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Sample records for stage ib-ii mycosis

  1. Patch stage of mycosis fungoides

    Directory of Open Access Journals (Sweden)

    Mavarkar Laxman

    2001-01-01

    Full Text Available Parapsoriasis is aeon troversial topic. There are many studies regarding the relationship of parapsoriasis to lymphoma but no correlation between histology and clinical appearance. Parapsoriasis satisfies histologic criteria for mycosis fungoides and therefore it should be considered as patch stage of mycosis fungoides. A 30-year-old man presented with scaly skin lesions over the trunk since 4 years. Routine blood and urine investigations were normal. Skin biopsy from the lesion revealed atypical lymphocytes within the epidermis without spongiosis.

  2. Stages of Mycosis Fungoides and the Sezary Syndrome

    Science.gov (United States)

    ... Childhood NHL Treatment Research Mycosis Fungoides (Including Sézary Syndrome) Treatment (PDQ®)–Patient Version General Information About Mycosis Fungoides (Including Sézary Syndrome) Go to Health Professional Version Key Points Mycosis ...

  3. [Contrast ultrasound using SonoVue for pelvic radiation with concurrent chemotherapy monitoring in stage IB-II cervical cancer].

    Science.gov (United States)

    Marret, H; Barillot, I; Rolland, Y; Lévèque, J

    2009-10-01

    The aim of the present study was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound and by enhanced cervix ultrasound may predict prognostic factors of stage IB greater than 4 cm and II cervical cancer treated by radiochemotherapy. A total of 40 patients with histologically proven advanced stage invasive cervical cancer will be evaluated by color Doppler, contrast ultrasound, and MRI before radiotherapy, after the second chemotherapy cycle and prior to surgery. Subjective assessment of the amount of vessels within the tumor (scanty-moderate or abundant) and resistance index (RI) will be recorded for Doppler, enhancement and washout period will be studied after injection of SonoVue for contrast ultrasound. All patients will have radical hysterectomy and pelvic lymph node dissection. Comparison with MRI results will be done. The main parameter studied will be persistence of tumor cells in the analysis of the radical hysterectomy. We expected to correlate contrast parameters with persistent disease in order to confirm ultrasound parameters that will be useful to monitor radiochemotherapy and to predict therapeutic answer of such treatment.

  4. The conundrum of parapsoriasis versus patch stage of mycosis fungoides

    Directory of Open Access Journals (Sweden)

    Sarveswari K

    2009-01-01

    Full Text Available Terminological confusion with benign dermatosis, such as parapsoriasis en plaques, makes it difficult to diagnose mycosis fungoides in the early patch stage. Early diagnosis of mycosis fungoides (MF is important for deciding on type of therapy, prognosis and for further follow-up. However, until recently, there has been no consensus on criteria that would help in diagnosing the disease early. Some believe that large plaque parapsoriasis (LPP should be classified with early patch stage of MF and should be treated aggressively. However, there is no firm clinical or laboratory criteria to predict which LPP will progress to MF and we can only discuss about statistical probability. Moreover, long-term outcome analysis of even patch stage of MF is similar to that of control population. We therefore believe that LPP should be considered as a separate entity at least to prevent the patient from being given a frightening diagnosis. We also feel that patients need not be treated with aggressive therapy for LPP and will need only a close follow-up. This article emphasizes the criteria for diagnosing early MF and has highlighted the importance of considering LPP as a distinct benign entity.

  5. The conundrum of parapsoriasis versus patch stage of mycosis fungoides.

    Science.gov (United States)

    Sarveswari, K N; Yesudian, Patrick

    2009-01-01

    Terminological confusion with benign dermatosis, such as parapsoriasis en plaques, makes it difficult to diagnose mycosis fungoides in the early patch stage. Early diagnosis of mycosis fungoides (MF) is important for deciding on type of therapy, prognosis and for further follow-up. However, until recently, there has been no consensus on criteria that would help in diagnosing the disease early. Some believe that large plaque parapsoriasis (LPP) should be classified with early patch stage of MF and should be treated aggressively. However, there is no firm clinical or laboratory criteria to predict which LPP will progress to MF and we can only discuss about statistical probability. Moreover, long-term outcome analysis of even patch stage of MF is similar to that of control population. We therefore believe that LPP should be considered as a separate entity at least to prevent the patient from being given a frightening diagnosis. We also feel that patients need not be treated with aggressive therapy for LPP and will need only a close follow-up. This article emphasizes the criteria for diagnosing early MF and has highlighted the importance of considering LPP as a distinct benign entity.

  6. Early-stage mycosis fungoides, parapsoriasis en plaque, and pregnancy.

    Science.gov (United States)

    Amitay-Layish, Iris; David, Michael; Kafri, Batia; Barzilai, Aviv; Feinmesser, Meora; Hodak, Emmilia

    2007-02-01

    Non-Hodgkin's lymphoma (NHL) coincident with pregnancy is rare, and the literature regarding mycosis fungoides (MF), the most common primary cutaneous NHL, and pregnancy is strikingly sparse. The effect of pregnancy on MF, or on parapsoriasis en plaque (PPP), and the effect of these diseases on pregnancy, are still unknown. To study the effect of pregnancy on MF and PPP and the impact of these diseases on pregnancy. The files of the MF and PPP patients seen during the past 12 years in our department were reviewed to search for patients who had been pregnant during the course of their disease. Nine women who met the study criteria were identified, seven with early-stage MF and two with PPP. A total of 12 pregnancies was recorded: nine in patients with MF and three in patients with PPP. In none of the patients was there any indication that pregnancy changed the course of MF or PPP. Of the 12 pregnancies, 11 were normal; one was naturally aborted. Two of the patients were treated with topical steroids during pregnancy. One patient was treated with narrow-band ultraviolet-B combined with topical steroids. The rest preferred to avoid any therapy. Pregnancy appeared to have no impact on the course of early MF or PPP, and no adverse effect was noted on pregnancy. Further studies are needed to clarify the interplay between pregnancy and MF or PPP.

  7. Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sézary Syndrome

    DEFF Research Database (Denmark)

    Scarisbrick, Julia J; Prince, H Miles; Vermeer, Maarten H

    2015-01-01

    PURPOSE: Advanced-stage mycosis fungoides (MF; stage IIB to IV) and Sézary syndrome (SS) are aggressive lymphomas with a median survival of 1 to 5 years. Clinical management is stage based; however, there is wide range of outcome within stages. Published prognostic studies in MF/SS have been sing...

  8. A prospective, open-label study of low-dose total skin electron beam therapy in mycosis fungoides

    DEFF Research Database (Denmark)

    Kamstrup, Maria R; Specht, Lena; Skovgaard, Gunhild L

    2008-01-01

    causes and did not complete treatment. Acute side effects included desquamation, xerosis, and erythema of the skin. No severe side effects were observed. CONCLUSION: Low-dose total skin electron beam therapy can induce complete and partial responses in Stage IB-II mycosis fungoides; however, the duration......PURPOSE: To determine the effect of low-dose (4 Gy) total skin electron beam therapy as a second-line treatment of Stage IB-II mycosis fungoides in a prospective, open-label study. METHODS AND MATERIALS: Ten patients (6 men, 4 women, average age 68.7 years [range, 55-82 years......]) with histopathologically confirmed mycosis fungoides T2-T4 N0-N1 M0 who did not achieve complete remission or relapsed within 4 months after treatment with psoralen plus ultraviolet-A were included. Treatment consisted of low-dose total skin electron beam therapy administered at a total skin dose of 4 Gy given in 4...

  9. Estimates of nuclear volume in plaque and tumor-stage mycosis fungoides. A new prognostic indicator

    DEFF Research Database (Denmark)

    Brooks, B; Sørensen, Flemming Brandt; Thestrup-Pedersen, K

    1994-01-01

    It is well documented that mycosis fungoides (MF), a cutaneous T-cell lymphoma, has a variable clinical course. Unbiased stereological estimates of three-dimensional volume-weighted mean nuclear size (nucl vV) of mycosis cells were obtained in a retrospective study of 18 patients with a total of ...

  10. Methotrexate-induced necrolysis in tumoral-stage mycosis fungoides: a challenging diagnosis.

    Science.gov (United States)

    Mna, Amira Ben; Souissi, Asmahene; Halouani, Slim; El Euch, Dalenda; Zahani, Alia; Kchir, Nidham; Zaraa, Ines; Mokni, Mourad

    2016-01-15

    Methotrexate-induced cutaneous ulceration is a rare but potentially serious drug adverse reaction. This adverse reaction of methotrexate therapy has been initially described in psoriasis patients and is unusual in patients with cutaneous T-cell lymphoma. In 1978, Mc Donald et al reported the first three cases of cutaneous ulcerations in patients treated for a mycosis fungoides with intravenous infusions of methotrexate. Since then, few cases of methotrexate-induced skin ulcers in patients with mycosis fungoides have been published. We report an additional patient with erythrodermic mycosis fungoides who developed cutaneous ulcerations as a sole manifestation of methotrexate toxicity.

  11. Efficacy of low-dose ultraviolet a-1 phototherapy for parapsoriasis/early-stage mycosis fungoides.

    Science.gov (United States)

    Aydogan, Kenan; Yazici, Serkan; Balaban Adim, Saduman; Tilki Gunay, Isil; Budak, Ferah; Saricaoglu, Hayriye; Tunali, Sukran; Bulbul Baskan, Emel

    2014-01-01

    Mycosis fungoides (MF) and parapsoriasis (PP) are major dermatologic conditions for which phototherapy continues to be a successful and valuable treatment option. UVA-1 phototherapy is effective in the management of cutaneous T-cell mediated diseases. The aim of the study was to evaluate the efficacy and safety of low-dose UVA-1 phototherapy for the management of PP/early-stage MF. A total of 30 patients, diagnosed with MF (n:19) or PP (n:11) were enrolled to the study. All patients were managed with low-dose UVA-1 (20 or 30 J cm(-2)). Response was assessed clinically and immunohistochemically. UVA-1 treatment led to clinical and histological complete remission (CR) in 11 of 19 MF patients (57.9%), partial remission (PR) in three of 19 (15.8%), after a mean cumulative dose of 1665 (range, 860-3120) J cm(-2) and mean number of 73 exposure (range, 43-107) sessions. Five patients with PP (45.5%) showed CR, and PR was observed in six patients with PP (54.5%) after a mean cumulative dose of 1723 (range, 1060-3030) J cm(-2) and mean number of 74 exposure (range, 53-101) sessions. We conclude that low-dose UVA-1 therapy seems to be an effective, safe, and well-tolerated treatment option for patients with PP/early-stage MF. © 2014 The American Society of Photobiology.

  12. Interleukin-12 and Interleukin-2 in Treating Patients With Mycosis Fungoides

    Science.gov (United States)

    2013-01-15

    Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Mycosis Fungoides/Sezary Syndrome; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage II Mycosis Fungoides/Sezary Syndrome; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome

  13. Narrowband (311-nm) UV-B therapy for small plaque parapsoriasis and early-stage mycosis fungoides.

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    Hofer, A; Cerroni, L; Kerl, H; Wolf, P

    1999-11-01

    Broadband UV-B phototherapy has been used for many years in the treatment of small plaque parapsoriasis (SPP) and early-stage mycosis fungoides (MF). Our purpose was to investigate the effect on these diseases of narrowband (311-nm) UV-B therapy, which was recently established for the treatment of psoriasis and found to be more effective than broadband UV-B therapy. Twenty patients (5 women, 15 men; age range, 39-85 years) with histologically confirmed SPP or early-stage MF were enrolled. Six patients had early-stage MF (patch stage), and 14 had SPP. Treatment with 311-nm UV-B was given 3 to 4 times a week for 5 to 10 weeks. In 19 patients, lesions completely cleared after a mean number of 20 treatments (range, 14-29 treatments) and a mean cumulative UV-B dose of 16.3J/cm2 (range, 7.4-36.4 J/cm2) within a mean time of 6 weeks (range, 5-10 weeks). Biopsy specimens taken immediately after the end of phototherapy showed only sparse inflammatory infiltrates but no signs of SPP or MF. Relapses at cutaneous sites occurred in all patients within a mean time of 6 months (range, 2-15 months). Narrowband UV-B therapy is an effective short-term treatment modality for clearing SPP and early-stage MF. However, the treatment response did not sustain long-term remission. Further studies are necessary to examine how the clinical response to and follow-up after narrowband UV-B therapy compares with that of established phototherapy modalities in these diseases.

  14. Estimates of nuclear volume in plaque and tumor-stage mycosis fungoides. A new prognostic indicator

    DEFF Research Database (Denmark)

    Brooks, B; Sørensen, Flemming Brandt; Thestrup-Pedersen, K

    1994-01-01

    biopsies of cutaneous plaque and tumor-stage MF. The value of nucl vV in the first sampled biopsy, as well as the average and highest values, were determined in biopsies from each patient. The patients were divided into two groups, either above or below the group median. There was a strong positive......V evolution in the patients with multiple biopsies, but the impact of various therapeutic regimens cannot be assessed. Certain estimates of nucl vV appear to be good prognostic indicators in plaque and tumor-stage MF, but further study of a larger series of patients is needed to corroborate these results...

  15. Prognostic miRNA classifier in early-stage mycosis fungoides

    DEFF Research Database (Denmark)

    Lindahl, Lise M; Besenbacher, Søren; Rittig, Anne H

    2018-01-01

    which patients develop severe disease and are in need of aggressive treatment. Accordingly, we investigated the prognostic potential of microRNAs (miRNAs) at the time of diagnosis in MF. Using a quantitative reverse transcription polymerase chain reaction platform, we analyzed miRNA expression...... in diagnostic skin biopsies from 154 Danish patients with early-stage MF. The patients were subdivided into a discovery cohort (n = 82) and an independent validation cohort (n = 72). The miRNA classifier was built using a LASSO (least absolute shrinkage and selection operator) Cox regression to predict...... progression-free survival (PFS). We developed a 3-miRNA classifier, based on miR-106b-5p, miR-148a-3p, and miR-338-3p, which successfully separated patients into high-risk and low-risk groups of disease progression. PFS was significantly different between these groups in both the discovery cohort...

  16. Mycosis Fungoides (Including Sézary Syndrome) Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Mycosis fungoides and Sézary syndrome are neoplasias of malignant T lymphocytes that affect the skin. Learn about the clinical presentation, prognosis, staging, and treatment for mycosis fungoides and Sézary syndrome in this expert-reviewed summary.

  17. Human herpesvirus 8 is not detectable in lesions of large plaque parapsoriasis, and in early-stage sporadic, familial, and juvenile cases of mycosis fungoides.

    Science.gov (United States)

    Amitay-Laish, Iris; Sarid, Ronit; Ben-Amitai, Dan; Kalt, Inna; Masa, Shiri Rivka; David, Michael; Feinmesser, Meora; Hodak, Emmilia

    2012-01-01

    Human herpesvirus (HHV) 8, an essential etiologic agent of Kaposi sarcoma, is also associated with several lymphoproliferative disorders. The involvement of HHV 8 in mycosis fungoides (MF) and large plaque parapsoriasis (LPP) is controversial, with contradictory reports from various countries worldwide. We sought to investigate the presence of the HHV 8 genome in skin lesions of LPP and early-stage sporadic, familial, and juvenile MF in patients in Israel. Archival paraffin-embedded and frozen samples from skin biopsies of untreated patients with LPP and early-stage MF performed in 1990 through 2006 were randomly collected from the department of dermatology of a tertiary medical center in central Israel. DNA was extracted, and a TaqMan-based real-time polymerase chain reaction assay specific for the K6 gene region was used to detect the HHV 8 genome. A total of 46 biopsies were sampled from 11 patients with LPP and 35 with early-stage MF (17 adults with sporadic MF, 10 children, and 8 patients with familial MF). In all, 44 samples were negative for HHV 8 DNA; two samples from adults with sporadic MF were positive. The presence of HHV 8 antibodies or virus sequences was not assessed in peripheral blood. The results of this study, conducted in a region relatively endemic for HHV 8, support most earlier studies showing a lack of association of HHV 8 infection with LPP and sporadic adult-type MF. To our knowledge, the lack of association of HHV 8 infection with juvenile and familial MF has not been previously reported. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Evaluation of Histopathological Changes in Control Biopsies Which Taken 48 Sessions after NBUVB Phototherapy for Early-Stage Mycosis Fungoides

    Directory of Open Access Journals (Sweden)

    Ebru Zemheri

    2012-01-01

    Full Text Available Background. There are not many studies investigating histomorphological changes in 48 sessions in patients with early-stage MF after narrowband UVB (NBUVB treatment. Our purpose is to evaluate histological features of phototherapy after 48 sessions and determine which parameters are more reliable for controlling skin biopsies. Methods. Biopsies of 32 patients with early stage of MF, who were treated with NBUVB phototherapy, were histologically evaluated before and after the treatments, including epidermotropism, stratum corneum, epidermal thickness, dermal infiltration, papillary dermal fibrosis, vascular alterations, and other dermal changes. We discuss the histomorphological effects of NBUVB phototherapy on skin biopsies by comparing the responders with nonresponders, with before and after the treatment. Results. 9 patients (28% did not give any response to treatment. Alleviation in epidermotropism, increases in parakeratosis and normal keratosis, perivascular infiltration, and melanophages, decrease in the lichenoid/patchy lichenoid infiltration pattern after the treatment was statistically significant. Comparing by response, normalization of stratum corneum and epidermis, orthohyperkeratosis, decrease in linearly arranged cells, the lichenoid/patchy lichenoid infiltration, the loss of inflammation were statistically significant in responders group. Conclusion. We detected a significant decrease in linearly arranged cells after phototherapy, indicating that it is an “important diagnostic parameter" in evaluation of therapeutic response.

  19. Koebner Phenomenon and Mycosis Fungoides

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    Eve Lebas

    2015-10-01

    Full Text Available Mycosis fungoides (MF is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc. In this case report, 3 patients with longstanding MF are presented, the 1st with the appearance of a circumscribed early-stage type MF lesion rapidly following a surgical excision of an infundibular cyst, the 2nd with the appearance of a unique unilateral palmar tumoral MF lesion at the pressure site of a crutch, and the 3rd presented localized MF early stage lesions at the friction site of a belt. This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon.

  20. Mycosis Fungoides mimic chronic eczema? Observation

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    Jacek Andruszkiewicz

    2013-07-01

    Full Text Available Mycosis fungoides (MF is the most common type of cutaneous T-cell lymphoma [1]. Because of its great variety of clinical features and nonspecific histological findings (especially in early stages has been named the "great imitator "and can induce many wrong diagnosis [2,3]. Mycosis fungoides (MF, is an epidermotropic lymphoma included as an indolent form in the recent WHO/EORTC classification. From a clinical point of view, the classic disease progression usually is slow and takes over years or even decades, and characterized by the evolution from patches to more infiltrated plaques and eventually to tumours or erythroderma. However, the analysis of the MF disease course has been greatly impaired by the rarity of the disease, thus data about the time course of disease progression and pattern of relapse during time are not well known [4,5]. Therefore very often Mycosis fungoides is misdiagnosed as chronic eczema [6]. MF can also mimic: vitiligo [6], alopecia-Areata [7], ecchymosis [8].

