)

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)

Water Mock-up for the Sodium Waste Treatment Process

Energy Technology Data Exchange (ETDEWEB)

Nam, Ho Yun; Kim, Jong Man; Kim, Byung Ho; Lee, Yong Bum [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2011-05-15

It is important to safely treat the waste sodium which was produced from the sodium cooled fast reactors and the sodium facilities. About 1.3 tons of sodium waste has accumulated at KAERI from the sodium experiments which have been carried out since 1990. Also, large scaled sodium experiments are scheduled to verify the design of the sodium cooled fast reactor. As a treatment method for the waste sodium produced at the sodium facility, an investigation of the reaction procedure of the waste sodium with the sodium hydroxide aqueous has been developed. The NOAH process was developed in France for the treatment of waste sodium produced from sodium facilities and reactors. In the NOAH process, a small amount of sodium waste is continuously injected into the upper space which is formed on the free surface of the aqueous and slowly reacted with sodium hydroxide aqueous. Since the density of the sodium is lower than that of the aqueous, the injected sodium waste sometimes accumulates above the free surface of the sodium hydroxide aqueous, and its reaction rate becomes slow or suddenly increases. In the improved process, the sodium was injected into a reaction vessel filled with a sodium hydroxide aqueous through an atomizing nozzle installed on a lower level than that of the aqueous to maintain the reaction uniformly. Fig.1 shows the sodium waste process which was proposed in KAERI. The aqueous is composed of 60% sodium hydroxide, and its temperature is about 60 .deg. C. The process is an exothermic reaction. The hydrogen gas is generated, and the concentration of the sodium hydroxide increases in this process. It needs several systems for the process, i.e. a waste sodium injection, a cooling of the aqueous, hydrogen ventilation, and neutralization with nitric acid. The atomizing nozzle was designed to inject the sodium with the nitrogen gas which supplies a heat to the sodium to prevent its solidification and to uniformly mix the sodium with the aqueous. There are

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

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

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.

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.

Computational methodology of sodium-water reaction phenomenon in steam generator of sodium-cooled fast reactor

International Nuclear Information System (INIS)

Takata, Takashi; Yamaguchi, Akira; Uchibori, Akihiro; Ohshima, Hiroyuki

2009-01-01

A new computational methodology of sodium-water reaction (SWR), which occurs in a steam generator of a liquid-sodium-cooled fast reactor when a heat transfer tube in the steam generator fails, has been developed considering multidimensional and multiphysics thermal hydraulics. Two kinds of reaction models are proposed in accordance with a phase of sodium as a reactant. One is the surface reaction model in which water vapor reacts directly with liquid sodium at the interface between the liquid sodium and the water vapor. The reaction heat will lead to a vigorous evaporation of liquid sodium, resulting in a reaction of gas-phase sodium. This is designated as the gas-phase reaction model. These two models are coupled with a multidimensional, multicomponent gas, and multiphase thermal hydraulics simulation method with compressibility (named the 'SERAPHIM' code). Using the present methodology, a numerical investigation of the SWR under a pin-bundle configuration (a benchmark analysis of the SWAT-1R experiment) has been carried out. As a result, the maximum gas temperature of approximately 1,300degC is predicted stably, which lies within the range of previous experimental observations. It is also demonstrated that the maximum temperature of the mass weighted average in the analysis agrees reasonably well with the experimental result measured by thermocouples. The present methodology will be promising to establish a theoretical and mechanical modeling of secondary failure propagation of heat transfer tubes due to such as an overheating rupture and a wastage. (author)

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

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

Improved modelling of sodium-spray fires and sodium-combustion aerosol chemical evolution - 15488

International Nuclear Information System (INIS)

Mathe, E.; Kissane, M.; Petitprez, D.

2015-01-01

In the context of the Generation IV Initiative, the consequences of a severe-accident in sodium-cooled fast reactor (SFR) must be studied. Being pyrophoric, sodium will burn upon contact with air in a containment creating toxic aerosols and we must take into account these fire aerosols when assessing the source term. We have developed a numerical simulation named NATRAC to calculate the mass of aerosols produced during a spray fire in a SFR severe accident. The results show that the mass of oxide aerosols can involve more than 60% of the ejected sodium. In a second part we have developed a numerical simulation named STARK based on the Cooper model that models the physico-chemical transformations of the aerosols. However, this model has never been validated and the literature does not permit to do so. In these conditions, we have designed and performed our own experiment ESSTIA to obtain the missing values of the parameters that govern Cooper model. The modified Cooper model we propose with the new parameters reproduces correctly the ESSTIA experimental data. The only parameter that has not yet been measured is the tortuosity of the sodium-fire aerosols surface layers. A dedicated experiment using real sodium-fire aerosols could eliminate any doubts about the uncertainty of the proposed Cooper model

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)

Evaluation tissue dissolution property of 2.5 % Sodium Hypochlorite Prepared by Hydrochloric Acid and Sodium Bicarbonate: An in vitro

Directory of Open Access Journals (Sweden)

Hamid Razavian

2016-08-01

Full Text Available Successful endodontic treatment requires chemical preparation in addition to mechanical preparation. The most common material for chemical preparations is sodium hypochlorite. One way to reduce the effects of pH adjustment is the use of sodium hypochlorite. The present paper was conducted to examine the effect of dilution with hydrochloric acid and sodium bicarbonate and reduce pH on ability of tissue solubility of sodium hypochlorite. The present study was conducted in vitro on bovine muscle tissue. Ability of tissue solubility was conducted in four groups respectively with active ingredient including 1 sodium hypochlorite diluted with distilled water 2 sodium hypochlorite diluted with sodium bicarbonate 3 sodium hypochlorite diluted with hydrochloric acid and finally 4 distilled water (control group. Each sample was firstly weighed and then placed in contact with 10 m/L solution for 60 minutes (five 12 -minute intervals. The sample was weighted every five minutes and solution was renewed. The results were analyzed using SPSS-21 Software based on variance analysis, Tukey and T-test (α=0.05. The findings showed that there was significant difference between first, second and third groups in terms of ability of tissue solubility. However, the tissue solubility in second and third groups was lower than first group and it was similar in second and third groups (P Value <0.001. Reduction of sodium bicarbonate PH using sodium hypochlorite and hydrochloric acid reduces ability of tissue solubility in sodium hypochlorite.

Enhanced electrochemical stability of carbon-coated antimony nanoparticles with sodium alginate binder for sodium-ion batteries

Directory of Open Access Journals (Sweden)

Jianmin Feng

2018-04-01

Full Text Available The poor cycling stability of antimony during a repeated sodium ion insertion and desertion process is the key issue, which leads to an unsatisfactory application as an anode material in a sodium-ion battery. Addressed at this, we report a facile two-step method to coat antimony nanoparticles with an ultrathin carbon layer of few nanometers (denoted Sb@C NPs for sodium-ion battery anode application. This carbon layer could buffer the volume change of antimony in the charge-discharge process and improve the battery cycle performance. Meanwhile, this carbon coating could also enhance the interfacial stability by firmly connecting the sodium alginate binders through its oxygen-rich surface. Benefitted from these advantages, an improved initial discharge capacity (788.5 mA h g−1 and cycling stability capacity (553 mA h g−1 after 50 times cycle have been obtained in a battery using Sb@C NPs as anode materials at 50 mA g−1. Keywords: Sodium-ion battery, Antimony, Sodium alginate, Liquid-phase reduction, Carbon coating

Restricting dietary sodium reduces plasma sodium response to exercise in the heat.

Science.gov (United States)

Koenders, E E; Franken, C P G; Cotter, J D; Thornton, S N; Rehrer, N J

2017-11-01

Exercise-associated hyponatremia can be life-threatening. Excessive hypotonic fluid ingestion is the primary etiological factor but does not explain all variability. Possible effects of chronic sodium intake are unknown. The aim of this study was to determine whether dietary sodium affects plasma sodium concentration [Na + ] during exercise in the heat, when water intake nearly matches mass loss. Endurance-trained men (n = 9) participated in this crossover experiment. Each followed a low-sodium (lowNa) or high-sodium (highNa) diet for 9 days with 24-h fluid intakes and urine outputs measured before experimental trials (day 10). The trials were ≥2 week apart. Trials comprised 3 h (or if not possible to complete, to exhaustion) cycling (55% VO 2max ; 34 °C, 65% RH) with water intake approximating mass loss. Plasma [Na + ], hematocrit, sweat and urine [Na + ], heart rate, core temperature, and subjective perceptions were monitored. Urine [Na + ] was lower on lowNa 24 h prior to (31 ± 24, 76 ± 30 mmol/L, P = 0.027) and during trials (10 ± 10, 52 ± 32 mmol/L, P = 0.004). Body mass was lower on lowNa (79.6 ± 8.5, 80.5 ± 8.9, P = 0.03). Plasma [Na + ] was lower on lowNa before (137 ± 2, 140 ± 3, P = 0.007) and throughout exercise (P = 0.001). Sweat [Na + ] was unaffected by diet (54.5 ± 40, 54.5 ± 23 mmol/L, P = 0.99). Heart rate and core temperature were higher on lowNa (P ≤ 0.001). Despite decreased urinary sodium losses, plasma sodium was lower on lowNa, with decreased mass indicating (extracellular) water may have been less, explaining greater heart rate and core temperature. General population health recommendations to lower salt intake may not be appropriate for endurance athletes, particularly those training in the heat. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Muzzle secretion electrolytes as a possible indicator of sodium status in buffalo (Bubalus bubalis) calves: effects of sodium depletion and aldosterone administration.