  1. Delay in the histopathologic diagnosis of mycosis fungoides

    DEFF Research Database (Denmark)

    Guldhammer Skov, Anne; Gniadecki, Robert

    2015-01-01

    The diagnosis of mycosis fungoides (MF) is difficult in early stages and is based on a combination of clinical findings and histopathologic criteria. The aim of this study was to assess the diagnostic delay in MF and to investigate the rationale for multiple biopsies in a single-centre, retrospec......The diagnosis of mycosis fungoides (MF) is difficult in early stages and is based on a combination of clinical findings and histopathologic criteria. The aim of this study was to assess the diagnostic delay in MF and to investigate the rationale for multiple biopsies in a single...

  2. Cutaneous Lymphoma International Consortium Study of Outcome in Advanced Stages of Mycosis Fungoides and Sézary Syndrome: Effect of Specific Prognostic Markers on Survival and Development of a Prognostic Model

    Science.gov (United States)

    Scarisbrick, Julia J.; Prince, H. Miles; Vermeer, Maarten H.; Quaglino, Pietro; Horwitz, Steven; Porcu, Pierluigi; Stadler, Rudolf; Wood, Gary S.; Beylot-Barry, Marie; Pham-Ledard, Anne; Foss, Francine; Girardi, Michael; Bagot, Martine; Michel, Laurence; Battistella, Maxime; Guitart, Joan; Kuzel, Timothy M.; Martinez-Escala, Maria Estela; Estrach, Teresa; Papadavid, Evangelia; Antoniou, Christina; Rigopoulos, Dimitis; Nikolaou, Vassilki; Sugaya, Makoto; Miyagaki, Tomomitsu; Gniadecki, Robert; Sanches, José Antonio; Cury-Martins, Jade; Miyashiro, Denis; Servitje, Octavio; Muniesa, Cristina; Berti, Emilio; Onida, Francesco; Corti, Laura; Hodak, Emilia; Amitay-Laish, Iris; Ortiz-Romero, Pablo L.; Rodríguez-Peralto, Jose L.; Knobler, Robert; Porkert, Stefanie; Bauer, Wolfgang; Pimpinelli, Nicola; Grandi, Vieri; Cowan, Richard; Rook, Alain; Kim, Ellen; Pileri, Alessandro; Patrizi, Annalisa; Pujol, Ramon M.; Wong, Henry; Tyler, Kelly; Stranzenbach, Rene; Querfeld, Christiane; Fava, Paolo; Maule, Milena; Willemze, Rein; Evison, Felicity; Morris, Stephen; Twigger, Robert; Talpur, Rakhshandra; Kim, Jinah; Ognibene, Grant; Li, Shufeng; Tavallaee, Mahkam; Hoppe, Richard T.; Duvic, Madeleine; Whittaker, Sean J.; Kim, Youn H.

    2015-01-01

    Purpose Advanced-stage mycosis fungoides (MF; stage IIB to IV) and Sézary syndrome (SS) are aggressive lymphomas with a median survival of 1 to 5 years. Clinical management is stage based; however, there is wide range of outcome within stages. Published prognostic studies in MF/SS have been single-center trials. Because of the rarity of MF/SS, only a large collaboration would power a study to identify independent prognostic markers. Patients and Methods Literature review identified the following 10 candidate markers: stage, age, sex, cutaneous histologic features of folliculotropism, CD30 positivity, proliferation index, large-cell transformation, WBC/lymphocyte count, serum lactate dehydrogenase, and identical T-cell clone in blood and skin. Data were collected at specialist centers on patients diagnosed with advanced-stage MF/SS from 2007. Each parameter recorded at diagnosis was tested against overall survival (OS). Results Staging data on 1,275 patients with advanced MF/SS from 29 international sites were included for survival analysis. The median OS was 63 months, with 2- and 5-year survival rates of 77% and 52%, respectively. The median OS for patients with stage IIB disease was 68 months, but patients diagnosed with stage III disease had slightly improved survival compared with patients with stage IIB, although patients diagnosed with stage IV disease had significantly worse survival (48 months for stage IVA and 33 months for stage IVB). Of the 10 variables tested, four (stage IV, age > 60 years, large-cell transformation, and increased lactate dehydrogenase) were independent prognostic markers for a worse survival. Combining these four factors in a prognostic index model identified the following three risk groups across stages with significantly different 5-year survival rates: low risk (68%), intermediate risk (44%), and high risk (28%). Conclusion To our knowledge, this study includes the largest cohort of patients with advanced-stage MF/SS and

  3. Rationale for curative radiotherapy in mycosis fungoides

    International Nuclear Information System (INIS)

    Hoppe, R.T.; Fuks, Z.; Bagshaw, M.A.

    1977-01-01

    From 1958 to 1975, 176 patients with documented mycosis fungoides were treated by total skin electron beam therapy at Stanford University. All patients were classified by the initial extent of skin involvement and staged with respect to overall evidence of disease. The technique of treatment is reviewed. The likelihood of initial complete regression of all skin lesions was inversely related to the initial extent of skin involvement, ranging from 86 percent in the limited plaque to 44 percent in the tumors group. Survival also correlated well with initial extent of skin involvement, with 10-year survivals of 76 percent, 44 percent, and 6 percent in the limited plaque, generalized plaque, and tumorous groups, respectively. Initial stage of disease also had a bearing on prognosis. Five year survivals for Stage I and II patients were 80 and 51 percent, respectively. There were no long-term survivors among patients with Stage III or IV disease. The significance of dermatophathic lymphadenopathy is discussed. Patients who have palpable nodes, even in the absence of their frank involvement by mycosis fungoides have a worse prognosis than patients without lymphadenopathy. Their survival is worse and they have an increased likelihood of extracutaneous spread of mycosis fungoides. The incidence of initial complete remission is directly related to the initial dose of electron beam therapy. Ninety-four percent (51/54) of patients receiving 3000 to 3600 rad entered complete remission, while only 18 percent (3/17) of patients receiving doses of 800 to 1000 rad had complete remission of all disease. Of the 51 patients who entered complete remission after total skin electron beam therapy with doses in excess of 3000 rad, 20 (39 percent) continued to be free of disease 3 to 14 years after completion of therapy

  4. Silicon Phthalocyanine 4 and Photodynamic Therapy in Stage IA-IIA Cutaneous T-Cell Non-Hodgkin Lymphoma

    Science.gov (United States)

    2015-12-03

    Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IA Mycosis Fungoides/Sezary Syndrome; Stage IB Mycosis Fungoides/Sezary Syndrome; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IIA Mycosis Fungoides/Sezary Syndrome

  5. The Use of Central Pathology Review With Digital Slide Scanning in Advanced-stage Mycosis Fungoides and Sézary Syndrome: A Multi-institutional and International Pathology Study.

    Science.gov (United States)

    Gru, Alejandro A; Kim, Jinah; Pulitzer, Melissa; Guitart, Joan; Battistella, Maxime; Wood, Gary S; Cerroni, Lorenzo; Kempf, Werner; Willemze, Rein; Pawade, Joya; Querfeld, Christiane; Schaffer, Andras; Pincus, Laura; Tetzlaff, Michael; Duvic, Madeleine; Scarisbrick, Julia; Porcu, Pierluigi; Mangold, Aaron R; Dicaudio, David J; Shinohara, Michi; Hong, Eric K; Horton, Bethany; Kim, Youn H

    2018-03-14

    This pathology PILOT study aims to define the role and feasibility of centralized pathology review in a cohort of 75 patients from different centers in the United States and Europe using digital slide scanning. The pathologic material from 75 patients who had been diagnosed with mycosis fungoides/Sézary syndrome and were clinically staged as IIb or above was retrieved from 11 participating centers. Each pathology reviewer was provided with the pathologic diagnosis (by the referring pathologist), and the following list of histopathologic criteria (presence or absence) from the initial report: epidermotropism, folliculotropism (FT), large cell transformation, syringotropism, and granulomas. Patients with advance stage were selected for this study as this is a population where there is significant variability in the diagnosis of pathologic prognostic and predictive biomarkers. The slides were digitally scanned with an Aperio scanner and consensus review of cases occurred when major or minor discrepancies between the referral diagnosis and central pathology review occurred. Among the 75 cases, 70 (93.3%) had a final consensus diagnosis between the 3 central review pathologists. The overall agreement between the consensus review and the referring pathologist was 60%. The overall agreement was also higher between the reviewers and consensus review, compared with the referring pathologist and consensus. 65.3% of cases had some type of discrepancy (major or minor) between the outside and consensus review. Major discrepancies were seen in 34 of 73 cases (46.6%; 73 cases indicated a yes or no response). Minor discrepancies were seen in 32 of 75 (42.7%) of cases. Most of the major discrepancies were accounted by a difference in interpretation in the presence or absence of large cell transformation or FT. Most minor discrepancies were explained by a different interpretation in the expression of CD30. We found digital slide scanning to be a beneficial, reliable, and practical

  6. Clonal T cell receptor gamma-chain gene rearrangement by PCR-based GeneScan analysis in the skin and blood of patients with parapsoriasis and early-stage mycosis fungoides.

    Science.gov (United States)

    Klemke, Claus-Detlev; Dippel, Edgar; Dembinski, Antje; Pönitz, Nina; Assaf, Chalid; Hummel, Michael; Stein, Harald; Goerdt, Sergij

    2002-07-01

    Cutaneous T cell lymphoma (CTCL) and reactive T cell skin diseases represent opposite ends of a spectrum of diseases ranging from overtly malignant to persistently benign. Within this spectrum, the parapsoriasis group is not clearly defined regarding malignant potential. In contrast to consistent findings in advanced-stage CTCL, clonality analysis of parapsoriasis has produced conflicting results in previous studies. As T cell receptor gamma-chain polymerase chain reaction GeneScan analysis (TCR-gamma-PCR-GSA) stands out by its sensitivity, its accuracy in size determination of PCR products, its capacity to identify false positives by repeated analysis and its easy applicability, this approach was used to analyse the clonality status of 41 patients with borderline T cell lymphoproliferative skin diseases, including parapsoriasis (n=27) and early-stage mycosis fungoides (MF) (n=14). A monoclonal T cell infiltrate was demonstrated by repeated TCR-gamma-PCR-GSA in lesional skin specimens in 19.2% of parapsoriasis patients and in 66.6% of early-stage MF cases (p=0.013). In peripheral blood, a monoclonal T cell population was found in a similar percentage of parapsoriasis and of early-stage MF patients (26.7% versus 12.5%; p=0.611). A detailed analysis of parapsoriasis subentities, namely small and large plaque parapsoriasis, and parapsoriasis lichenoides, revealed monoclonality in 2(6)/2(5), 3(14)/2(8) and 0(6)/0/(3) of the skin and peripheral blood specimens, respectively. The high detection rate of false positive cases by repeated analysis (20-37.5%) provides a corrected perspective for the high rates of dominant T cell clones found by others in the peripheral blood of such patients. From the results obtained, three major conclusions can be drawn: firstly, CTCL is clearly associated with detection of monoclonality, even in its early stages; secondly, monoclonality is not a prerequisite for potential CTCL precursor entities; and thirdly, recirculating malignant T

  7. Nodular Prurigo Associated with Mycosis Fungoides - Case Report

    OpenAIRE

    Sandra Jerković Gulin; Romana Čeović; Davorin Lončarić; Ivana Ilić

    2015-01-01

    Mycosis fungoides (MF) is the most common type of cutaneous lymphoma and accounts for approximately 50% of all lymphomas arising primarily in the skin. The three types of MF lesions are patches, plaques, and tumors, according to which the disease is traditionally divided into three clinical stages. The clinical course can be protracted and take years or decades. In the final stage, MF evolves to a systemic form of the disease. Nodular prurigo (NP) is still a condition of unknown etiology char...

  8. Level of the proliferative activity of lymphocytes in case of mycosis fungoides and plaque parapsoriasis

    Directory of Open Access Journals (Sweden)

    A. S. Zhukov

    2014-01-01

    Full Text Available The level of the proliferative activity is an important predictor of a number of oncologic diseases; at the same time, its diagnostic value for mycosis fungoides was not adequately investigated. Goal. To study the proliferative activity of lymphocytes in the skin of patients suffering form mycosis fungoides and plaque parapsoriasis. Materials and methods. The level of CD3+ and Ki-67+ cells was determined in skin biopsy samples taken from patients suffering from mycosis fungoides (18 subjects and plaque parapsoriasis (6 subjects by means of immunohistochemistry. The epidermal to dermal skin cell proliferative activity ratio (Ki-67+ and cell proliferative activity index were calculated. The control group comprised 16 healthy people. Results. The epidermal to dermal skin cell proliferative activity ratio amounted to 10.9 in healthy people, 5.43 in patients suffering from plaque parapsoriasis, and 3.84 and 2.42 in patients suffering from mycosis fungoides, spotty and plaque and tumor stages, respectively. The percentage of proliferative CD3+Ki-67+ cells relative to the total number of T-lymphocytes amounted to 1% in the patients suffering from plaque parapsoriasis and 3% in the patients with mycosis fungoides, spotty stage. Conclusion. The epidermal to dermal skin cell proliferative activity ratio (Ki-67+ in patients suffering from mycosis fungoides at any stage is lower than that in healthy subjects and patients suffering from parapsoriasis. The cell proliferative activity index was higher in the patients with mycosis fungoides, plaque and tumor stage, than in the patients with parapsoriasis. The number of CD3+Ki-67+ cells was higher in the patients with mycosis fungoides, spotty and plaque and tumor stages, than in the healthy subjects and patients suffering from parapsoriasis.

  9. Foxp3+ T-lymphocytes in the pathogenesis of mycosis fungoides

    Directory of Open Access Journals (Sweden)

    A. S. Zhukov

    2014-01-01

    Full Text Available The pathogenesis of mycosis fungoides (MF is not fully understood, nevertheless it is believed that the microenvironment of the tumor cells could influence the development of malignant lymphocytes. T-regulatory cells are a specialized subpopulation of T-lymphocytes, which can have an immunosuppressive effect and thus affect the immune response. Goal. The study population of regulatory T-cells in the skin of patients with mycosis fungoides and llaque parapsoriasis. Materials and methods. The content of Foxp3+ and CD3+ cells by immunohistochemical studies of skin biopsy specimens from patients with patch stage mycosis fungoides (10 patients and plaque parapsoriasis (10 patients. The control group consisted of 16 healthy individuals. Results. Relative expression area Foxp3+ cells in patients with mycosis fungoides patch stage (0.44% 2.6 times greater than in patients with plaque parapsoriasis (0,14%; p 0,05. Conclusion. In the initial stage of patients with mycosis fungoides determined a statistically significant predominance of the absolute number of T-regulatory cells in the epidermis and in the dermis. Part T-regulatory cells from all of T-lymphocytes in patients with skin patch stage mycosis fungoides and plaque parapsoriasis not statistically significantly different.

  10. A patient with clinicopathologic features of small plaque parapsoriasis presenting later with plaque-stage mycosis fungoides: report of a case and comparative retrospective study of 27 cases of "nonprogressive" small plaque parapsoriasis.

    Science.gov (United States)

    Belousova, Irena E; Vanecek, Tomas; Samtsov, Alexey V; Michal, Michal; Kazakov, Dmitry V

    2008-09-01

    It is unsettled whether small plaque parapsoriasis (SPP) represents an inflammatory dermatosis or has a potential to transform into mycosis fungoides (MF) or is, in fact, MF. The literature contains no fully documented example of progression of SPP into MF. The purpose of our study was to present a patient with clinical features of SPP who later developed plaque-stage MF, as seen both clinically and pathologically and to compare the clinicopathologic features of this unique case with 27 "nonprogressive" SPP cases. This study is a prospective and retrospective evaluation of 28 patients, using light microscopy, immunohistochemistry, and molecular biology. A 56-year-old man with a 3-year history of persistent SPP with typical small (<5 cm), elongated and "digitate" lesions presented with newly developed larger patches and plaques. Whereas histologic examination of the patch lesion revealed relatively nonspecific features, a specimen of the crusted plaque showed a dense lymphoid infiltrate composed of small cerebriform lymphocytes, medium-sized lymphoid cells, and occasional large hyperchromatic cells that infiltrated the basal layer of the epidermis and formed small collections. There were atypical mitotic figures. Immunohistochemically, an aberrant immunophenotype with the loss of CD5 expression was found in the plaque specimen. T-cell receptor (TCR)-gamma gene rearrangement studies detected clones in the plaque and in the peripheral blood (biallelic in blood), while the patch tested polyclonal. The 27 SPP patients included 23 men and 4 women, ranging in age from 29 to 75 years. They were followed up and treated for 1.2 to 52 years (mean 10); no patient's SPP progressed into MF. All patients presented with small patch lesions measuring 3 to 6 cm lengthwise and 0.5 to 2 cm in width. Histologic features were nonspecific. Molecular genetic studies revealed the following results: two cases tested polyclonal, 3 cases demonstrated the oligoclonal pattern, whereas the

  11. γδ T cells as potential contributors to the progression of parapsoriasis to mycosis fungoides.

    Science.gov (United States)

    Bordignon, Matteo; Belloni Fortina, Anna; Pigozzi, Barbara; Alaibac, Mauro

    2008-01-01

    It has recently been demonstrated that γδ T lymphocytes play a role in innate immunity to the neoplastic process; however, the significance of this subset of T lymphocytes in the pathophysiology of the most common form of cutaneous T cell lymphomas, mycosis fungoides, has yet to be investigated. In order to identify whether γδ T lymphocytes play a role in the progression of a pre-lymphomatous stage (parapsoriasis) to frank lymphoma (mycosis fungoides), we evaluated their presence in the skin biopsies of patients affected by mycosis fungoides and parapsoriasis. The skin biopsies of ten patients with mycosis fungoides and nine patients with parapsoriasis were analyzed using immunohistochemistry with a panel of different antibodies for T cell-associated markers (CD3, CD4, CD5, CD8 and γδ TCR). The percentage of T cells expressing γδ T cell receptors (TCR) was similar in the biopsies from both groups of skin disorders, ranging from 1 to 5% of the total T cell population. We observed a constant presence of T cells bearing γδ TCR in parapsoriasis and mycosis fungoides that did not differ between the two conditions. This presence is consistent with the role played by this subgroup of T cells of the innate immunity system in the development and maintenance of the two skin disorders. However, the contribution of γδ T cells to the progression of parapsoriasis to mycosis fungoides remains to be elucidated.

  12. Clinicopathologic Variants of Mycosis Fungoides.

    Science.gov (United States)

    Muñoz-González, H; Molina-Ruiz, A M; Requena, L

    2017-04-01

    Mycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma. The clinical course of the disease is typically characterized by progression from a nonspecific phase of erythematous macules to the appearance of plaques and ultimately, in some patients, tumors. However, numerous clinical and histopathologic variants of MF with specific therapeutic and prognostic implications have been described in recent decades. Clarification of the differential diagnosis can be frustrated by the wide range of clinical manifestations and histopathologic patterns of cutaneous infiltration, particularly in the early phases of the disease. In this paper, we review the main clinical, histopathologic, and immunohistochemical characteristics of the variants of MF described in the literature in order to facilitate early diagnosis of the disease. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. CD13 and TCR clone: markers of early mycosis fungoides.