Science.gov (United States)

Kumar, S; Singh, S P

1981-01-01

In two separate experiments, the effects of sodium depletion and aldosterone administration on sodium and potassium concentrations in muzzle secretion, saliva and urine were studied in buffalo calves. Sodium deficiency in the animals was experimentally produced by unilateral parotid saliva deprivation for 18 days. During sodium depletion, the sodium levels in saliva and muzzle secretion gradually fell while the potassium level gradually rose. The concentrations of both of these cations in urine gradually fell during the course of sodium depletion. Aldosterone administration in normal (sodium-replete) animals simulated the effects of sodium depletion as far as cationic changes in saliva were concerned. However, aldosterone did not affect sodium and potassium concentration in the urine and in muzzle secretion in a manner similar to that caused by sodium depletion. Though the hormone decreased urinary sodium without affecting urinary potassium, it did not affect the muzzle sodium or potassium. Results suggest that aldosterone affects the composition of saliva and urine in buffaloes as it does in sheep and other ruminants. Similar changes in composition of muzzle secretion and saliva during sodium depletion indicate that the concentration of sodium in muzzle secretion could possibly be used to evaluate the sodium status of animals.

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

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)

Modeling and Validation of Sodium Plugging for Heat Exchangers in Sodium-cooled Fast Reactor Systems

Energy Technology Data Exchange (ETDEWEB)

Ferroni, Paolo [Westinghouse Electric Company LLC, Cranberry Township, PA (United States). Global Technology Development; Tatli, Emre [Westinghouse Electric Company LLC, Cranberry Township, PA (United States); Czerniak, Luke [Westinghouse Electric Company LLC, Cranberry Township, PA (United States); Sienicki, James J. [Argonne National Lab. (ANL), Argonne, IL (United States); Chien, Hual-Te [Argonne National Lab. (ANL), Argonne, IL (United States); Yoichi, Momozaki [Argonne National Lab. (ANL), Argonne, IL (United States); Bakhtiari, Sasan [Argonne National Lab. (ANL), Argonne, IL (United States)

2016-06-29

The project “Modeling and Validation of Sodium Plugging for Heat Exchangers in Sodium-cooled Fast Reactor Systems” was conducted jointly by Westinghouse Electric Company (Westinghouse) and Argonne National Laboratory (ANL), over the period October 1, 2013- March 31, 2016. The project’s motivation was the need to provide designers of Sodium Fast Reactors (SFRs) with a validated, state-of-the-art computational tool for the prediction of sodium oxide (Na₂O) deposition in small-diameter sodium heat exchanger (HX) channels, such as those in the diffusion bonded HXs proposed for SFRs coupled with a supercritical CO₂ (sCO₂) Brayton cycle power conversion system. In SFRs, Na₂O deposition can potentially occur following accidental air ingress in the intermediate heat transport system (IHTS) sodium and simultaneous failure of the IHTS sodium cold trap. In this scenario, oxygen can travel through the IHTS loop and reach the coldest regions, represented by the cold end of the sodium channels of the HXs, where Na₂O precipitation may initiate and continue. In addition to deteriorating HX heat transfer and pressure drop performance, Na₂O deposition can lead to channel plugging especially when the size of the sodium channels is small, which is the case for diffusion bonded HXs whose sodium channel hydraulic diameter is generally below 5 mm. Sodium oxide melts at a high temperature well above the sodium melting temperature such that removal of a solid plug such as through dissolution by pure sodium could take a lengthy time. The Sodium Plugging Phenomena Loop (SPPL) was developed at ANL, prior to this project, for investigating Na₂O deposition phenomena within sodium channels that are prototypical of the diffusion bonded HX channels envisioned for SFR-sCO₂ systems. In this project, a Computational Fluid Dynamic (CFD) model capable of simulating the thermal-hydraulics of the SPPL test

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.

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.

Numerical Analysis of Flow Distribution in a Sodium Chamber of a Finned-tube Sodium-to-Air Heat Exchanger

Energy Technology Data Exchange (ETDEWEB)

Jo, Youngchul; Son, Seokkwon; Kim, Hyungmo; Eoh, Jaehyuk; Jeong, Jiyoung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

DHR systems consist of two diverse heat removal loops such as passive and active DHR systems, and the heat load imposed on the primary sodium pool is safely rejected into the environment through different kinds of sodium-to-air heat exchangers, e.g. M-shape and helical-coil type air-coolers. The former is called as an FHX(Forced-draft sodium-to-air Heat Exchanger) and the latter is simply called as an AHX(natural-draft sodium-to-Air Heat Exchanger). In a general sodium-to-air heat exchanger design, convection resistance in a shell-side air flow path becomes dominant factor affecting the mechanism of conjugate heat transfer from the sodium flow inside the tube to the air path across the sodium tube wall. Hence verification of the flow and heat transfer characteristics is one of the most important tasks to demonstrate decay heat removal performance. To confirm a kind of ultimate heat sink heat exchanger, a medium-scale Sodium thermal-hydraulic Experiment Loop for Finned-tube sodium-to-Air Heat exchanger (here after called the SELFA) has been designed and is recently being constructed at KAERI site. The introduction of the flow baffle inside the upper sodium chamber of the model FHX unit in the SELFA facility is briefly proposed and discussed as well. The present study aims at introducing a flow baffle design inside the upper sodium chamber to make more equalized flowrates flowing into each heat transfer tube of the model FHX unit. In the cases without the flow baffle geometry, it was observed lager discrepancies in flowrates at the heat transfer tubes. However it was also found that those kinds of discrepancies could be definitely decreased at around 1/10 by employing a flow baffle.

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

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.

Corrosion performance of advanced structural materials in sodium.

Energy Technology Data Exchange (ETDEWEB)

Natesan, K.; Momozaki, Y.; Li, M.; Rink, D.L. (Nuclear Engineering Division)

2012-05-16

This report gives a description of the activities in design, fabrication, construction, and assembling of a pumped sodium loop for the sodium compatibility studies on advanced structural materials. The work is the Argonne National Laboratory (ANL) portion of the effort on the work project entitled, 'Sodium Compatibility of Advanced Fast Reactor Materials,' and is a part of Advanced Materials Development within the Reactor Campaign. The objective of this project is to develop information on sodium corrosion compatibility of advanced materials being considered for sodium reactor applications. This report gives the status of the sodium pumped loop at Argonne National Laboratory, the specimen details, and the technical approach to evaluate the sodium compatibility of advanced structural alloys. This report is a deliverable from ANL in FY2010 (M2GAN10SF050302) under the work package G-AN10SF0503 'Sodium Compatibility of Advanced Fast Reactor Materials.' Two reports were issued in 2009 (Natesan and Meimei Li 2009, Natesan et al. 2009) which examined the thermodynamic and kinetic factors involved in the purity of liquid sodium coolant for sodium reactor applications as well as the design specifications for the ANL pumped loop for testing advanced structural materials. Available information was presented on solubility of several metallic and nonmetallic elements along with a discussion of the possible mechanisms for the accumulation of impurities in sodium. That report concluded that the solubility of many metals in sodium is low (<1 part per million) in the temperature range of interest in sodium reactors and such trace amounts would not impact the mechanical integrity of structural materials and components. The earlier report also analyzed the solubility and transport mechanisms of nonmetallic elements such as oxygen, nitrogen, carbon, and hydrogen in laboratory sodium loops and in reactor systems such as Experimental Breeder Reactor-II, Fast Flux

Corrosion performance of advanced structural materials in sodium

International Nuclear Information System (INIS)

Natesan, K.; Momozaki, Y.; Li, M.; Rink, D.L.