    Science.gov (United States)

    Bernier, Claire; Nguyen, Jean Michel; Quéreux, Gaëlle; Renault, Jean Jaques; Bureau, Brigine; Dreno, Brigitte

    2007-01-01

    Making a differential diagnosis between early mycosis fungoides and parapsoriasis is often difficult at the clinical and histological level. The aim of this study was to explore markers that could help in this process. A total of 88 patients were included in 2 categories: large plaque parapsoriasis and digitiform parapsoriasis. A histological examination was performed for each patient, and expression of the antigen My7 (CD13), which is lacking in cutaneous T-lymphomas (but not in inflammatory lesions) and rearrangement of the T-cell receptor gene were analysed. A histological aspect of epidermotropic cutaneous T-cell lymphoma was observed in 23.5% of cases of large plaque parapsoriasis and 15% of cases of digitiform parapsoriasis. A disappearance of My7 antigen was noted in the 2 forms of parapsoriasis, more frequently when there was cutaneous T-cell lymphoma histology. A cutaneous clone was observed in 10.3% of cases of large plaque parapsoriasis, but not of digitiform parapsoriasis. For 3 patients, a cutaneous clone and a disappearance of My7 were associated with a non-specific histology. Considering these histological, immunological and molecular biological data, it appears that My7 antigen combined with T-cell clone may help the dermatologist to confirm the diagnosis of early mycosis fungoides. Moreover, further studies will determine whether CD13 is an early prognostic marker of evolution of a parapsoriasis to mycosis fungoides. Finally, these results demonstrate that digitiform parapsoriasis can be an early stage of MF.

  14. Pathogens spectrum of deep human mycosis

    Directory of Open Access Journals (Sweden)

    A. B. Kulko

    2012-01-01

    Full Text Available The article describes characteristics of two different etiology groups of deep human mycosis — extremely dangerous endemic deep mycoses (histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, penicilliosis due to Penicillium marneffei and opportunistic deep mycosis (candidiasis, cryptococcosis, aspergillosis, mucormycosis. Information on fungal pathogens and antifungal agents is presented. The own results of cultural studies obtained during pneumomycosis diagnosis in patients with tuberculosis are shown.

  15. Mycosis Fungoides: Experience in a Pediatric Hospital.

    Science.gov (United States)

    Cervini, A B; Torres-Huamani, A N; Sanchez-La-Rosa, C; Galluzzo, L; Solernou, V; Digiorge, J; Rubio, P

    Mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma, is unusual in children. We aimed to describe the epidemiologic, clinical, histopathologic, and immunophenotypic characteristics of MF as well as treatments and course of disease in a pediatric case series. Data for all patients admitted to our pediatric hospital (Hospital Dr. J. P. Garrahan) in Argentina with a clinical and histopathologic diagnosis of MF between August 1988 and July 2014 were included. A total of 14 patients were diagnosed with MF. The ratio of boys to girls was 1:1.33. The mean age at diagnosis was 11.23 years (range, 8-15 years). The mean time between onset and diagnosis was 3.5 years (range, 4 months-7 years). All patients had hypopigmented MF and 42% also presented the features of classic MF. Seven (50%) had the CD8 + immunophenotype exclusively. Seventy-eight percent were in stage IB at presentation. Phototherapy was the treatment of choice. Four patients relapsed at least once and skin lesions progressed in 3 patients. All patients improved. MF is unusual in children. The hypopigmented form is the most common. Diagnosis is delayed because the condition is similar to other hypopigmented diseases seen more often in childhood. Although prognosis is good, the rate of recurrence is high, so long-term follow-up is necessary. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Kaposi's varicelliform eruption in a patient with mycosis fungoides.

    Science.gov (United States)

    Hayashi, S; Yamada, Y; Dekio, S; Jidoi, J

    1997-01-01

    A 39-year-old Japanese woman suffering from plaque stage of mycosis fungoides (MF) developed Kaposi's varicelliform eruption (KVE) on her face. KVE appeared 1 month after commencing skin electron beam irradiation (SEBI), when the total irradiation had reached 46 Gy. Natural killer (NK) cell activity in the peripheral blood was abnormally low, but returned to normal after 1 year. However, lymphocyte reactivity to mitogens was persistently low. These facts suggested that the KVE in our patient developed because of abnormally low NK cell reactivity probably induced by radiation therapy.

  17. Occupational exposure to chlorinated and petroleum solvents and mycosis fungoides

    DEFF Research Database (Denmark)

    Morales-Suárez-Varela, Maria M; Olsen, Jørn; Villeneuve, Sara

    2013-01-01

    To evaluate the potential association between occupational exposure to chlorinated and petroleum solvents and mycosis fungoides (MF).......To evaluate the potential association between occupational exposure to chlorinated and petroleum solvents and mycosis fungoides (MF)....

  18. Assessment of prognostic predictive value at the mycosis fungoides

    Directory of Open Access Journals (Sweden)

    A. S. Zhukov

    2017-01-01

    Full Text Available Micosis fungoides is a primary skin lymphoma characterized with indolent disease course and favorable prognosis. Опіу at some patients one can observe aggressive development of the disease to malignant stage with the exracutaneous outspread. the modern data about the prognostic factors are presented in the review. Disclosure of these factors allows to forecast the course of disease. there is given attention to integral estimation of survival rates on the ground of tNMB-staging sand estimation of the CUP-index. Definition of combination of different prognostic factors would allow to create prognostic models enabling to diagnose on the early stages of disease the patients with high risk of progression of mycosis fungoides.

  19. [Mycosis fungoides or inflammatory dermatitis: differential diagnosis between early lymphoma and inflammation in skin biopsies].

    Science.gov (United States)

    Oschlies, I; Klapper, W

    2013-05-01

    Mycosis fungoides is a cutaneous T-cell lymphoma with protracted clinical course and progression in different stages with increasing aggressiveness. The clinical picture as well as the histopathology of mycosis fungoides within the early patch and plaque phase is difficult to delineate from some inflammatory skin diseases. Thus, the diagnosis of these early stages of the lymphoma is only possible when clinical, histopathological, and molecular features are integrated into the diagnosis, especially as none of the individual disease criteria is specific. Important clues towards the diagnosis of mycosis fungoides are cytologically abnormal epidermotropic CD4-positive T-cells causing only minor epidermal alterations, the formation of Pautrier-abscesses and basal alignment of the epidermotropic T-cells. The findings of an aberrant T-cell immunophenotype of the intraepidermal lymphoid component as well as the molecular proof of T-cell clonality are important further features. In the differential diagnosis between early stage mycosis fungoides and parapsoriasis, there remains nevertheless a diagnostic and maybe also a true biological grey zone.

  20. Mycosis Fungoides: Historical aspects | Osman | Sudanese Journal ...

    African Journals Online (AJOL)

    Mycosis fungoides was first described in 1806 by Jean Louis Albert, the French dermatologist. The lack of a sound knowledge of the exact aetiology and pathogenesis of MF has led the clinicians to adopt so many synonyms for the disease. The present paper is trying to give a detailed history of the disease called now ...

  1. Occupational sun exposure and mycosis fungoides

    DEFF Research Database (Denmark)

    Morales-Suárez-Varela, Maria M.; Olsen, Jorn; Johansen, Preben

    2006-01-01

    OBJECTIVE: We sought to study the association between occupational sun exposure and mycosis fungoides (MF), a peripheral T-cell lymphoma. SUBJECTS and METHODS: A European multicenter case-control study including seven rare cases (one being MF) was conducted between 1995 and 1997. From the 118...

  2. Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides

    Directory of Open Access Journals (Sweden)

    Tebeică T.

    2016-03-01

    Full Text Available Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective.

  3. [Parapsoriasis--to be or not be (mycosis fungoides)].

    Science.gov (United States)

    Goldberg, Ilan

    2012-10-01

    Mycosis fungoides (MF) is the most prevalent cutaneous lymphoma, characterized by uncontrolled growth of T cells within the skin. The diagnosis in the early stages may be difficult, since, in these stages, the disease can imitate benign inflammatory processes, both clinically and histologically. One of the difficulties in determining diagnostic criteria for early MF is the existing terminology of parapsoriasis. There is disagreement concerning the exact definition and whether it is a chronic benign condition with similar clinical and histological characteristics as MF, or rather it is part of the disease spectrum itself. There is a need for uniformity in the definition for treatment decisions, for epidemiological purposes and for clinical and experimental research. This article reviews the different approaches to parapsoriasis as part of MF over the years.

  4. TP53 gene status affects survival in advanced mycosis fungoides

    Directory of Open Access Journals (Sweden)

    Gitte Wooler

    2016-11-01

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

  5. Secondary Cutaneous Amyloidosis Associated with Mycosis Fungoides

    Science.gov (United States)

    2018-02-16

    and has been reported with PUVA use. To date, there are three reported cases of secondary localized cutaneous amyloidosis associated with mycosis...Secondary localized cutaneous amyloidosis is often not clinically apparent , but may be seen histologically. It is associated with several skin tumors...fungoides prior to any treatment. We present a case of a 39-year-old female who presented to the dermatology clinic for evaluation of facial acne

  6. Hypopigmented mycosis fungoides: a 20-case retrospective series.

    Science.gov (United States)

    Amorim, Gustavo M; Niemeyer-Corbellini, Joao P; Quintella, Danielle C; Cuzzi, Tullia; Ramos-E-Silva, Marcia

    2018-03-01

    Hypopigmented mycosis fungoides (hMF) is a rare subtype of mycosis fungoides. The aim of this study was to identify the clinical-epidemiological profile of our patient group and also to provide additional information about treatment responses and prognosis. This is a cross-sectional retrospective observational study, with exploratory analysis. The outcome variables were disease progression and related death. Twenty patients with hMF were selected from a group of 102 patients diagnosed with MF. There was no gender difference (10 females and 10 males). Mean age at diagnosis was 43.85 years, and most patients had mixed or black skin color. The mean time between the onset of the lesions and the diagnosis was 66.75 months. Patients were equally distributed in stages IA (50%) and IB (50%). Photochemotherapy (psoralen and ultraviolet A) was the predominant therapeutic modality. The mean follow-up time was 7.25 years. In 10%, disease progression was observed. Death related to the disease occurred in one patient. The clinical and epidemiological profile of patients with hypopigmented MF found in our sample is in agreement with what is described in the literature, with the exception of the age at diagnosis, higher than expected. Diagnostic delay time, despite long, is also consistent with the medical literature; however, in this sample, we had two cases of disease progression, with death of one patient, despite the treatment, which is extremely important since hypopigmented MF is usually associated with good prognosis. © 2018 The International Society of Dermatology.

  7. Juvenile folliculotropic and ichthyosiform mycosis fungoides.

    LENUS (Irish Health Repository)

    Ryan, C

    2012-02-01

    Ichthyosiform mycosis fungoides (MF) is a recently recognized clinical variant of MF, which appears as dry scaling patches and plaques, or as a generalized eruption. Acquired ichthyosis is well recognized as a paraneoplastic cutaneous presentation of malignancy, especially in lymphoproliferative disorders. In contrast, the ichthyosiform eruption in ichthyotic MF is attributable to infiltration of the skin by tumour cells. We report the case of a 15-year-old boy who presented with a 5-year history of enlarging pruritic plaques on the forehead and back, patchy alopecia and generalized ichthyosis. Histology of the forehead and back showed a dense, lymphocytic, folliculocentric and perivascular infiltrate of predominantly CD4-positive T cells consistent with folliculotropic MF. Histological examination of biopsies from ichthyotic skin found similar features. Our patient had a histological diagnosis at the age of 15 years, making him the youngest reported patient with either folliculotropic MF or ichthyotic MF.

  8. Viral infection, atopy and mycosis fungoides

    DEFF Research Database (Denmark)

    Morales, Maria; Olsen, Jørn; Johansen, P.

    2003-01-01

    involving seven rare cancers, including MF, was conducted from 1995 to 1998. Patients between 35 and 69 years of age diagnosed with MF (n=140) were recruited, and the diagnoses were verified by a reference pathologist, who classified 83 cases as definitive and 35 cases as possible; 22 cases were......Mycosis fungoides (MF) is a rare disease with an unknown aetiology, although it has been suggested that infections may play a role. The present study investigates whether infections, atopic disorders and some other diseases are risk indicators for MF. A European multicentre case–control study...... not accepted. Of the 118 accepted cases, 104 patients were interviewed (including 76 definitive cases and 28 possible cases). These 76 definitive cases were used for this study. A common set of controls to serve all case groups were interviewed, representing a total of 4574 controls. The latter included 1008...

  9. CD8+mycosis fungoides: A low-grade lymphoproliferative disorder.

    Science.gov (United States)

    Martinez-Escala, Maria Estela; Kantor, Robert W; Cices, Ahuva; Zhou, Xiaolong A; Kaplan, Jason B; Pro, Barbara; Choi, Jaehyuk; Guitart, Joan

    2017-09-01

    The prognosis of the CD8 + subtype of mycosis fungoides (MF) is controversial. Although most authors believe that determining the presence of this cell surface antigen has no prognostic value, others have observed a more indolent course for CD8 + MF compared with CD4 + MF. To review the cases of CD8 + MF in the pediatric and adult populations seen at our institution. This is a retrospective review of clinical and pathologic data. Age, stage at presentation, and outcomes of patients at our institution were compared with those of 2 large MF cohorts that predominantly were CD4 + from the relevant literature. Sixty-seven patients of a median age of 46 years were included. A higher frequency of early-stage disease was observed for CD8 + MF patients at diagnosis when compared with other cohorts, including 31 (47%) patients with stage IA, 33 (50%) with stage IB, and 2 (3%) with stage IIB (P = .001, P = .001, and P = .002, respectively). With a median follow-up (5.5 years, range 0.2-21 years) similar to other cohorts, a higher rate of complete remission was achieved (65.5%, P = .001), and a lower rate of progression was observed (P = .004). This is a retrospective review. Our experience with CD8 + MF confirms a more indolent course of disease with this MF variant. Our results warrant a conservative treatment approach limited to skin-directed therapies and observation in most patients. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Index Case of Cutaneous Follicular Mycosis Fungoides With Central Nervous System Involvement and Review of Literature.

    Science.gov (United States)

    Nguyen, Giang Huong; Mohler, Alexander; Leppert, Michelle; Parra, Cindy; Zeng, Yue-Ping; Prok, Lori; Schowinsky, Jeffrey; Magro, Cynthia M; Pacheco, Theresa; Ney, Douglas

    2018-03-01

    Central nervous system involvement by mycosis fungoides (MF) is rare and is usually seen in advanced stages of the disease. We describe a patient with early-stage follicular MF who presented with changes in mental status. Despite an initial diagnosis of vasculitis based on clinical and brain biopsy results, the postmortem examination revealed extensive infiltration of MF cells throughout the brain with leptomeningeal involvement. This case in addition to the accompanied review of literature illustrates the importance of the awareness of central nervous system involvement by MF and highlights the need for an urgent neurologic evaluation in patients with a history of MF now presenting with neurologic signs or symptoms.

  11. A Phase Ib/II Study of Gemcitabine and Docetaxel in Combination With Pazopanib for the Neoadjuvant Treatment of Soft Tissue Sarcomas

    Science.gov (United States)

    Munhoz, Rodrigo R.; D’Angelo, Sandra P.; Gounder, Mrinal M.; Keohan, Mary L.; Chi, Ping; Carvajal, Richard D.; Singer, Samuel; Crago, Aimee M.; Landa, Jonathan; Healey, John H.; Qin, Li-Xuan; Hameed, Meera; Ezeoke, Marietta O.; Singh, Arun S.; Agulnik, Mark; Chmielowski, Bartosz; Luke, Jason J.; Van Tine, Brian A.; Schwartz, Gary K.; Tap, William D.

    2015-01-01

    Lessons Learned Our results highlight some of the challenges in the management of soft tissue sarcomas, which requires close cooperation between surgeons and medical oncologists and a careful selection of patients. The incidence of hepatotoxicity was a concerning finding and had been previously reported in patients treated with pazopanib. Although pharmacokinetic analysis was not part of this study, concomitant treatment with pazopanib has been recently reported to increase docetaxel exposure, which may explain the increased toxicity of combination regimens. It remains possible that lower doses of combined gemcitabine, docetaxel, and pazopanib may be tolerable. However, caution should be exercised in future trials investigating similar combinations. Background. For extremity soft tissue sarcomas (STS), surgical resection remains the standard of care, and the addition of chemotherapy is controversial. This was a phase Ib/II trial of neoadjuvant therapy for patients with STS. Methods. Patients with high grade, extremity STS of >8 cm and amenable to definitive resection were treated with up to four 21-day cycles of 900 mg/m2 gemcitabine on days 1 and 8, 75 mg/m2 docetaxel on day 8, and 400 mg of pazopanib daily (GDP), followed by surgery and, if indicated, radiation therapy. Primary and secondary endpoints (phase Ib portion) were the safety and rate of pathologic response. Results. The trial was discontinued because of slow accrual after inclusion of five patients (leiomyosarcoma: two; undifferentiated pleomorphic sarcoma: three). Two patients completed four treatment cycles: one underwent surgery and one had insufficient response and received additional therapies. Three patients discontinued treatment because of toxicity. Grade 3 adverse events included hypertension, fatigue, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation, hoarseness, and myelotoxicity. There were no complete or partial responses. One patient had ≥90% pathologic

  12. Indications for total cutaneous electron beam radiation therapy of mycosis fungoides

    International Nuclear Information System (INIS)

    Le Bourgeois, J.P.; Haddad, E.; Marinello, G.; Marin, L.; Mazeron, J.J.; Ganem, G.

    1987-01-01

    From 1977 to 1984, we treated 34 patients with mycosis fungoides and 9 patients with B cutaneous lymphomas. Eighteen patients with mycosis fungoides were treated with total skin electron irradiation (TSEI) and had a minimum follow-up of 15 months (range 15 months to 7 years). The lowest electron energy of the linear accelerator was 8 MeV therefore we placed a plexiglas screen between the patient and the machine; the resulting electron energy was 4 MeV. The total dose was 30 Gy delivered in 12 fractions over 40 days. There were 8 males and 10 females. The median age was 48 years (ranging from 13 to 78 years). All patients were staged as follows: Stage A = superficial lesions covering less than 50% of the body surface; Stage B = superficial lesions covering more than 50% of the body surface; Stage C = tumors involving the skin, lymph nodes and/or visceral organs. Five patients with Stage A (5/5) and 5 patients with Stage B (5/5) had a complete remission, 1 stage A patient relapsed 6 months after completion of treatment. All the Stage B patients recurred between 3 and 15 months. The recurrences were localized to the skin and were well controlled with topical nitrogen mustard or puvatherapy. Among the Stage C patients, 3 did not respond to treatment and died of their disease; the remaining 5 patients achieved complete remission but they all relapsed from 2 to 9 months following completion of treatment. The median follow-up was 32 months and the average time for relapse was 6.5 months. All relapses except one (15 months) occurred within the first year. We feel that total skin electron irradiation is indicated in Stage A and B patients. However, we feel Stage C patients should receive TSEI for palliative purposes only

  13. Role of radiation therapy in mycosis fungoides refractory to systemic therapy.

    Science.gov (United States)

    de Sanctis, Vitaliana; Persechino, Severino; Fanelli, Alessandro; Valeriani, Maurizio; Bracci, Stefano; D'Arienzo, Marco; Monarca, Bruno; Caperchi, Cristiano; Raffa, Salvatore; Enrici, Riccardo Maurizi

    2011-01-01

    The long natural history of early stage mycosis fungoides (MF) makes its management a difficult problem. Skin lesions are sensitive to different therapies and a variety of treatment modalities have been used, such as topical nitrogen mustard, puvatherapy, UV-B, retinoids, radiation therapy, extracorporal photopheresis and systemic chemotherapy. For patients with refractory early stage MF, treatment selection is made by clinical parameters such as the age, sex and performance status of the patients, as well as the institutional expertise and the toxicity profiles of the different therapeutic approaches. We report radiation therapy in a relapsed/resistant stage IB patient with mycosis fungoides treated with local radiation therapy for symptomatic progression unresponsive to bexarotene therapy. Total skin electron beam therapy has been employed in early stage and for limited skin failure MF, while the role of local radiation therapy in MF is less defined. In our experience local radiotherapy has proved to be a very efficient, tolerable and cost effective approach in patients with MF unresponsive to systemic approaches.