2012-01-01

This report gives a description of the activities in design, fabrication, construction, and assembling of a pumped sodium loop for the sodium compatibility studies on advanced structural materials. The work is the Argonne National Laboratory (ANL) portion of the effort on the work project entitled, 'Sodium Compatibility of Advanced Fast Reactor Materials,' and is a part of Advanced Materials Development within the Reactor Campaign. The objective of this project is to develop information on sodium corrosion compatibility of advanced materials being considered for sodium reactor applications. This report gives the status of the sodium pumped loop at Argonne National Laboratory, the specimen details, and the technical approach to evaluate the sodium compatibility of advanced structural alloys. This report is a deliverable from ANL in FY2010 (M2GAN10SF050302) under the work package G-AN10SF0503 'Sodium Compatibility of Advanced Fast Reactor Materials.' Two reports were issued in 2009 (Natesan and Meimei Li 2009, Natesan et al. 2009) which examined the thermodynamic and kinetic factors involved in the purity of liquid sodium coolant for sodium reactor applications as well as the design specifications for the ANL pumped loop for testing advanced structural materials. Available information was presented on solubility of several metallic and nonmetallic elements along with a discussion of the possible mechanisms for the accumulation of impurities in sodium. That report concluded that the solubility of many metals in sodium is low (<1 part per million) in the temperature range of interest in sodium reactors and such trace amounts would not impact the mechanical integrity of structural materials and components. The earlier report also analyzed the solubility and transport mechanisms of nonmetallic elements such as oxygen, nitrogen, carbon, and hydrogen in laboratory sodium loops and in reactor systems such as Experimental Breeder Reactor-II, Fast Flux Test Facility, and

Amiloride-Sensitive Sodium Channels and Pulmonary Edema

Directory of Open Access Journals (Sweden)

Mike Althaus

2011-01-01

Full Text Available The development of pulmonary edema can be considered as a combination of alveolar flooding via increased fluid filtration, impaired alveolar-capillary barrier integrity, and disturbed resolution due to decreased alveolar fluid clearance. An important mechanism regulating alveolar fluid clearance is sodium transport across the alveolar epithelium. Transepithelial sodium transport is largely dependent on the activity of sodium channels in alveolar epithelial cells. This paper describes how sodium channels contribute to alveolar fluid clearance under physiological conditions and how deregulation of sodium channel activity might contribute to the pathogenesis of lung diseases associated with pulmonary edema. Furthermore, sodium channels as putative molecular targets for the treatment of pulmonary edema are discussed.

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

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...

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...

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...

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.

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)

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...

Determination of chloride and sulphur in sodium by ion chromatography and its application to PFBR sodium samples

International Nuclear Information System (INIS)

Vijayalakshmi, S.; Ushalakshmi, K.

2011-01-01

Analytical method using ion chromatography was developed for the determination of chloride and sulphur in sodium. In this method, sodium was dissolved in water and various sulphur species present in the sample was oxidized to sulphate using hydrogen peroxide. Carbon dioxide gas was passed through the solution to convert sodium hydroxide to carbonate solution. The resulting sample solution was analysed using suppressed Ion chromatography employing carbonate eluent. This method was applied to the analysis of sodium samples procured for prototype fast breeder reactor. (author)

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...

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...

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)

Sodium and potassium content and their ratio in meatballs in tomato sauce produced with lower amounts of sodium

Science.gov (United States)

Lilić, S.; Nikolić, D.; Pejkovski, Z.; Velebit, B.; Lakićević, B.; Korićanac, V.; Vranić, D.

2017-09-01

The goal of this study was to examine the possibility of partial replacement of sodium chloride with potassium chloride and ammonium chloride, with the target of achieving less sodium content in meatballs and tomato sauce as well as achieving a better Na:K ratio. The trial consisted of five groups. In the control group of meatballs and sauce, only sodium chloride was added. In group 1, half of the sodium chloride was replaced with potassium chloride related to control group while in group 2 one third of the sodium chloride was replaced with potassium chloride. In group 3, one third of the sodium chloride was replaced with ammonium chloride, and in group 4, sodium chloride was reduced to half the amount in the control group, and 1 g (0.25%) of ammonium chloride was also added. All products were acceptable according to sensory analyses. The largest reductions of sodium content were 44.64%, achieved in meatballs from group 1 and 50.62% in tomato sauce from group 4 in relation to meatballs and tomato sauce from control group. The highest Na:K ratio was calculated in meatballs and tomato sauce from control group, 2.88 and 4.39, respectively. The best Na:K ratio was in meatballs and tomato sauce from group 1, 0.60 and 0.92, respectively, in which half of sodium chloride was replaced with potassium chloride. However, in meatballs and tomato sauce from group 4, with only half the amount of sodium chloride related to control group, the Na:K ratio was worse because in these products, potassium chloride was not added.

Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations

DEFF Research Database (Denmark)

Brown, Ian J; Dyer, Alan R; Chan, Queenie

2013-01-01

High intakes of dietary sodium are associated with elevated blood pressure levels and an increased risk of cardiovascular disease. National and international guidelines recommend reduced sodium intake in the general population, which necessitates population-wide surveillance. We assessed the util...

The dual orexin receptor antagonist, DORA-22, lowers histamine levels in the lateral hypothalamus and prefrontal cortex without lowering hippocampal acetylcholine.

Science.gov (United States)

Yao, Lihang; Ramirez, Andres D; Roecker, Anthony J; Fox, Steven V; Uslaner, Jason M; Smith, Sean M; Hodgson, Robert; Coleman, Paul J; Renger, John J; Winrow, Christopher J; Gotter, Anthony L

2017-07-01

Chronic insomnia is defined as a persistent difficulty with sleep initiation maintenance or non-restorative sleep. The therapeutic standard of care for this condition is treatment with gamma-aminobutyric acid (GABA) A receptor modulators, which promote sleep but are associated with a panoply of side effects, including cognitive and memory impairment. Dual orexin receptor antagonists (DORAs) have recently emerged as an alternative therapeutic approach that acts via a distinct and more selective wake-attenuating mechanism with the potential to be associated with milder side effects. Given their distinct mechanism of action, the current work tested the hypothesis that DORAs and GABA A receptor modulators differentially regulate neurochemical pathways associated with differences in sleep architecture and cognitive performance induced by these pharmacological mechanisms. Our findings showed that DORA-22 suppresses the release of the wake neurotransmitter histamine in the lateral hypothalamus, prefrontal cortex, and hippocampus with no significant alterations in acetylcholine levels. In contrast, eszopiclone, commonly used as a GABA A modulator, inhibited acetylcholine secretion across brain regions with variable effects on histamine release depending on the extent of wakefulness induction. In normal waking rats, eszopiclone only transiently suppressed histamine secretion, whereas this suppression was more obvious under caffeine-induced wakefulness. Compared with the GABA A modulator eszopiclone, DORA-22 elicits a neurotransmitter profile consistent with wake reduction that does not impinge on neurotransmitter levels associated with cognition and rapid eye movement sleep. © 2017 International Society for Neurochemistry.

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)

A high-capacity, low-cost layered sodium manganese oxide material as cathode for sodium-ion batteries.

Science.gov (United States)

Guo, Shaohua; Yu, Haijun; Jian, Zelang; Liu, Pan; Zhu, Yanbei; Guo, Xianwei; Chen, Mingwei; Ishida, Masayoshi; Zhou, Haoshen

2014-08-01

A layered sodium manganese oxide material (NaMn3 O5 ) is introduced as a novel cathode materials for sodium-ion batteries. Structural characterizations reveal a typical Birnessite structure with lamellar stacking of the synthetic nanosheets. Electrochemical tests reveal a particularly large discharge capacity of 219 mAh g(-1) in the voltage rang of 1.5-4.7 V vs. Na/Na(+) . With an average potential of 2.75 V versus sodium metal, layered NaMn3 O5 exhibits a high energy density of 602 Wh kg(-1) , and also presents good rate capability. Furthermore, the diffusion coefficient of sodium ions in the layered NaMn3 O5 electrode is investigated by using the galvanostatic intermittent titration technique. The results greatly contribute to the development of room-temperature sodium-ion batteries based on earth-abundant elements. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

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.

austenitic steel corrosion by oxygen-containing liquid sodium

International Nuclear Information System (INIS)

Rivollier, Matthieu

2017-01-01

France is planning to construct the 4. generation of nuclear reactors. They will use liquid sodium as heat transfer fluid and will be made of 316L(N) austenitic steel as structural materials. To guarantee optimal operation on the long term, the behavior of this steel must be verified. This is why corrosion phenomena of 316L(N) steel by liquid sodium have to be well-understood. Literature points out that several corrosion phenomena are possible. Dissolved oxygen in sodium definitely influences each of the corrosion phenomenon. Therefore, the austenitic steel corrosion in oxygen-containing sodium is proposed in this study. Thermodynamics data point out that sodium chromite formation on 316L(N) steel is possible in sodium containing roughly 10 μg.g -1 of oxygen for temperature lower than 650 C (reactor operating conditions).The experimental study shows that sodium chromite is formed at 650 C in the sodium containing 200 μg.g -1 of oxygen. At the same concentration and at 550 C, sodium chromite is clearly observed only for long immersion time (≥ 5000 h). Results at 450 C are more difficult to interpret. Furthermore, the steel is depleted in chromium in all cases.The results suggest the sodium chromite is dissolved in the sodium at the same time it is formed. Modelling of sodium chromite formation - approached by chromium diffusion in steel (in grain and grain boundaries -, and dissolution - assessed by transport in liquid metal - show that simultaneous formation and dissolution of sodium chromite is a possible mechanism able to explain our results. (author) [fr

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.)