  14. Podoplanin Expression Correlates with Disease Progression in Mycosis Fungoides.

    Science.gov (United States)

    Jankowska-Konsur, Alina; Kobierzycki, Christopher; Grzegrzółka, Jędrzej; Piotrowska, Aleksandra; Gomulkiewicz, Agnieszka; Glatzel-Plucinska, Natalia; Reich, Adam; Podhorska-Okołów, Marzenna; Dzięgiel, Piotr; Szepietowski, Jacek C

    2017-02-08

    The aim of this study was to investigate the role of lymphangiogenesis in the clinical progression and outcome of mycosis fungoides. Immunohistochemistry and Western blot techniques were used to assess the expression of podoplanin and vascular endothelial growth factor C in mycosis fungoides. Expression of vascular endothelial growth factor C measured by immunohistochemistry was significantly higher in mycosis fungoides samples in comparison with control cases (chronic benign dermatoses) (p = 0.0012). Increased expression of podoplanin was found in advanced vs. early mycosis fungoides (p < 0.0001), and was positively correlated with cutaneous and nodal involvement (p < 0.001, p < 0.0001; respectively). Higher podoplanin expression was also significantly associated with shorter survival (p < 0.001). Strong positive correlation was observed between expression of podoplanin analysed by immunohistochemistry and Western blot (r = 0.75, p < 0.0001). A similar association was shown regarding expression of vascular endothelial growth factor C (r = 0.68, p = 0.0007). In conclusion, these results suggest that increased expression of podoplanin is associated with poor clinical course, as well as shorter survival, of patients with mycosis fungoides.

  15. [Dementia in Patients with Central Nervous System Mycosis].

    Science.gov (United States)

    Morita, Akihiko; Ishihara, Masaki; Konno, Michiko

    2016-04-01

    Central nervous system (CNS) mycosis is a potentially life-threatening but treatable neurological emergency. CNS mycoses progress slowly and are sometimes difficult to distinguish from dementia. Though most patients with CNS mycosis have an underlying disease, such as human immunodeficiency virus (HIV) infection, cancer, diabetes mellitus, and/or use of immunosuppressants, cryptococcosis can occur in non-immunosuppressed persons. One of the major difficulties in accurate diagnosis is to detect the pathogen in patients' cerebrospinal fluid (CSF) cultures. Thus, the clinical diagnosis is often made by combining circumstantial evidence, including mononuclear cell-dominant pleocytosis with low glucose and protein elevation in the CSF, as well as positive results from an antigen-based assay and a (1-3)-beta-D-glucan assay using plasma and/or CSF. Polymerase chain reaction (PCR)-based diagnostics, which are not performed as routine examinations and are mostly performed as part of academic research in Japan, are sensitive tools for the early diagnosis of CNS mycosis. Mognetic resonance imaging (MRI) is useful to assess the complications of fungal meningitis, such as abscess, infarction, and hydrocephalus. Clinicians should realize the advantages and disadvantages of these diagnostic tools. Early and accurate diagnosis, including identification of the particular fungal species, enables optimal antifungal treatment that produces good outcomes in patients with CNS mycosis.

  16. Hypopigmented mycosis fungoides in a twenty-year-old Saudi woman with fair skin

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    Al-Ratrout J

    2006-01-01

    Full Text Available The hypopigmented variant of mycosis fungoides (MF is charactrized by the presence of hypopigmented patches as the sole manifestation of the disease. This variant is usually observed in the dark skin of African or Asian individuals particularly children, but nevertheless is an uncommonly reported presentation of the disease. The incidence of hypopigmented MF in Caucasian patients and others of fair skin color is rare. We describe hypopigmented lesions arising in a twenty-year-old Saudi woman with type IV skin color. The diagnosis of mycosis fungoides stage IA was made based on the clinico-radiological and histological features. The patient responded well to PUVA therapy and is currently clear of lesions. MF should be considered in the differential diagnosis of hypopigmented macular lesions in patients of any skin color and age. Multiple skin biopsies must be performed on different occasions so as not to miss the diagnosis; and long term follow up is recommended since recurrence is common and occasional cases behave aggressively.

  17. The utility of bexarotene in mycosis fungoides and Sézary syndrome

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    Panchal MR

    2015-02-01

    Full Text Available Manisha R Panchal, Julia J Scarisbrick Department Dermatology, University Hospital Birmingham, Birmingham, UK Abstract: Cutaneous T-cell lymphoma (CTCL is an umbrella term that encompasses a group of neoplasms that have atypical T-lymphocytes in the skin. Mycosis fungoides (MF is the most common type of CTCL and Sézary syndrome (SS is the leukemic form. Treatment for CTCL is dependent on the stage of disease and response to previous therapy. Therapy is divided into skin-directed treatment, which tends to be first line for early-stage disease, and systemic therapy, which is reserved for refractory CTCL. Bexarotene is a rexinoid and was licensed in Europe in 2002 for use in patients with advanced disease that have been refractory to a previous systemic treatment. We review the use of bexarotene as monotherapy and in combination with other treatments. Keywords: retinoid, CTCL, cutaneous T-cell lymphoma

  18. Nail involvement in mycosis fungoides: brief report

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    Amir Houshang Ehsani

    2014-11-01

    Conclusion: We found about 30% prevalence that is a little higher than previously shown. It seems that nail changes in CTCL have no relationship to CTCL staging or other specifications including demographic specifications.

  19. Expression of HECA-452 in parapsoriasis and mycosis fungoides.

    Science.gov (United States)

    Di Trolio, R; Di Lorenzo, G; Barbiero, E; Iacono, A; Franco, R; D Armiento, M; Delfino, M; D Armiento, F P

    2006-01-01

    We have investigated the HECA-452 expression in large plaque parapsoriasis (PP) and mycosis fungoides (MF) patients, evaluating the potential role of this biomarker in both cutaneous disorders. Skin specimens from 72 PP and 61 MF patients were selected in this study. We compared their actual histological diagnosis with their previous diagnosis and we found that all 72 PP patients had the same diagnosis as before (stable PP), while 26 out of 61 MF had a previous PP histological diagnosis (evolving PP). Our results show an increased expression of HECA-452 in MF compared to PP (p<0.01). Furthermore, evolving PP showed a significantly higher level of HECA-452 than stable PP (p<0.05). We conclude that HECA-452 expression increases during the natural history of Mycosis Fungoides. HECA-452 could be used as a biomarker for MF and predict which PP evolves to MF.

  20. Flow Cytometric Analysis of T, B, and NK Cells Antigens in Patients with Mycosis Fungoides

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    Serkan Yazıcı

    2015-01-01

    Full Text Available We retrospectively analyzed the clinicopathological correlation and prognostic value of cell surface antigens expressed by peripheral blood mononuclear cells in patients with mycosis fungoides (MF. 121 consecutive MF patients were included in this study. All patients had peripheral blood flow cytometry as part of their first visit. TNMB and histopathological staging of the cases were retrospectively performed in accordance with International Society for Cutaneous Lymphomas/European Organization of Research and Treatment of Cancer (ISCL/EORTC criteria at the time of flow cytometry sampling. To determine prognostic value of cell surface antigens, cases were divided into two groups as stable and progressive disease. 17 flow cytometric analyses of 17 parapsoriasis (PP and 11 analyses of 11 benign erythrodermic patients were included as control groups. Fluorescent labeled monoclonal antibodies were used to detect cell surface antigens: T cells (CD3+, CD4+, CD8+, TCRαβ+, TCRγδ+, CD7+, CD4+CD7+, CD4+CD7−, and CD71+, B cells (HLA-DR+, CD19+, and HLA-DR+CD19+, NKT cells (CD3+CD16+CD56+, and NK cells (CD3−CD16+CD56+. The mean value of all cell surface antigens was not statistically significant between parapsoriasis and MF groups. Along with an increase in cases of MF stage statistically significant difference was found between the mean values of cell surface antigens. Flow cytometric analysis of peripheral blood cell surface antigens in patients with mycosis fungoides may contribute to predicting disease stage and progression.

  1. A Clinical Evaluation of Definitive and Clinical Allergic Bronchopulmonary Mycosis

    OpenAIRE

    Matsuse, Hiroto; Nakata, Hiroko; Fukahori, Susumu; Tsuchida, Tomoko; Kawano, Tetsuya; Tomari, Shinya; Fukushima, Chizu; Matsuo, Nobuko; Asai, Sadahiro; Kohno, Shigeru

    2006-01-01

    Objective: The present study aims to overcome problems associated with the early diagnosis of allergic bronchopulmonary mycosis (ABPM) using the current criteria. Patients and Methods: Clinical features including radiographic findings from 10 patients with definitive ABPM based on the diagnostic criteria of Rosenberg-Patterson were compared with those from 9 patients with ABPM clinically diagnosed by respiratory allergy specialists. Results: ABPM should be considered in patients with peripher...

  2. Early onset of mycosis fungoides. Case from practice

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    D. V. Zaslavsky

    2015-01-01

    Full Text Available Clinical and morphological heterogeneity of malignant lymphoproliferative lesions of the skin is explained by the peculiarities of their pathogenesis and organization of the lymphoid tissue in the skin. These features determine the authenticity of therapeutic approaches to patients with this pathology and exclude the use of standard regimens of polychemotherapy used in oncology due to their low efficacy. The authors describe a case study of a suberythrodermic form of mycosis fungoides in a 16-year-old female patient.

  3. Parapsoriasis and mycosis fungoides: the Northwestern University experience, 1970 to 1985.

    Science.gov (United States)

    Lazar, A P; Caro, W A; Roenigk, H H; Pinski, K S

    1989-11-01

    One hundred sixty skin biopsy specimens from 89 patients with the clinical diagnosis of large plaque parapsoriasis and 240 specimens from 106 patients with mycosis fungoides were reviewed. Through the use of chart reviews and a retrospective questionnaire, various factors (sex, age, history of eczema/atopy, occupation) were examined in these two patient groups. Mycosis fungoides developed in 30% of the patients in the parapsoriasis group. Nineteen percent of patients in the mycosis fungoides group had worked in industry. Once the clinical diagnosis of mycosis fungoides was considered, an average of four biopsy specimens were needed to establish the diagnosis. The average interval from the initial visit to the diagnosis of mycosis fungoides from examination of biopsy specimens was 22 months. These findings support further the view that large plaque parapsoriasis represents an important precursor of mycosis fungoides. A designation of premycosis fungoides would emphasize this relation more than the term parapsoriasis.

  4. Photodynamic therapy for mycosis fungoides: a case series and review of the literature

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    Robert E. Hunger

    2015-01-01

    Full Text Available Mycosis fungoides (MF is the most common form of cutaneous T cell lymphoma. In early stages of the disease, topical therapeutic approaches like steroids, chemotherapy, phototherapy or spot radiation therapy are most commonly used. Photodynamic therapy (PDT is widely executed in the treatment of actinic keratosis and superficial basal cell carcinoma. The effective use of PDT for early forms of MF has been previously demonstrated in a series of cases. In this instance, the treatment of MF (n = 6, 11 lesions with methyl alanine PDT (MAL-PDT in 73% of the treated lesions showed a complete response. Within the timeframe of 25-51 months, no recurrence of the successfully treated lesions was observed, on the contrary some of the patients developed new lesions on different sites. Hence, this case study shows that patients having a single or few MF lesions can be successfully treated by PDT.

  5. Fine needle aspiration cytology of unilesional mycosis fungoides d′emblee

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    K Amita

    2012-01-01

    Full Text Available Primary cutaneous T-cell lymphoma is a rare lymphoproliferative disorder accounting for 2% of all lymphomas. Mycosis fungoides (MF is a rare, albeit commonest form of primary cutaneous T cell lymphoma. MF d′emblee is an uncommon variant which is easily mistaken clinically for epithelial malignancy. Diagnosis at cytology is challenging due to low degree of suspicion, rare occurrence and diverse morphology. We report a case of 51-year-old male presenting with a solitary nodulo-ulcerative lesion over right thigh. Smear showed atypical lymphocytes with hyper-convoluted cerebriform nuclei along with few mature lymphocytes consistent with MF. To our knowledge, this is the first report of unilesional MF d′emblee diagnosed at fine needle aspiration cytology (FNAC. Our case emphasizes that FNAC is an accurate method for early diagnosis and clinical staging of patients with MF.

  6. Phototherapy UVB narrow band treatment of psoriasis, mycosis fungoides and vitiligo

    International Nuclear Information System (INIS)

    Reyes, M.V.; Kutnizky, R.; Bosch, M.P.; Ruiz Lascano, A.

    2013-01-01

    Introduction: Numerous studies have shown the beneficial effect of ultraviolet radiation for the treatment of lymphoproliferative or inflammatory skin diseases. Objective: To determine the response to UVB narrow band (UVB-nb) in psoriasis, mycosis fungoides stage IA, IB and vitiligo, in the Dermatology Department of Hospital Privado from May 2009 to January 2011. To correlate total energy dose used and the total number of sessions with the response achieved in each disease. To describe adverse reactions; determine demographic characteristics of the population and comorbidities in psoriasis and vitiligo. Material and Methods: We performed a prospective, descriptive, analytical, observational study. We included all patients assessed for initiation of UVB-nb. Regarding the patients who did not start or interrupted the treatment a survey was conducted to assess the causes. We calculated the cumulative dose and number of sessions at the end of treatment. (authors) [es

  7. Spectrum of Misdiagnosis of Allergic Bronchopulmonary Mycosis: Case Reports

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    Sandeep Rana

    2018-01-01

    Full Text Available Allergic bronchopulmonary mycosis (ABPM is most commonly seen in cystic fibrosis and bronchial asthma. Most of patients are misdiagnosed at initial outpatient department visit due to low suspicion, lack of awareness of entity and similarity in clinical symptoms and radiological findings with other common pulmonary diseases. Pulmonary tuberculosis is the most common entity diagnosed, and anti-tubercular treatment is the most commonly abused chemotherapy. Careful history taking, astute initial examination and awareness may help in curbing wrong diagnosis and treatment. This article present two cases of ABPM who were initially misdiagnosed as pulmonary tuberculosis and carcinoma lung, respectively.

  8. Granulomatous slack skin: a distinct disorder or a variant of mycosis fungoides?

    Science.gov (United States)

    Topar, G; Zelger, B; Schmuth, M; Romani, N; Thaler, J; Sepp, N

    2001-01-01

    About 75% of cutaneous lymphomas belong to the group of T-cell lymphomas. Mycosis fungoides is the most common entity in this group. Granulomatous slack skin is a rare form of cutaneous T-cell lymphoma closely related to mycosis fungoides. We present here a patient with areas of lax skin for several years who developed a generalized erythroderma with associated immunoactivation and a deterioration in his general condition. This report discusses clinically and histologically the differential diagnoses, namely granulomatous slack skin and granulomatous mycosis fungoides, and suggests that these 2 disorders are only variants in the broad spectrum of a single disease.

  9. Mycosis fungoides: Current trends in diagnosis and management

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    Panda Saumya

    2007-01-01

    Full Text Available Mycosis fungoides (MF is the most common group of cutaneous T-cell lymphomas. It is a rare non-Hodgkin′s lymphoma of mature, skin-homing, clonal, malignant T lymphocytes, usually observed in mid to late adulthood, that initially presents in the skin as patches, plaques, tumors, or generalized erythema (erythroderma and can involve the lymph nodes and peripheral blood. Much progress has been made in recent years in understanding the origin of the malignant T cell in MF and the patho-physiology and immunology of the disease. This recent work has made a great impact on diagnosis, prognostication, and treatment. In this review, we survey the MF literature of the last decade and highlight the major trends.

  10. Total skin electron beam therapy in mycosis fungoides

    International Nuclear Information System (INIS)

    Terashima, Hiromi; Yamashita, Shigeru; Ishino, Yohichi; Suenaga, Yoshinori

    1988-01-01

    The studies using phantoms confirmed that the reduction of electron beam energy and minimization of X-ray contamination could be achieved when electron beam was interposed by an acrylic plate placed 20 cm anterior to a patient. Four patients of mycosis fungoides were treated with 8 MeV electron beam of a linear accelerator at UOEH Hospital from October 1981 to December 1986. Two of them were treated with this technique by placing 2 cm thick acrylic plate anterior to the patients and satisfactory results were obtained. Cutaneous lesions subsided remarkably with the dosage of 2000 cGy given in 2 months. Leucopenia due to bone marrow suppression was mild and the patients tolerated the treatment well. (author)

  11. Development of Scabies During Treatment for Mycosis Fungoides: Dermatoscopic Diagnosis

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    Caner Aykol

    2012-09-01

    Full Text Available Scabies is a cutaneous infestation caused by Sarcoptes scabiei var. hominis and characterized by severe and generalized pruritus. A clinical diagnosis can be made when a burrow is detected at a typical predilection site and the lesion is severely itching. Scabies which occurs in the elderly and also in patients who are immunosuppressed, the lesions are very variable and clinical diagnosis may be difficult. In such cases, dermatoscopy is a simple and rapid diagnostic tool for the diagnosis of scabies with high sensitivity and specificity. Here, a 61-year-old woman who was diagnosed as scabies with dermatoscopic findings and already had mycosis fungoides is reported. (Turk J Dermatol 2012; 6: 114-6

  12. Treatment of mycosis fungoides with total skin electron beam: response and relapse by ethnicity and sex.

    Science.gov (United States)

    Hinds, Ginette A; Alhariri, Jihad; Klein, Rhonda Q; Wilson, Lynn D

    2013-10-01

    To determine whether clinical response to total skin electron beam (TSEB) and relapse after TSEB differs by ethnicity and sex. Retrospective chart review of 77 patients with mycosis fungoides (MF), treated with TSEB in 2002 to 2008 at Yale University School of Medicine, Departments of Dermatology and Therapeutic Radiology. Women had better odds of response to TSEB than men (OR=6.4; 95% CI, 1.45-28.5; P=0.01). No significant difference was observed in response to TSEB between white and black patients (OR=0.69; 95% CI, 0.16-2.91; P=0.62). When stratified by race and sex, in comparison with black females, all other groups had lower odds of complete response (CR) to TSEB: black males (OR=0.39; 95% CI, 0.002-0.70; P=0.03), white females (OR=0.24; 95% CI, 0.02-2.53; P=0.24), and white males (OR=0.06; 95% CI, 0.006-0.60; P=0.02). Clinical CR was significantly predicted by the duration of symptoms (OR=0.98; 95% CI, 0.97-0.99; P=0.01); and nearly significant by clinical stage; stage III to stage I (OR=0.17; 95% CI, 0.02-1.02; P=0.07). Adjuvant treatment, previous treatment, and time from diagnosis to treatment have no significant effect on CR to TSEB. There was no statistically significant association between relapse after treatment and race, sex, clinical stage, or symptom duration. The odds of achieving a CR to TSEB decrease when diagnosis of MF is delayed and when patients present with advanced-stage disease. Women with MF were more likely to have a CR to treatment, and this response was even more significant in black women.