Identification of impurities in sodium and its purification

International Nuclear Information System (INIS)

Subbotin, B.I.; Voltchkov, L.G.; Kozlov, F.A.; Zagorulko, Yu.I.; Kuznetsov, E.K.

1976-01-01

The paper presents some investigation results on sodium technology. In particular, a description is given of a calculation method for evaluation of sodium-cover gas-impurities equilibrium compositions as well as experimental results on development of methods for sodium sampling, equipment for non-metallic impurities (oxygen, hydrogen, carbon) constant control in sodium. The investigation results on sodium purification with cold traps are presented

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)

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)

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)

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.

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...

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...

The Sodium Process Facility at Argonne National Laboratory-West

International Nuclear Information System (INIS)

Michelbacher, J.A.; Henslee, S.P.; McDermott, M.D.; Price, J.R.; Rosenberg, K.E.; Wells, P.B.

1998-01-01

Argonne National Laboratory-West (ANL-W) has approximately 680,000 liters of raw sodium stored in facilities on site. As mandated by the State of Idaho and the US Department of Energy (DOE), this sodium must be transformed into a stable condition for land disposal. To comply with this mandate, ANL-W designed and built the Sodium Process Facility (SPF) for the processing of this sodium into a dry, sodium carbonate powder. The major portion of the sodium stored at ANL-W is radioactively contaminated. The sodium will be processed in three separate and distinct campaigns: the 290,000 liters of Fermi-1 primary sodium, the 50,000 liters of the Experimental Breeder Reactor-II (EBR-II) secondary sodium, and the 330,000 liters of the EBR-II primary sodium. The Fermi-1 and the EBR-II secondary sodium contain only low-level of radiation, while the EBR-II primary sodium has radiation levels up to 0.5 mSv (50 mrem) per hour at 1 meter. The EBR-II primary sodium will be processed last, allowing the operating experience to be gained with the less radioactive sodium prior to reacting the most radioactive sodium. The sodium carbonate will be disposed of in 270 liter barrels, four to a pallet. These barrels are square in cross-section, allowing for maximum utilization of the space on a pallet, minimizing the required landfill space required for disposal

The Sodium Process Facility at Argonne National Laboratory-West

Energy Technology Data Exchange (ETDEWEB)

Michelbacher, J.A.; Henslee, S.P. McDermott, M.D.; Price, J.R.; Rosenberg, K.E.; Wells, P.B.

1998-07-01

Argonne National Laboratory-West (ANL-W) has approximately 680,000 liters of raw sodium stored in facilities on site. As mandated by the State of Idaho and the US Department of Energy (DOE), this sodium must be transformed into a stable condition for land disposal. To comply with this mandate, ANL-W designed and built the Sodium Process Facility (SPF) for the processing of this sodium into a dry, sodium carbonate powder. The major portion of the sodium stored at ANL-W is radioactively contaminated. The sodium will be processed in three separate and distinct campaigns: the 290,000 liters of Fermi-1 primary sodium, the 50,000 liters of the Experimental Breeder Reactor-II (EBR-II) secondary sodium, and the 330,000 liters of the EBR-II primary sodium. The Fermi-1 and the EBR-II secondary sodium contain only low-level of radiation, while the EBR-II primary sodium has radiation levels up to 0.5 mSv (50 mrem) per hour at 1 meter. The EBR-II primary sodium will be processed last, allowing the operating experience to be gained with the less radioactive sodium prior to reacting the most radioactive sodium. The sodium carbonate will be disposed of in 270 liter barrels, four to a pallet. These barrels are square in cross-section, allowing for maximum utilization of the space on a pallet, minimizing the required landfill space required for disposal.

Modeling of under-expanded reactive CO2-into-sodium jets, in the frame of sodium fast reactors

International Nuclear Information System (INIS)

Vivaldi, D.