  13. Winter prevalence of obligate aphid pathogen Pandora neoaphidis mycosis in the host Myzus persicae populations in southern China: modeling description and biocontrol implication

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    Xiang Zhou

    2012-03-01

    Full Text Available Pandora neoaphidis overwintering had been investigated by monitoring its prevalence in Myzus persicae populations in open fields. Cabbage plants in field plots were weekly taken after mycosis initiation, to count and examine the living and dead aphids infected by P. neoaphidis. Based on the field data, infection levels (I varied with field temperature (T, relative humidity (RH and aphid count (numbers of living aphids per plant, N over days (D, fitting well to the modified logistic equation I=0.91/[1+exp(8.5+(2.0H T H RH-20.2NI0D] (r²=0.897, where H T indicated daily hours of low temperature (90% RH and I0 primary infection level. The model demonstrated the abiotic and biotic factors influencing P. neoaphidis mycosis development in winter, and also verifies the fungal overwintering by infecting available host aphids without a resting stage. Ultimately, P. neoaphidis mycosis reduced 81.4% of aphid populations, presenting great potential for biocontrol.

  14. Evaluation of bacterial colonization in patients with the diagnosis of mycosis fungoides

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    Bengü Nisa Akay

    2014-12-01

    Full Text Available Background and Design: Mycosis fungoides (MF is the most common form of cutaneous T-cell lymphoma (CTCL. Bacterial infections are a common complication of MF/Sezary syndrome (SS. Staphylococcus aureus is the most common causes of skin infections in patients with MF/SS. However, the role of infectious agents and their effects on the clinical course is controversial. In this study, we aimed to assess the prevalence of the colonization of bacterial pathogens among individuals with MF/SS in comparison with control subjects. Materials and Methods: Sixty-six patients with MF/SS and 66 healthy control subjects were included in this study. The subjects were swabbed in the nose, throat and axilla and the samples were evaluated according to the Clinical Laboratory Standards Institute (CLSI criteria. Results: The mean age of the patients was 55.9±14.8 years (range: 21-84 years. Forty-eight patients were with ≤stage 2A, 18 were ≥stage 2B SS and MF. No statistically significant difference was observed in the frequency of pathogenic bacteria colonization in the nose and axilla between the two groups. However, in the throat it was statistically higher in MF/SS (p=0.001. There was no statistically significant difference between the two groups in terms of S.aureus colonization. The frequency of pathogenic bacteria colonization in the throat cultures were significant (p=0.004 for patients with late stage disease compared to those with early stages, but this was not shown in axilla and nose cultures. Conclusion: In this study, bacterial colonization in the throat and nasal carriage of S.aureus were found to be higher in patients with MF/SS. Further studies on the benefits of controlling this problem, possibly with simple and inexpensive methods that might ameliorates the symptoms such as itching, scaling and erythema are needed.

  15. Evaluation of cardiovascular disease risk factors in patients with mycosis fungoides*

    Science.gov (United States)

    Cengiz, Fatma Pelin; Emiroglu, Nazan

    2015-01-01

    BACKGROUND Mycosis fungoides, the most common subtype of cutaneous T-cell lymphoma, is more common in patients aged 45-55. OBJECTIVE Cardiovascular risk factors have been investigated in several skin diseases. However, the relation between cardiovascular diseases and mycosis fungoides remains unclear. Therefore, the aim of this study was to assess cardiovascular risk factors in patients with mycosis fungoides. METHODS 32 patients with mycosis fungoides and 26 healthy controls were enrolled in the study. Glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, homocystein, high sensitivity C-reactive protein, low-density lipoprotein – cholesterol, were measured in the sera of patients. RESULTS Patients had significantly higher high-sensitivity C-reactive protein, homocysteine, low-density lipoprotein - cholesterol, total cholesterol (p= 0.032) (phomocysteine and high-sensitivity C-reactive protein than healthy subjects. The present study has demonstrated an increased rate of cardiovascular risk in patients with mycosis fungoides. Even though the etiology of these associations is elusive, dermatologists should be sensitized to investigate metabolic derangements in patients with mycosis fungoides, in order to lessen mortality and comorbidity with a multidisciplinary approach. PMID:25672297

  16. CD8-positive juvenile onset mycosis fungoides: an immunohistochemical and genotypic analysis of six cases.

    Science.gov (United States)

    Whittam, L R; Calonje, E; Orchard, G; Fraser-Andrews, E A; Woolford, A; Russell-Jones, R

    2000-12-01

    Childhood cases of cytotoxic T-cell lymphoma have not been well described. We have undertaken an immunohistochemical and genotypic analysis of patients presenting with juvenile onset mycosis fungoides (MF). Of 10 patients presenting over a 3-year period, six exhibited a CD8-positive phenotype. These six patients were also CD2, CD3 and TIA1 positive, but CD56 negative. Apart from the cytotoxic phenotype, these patients had clinicopathological features that were indistinguishable from ordinary cases of MF, with slowly evolving patches and plaques. Three patients were staged as 1A and three as 1B, with no evidence of nodal or systemic disease. Patients responded well to conventional therapy, with no evidence of disease progression after 3 years follow-up. Epidermotropism was a prominent feature in four of the six cytotoxic cases. In two patients with an equivocal histology the diagnosis was confirmed by the finding of a clonal population, using polymerase chain reaction/single strand conformational polymorphism analysis of the T-cell receptor gamma gene in lesional skin. The same technique revealed that all blood samples analysed were polyclonal. These data show that cytotoxic T-cell lymphoma can pursue an indolent course and that cases of CD8-positive MF may be over-represented in childhood.

  17. Topical nitrogen mustard therapy in patients with mycosis fungoides or parapsoriasis.

    Science.gov (United States)

    Lindahl, L M; Fenger-Gron, M; Iversen, L

    2013-02-01

    Topical nitrogen mustard is a chemotherapeutic agent used in treatment of mycosis fungoides (MF). To evaluate the response and side effects in patients with MF and parapsoriasis treated with topical nitrogen mustard. A retrospective study of treatment response in 116 patients diagnosed with MF and 71 patients with parapsoriasis and treated with topical nitrogen mustard from 1991 to 2009. Overall response rate and complete response (CR) rate was 91.4% and 53.4% in patients with MF and 90.1% and 40.8% in patients with parapsoriasis, respectively. Relapse following CR was observed in 67.7% in patients with MF and 62.1% in patients with parapsoriasis. Freedom-from-relapse was higher in patients with T1-T2 than in T3 disease (P parapsoriasis, respectively. Progression-free survival was similar in patients with T1-T2 compared with T3 (P = 0.79) and T4 disease (P = 0.22) and lower in patients with parapsoriasis with 10% skin involvement (P = 0.05). The present study confirms that topical nitrogen mustard is a safe and effective therapy. The treatment response in patients with parapsoriasis was not statistically different from the response in patients with MF. This supports, that parapsoriasis is not a distinct entity, but an early stage of MF. Nitrogen mustard should therefore still be considered as an important treatment modality in patients with early stages (parapsoriasis) and later stages of MF either as monotherapy or in combination with other topical or systemic therapies. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  18. Vitiligo-like lesions of mycosis fungoides coexisting with large plaque parapsoriasis: An association or a spectrum?

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    Das Jayanta

    2006-01-01

    Full Text Available Mycosis fungoides is the commonest type of primary cutaneous T cell lymphoma. Hypopigmented mycosis fungoides is an uncommon variant usually observed in dark-skinned individuals, especially children. Large plaque parapsoriasis, a disease of the middle-aged, and with no racial and geographical predilection, can be regarded as the clinically benign end of the mycosis fungoides disease spectrum. Case of a 24-year-old male, with asymptomatic hypopigmented lesions with characteristics of large plaque parapsoriasis, and vitiligo-like skin lesions with characteristics of mycosis fungoides developing over pre-existing hypopigmented lesions, with no systemic features, is presented for its unusual clinical features and conspicuous histopathological findings.

  19. Clinicopathologic profile of hypopigmented mycosis fungoides in India.

    Science.gov (United States)

    Koorse, Sharon; Tirumalae, Rajalakshmi; Yeliur, Inchara K; Jayaseelan, Elizabeth

    2012-04-01

    Hypopigmented mycosis fungoides (HMF) is an under recognized disease in India, which is often mistaken for Hansen disease or vitiligo, resulting in delayed diagnosis and treatment. To describe the clinical, histopathologic and immunohistochemical features of HMF in Indian patients. All cases presenting as hypopigmented lesions that were signed out as MF between 2001 and 2009 (15 cases) were included. Clinical data and histopathology slides were reviewed. Immunostains for CD4, CD8, and CD1a were done, where tissue was available. The age ranged from 14 to 38 years with a male preponderance. The commonest presentation was multiple hypopigmented patches on limbs and trunk with the duration of the lesions varying from 4 months to 14 years. All cases showed a psoriasiform/lichenoid epidermal pattern, disproportionate epidermotropism, basilar tagging of lymphocytes, monomorphous lymphocytes, haloed lymphocytes, and wiry dermal collagen. Other important findings were infiltration of hair follicles, larger epidermal lymphocytes, atypia of dermal lymphocytes, and stuffed dermal papillae. Dermal edema was absent in all cases. Immunohistochemistry done on 10 cases showed a CD8 phenotype in 6 cases and CD4 phenotype in the remaining 4 cases. Histopathology supplemented by immunohistochemistry is reliable in making a diagnosis of HMF. It is important to be aware of this uncommon, yet significant disease.

  20. Ichthyosiform mycosis fungoides with alopecia and atypical membranous nephropathy

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    Qiang Zhou

    2011-01-01

    Full Text Available We describe here a rare case of variant of mycosis fungoides (MF: ichthyosiform MF with alopecia and atypical membranous nephropathy. The diagnosis was made based on the following findings: generalized ichthyosis-like eruption, alopecia, enlarged superficial lymph nodes, proteinuria, and hematuria, the histological features of the skin biopsy from both ichthyotic and alopecic lesions with immunohistochemical staining, and the renal biopsy examination with immunofluorescence. The histological examination of ichthyotic and alopecic lesions displayed a predominant infiltration of atypical lymphocytes in the upper dermis with the characteristics of epidermotropism and folliculotropism. Immunohistochemical studies demonstrated that most infiltrated atypical lymphocytes were CD3, CD4, and CD45RO positive, whereas negative for CD5, CD7, CD20, CD30, and CD56. A renal biopsy examination revealed atypical membranous nephropathy with deposition of immunoglobulin G (IgG, IgM, IgA, C1q, and C3. In this case atypical membranous nephropathy was involved, which is very uncommon and has never been presented in the literature to date. Although ichthyosiform MF usually features a relatively favorable course, diffuse alopecia and the renal involvement in this case might indicate aggressive disease and poor prognosis.

  1. Photodynamic therapy as an alternative treatment for relapsed or refractory mycosis fungoides: A systemic review.

    Science.gov (United States)

    Xue, Jingwen; Liu, Cynthia; Liu, Yuehua

    2017-03-01

    Mycosis fungoides is the most common cutaneous T-cell lymphoma. It is characterized by slow progress over years to decades, developing from patches to infiltrated plaques, and sometimes to tumors. Therapies such as localized chemotherapy, photochemotherapy and radiotherapy are often employed when lesions of refractory or relapsing mycosis fungoides are resistant to conventional therapies. However, these methods have acute or chronic side effects and toxicity, which may accumulate with repeated and protracted treatment cycles. Photodynamic therapy is a promising, well-tolerated option for the treatment of localized lesions with excellent cosmetic outcomes. In this article, we systematically reviewed and discussed clinical application of photodynamic therapy in relapsed or refractory mycosis fungoides. There are 20 papers included in this review article. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Non-aspergillus allergic bronchopulmonary mycosis in a pediatric patient with cystic fibrosis.

    Science.gov (United States)

    Gondor, M; Michaels, M G; Finder, J D

    1998-12-01

    This article describes a child with cystic fibrosis (CF) and allergic bronchopulmonary mycosis caused by Tricosporon beigelii. An 11-year-old boy with CF failed to respond to conventional treatment for a pulmonary exacerbation. Bronchial washings contained copious budding yeast forms, subsequently identified as T beigelii. Total serum immunoglobulin E was elevated and precipitating antibodies to T beigelii were positive. Together these findings support the diagnosis of allergic bronchopulmonary mycosis. The patient improved with antifungal therapy and systemic glucocorticoid therapy. The pathologic potential of yeast in the airways of patients with CF is unclear. The diagnosis of non-Aspergillus allergic bronchopulmonary mycosis requires a high degree of suspicion and has potentially important implications for the management of patients with CF.

  3. TCRgamma gene rearrangement analysis in skin samples and peripheral blood of mycosis fungoides patients.

    Science.gov (United States)

    Kandolf Sekulović, L; Cikota, B; Stojadinović, O; Basanović, J; Skiljević, D; Medenica, Lj; Pavlović, M; Magić, Z

    2007-12-01

    Diagnosing mycosis fungoides (MF) can be challenging in the early stage of the disease because histopathological features may simulate a variety of benign inflammatory skin diseases. Assessment of T-cell clonality was found to be useful in diagnosis and follow-up of patients. In this study, PCR-based TCRgamma gene rearrangement analysis was performed in skin and peripheral blood samples of patients with MF treated at the two largest referral centers in Serbia, and the results obtained were correlated with clinical and follow-up data. Skin and peripheral blood samples were obtained with informed consent from 37 patients treated at the Department of Dermatology of the Military Medical Academy and the Medical Center of Serbia from 2001 to 2006. The median time of follow-up was 4 years. Multiplex PCR was used for TCRgamma gene rearrangement analysis in skin and peripheral blood samples. Clonality results were correlated with the clinical data and disease course data. Monoclonality was detected in skin samples of 30/37 patients (81%), in 2/5 patients with large-plaque parapsoriasis (LPP), in 28/32 (88%) patients with histologically proven MF, and in 1/16 (6%) patients with benign inflammatory dermatoses. A monoclonal pattern in both skin and peripheral blood was detected in 7/16 (44%) patients in the late stage of the disease, and in 1/7 (14%) patients in the early stage of the disease. A dominant clone was found in both skin and peripheral blood in 1/4 patients in remission, 2/5 with a stable disease, and 4/9 (44%) with disease progression. TCR-gamma gene rearrangement analysis can be regarded as a useful adjunct to diagnosis of epidermotropic lymphoproliferative disorders. The presence of a dominant clone in both the skin and peripheral blood was more frequently detected in late stages and in patients with disease progression, confirming the usefulness of clonality detection by TCR-gamma gene rearrangement analysis in follow-up of patients with primary cutaneous T

  4. High association of human herpesvirus 8 in large-plaque parapsoriasis and mycosis fungoides.

    Science.gov (United States)

    Kreuter, Alexander; Bischoff, Sebastian; Skrygan, Marina; Wieland, Ulrike; Brockmeyer, Norbert H; Stücker, Markus; Altmeyer, Peter; Gambichler, Thilo

    2008-08-01

    To investigate the presence of human herpesvirus 8 (HHV-8) in lesional skin of German patients with large-plaque parapsoriasis (LPP) or mycosis fungoides (MF). The pathogenetic relevance of HHV-8 in cutaneous T-cell lymphoma is controversial. Recently, a highly significant association of HHV-8 in LPP was found, which suggests a role in the pathogenesis of this disease. Retrospective study of the presence of HHV-8 in German patients with lymphoproliferative diseases. Dermatologic clinic at a university hospital of the Ruhr University Bochum, Bochum, Germany. Fifty-three patients treated for lymphoproliferative skin diseases were included in the study, including 14 patients with LPP, 31 with different stages of MF, and 8 with lymphomatoid papulosis (LyP). Twenty-three patients with Kaposi sarcoma (KS) made up the positive control group, and 10 patients with atopic dermatitis served as negative controls. The presence of HHV-8 was analyzed from paraffin-embedded lesional tissue samples using a nested polymerase chain reaction for the open reading frame (ORF) 26 and with immunohistochemical staining for the latency-associated nuclear antigen (LANA) encoded by ORF 73. A high association of HHV-8 infection in both lymphoproliferative skin diseases was observed: 87% of LPP and 70% of MF tissue samples tested positive for HHV-8 DNA from ORF 26. However, HHV-8 was not detectable in LPP and MF by using the immunohistochemical marker LANA. A virus unambiguously associated with KS, HHV-8 was frequently detected at low amounts in LPP and MF specimens. However, based on the methods of HHV-8 detection used in this study, no conclusion can be drawn on the etiologic and pathogenetic role of HHV-8 in these diseases.

  5. Revisiting Low-Dose Total Skin Electron Beam Therapy in Mycosis Fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, Cameron, E-mail: cameronh@stanford.edu [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Young, James; Navi, Daniel [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Riaz, Nadeem [Department of Radiation Oncology, Stanford Cancer Center, Stanford, California (United States); Lingala, Bharathi; Kim, Youn [Department of Dermatology, Stanford Cancer Center, Stanford, California (United States); Hoppe, Richard [Department of Radiation Oncology, Stanford Cancer Center, Stanford, California (United States)

    2011-11-15

    Purpose: Total skin electron beam therapy (TSEBT) is a highly effective treatment for mycosis fungoides (MF). The standard course consists of 30 to 36 Gy delivered over an 8- to 10-week period. This regimen is time intensive and associated with significant treatment-related toxicities including erythema, desquamation, anhydrosis, alopecia, and xerosis. The aim of this study was to identify a lower dose alternative while retaining a favorable efficacy profile. Methods and Materials: One hundred two MF patients were identified who had been treated with an initial course of low-dose TSEBT (5-<30 Gy) between 1958 and 1995. Patients had a T stage classification of T2 (generalized patch/plaque, n = 51), T3 (tumor, n = 29), and T4 (erythrodermic, n = 22). Those with extracutaneous disease were excluded. Results: Overall response (OR) rates (>50% improvement) were 90% among patients with T2 to T4 disease receiving 5 to <10 Gy (n = 19). In comparison, OR rates between the 10 to <20 Gy and 20 to <30 Gy subgroups were 98% and 97%, respectively. There was no significant difference in median progression free survival (PFS) in T2 and T3 patients when stratified by dose group, and PFS in each was comparable to that of the standard dose. Conclusions: OR rates associated with low-dose TSEBT in the ranges of 10 to <20 Gy and 20 to <30 Gy are comparable to that of the standard dose ({>=} 30 Gy). Efficacy measures including OS, PFS, and RFS are also favorable. Given that the efficacy profile is similar between 10 and <20 Gy and 20 and <30 Gy, the utility of TSEBT within the lower dose range of 10 to <20 Gy merits further investigation, especially in the context of combined modality treatment.

  6. A rare case of allergic bronchopulmonary mycosis caused by Alternaria alternata.

    NARCIS (Netherlands)

    Chowdhary, A.; Agarwal, K.; Randhawa, H.S.; Kathuria, S.; Gaur, S.N.; Najafzadeh, M.J.; Roy, P.; Arora, N.; Khanna, G.; Meis, J.F.G.M.

    2012-01-01

    A rare case of allergic bronchopulmonary mycosis (ABPM), caused by Alternaria alternata, is reported in an immunocompetent resident of Delhi. Her complaints included a generalized, urticarial skin rash and occasional pain in the right lower chest. Her differential count showed eosinophils, 22%;

  7. A retrospective study of the probability of the evolution of parapsoriasis en plaques into mycosis fungoides.

    Science.gov (United States)

    Väkevä, Liisa; Sarna, Seppo; Vaalasti, Annikki; Pukkala, Eero; Kariniemi, Arja-Leena; Ranki, Annamari

    2005-01-01

    Parapsoriasis en plaque has been suggested to be an early manifestation of mycosis fungoides (cutaneous T-cell lymphoma). We explored the disease course of patients with small plaque or large plaque parapsoriasis in a 26-year retrospective cohort analysis of 105 parapsoriasis patients, who were clinically and histopathologically followed up in Helsinki and Tampere University Hospitals. Eventual later cancers of these patients were verified from the Finnish Cancer Registry. In the small plaque parapsoriasis group, 7 patients (10%) and in the large plaque parapsoriasis group 12 patients (35%), developed histologically confirmed mycosis fungoides during a median of 10 and 6 years, respectively. No significant differences were found regarding the risk of developing mycosis fungoides or the tendency to remission in patients treated with or without phototherapy. Our results show that not only large plaque parapsoriasis, but also small plaque parapsoriasis, as currently defined in textbooks, can progress to mycosis fungoides. The benefits of phototherapy are equivocal in parapsoriasis treatment as far as progression to cancer is concerned.

  8. STAT3/5-dependent IL9 overexpression contributes to neoplastic cell survival in mycosis fungoides

    DEFF Research Database (Denmark)

    Vieyra-Garcia, Pablo A.; Wei, Tianling; Naym, David Gram

    2016-01-01

    Purpose: Sustained inflammation is a key feature of mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma (CTCL). Resident IL9-producing T cells have been found in skin infections and certain inflammatory skin diseases, but their role in MF is currently unknown.  Experimental ...

  9. Case-control study of possible causative factors in mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Tuyp, E.; Burgoyne, A.; Aitchison, T.; MacKie, R.

    1987-02-01

    A detailed case control study was carried out on 53 patients (33 males and 20 females) with histologically proven mycosis fungoides and on an age- and sex-matched control population. Possible causative factors investigated included occupation, recreation, and exposure to petrochemicals, pesticides, insecticides, and potential carcinogens. Exposure to plants of the Compositae family, tanning history, and chronic sun exposure were also investigated, as were smoking history, drug ingestion history, and other skin disease. Personal and family histories of other malignancies were also investigated. The only statistically significant difference to emerge was that the patients with mycosis fungoides had significantly more family history of atopic dermatitis. In view of the absence of any significant difference between patients and controls with regard to personal history of atopic dermatitis, this difference may be the result of multiple statistical testing rather than a phenomenon of true biological significance.

  10. Risk of venous thromboembolism in patients with mycosis fungoides and parapsoriasis: A Danish nationwide population-based cohort study.

    Science.gov (United States)

    Lindahl, Lise M; Schmidt, Morten; Farkas, Dora K; Sørensen, Henrik T; Iversen, Lars

    2017-12-01

    Mycosis fungoides (MF) and parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may affect the risk for venous thromboembolism (VTE). To examine the risk for VTE in patients with MF and parapsoriasis. We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with parapsoriasis compared with that in sex- and age-matched controls from the general population. In patients with MF, the 10-year absolute risk for VTE was 3.4% (95% confidence interval [CI], 2.0-5.4). The adjusted RRs were 2.41 (95% CI, 1.49-3.90) for VTE and 4.01 (95% CI, 2.16-7.46) for pulmonary embolism. Notably, within the first 5 years after diagnosis with MF, the RR of pulmonary embolism was increased 6.7-fold (to 6.71 [95% CI, 2.86-15.72]). Patients with parapsoriasis had a 2.7-fold increased RR of VTE (to 2.67 [95% CI, 1.32-5.40]) in the absence of other established VTE risk factors. We had no information regarding disease stage of MF and prescribed drugs. Patients with MF and parapsoriasis had an increased RR of VTE, although the absolute risk remained low. These findings should increase awareness of comorbidities in patients with MF and parapsoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. [The lifestyle of Pilsner University female students and its effect on vaginal mycosis].

    Science.gov (United States)

    Cedíková, M; Cerná, L; Ulcová-Gallová, Z; Bibková, K; Hodinová, A; Micanová, Z

    2009-02-01

    Up to now, it does not exit whole look at the life quality of the Pilsner female University students, especially in connection with gynecological history. It is reality that in last years the number of gynecological problems among young women increases such as the number of diseases with immunological background. We prepared questionnaire with 36 questions directed to life style, gynecological history, partner's life, food and hygienic habits, and nicotinism. 28 female students from the total group of 141 suffered from vaginal mycosis--22 (78.6%) use pills, 6 (21.4%) no hormonal contraception. 17 (60.7%) prefer flyaway cloth and 9 (32.1%) tight cloth. 141 students mentioned various number (0-25) of their sexual partners: 1-3 (79 students) in 15 cases (19%) mycoses, more than 4 partners (49 students) in 13 (26.5%) mycoses appeared. The first menstruation appeared in o 13 years (10-17 years). High incidence of vaginal mycosis was proven in students using only tampons than hygienic towels. Vaginal mycosis is affected by many endogenous and exogenous factors. The main factors in pilsner university female students are hormonal contraception, promiscuity and hygienic habits.

  12. Epidemiology of superficial and cutaneous mycosis in 5500 suspected patients in Tehran

    Directory of Open Access Journals (Sweden)

    Ayatollah Nasrollahi Omran

    2010-04-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Identification of the determatophytosis species and superficial mycosis agents may be useful in directing the survey for environmental and animal sources of infection to educate the danger of acquiring infections from infected persons and other animals. Based on this background the identification of cutaneous mycosis distribution was the main purpose."n"nMethods: From March 2005 to Feb 2009 we examined 5500 patients suspected to superficial and cutaneous mycosis referred to medical mycology labs in Tehran, Iran for Medical Mycology examination. Skin, hair and nail sampling were taken by scraping from patients and collected for diagnosis. Diagnosis was confirmed by direct microscopy and culture according to the mycology routine laboratory methods."n"nResults: A total of 2271 cases (41.3% suffered from superficial and cutaneous mycosis. The most common infections were dermatophytosis 1279 cases (56.31%, Tinea Versicolor 356 cases (15.47%, Erythersma 283 cases (12.46%, cutaneous candidiosis 243 cases (10.7% and sacrophytic cutaneous mycosis 110 cases (4.83%. Tichophyton mentagrophytes was the most common etiological agent with 198 cases (41.56%. The most common clinical type of cutaneous candidiasis was

  13. NICOTINAMIDE IN COMPLEX TREATMENT OF LARGE-PLAQUE PARAPSORIASIS AND EARLY STAGES OF MALIGNANT T-CELL SKIN LYMPHOMAS

    Directory of Open Access Journals (Sweden)

    I. V. Khamaganova

    2014-01-01

    Full Text Available Aim: To assess clinical efficacy of nicotinamide in 2 the treatment of patients with early stages of malignant T-cell skin lymphomas and large-plaque parapsoriasis. Materials and methods: 12 patients with erythematous stage of mycosis fungoides and 14 patients with large-plaque parapsoriasis were treated by nicotinamide 15 mg twice daily during 2 weeks. Treatment cycles were repeated 4–5 times per year; topical therapy was also administrated. Results: Nicotinamide demonstrated high therapeutic effect and good tolerability in patients with early stage of mycosis fungoides and large-plaque parapsoriasis. Stable remission was achieved in 1  woman with malignant T-cell lymphoma and 12  patients with large-plaque parapsoriasis; significant clinical improvement was shown in 8 and 12 patients, respectively. Conclusion: Thus, nicotinamide is recommended for comprehensive treatment of large-plaque parapsoriasis and early stages of mycosis fungoides.

  14. Development of Scabies During Treatment for Mycosis Fungoides: Dermatoscopic Diagnosis - Case Report

    Directory of Open Access Journals (Sweden)

    Caner Aykol

    2012-09-01

    Full Text Available Scabies is a cutaneous infestation caused by Sarcoptes scabiei var. hominis and characterized by severe and generalized pruritus. A clinical diagnosis can be made when a burrow is detected at a typical predilection site and the lesion is severely itching. Scabies which occurs in the elderly and also in patients who are immunosuppressed, the lesions are very variable and clinical diagnosis may be difficult. In such cases, dermatoscopy is a simple and rapid diagnostic tool for the diagnosis of scabies with high sensitivity and specificity. Here, a 61-year-old woman who was diagnosed as scabies with dermatoscopic findings and already had mycosis fungoides is reported.

  15. A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation

    Directory of Open Access Journals (Sweden)

    Drew Arthur Emge

    2016-11-01

    Full Text Available Extracutaneous involvement in mycosis fungoides (MF carries a poor prognosis. Oral and gastrointestinal (GI tract lesions are both rare locations of disease. We describe the clinical findings of one case with oral and GI MF complicated by perforation after systemic antineoplastic treatment, and review the relevant literature. The patient had a 1-year history of MF before development of tongue and palate tumors. He was treated with local electron beam radiation, but re-presented to the hospital after what was found to be small intestine perforation following systemic antineoplastic therapy. The case reveals key insights into the progression and complications of lymphomas with GI tract involvement.

  16. Periostin in the Cancer Stroma of Mycosis Fungoides Palmaris et Plantaris: A Case Report and Immunohistochemical Study

    Directory of Open Access Journals (Sweden)

    Kayo Tanita

    2016-02-01

    Full Text Available Mycosis fungoides palmaris et plantaris (MFPP is a rare variant of mycosis fungoides limited to the palms and soles. Although little is known about the pathogenesis of MFPP, this variant of mycosis fungoides presents a relatively good prognosis. In this report, we describe an 85-year-old Japanese man with MFPP. Immunohistochemical staining revealed the dense deposition of periostin in the cancer stroma, as well as infiltration of CD163+CD206- tumor-associated macrophages (TAMs, which suggested the phenotypes of TAMs were not polarized to the M2 phenotype in the lesional skin of MFPP. Our present case might suggest one of the possible reasons for the good prognosis of MFPP.

  17. Shared clonality in distinctive lesions of lymphomatoid papulosis and mycosis fungoides occurring in the same patients suggests a common origin.

    Science.gov (United States)

    de la Garza Bravo, Maria M; Patel, Keyur P; Loghavi, Sanam; Curry, Jonathan L; Torres Cabala, Carlos A; Cason, Ronald C; Gangar, Pamela; Prieto, Victor G; Medeiros, L Jeffrey; Duvic, Madeleine; Tetzlaff, Michael T

    2015-04-01

    Lymphomatoid papulosis (LyP) lies within the spectrum of primary cutaneous CD30-positive lymphoproliferative disorders. Approximately 10% to 15% of patients with LyP develop other lymphomas, most commonly mycosis fungoides (MF), suggesting a biological relationship between these distinctive diseases. Here, we describe the clinical and histopathologic features of 11 patients who had both LyP and MF, including a total of 30 biopsy specimens (14 LyP and 16 MF). Clinically, LyP lesions were characterized by clustered papules undergoing spontaneous regression and were classified as type A (n = 11), type C (n = 2), or type D (n = 1). All cases of MF were characterized clinically by patch/plaque disease, were stage I or II at the time of diagnosis, and consisted of a CD4-predominant epidermotropic T-cell infiltrate. We used polymerase chain reaction-based methods to assess the TCR-β chain (TCRB) and TCR-γ chain (TCRG) in both LyP and MF lesions of all patients. Monoclonal TCR gene rearrangements were detected in 13 LyP lesions from 10 of 11 patients and in 14 MF lesions from 10 of 11 patients. All 10 patients in whom their skin lesions carried monoclonal TCR gene rearrangements exhibited overlapping clones in both their LyP and MF lesions; additional non-overlapping clones were identified in 3 LyP lesions from 2 patients and 1 MF lesion from another patient. The demonstration of shared monoclonal T-cell receptor gene rearrangements in LyP and MF lesions in almost all patients suggests a common origin between these distinctive clinicopathological diseases. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Total Skin Electron Beam Therapy in the Treatment of Mycosis Fungoides: A Review of Conventional and Low-Dose Regimens.

    Science.gov (United States)

    Chowdhary, Mudit; Chhabra, Arpit M; Kharod, Shivam; Marwaha, Gaurav

    2016-12-01

    Mycosis fungoides (MF) is the most prevalent subtype of cutaneous T-cell lymphoma, which is characterized by the proliferation of CD4 + T cells. While often an indolent disease, most patients eventually develop progression from isolated patches to tumors and finally nodal or visceral involvement. Treatment choice is largely based on disease burden, though prognostic factors such as disease stage, patient age, and extracutaneous involvement must be taken into consideration. Radiotherapy represents one of the most effective therapeutic modalities in the treatment of MF. Lymphocytes are exquisitely radiosensitive, and excellent responses are observed even with low doses of radiation. Total skin electron beam therapy (TSEBT) is a special technique that allows for the homogenous irradiation of the entire skin. There are well-documented radiation dose-response relationships for achieving a complete response. As such, TSEBT doses ≥ 30 Gy comprise the current standard of care. Although highly effective, most patients experience recurrent disease even after conventional-dose (≥ 30 Gy) TSEBT. In addition, toxicity is cumulatively dose dependent, and there is reluctance to administer multiple courses of conventional-dose TSEBT. Consequently, there has been renewed interest in determining the utility of TSEBT at lower total (≤ 30 Gy) doses. Advantages of low-total-dose (with standard dose per fraction) TSEBT include a shortened treatment course, the potential to minimize the risk of adverse events, and the opportunity to allow for retreatment in cases of disease recurrence. This comprehensive review compares the impact of different TSEBT dosing schemes on clinical outcomes of MF. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Micose fungóide: estudo epidemiológico de 17 casos e avaliação da resposta terapêutica à PUVA Mycosis fungoides: epidemiologic study of 17 cases and evaluation of PUVA photochemotherapy

    Directory of Open Access Journals (Sweden)

    Ida Duarte

    2006-02-01

    Full Text Available FUNDAMENTOS: A fotoquimioterapia com PUVA é indicada para tratamento da micose fungóide, empregada como monoterapia em estágios precoces ou combinada a outras drogas nos estágios mais avançados da doença. OBJETIVOS: Avaliação da resposta terapêutica à fotoquimioterapia PUVA em pacientes com micose fungóide. MÉTODOS: Entre janeiro de 1996 e novembro de 2003 avaliaram-se 17 pacientes com micose fungóide no setor de Fototerapia da Clínica Dermatológica da Santa Casa de São Paulo. A terapia com PUVA foi realizada como monoterapia nos estádios iniciais ou como coadjuvante nos estádios avançados da doença. Avaliou-se o resultado do tratamento quanto ao aspecto clínico das lesões e parâmetros histológicos após tratamento. RESULTADOS: Quatorze de 16 pacientes responderam à fotoquimioterapia. Relacionando o estadiamento da doença à resposta terapêutica obteve-se o seguinte: cinco pacientes (um em estágio IA e quatro em IB com controle total (cura das lesões; quatro (todos IB com melhora intensa (controle de 70-99%; dois (IIB e IVA com melhora moderada (de 50 a 69%; três (IA, IB, IIA com melhora discreta (menos 50%; dois (IB, IIB inalterados (sem resposta. Um paciente teve de descontinuar o tratamento por apresentar intenso ardor. CONCLUSÃO: Houve resposta à terapia PUVA em 87% dos pacientes, com controle total ou melhora intensa da doença em 56% dos casos. Sua efetividade permitiu regressão das lesões cutâneas, principalmente nos casos precoces. A fotoquimioterapia com PUVA mostrou ser tratamento seguro e efetivo, devendo ser considerado em pacientes com micose fungóide.BACKGROUND: PUVA photochemotherapy is indicated to treat mycosis fungoides, either as monotherapy in the earlier stages of the disease or in combination with other drugs in more advanced stages of evolution. OBJECTIVES: To evaluate PUVA photochemotherapy response in patients with mycosis fungoides. METHODS: From January 1996 to November 2003, 17

  20. Mycosis fungoides and Sézary syndrome: clinical, histopathological and immunohistochemical review and update Micose fungóide e síndrome de Sézary: revisão e atualização clínica, histopatológica e imuno-histoquímica

    Directory of Open Access Journals (Sweden)

    Thamy Yamashita

    2012-12-01

    Full Text Available This paper reviews the diagnostic and classificatory concepts of mycosis fungoides and Sézary syndrome in light of the latest normative publications. It describes the great variability of the clinical expression of mycosis fungoides in its early stages as well as the histopathological and immunohistochemical aspects that help with diagnosis. The diagnostic criteria required for characterizing Sézary syndrome and the staging system used for both mycosis fungoides and Sézary syndrome are described.O artigo revisa os conceitos diagnósticos e de classificação da micose fungóide e da síndrome de Sézary a luz das publicações normativas mais recentes. Descreve a grande variabilidade de expressão clinica da micose fungóide em seus estágios iniciais assim como os aspectos histopatológicos e imuno-histoquímicos auxiliares ao diagnóstico. São descritos os critérios de diagnósticos exigidos para que se caracterize a síndrome de Sézary e o sistema de estadiamento, utilizado para ambas, micose fungóide e síndrome de Sézary.

  1. Predictive factors for oropharyngeal mycosis during radiochemotherapy for head and neck carcinoma and consequences on treatment duration. Results of mycosis in radiotherapy (MIR): A prospective longitudinal study

    International Nuclear Information System (INIS)

    Busetto, Mario; Fusco, Vincenzo; Corbella, Franco; Bolzan, Mario; Pavanato, Giovanni; Bonetti, Bartolomea; Maggio, Francesca; Orsatti, Marco; De Renzis, Costantino; Mandoliti, Giovanni; Sotti, Guido; Di Monale e Bastia, Michela Buglione; Turcato, Giacomo; Colombo, Sara; Magrini, Stefano Maria; Guglielmi, Rosa Bianca; Cionini, Luca; Montemaggi, Paolo; Panizzoni, Gino; Delia, Paolo

    2013-01-01

    Background and purpose: Oropharyngeal mycosis (OPM) is a complication of radiotherapy (RT) treatments for head and neck (H and N) cancer, worsening mucositis and dysphagia, causing treatment interruptions and increasing overall treatment time. Prophylaxis with antifungals is expensive. Better patient selection through the analysis of prognostic factors should improve treatment efficacy and reduce costs. Materials and methods: A multicentre, prospective, controlled longitudinal study, with ethics committee approval, examined H and N cancer patients who were candidates for curative treatments with radio-chemotherapy. Patients were divided in groups according to OPM appearance: before the starting of RT (cases), during RT (new cases) and never (no cases). Results: Of 410 evaluable patients, 20 were existing cases, 201 new cases and 189 did not report OPM. In our study OPM appears in 42.4% of people >70 years and in 58.2% of younger individuals (p = 0.0042), and in 68.6% of women versus 50.8% of men (p = 0.0069). Mucositis and dysphagia were higher and salivation reduced among people with OPM (p 12 days) treatment interruptions (p = 0.0288). Conclusions: Patients with OPM had higher toxicity and a greater number of long treatment interruptions. Analyses of prognostic factors can help clinicians understand OPM distribution and select patients with the highest probability of OPM for antifungal prophylaxis

  2. Psychological characteristics of early-stage melanoma patients: a cross-sectional study on 204 patients.

    Science.gov (United States)

    Tesio, Valentina; Ribero, Simone; Castelli, Lorys; Bassino, Stefania; Leombruni, Paolo; Caliendo, Virginia; Grassi, Marcella; Lauro, Danilo; Macripò, Giuseppe; Torta, Riccardo G V

    2017-06-01

    The presence of psychological distress has a negative impact not only on cancer patients' quality of life but also on the course of the disease, with slower recovery and increased morbidity. These issues are of particular importance in melanoma patients (MP), who remain at risk of disease progression for many years after diagnosis. This study aimed to investigate psychological distress, coping strategies, and their possible relationships with demographic-clinical features in patients with early-stage melanoma in follow-up. The investigation focused in particular on whether the psychological profile differed between patients at different melanoma stages. Data of 118 patients with melanoma in the Tis-Ia stages (MP_Tis-Ia) and 86 patients with melanoma in the Ib-IIa-IIb stages (MP_Ib-II) were gathered through a self-administered survey and compared using a cross-sectional design. The results evidenced a high percentage of anxiety (25%) and distress symptoms (44%), whereas depressive symptoms seemed less frequent (8%). Psychological distress was higher in women than in men, and in patients with a higher educational level. Nevertheless, no significant differences were found between MP_Tis-Ia and MP_Ib-II. With respect to coping style, the patients in this sample adopted predominantly positive and active strategies. Correlational analyses showed that maladaptive coping strategies such as behavioral disengagement, denial, self-distraction, and self-blame were most strongly related to increased levels of psychological distress. The high presence of anxiety and distress symptoms, their relationship, and the use of negative coping strategies underline the importance of psychological distress screening also in early-stage MP, including at long-term follow-up.