2013-01-01

This PhD work was motivated by the investigations in the frame of supercritical CO 2 Brayton cycles as possible energy conversion cycles for the Sodium-cooled Fast nuclear Reactors (SFRs). This technology represents an alternative to conventional steam Rankine cycles, with the main advantage represented by the elimination of the accidental sodium-water reaction scenario. Nevertheless, CO 2 chemically reacts with sodium, through an exothermic reaction leading to solid reaction products, mainly sodium carbonate. Following an accidental leakage inside the sodium-CO 2 heat exchanger of a SFR, the CO 2 , having an operating pressure of about 200 bars, would be injected into the low-operating pressure liquid sodium, creating an under-expanded reactive CO 2 -into-sodium jet. The under-expanded jet features a sonic gas injection velocity and an under-expansion in the first region downstream the leakage, where the CO 2 is accelerated to supersonic velocities. The exothermic reaction between the CO 2 and the sodium causes an increasing of the temperature inside the heat exchanger. An experimental facility was built at CEA Cadarache, for the realization of CO 2 -into-sodium jets: this facility has provided preliminary results in terms of temperature variations inside the jet due to the exothermic reaction. However, this type of experimental tests are complicated to realize and to analyse, due to the technical difficulties of realizing the contact between CO 2 and sodium, and to the incertitude of temperature measurement inside a two-phase high velocity jet. It follows that a numerical model of this kind of jets is required, in order to understand the CO 2 -sodium kinetics of reaction inside the jet and being able to transpose the phenomenon to relevant SFR sodium-CO 2 heat exchangers. This would allow to understand the consequences of a leakage inside a sodium-CO 2 heat exchanger, in terms of, for instance, temperature profiles inside the heat exchanger and on tube surfaces

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.

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.

Hydration status regulates sodium flux and inflammatory pathways through epithelial sodium channel (ENaC) in the skin.

Science.gov (United States)

Xu, Wei; Hong, Seok Jong; Zeitchek, Michael; Cooper, Garry; Jia, Shengxian; Xie, Ping; Qureshi, Hannan A; Zhong, Aimei; Porterfield, Marshall D; Galiano, Robert D; Surmeier, D James; Mustoe, Thomas A

2015-03-01

Although it is known that the inflammatory response that results from disruption of epithelial barrier function after injury results in excessive scarring, the upstream signals remain unknown. It has also been observed that epithelial disruption results in reduced hydration status and that the use of occlusive dressings that prevent water loss from wounds decreases scar formation. We hypothesized that hydration status changes sodium homeostasis and induces sodium flux in keratinocytes, which result in activation of pathways responsible for keratinocyte-fibroblast signaling and ultimately lead to activation of fibroblasts. Here, we demonstrate that perturbations in epithelial barrier function lead to increased sodium flux in keratinocytes. We identified that sodium flux in keratinocytes is mediated by epithelial sodium channels (ENaCs) and causes increased secretion of proinflammatory cytokines, which activate fibroblast via the cyclooxygenase 2 (COX-2)/prostaglandin E2 (PGE2) pathway. Similar changes in signal transduction and sodium flux occur by increased sodium concentration, which simulates reduced hydration, in the media in epithelial cultures or human ex vivo skin cultures. Blockade of ENaC, prostaglandin synthesis, or PGE2 receptors all reduce markers of fibroblast activation and collagen synthesis. In addition, employing a validated in vivo excessive scar model in the rabbit ear, we demonstrate that utilization of either an ENaC blocker or a COX-2 inhibitor results in a marked reduction in scarring. Other experiments demonstrate that the activation of COX-2 in response to increased sodium flux is mediated through the PIK3/Akt pathway. Our results indicate that ENaC responds to small changes in sodium concentration with inflammatory mediators and suggest that the ENaC pathway is a potential target for a strategy to prevent fibrosis.

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

Dietary sodium: where science and policy conflict: impact of the 2013 IOM Report on Sodium Intake in Populations.

Science.gov (United States)

Graudal, Niels

2015-02-01

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-based health outcome evidence was not sufficient to define a safe upper intake level for sodium. Recent studies have extended this conclusion to show that a sodium intake below 2,300 mg/day is associated with increased mortality. In spite of this increasing body of evidence, the AHA, Centers for Disease Control (CDC), other public health advisory bodies, and major medical journals have continued to support the current policy of reducing dietary sodium.

UK position paper on sodium fires