  3. Regulatory T cells and immunodeficiency in mycosis fungoides and Sézary syndrome

    DEFF Research Database (Denmark)

    Krejsgaard, Thorbjørn Frej; Ødum, Niels; Geisler, Carsten

    2012-01-01

    unclear. The identification of a subset of highly immunosuppressive regulatory T cells (Tregs) triggered a variety of studies investigating if MF and SS are malignant proliferations of Tregs but seemingly discordant findings have been reported. Here, we review the literature to clarify the role of Tregs......Cutaneous T-cell lymphoma (CTCL) is the term for diseases characterized by primary accumulation of malignant T cells in the skin. Patients with the two predominant clinical forms of CTCL called mycosis fungoides (MF) and Sézary syndrome (SS) characteristically develop severe immunodeficiency during...... disease progression and consequently patients with advanced disease frequently die of infections and not from the tumor burden. For decades, it has been suspected that the malignant T cells actively drive the evolving immunodeficiency to avoid antitumor immunity, yet, the underlying mechanisms remain...

  4. Photodynamic Therapy with the Silicon Phthalocyanine Pc 4 Induces Apoptosis in Mycosis Fungoides and Sezary Syndrome

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    Minh Lam

    2010-01-01

    Full Text Available Our current focus on the effects of Photodynamic Therapy (PDT using silicon phthalocyanine Pc 4 photosensitizer on malignant T lymphocytes arose due to preclinical observations that Jurkat cells, common surrogate for human T cell lymphoma, were more sensitive to Pc 4-PDT-induced killing than epidermoid carcinoma A431 cells. Mycosis fungoides (MF as well as Sezary syndrome (SS are variants of cutaneous T-cell lymphoma (CTCL in which malignant T-cells invade the epidermis. In this study, we investigated the cytotoxicity of Pc 4-PDT in peripheral blood cells obtained from patients with SS and in skin biopsies of patients with MF. Our data suggest that Pc 4-PDT preferentially induces apoptosis of CD4+CD7− malignant T-lymphocytes in the blood relative to CD11b+ monocytes and nonmalignant T-cells. In vivo Pc 4-PDT of MF skin also photodamages the antiapoptotic protein Bcl-2.

  5. Photodynamic Therapy with the Silicon Phthalocyanine Pc 4 Induces Apoptosis in Mycosis Fungoides and Sezary Syndrome

    Science.gov (United States)

    Lam, Minh; Lee, YooJin; Deng, Min; Hsia, Andrew H.; Morrissey, Kelly A.; Yan, Chunlin; Azzizudin, Kashif; Oleinick, Nancy L.; McCormick, Thomas S.; Cooper, Kevin D.; Baron, Elma D.

    2010-01-01

    Our current focus on the effects of Photodynamic Therapy (PDT) using silicon phthalocyanine Pc 4 photosensitizer on malignant T lymphocytes arose due to preclinical observations that Jurkat cells, common surrogate for human T cell lymphoma, were more sensitive to Pc 4-PDT-induced killing than epidermoid carcinoma A431 cells. Mycosis fungoides (MF) as well as Sezary syndrome (SS) are variants of cutaneous T-cell lymphoma (CTCL) in which malignant T-cells invade the epidermis. In this study, we investigated the cytotoxicity of Pc 4-PDT in peripheral blood cells obtained from patients with SS and in skin biopsies of patients with MF. Our data suggest that Pc 4-PDT preferentially induces apoptosis of CD4+CD7− malignant T-lymphocytes in the blood relative to CD11b+ monocytes and nonmalignant T-cells. In vivo Pc 4-PDT of MF skin also photodamages the antiapoptotic protein Bcl-2. PMID:21197103

  6. Clinicopathological features of mycosis fungoides in patients exposed to Agent Orange during the Vietnam War.

    Science.gov (United States)

    Jang, Min Soo; Jang, Jun Gyu; Han, Sang Hwa; Park, Jong Bin; Kang, Dong Young; Kim, Sang Tae; Suh, Kee Suck

    2013-08-01

    There are no reports on the clinicopathological features of mycosis fungoides (MF) among veterans exposed to Agent Orange, one of the herbicides used during the Vietnam War. To evaluate the clinical, histopathological and genotypic findings of Vietnam War veterans with MF and a positive history of exposure to Agent Orange, we performed a comparative clinicopathological study between MF patients with a history of Agent Orange exposure and those without a history of Agent Orange exposure. Twelve Vietnam War veterans with MF were identified. The mean interval from Agent Orange exposure to diagnosis was 24.5 years (range, 9-35). Skin lesions were significantly present on exposed and unexposed areas. Most patients (75%) experienced pruritus (mean visual analog scale score of 6.7). MF was manifested by plaques in 10 patients and by lichenification in five. Histopathological features of most cases were consistent with MF. Biopsy specimens also demonstrated irregular acanthosis (66.7%). In the comparative study, MF patients with a history of Agent Orange exposure differed significantly from those without exposure to Agent Orange in demographic and clinical characteristics. In addition, patients with exposure had an increased tendency for lesions in the exposed area. Notably, our patients showed a higher frequency (33.3%) of mycosis fungoides palmaris et plantaris than in previous studies. Histologically, irregular acanthosis was more frequently observed than ordinary MF. Our results indicate that dermatologists should pay close attention to these clinicopathological differences. Careful assessment of history of exposure to defoliants is warranted in some cases suspicious for MF. © 2013 Japanese Dermatological Association.

  7. Clinical Significance of IGFBP-3 Methylation in Patients with Early Stage Gastric Cancer

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    Seung Tae Kim

    2015-08-01

    Full Text Available BACKGROUND: IGFBP-3 is a multifunctional protein that inhibits growth and induces apoptosis of cancer cells. Hypermethylation of the promoter represses expression of the IGFBP-3 gene. We undertook this study to assess the impact of IGFBP-3 methylation on survival of early stage gastric cancer patients. METHODS: Of the 482 tissue samples from gastric cancer patients who underwent curative surgery, IGFBP-3 methylation was tested in 138 patients with stage IB/II gastric cancer. We also analyzed IGFBP-3 methylation in 26 gastric cancer cell lines. IGFBP-3 methylation was evaluated by methylation-specific polymerase chain reaction (MethyLight. Statistical analyses, all two-sided, were performed to investigate the prognostic effects of methylation status of the IGFBP-3 promoter on various clinical parameters. RESULTS: Hypermethylation of IGFBP-3 was observed in 26 (19% of the 138 stage IB/II gastric cancer patients. Clinicopathological factors such as age, Lauren classification, sex, tumor infiltration, lymph node metastasis, and histologic grade did not show a statistically significant association with the methylation status of the IGFBP-3 promoter. Patients with a hypermethylated IGFBP-3 promoter had similar 8-year disease-free survival compared with those without a hypermethylated IGFBP-3 promoter (73% vs 75%, P = .78. In subgroup analyses, females, but not males, seemed to have poorer prognosis for DFS and OS in the subset of patients with IGFBP-3 methylation as compared with those without IGFBP-3 methylation (8-year DFS: 55.6% vs 71.6%, P = .3694 and 8-year overall survival: 55.6% vs 68.4%, P = .491, respectively even with no statistical significance. CONCLUSIONS: The status of IGFBP-3 methylation as measured by methylation-specific polymerase chain reaction proposed the modest role for predicting survival in specific subgroups of patients with early-stage gastric cancer who undergo curative surgery. However, this needs further investigation.

  8. Proposed Lymph Node Staging System Using the International Consensus Guidelines for Lymph Node Levels Is Predictive for Nasopharyngeal Carcinoma Patients From Endemic Areas Treated With Intensity Modulated Radiation Therapy

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    Li, Wen-Fei; Sun, Ying; Mao, Yan-Ping; Chen, Lei; Chen, Yuan-Yuan; Chen, Mo [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Liu, Li-Zhi [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Lin, Ai-Hua [Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou (China); Li, Li [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China); Ma, Jun, E-mail: majun2@mail.sysu.edu.cn [Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou (China)

    2013-06-01

    Purpose: To propose a lymph node (N) staging system for nasopharyngeal carcinoma (NPC) based on the International Consensus Guidelines for lymph node (LN) levels and MRI-determined nodal variables. Methods and Materials: The MRI scans and medical records of 749 NPC patients receiving intensity modulated radiation therapy with or without chemotherapy were retrospectively reviewed. The prognostic significance of nodal level, laterality, maximal axial diameter, extracapsular spread, necrosis, and Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) size criteria were analyzed. Results: Nodal level and laterality were the only independent prognostic factors for distant failure and disease failure in multivariate analysis. Compared with unilateral levels Ib, II, III, and/or Va involvement (hazard ratio [HR] 1), retropharyngeal lymph node involvement alone had a similar prognostic value (HR 0.71; 95% confidence interval [CI] 0.43-1.17; P=.17), whereas bilateral levels Ib, II, III, and/or Va involvement (HR 1.65; 95% CI 1.06-2.58; P=.03) and levels IV, Vb, and/or supraclavicular fossa involvement (HR 3.47; 95% CI 1.92-6.29; P<.01) both significantly increased the HR for distant failure. Thus we propose that the N category criteria could be revised as follows: N0, no regional LN metastasis; N1, retropharyngeal lymph node involvement, and/or unilateral levels Ib, II, III, and/or Va involvement; N2, bilateral levels Ib, II, III, and/or Va involvement; N3, levels IV, Vb, and/or supraclavicular fossa involvement. Compared with the 7th edition of the UICC/AJCC criteria, the proposed N staging system provides a more satisfactory distinction between the HRs for regional failure, distant failure, and disease failure in each N category. Conclusions: The proposed N staging system defined by the International Consensus Guidelines and laterality is predictive and practical. However, because of no measurements of the maximal nodal diameter on MRI slices

  9. Subsequent cancers, mortality, and causes of death in patients with mycosis fungoides and parapsoriasis: a Danish nationwide, population-based cohort study.

    Science.gov (United States)

    Lindahl, Lise M; Fenger-Grøn, Morten; Iversen, Lars

    2014-09-01

    Data on subsequent cancers, prognostic factors for mortality, and causes of death are limited in mycosis fungoides (MF) and parapsoriasis. To assess subsequent cancers, mortality, and causes of death in MF and parapsoriasis. Using the Danish nationwide population-based registries, we identified 368 MF patients and 582 parapsoriasis patients and compared them with the general Danish population for subsequent cancers, mortality, and causes of death. Subsequent cancers were significantly increased in parapsoriasis patients (standardized incidence ratio [SIR], 2.0 [95% confidence interval {CI}, 1.6-2.5]), and a trend was observed in MF (SIR, 1.2 [95% CI, 0.9-1.5]). Mortality was significantly increased in MF (SIR, 2.0 [95% CI, 1.8-2.3]) and parapsoriasis (SIR, 1.3 [95% CI, 1.1-1.5]). Excess mortality from MF was highest during the first 5 years of follow-up, and causes of increased death included both malignant and nonmalignant diseases. We have no information regarding clinical stage, treatments, and patient lifestyles. Patients with parapsoriasis had a significantly increased risk of subsequent cancers and increased mortality. In addition, the highest excess mortality in the MF group was observed during the first 5 years of follow-up, which suggests that MF exists in both an aggressive and a more indolent form. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. IL-15 and IL-17F are differentially regulated and expressed in mycosis fungoides (MF)

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    Willerslev-Olsen, Andreas; Litvinov, Ivan V; Fredholm, Simon M

    2014-01-01

    Skin lesions from mycosis fungoides (MF) patients display an increased expression of interleukin-15 (IL-15), IL-17F, and other cytokines implicated in inflammation and malignant cell proliferation in cutaneous T-cell lymphoma (CTCL). In the leukemic variant of CTCL, Sézary syndrome (SS), IL-2...... and IL-15 trigger activation of the Jak-3/STAT3 pathway and transcription of IL17A gene, whereas it is unknown what causes IL-15 expression, Jak3/STAT3 activation, and production of IL-17F in MF. Here, we studied the expression and regulation of IL-15 and its relation to IL-17F in MF cell lines and skin......-malignant MF T cells, whereas the spontaneous STAT3 activation and IL-17F expression in malignant T cells is not inhibited; (3) patients display heterogeneous IL-15/IL-17F mRNA expression patterns in skin lesions; and (4) IL-15 expression (in contrast to IL-17F) is not associated with progressive disease...

  11. PARACOCCIDIOIDOMYCOSIS: CHALLENGES IN THE DEVELOPMENT OF A VACCINE AGAINST AN ENDEMIC MYCOSIS IN THE AMERICAS.

    Science.gov (United States)

    Taborda, Carlos P; Urán, M E; Nosanchuk, J D; Travassos, L R

    2015-09-01

    Paracoccidioidomycosis (PCM), caused by Paracoccidioides spp, is an important endemic mycosis in Latin America. There are two recognized Paracoccidioides species, P. brasiliensis and P. lutzii, based on phylogenetic differences; however, the pathogenesis and disease manifestations of both are indistinguishable at present. Approximately 1,853 (~51,2%) of 3,583 confirmed deaths in Brazil due to systemic mycoses from 1996-2006 were caused by PCM. Antifungal treatment is required for patients with PCM. The initial treatment lasts from two to six months and sulfa derivatives, amphotericin B, azoles and terbinafine are used in clinical practice; however, despite prolonged therapy, relapses are still a problem. An effective Th1-biased cellular immune response is essential to control the disease, which can be induced by exogenous antigens or modulated by prophylactic or therapeutic vaccines. Stimulation of B cells or passive transference of monoclonal antibodies are also important means that may be used to improve the efficacy of paracoccidioidomycosis treatment in the future. This review critically details major challenges facing the development of a vaccine to combat PCM.

  12. Utilization of thermoluminescent dosimetry in total skin electron beam radiotherapy of mycosis fungoides

    International Nuclear Information System (INIS)

    Antolak, John A.; Cundiff, Jackson H.; Ha, Chul S.

    1998-01-01

    Purpose: The purpose of this report is to discuss the utilization of thermoluminescent dosimetry (TLD) in total skin electron beam (TSEB) radiotherapy to: (a) compare patient dose distributions for similar techniques on different machines, (b) confirm beam calibration and monitor unit calculations, (c) provide data for making clinical decisions, and (d) study reasons for variations in individual dose readings. Methods and Materials: We report dosimetric results for 72 cases of mycosis fungoides, using similar irradiation techniques on two different linear accelerators. All patients were treated using a modified Stanford 6-field technique. In vivo TLD was done on all patients, and the data for all patients treated on both machines was collected into a database for analysis. Means and standard deviations (SDs) were computed for all locations. Scatter plots of doses vs. height, weight, and obesity index were generated, and correlation coefficients with these variables were computed. Results: The TLD results show that our current TSEB implementation is dosimetrically equivalent to the previous implementation, and that our beam calibration technique and monitor unit calculation is accurate. Correlations with obesity index were significant at several sites. Individual TLD results allow us to customize the boost treatment for each patient, in addition to revealing patient positioning problems and/or systematic variations in dose caused by patient variability. The data agree well with previously published TLD results for similar TSEB techniques. Conclusion: TLD is an important part of the treatment planning and quality assurance programs for TSEB, and routine use of TLD measurements for TSEB is recommended

  13. Risk of venous thromboembolism in patients with mycosis fungoides and parapsoriasis

    DEFF Research Database (Denmark)

    Lindahl, Lise M; Schmidt, Morten; Farkas, Dora K

    2017-01-01

    BACKGROUND: Mycosis fungoides (MF) and parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may impact the risk of venous thromboembolism (VTE). OBJECTIVES: To examine the risk of VTE in patients with MF and parapsoriasis. METHODS: We conducted a nationwide...... population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with parapsoriasis compared with sex- and age-matched controls from the general population. RESULTS: In patients with MF, the 10-year absolute risk of VTE was 3.4% (95% CI confidence...... interval (CI) 2.0-5.4). The adjusted RRs were 2.41 (95% CI 1.49-3.90) for VTE and 4.01 (95% CI 2.16-7.46) for pulmonary embolism (PE). Notably, within the first 5 years after diagnosis with MF, the RR of PE was 6.7-fold increased (6.71, 95% CI 2.86-15.72). Patients with parapsoriasis had a 2.7-fold...

  14. Risk of Acute Myocardial Infarction or Stroke in Patients with Mycosis Fungoides and Parapsoriasis.

    Science.gov (United States)

    Lindahl, Lise M; Heide-Jørgensen, Uffe; Pedersen, Lars; Sørensen, Henrik Toft; Iversen, Lars

    2016-05-01

    Mycosis fungoides (MF) and parapsoriasis display increased inflammation, which may be associated with increased risk of arterial cardiovascular events. The aim of this Danish nationwide population-based cohort study was to assess the relative risk (RR) of acute myocardial infarction (AMI) or stroke in patients with MF and parapsoriasis. In patients with MF, the RR of AMI or stroke was 1.0 (95% confidence interval (95% CI) 0.7-1.3). In the second half of the study period, the RR was 1.8 (95% CI 1.1-2.9) during the first 5 years of follow-up. In men with parapsoriasis, the RR of AMI or stroke was 1.7 (95% CI 1.1-2.7) within the first 5 years of follow-up, whereas the RR of AMI during the first 5 years of follow-up was 2.0 (95% CI 1.2-3.4). In conclusion, patients with MF and parapsoriasis have an increased RR of AMI or stroke within the first 5 years of follow-up.

  15. Skin Recurrence of Transformed Mycosis Fungoides Postumbilical Cord Blood Transplant despite Complete Donor Chimerism

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    Rahul Pawar

    2014-01-01

    Full Text Available Background. Allogeneic stem cell transplant is the treatment of choice for systemic cutaneous T-cell lymphoma (CTCL which provides graft-versus-lymphoma effect. Herein we discuss a case of recurrence of CTCL skin lesions after cord blood transplant in a patient who continued to have 100% donor chimerism in bone marrow. Case Presentation. A 48-year-old female with history of mycosis fungoides (MF presented with biopsy proven large cell transformation of MF. PET scan revealed multiple adenopathy in abdomen and chest suspicious for lymphoma and skin biopsy showed large cell transformation. She was treated with multiple cycles of chemotherapy. Posttherapy PET scan showed resolution of lymphadenopathy. Later she underwent ablative preparative regimen followed by single cord blood transplant. Bone marrow chimerism studies at day +60 after transplant showed 100% donor cells without presence of lymphoma. However 5 months after transplant she had recurrence of MF with the same genotype as prior skin lesion. Bone marrow chimerism study continued to show 100% donor cells. Conclusion. A differential graft-versus-lymphoma effect in our case prevented lymphoma recurrence systemically but failed to do so in skin. We hypothesize that this response may be due to presence of other factors in the bone marrow and lymph node microenvironments preventing recurrence in these sites.

  16. Risk of Cutaneous Malignancy in Mycosis Fungoides Patients Treated with PUVA: A Retrospective Study

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    Melike Umarova Aslan

    2015-03-01

    Full Text Available Objective: PUVA therapy is mostly used longer than other diseases in mycosis fungoides (MF patients. We aimed to investigate the chronic side effects of PUVA therapy, including skin cancer to disclose the actual risk in Turkish population. Methods: We screened all MF patients treated with PUVA at the Department of Dermatology and Venereology of İstanbul Medical Faculty and included patients in whom PUVA has first initiated between 1994 and 2006 and administered in one or several courses and who were followed up more than five years with last visit in 2012. Results: Fifty patients with MF had a mean follow-up duration of 10.2±2.8 years. Six patients (12% had PUVA lentigines. Two of them (4% developed skin cancer (basal cell carcinoma, Bowen’s disease during their follow-up. The mean sessions (295.5±7.8 sessions and total UVA doses (1452 J/cm2 in these patients with skin cancer were higher than those who did not develop skin cancer (128.7±73 sessions and 515±31 J/cm2, respectively. There was a significant relationship between the PUVA lentigines and development of cutaneous malignancy (p=0.01. Conclusion: Cutaneous malignancies were detected in 4% of MF patients followed up approximately 10 years. Due to this low risk, we conclude that PUVA therapy is relatively safe in patients with MF in our country. However, UVA should not be applied in high total doses and patients should be followed-up lifelong.

  17. Lymphomatoid papulosis in association with mycosis fungoides: a study of 15 cases.

    Science.gov (United States)

    Basarab, T; Fraser-Andrews, E A; Orchard, G; Whittaker, S; Russel-Jones, R

    1998-10-01

    We report clinical findings in 15 patients with lymphomatoid papulosis (LyP) associated with mycosis fungoides (MF). LyP either preceded (n = 4), followed (n = 5) or occurred concurrently with the MF lesions (n = 6). Twenty-eight LyP lesions were classified histologically and analysed further with immunostaining for CD3 and CD30. Five biopsies contained a predominance of type A cells, six biopsies contained a predominance of type B cells. and six were mixed (A + B). However, 11 biopsies contained a population of atypical mononuclear cells with large hyperchromatic nuclei that we have termed indeterminate cells. These cells contained a thin rim of eosinophilic cytoplasm and showed strong CD30 but absent, faint or normal CD3 staining. In seven biopsies from five separate patients these cells represented the predominant cell type and we have termed this the pleomorphic variant of LyP. Analysis of T-cell receptor genes using Southern blot analysis and polymerase chain reaction/single strand conformational polymorphism analysis identified a T-cell clone in six of 16 LyP lesions and nine of 16 MF lesions. In the three patients who had clones in both types of skin lesions, the clones were identical. Only two of 10 blood samples, both of which were from the same patient, had a T-cell clone and none of two lymph nodes showed evidence of a clonal population. To date all patients are alive with a median follow-up of 15 years from the onset of the first lesion. One patient has developed Lin anaplastic large cell lymphoma of the nasopharynx. These data augment the current literature on the association of LyP and MF and suggest that the

  18. Occurrence of allergic bronchopulmonary mycosis in patients with asthma: An Eastern India experience

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    Sarkar Anirban

    2010-01-01

    Full Text Available Background: Allergic bronchopulmonary mycosis (ABPM is a clinical syndrome associated with immune sensitivity to various fungi notably Aspergillus spp. that colonize the airways of asthmatics. Early diagnosis and treatment with systemic corticosteroids is the key in preventing the progression of the disease to irreversible lung fibrosis. Aims: To study the occurrence of ABPM among asthma patients with fungal sensitization attending a chest clinic of a tertiary hospital of eastern India. The clinico-radiological and aetiological profiles are also described. Materials and Methods: All consecutive patients with asthma presenting to the chest clinic over a period of one year were screened for cutaneous hypersensitivity to 12 common fungal antigens. The skin test positive cases were further evaluated for ABPM using standard criteria. Results: One hundred and twenty-six asthma patients were screened using twelve common fungal antigens; forty patients (31.74% were found to be skin test positive, and ABPM was diagnosed in ten patients (7.93%. Of the 10 cases of ABPM, nine cases were those of allergic bronchopulmonary aspergillosis (ABPA and one case was identified as caused by sensitization to Penicillium spp. A majority of the cases of ABPM had advanced disease and had significantly lower FEV1 compared to non-ABPM skin test positive asthmatics. Central bronchiectasis on high resolution CT scan was the most sensitive and specific among the diagnostic parameters. Conclusion: There is a significant prevalence of ABPM in asthma patients attending our hospital and this reinforces the need to screen asthma patients for fungal sensitisation. This will help in early diagnosis and prevention of irreversible lung damage.

  19. Clinical characteristics of biopsy-proven allergic bronchopulmonary mycosis: variety in causative fungi and laboratory findings.

    Science.gov (United States)

    Ishiguro, Takashi; Takayanagi, Noboru; Kagiyama, Naho; Shimizu, Yoshihiko; Yanagisawa, Tsutomu; Sugita, Yutaka

    2014-01-01

    The diagnosis of allergic bronchopulmonary mycosis (ABPM) has traditionally relied widely on Rosenberg's criteria, which emphasize immunologic responses while overlooking the investigation of mucous plugs as a primary criterion. Therefore, the characteristics of biopsy-proven ABPM require further elucidation. The aim of this study was to analyze the clinical characteristics of biopsy-proven ABPM and address whether full compliance with clinical criteria, such as the presence of asthma, and certain laboratory findings is necessary to establish a diagnosis of ABPM. We retrospectively analyzed 17 patients with biopsy-proven ABPM focusing on causative fungi and laboratory findings. Causative fungi included Aspergillus sp. in seven patients, Schizophyllum commune in four patients, Penicillium sp. in two patients and unknown in five patients. Bronchial asthma was observed in 10 patients, eosinophilia was observed in 10 patients and an increased serum immunoglobulin (Ig) E level was observed in 14 of the 17 patients. IgG for Aspergillus sp. was positive in six of the seven patients with ABPM due to Aspergillus and turned positive in the remaining patient during follow-up. Technological limitations prevented the measurement of specific IgE for S. commune and IgG for S. commune and Penicillium sp. in most patients. Computed tomography revealed central bronchiectasis, pulmonary infiltration and mucous plugs in all patients. Causative fungi other than Aspergillus sp. are not uncommon, and immunological tests for other fungi should be popularized. Asthma and characteristic laboratory findings, such as peripheral blood eosinophilia, increased serum IgE and precipitating antibodies, may not always be required to diagnose ABPM. The importance of typical pathologic findings of mucous plugs for diagnosing ABPM requires reevaluation. Further studies are needed to establish more elaborate diagnostic criteria for ABPM.

  20. Recommendations for the diagnosis of candidemia in Latin America. Latin America Invasive Mycosis Network.

    Science.gov (United States)

    Colombo, Arnaldo Lopes; Cortes, Jorge Alberto; Zurita, Jeannete; Guzman-Blanco, Manuel; Alvarado Matute, Tito; de Queiroz Telles, Flavio; Santolaya, María E; Tiraboschi, Iris Nora; Echevarría, Juan; Sifuentes, Jose; Thompson-Moya, Luis; Nucci, Marcio

    2013-01-01

    Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'. Copyright © 2013 Revista

  1. Recommendations for the management of candidemia in neonates in Latin America. Latin America Invasive Mycosis Network.

    Science.gov (United States)

    Santolaya, María E; Alvarado Matute, Tito; de Queiroz Telles, Flavio; Colombo, Arnaldo Lopes; Zurita, Jeannete; Tiraboschi, Iris Nora; Cortes, Jorge Alberto; Thompson-Moya, Luis; Guzman-Blanco, Manuel; Sifuentes, Jose; Echevarría, Juan; Nucci, Marcio

    2013-01-01

    Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in neonates in Latin America', was written to provide guidance to healthcare professionals on the management of neonates who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in neonates in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, central venous catheter management, and management of complications. This manuscript is the fourth of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in children in Latin America'. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights

  2. Recommendations for the management of candidemia in adults in Latin America. Latin America Invasive Mycosis Network.

    Science.gov (United States)

    Nucci, Marcio; Thompson-Moya, Luis; Guzman-Blanco, Manuel; Tiraboschi, Iris Nora; Cortes, Jorge Alberto; Echevarría, Juan; Sifuentes, Jose; Zurita, Jeannete; Santolaya, María E; Alvarado Matute, Tito; de Queiroz Telles, Flavio; Colombo, Arnaldo Lopes

    2013-01-01

    Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'. Copyright © 2013 Revista Iberoamericana de Micología. Published by

  3. Recommendations for the management of candidemia in children in Latin America. Latin America Invasive Mycosis Network.

    Science.gov (United States)

    Santolaya, María E; de Queiroz Telles, Flavio; Alvarado Matute, Tito; Colombo, Arnaldo Lopes; Zurita, Jeannete; Tiraboschi, Iris Nora; Cortes, Jorge Alberto; Thompson-Moya, Luis; Guzman-Blanco, Manuel; Sifuentes, Jose; Echevarría, Juan; Nucci, Marcio

    2013-01-01

    Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'. Copyright © 2013 Revista Iberoamericana de Micología. Published by

  4. Disseminated Mycosis in Veiled Chameleons (Chamaeleo calyptratus) Caused by Chamaeleomyces granulomatis, a New Fungus Related to Paecilomyces viridis

    DEFF Research Database (Denmark)

    Sigler, Lynne; Gibas, Connie Fe C.; Kokotovic, Branko

    2010-01-01

    An outbreak of disseminated granulomatous disease occurred in a group of veiled chameleons (Chamaeleo calyptratus) in a zoo collection. An adult female and six offspring developed large granulomas in multiple organs and were euthanized. At necropsy, roughly spherical yellow-to-white nodules 1 to 3...... of morphology results to represent Paecilomyces viridis, a species known only from one outbreak of fatal mycosis in carpet chameleons (Furcifer lateralis). Data obtained from morphological studies and from phylogenetic analyses of nuclear ribosomal rRNA (rDNA) sequence data revealed the Danish chameleon....... Chamaeleomyces species appear to be rare but aggressive pathogens of chameleons....

  5. T cells and T-cell subsets in mycosis fungoides and parapsoriasis. A study of 18 cases with anti-human T-cell monoclonal antibodies and histochemical techniques.

    Science.gov (United States)

    Buechner, S A; Winkelmann, R K; Banks, P M

    1984-07-01

    Skin lesions from 15 patients with mycosis fungoides (MF) and from three with parapsoriasis were studied immunohistochemically with monoclonal antibodies against T cells (Leu 1) and against T-cell subsets (Leu 2a, Leu 3a). Lymphoid cell reactivity was diverse among these sampled cases. In two cases of parapsoriasis and nine of MF, there was a predominance of helper/inducer (Leu-3a-reactive) cells over suppressor/cytotoxic (Leu-2a-reactive) cells. In one case of parapsoriasis and one (advanced tumor stage) of MF, there was suppressor/cytotoxic cell predominance. One case of MF showed strong reactivity for both T-cell subset markers. Four cases of MF (two plaque-stage and two tumor-stage) featured a predominant cell type in the dermis which was nonreactive for all three antibodies. The intraepidermal lymphoid cellularity was Leu-1-reactive in ten cases of MF and two of parapsoriasis. Among these 12 cases, the intraepidermal cellularity was Leu-2a-reactive in four and Leu-3a-reactive in three. The use of such studies of T-cell subsets on in situ cutaneous lymphoid infiltrates may demonstrate a correlation with cytomorphology, clinical stage, and disease prognosis.

  6. [Epidemiological aspects of cutaneous mycosis of HIV-infected patients in the National Referral Center of Burkina Faso, West Africa].

    Science.gov (United States)

    Zida, A; Sawadogo, P M; Diallo, I; Tapsoba, H; Bazie, Z; Drabo, Y J; Guiguemde, T R

    2016-06-01

    Our study aimed to analyze the epidemiological aspects of cutaneous mycosis in people living with human immunodeficiency virus (PLHIV). This is a descriptive study of 382 patients living with HIV. Following an investigation into the risk factors, mycological samples have been performed. Each sample underwent direct examination and cultivation for the identification of fungal species. The Blastese test is used for the identification of Candida albicans. One hundred and six (106) of the 382 people living with human immunodeficiency virus undergo a mycological collection of which 76 gave a positive result. The overall prevalence of cutaneous mycosis was 19.9 %. It was significantly higher in women and in patients who had a CD4 count ≤500/mm3. C. albicans and Trichophyton rubrum were the most isolated species with 22.4 and 19.8 % of all fungal species isolated, respectively. Cutaneous mycoses are common among people living with human immunodeficiency virus and whose CD4 count ≤ 500/mm(3). Copyright © 2016. Published by Elsevier Masson SAS.

  7. Antifungal Potential and Antioxidant Efficacy in the Shell Extract of Cocos nucifera (L.) (Arecaceae) against Pathogenic Dermal Mycosis.

    Science.gov (United States)

    Khalid Thebo, Nasreen; Ahmed Simair, Altaf; Sughra Mangrio, Ghulam; Ansari, Khalil Ahmed; Ali Bhutto, Aijaz; Lu, Changrui; Ali Sheikh, Wazir

    2016-05-25

    Background: Coconut is a tropical fruit well known for its essential oils that have been recognized for their biological activities since ancient times. There have been no previous investigations on the essential oils from coconut shells. Method: The shell extract of Cocos nucifera (L.) was prepared by the Soxhlet method and total phenolic content (TPC) in the extract was determined by Folin-Ciocalteu (FC) assay. The antioxidant potential of the coconut shell extract was evaluated by using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay. Minimum inhibitory concentration (MIC) of the extract was determined by the strip method against clinically isolated dermal mycosis of 20 infected patients. Result: Total antioxidant activity varied from 92.32% to 94.20% and total phenolic content was found at 5.33 ± 0.02 mg/g in the coconut shell extract. The extract was found to be most effective as an antifungal against human pathogenic fungi, including A. niger , A. flavus , T. rubrum , M. canis , M. gypseum , A. fumigates , T. mentagrophyte and T. vercossum . The crude shell extract was highly effective against all dermal mycosis tested with the MIC ranging from 62 mm to 90 mm, whereas all fungal samples showed good inhibitory effect. Conclusion: The results of the present study provide a potential cure for microbial infections.

  8. Antifungal Potential and Antioxidant Efficacy in the Shell Extract of Cocos nucifera (L. (Arecaceae against Pathogenic Dermal Mycosis

    Directory of Open Access Journals (Sweden)

    Nasreen Khalid Thebo

    2016-05-01

    Full Text Available Background: Coconut is a tropical fruit well known for its essential oils that have been recognized for their biological activities since ancient times. There have been no previous investigations on the essential oils from coconut shells. Method: The shell extract of Cocos nucifera (L. was prepared by the Soxhlet method and total phenolic content (TPC in the extract was determined by Folin-Ciocalteu (FC assay. The antioxidant potential of the coconut shell extract was evaluated by using the 2,2-diphenyl-1-picrylhydrazyl (DPPH radical scavenging assay. Minimum inhibitory concentration (MIC of the extract was determined by the strip method against clinically isolated dermal mycosis of 20 infected patients. Result: Total antioxidant activity varied from 92.32% to 94.20% and total phenolic content was found at 5.33 ± 0.02 mg/g in the coconut shell extract. The extract was found to be most effective as an antifungal against human pathogenic fungi, including A. niger, A. flavus, T. rubrum, M. canis, M. gypseum, A. fumigates, T. mentagrophyte and T. vercossum. The crude shell extract was highly effective against all dermal mycosis tested with the MIC ranging from 62 mm to 90 mm, whereas all fungal samples showed good inhibitory effect. Conclusion: The results of the present study provide a potential cure for microbial infections.

  9. Dose measurements in the treatment of mycosis fungoides with total skin irradiation using a 4 MeV electron beam

    Energy Technology Data Exchange (ETDEWEB)

    Poli, M.E.R. [Hospital Real e Benemerita Sociedade Portuguesa de Beneficencia (Brazil); Todo, A.S.; Campos, L.L. [Instituto de Pesquisas Energeticas e Nucleares, CNEN/SP Travessa R, Sao Paulo (Brazil)

    2000-05-01

    The total skin irradiation (TSI) is one of the most efficient techniques in the treatment administered with curative intent of the mycosis fungoides. The cure may be obtained in 10% to 40% of cases. The original Stanford University technique, created in 1960, was applied in a 4.8 MeV linear accelerator, that provided 2.5 MeV electrons in the patient, by the use of 4 couple beams with the patient placed in front of the beam, 3 meters distant from the apparatus. In this work we describe a 4 MeV electrons beam treatment method. We intend to improve the uniformity of the dose in the patient, as well, to reduce the problems with the overlapping treatment fields, that occurs in conventional treatment that uses 1 meter of focus-skin distance, and the treatment time to the patient. Only one modification was done in the apparatus: the dose rate for this treatment was doubled. The patient is placed on a rotative base and he assumes successively 6 positions: stand up and perpendicular to the beam, distant 2.83 meters from the gantry, with 60 degrees of interval between the rotations. In each position, the patient receives a couple of beams (the beam angulation is 19.5 degrees above the transversal axis in the middle of the patient and 19.5 degrees below it). The dosimetric data obtained were compared to the international protocols (AAPM). The delivered doses in the patient were measured with thermoluminescent dosimeters placed on skin surface and with Kodak XV-2 films placed between different slabs of an anthropomorphic phantom. The dose distribution in the phantom shows a good uniformity, in all thickness of interest, so it is possible to use this technique in the treatment of the mycosis fungoides as well Kaposi's sarcoma. (author)

  10. Unrelated immunodeficiency states may impact outcomes and immune checkpoint molecule expression in patients with mycosis fungoides: A clinicopathologic case-control study.

    Science.gov (United States)

    Warren, Shay; Kheterpal, Meenal; Myskowski, Patricia L; Moskowitz, Alison; Horwitz, Steven M; Pulitzer, Melissa P

    2018-03-01

    Immunodeficiency (ID) correlates with worse outcomes and decreased immune checkpoint molecule expression in melanoma. The impact of ID in mycosis fungoides (MF) is unknown. Our goal was to evaluate the impact of ID in MF. We conducted a case-control study of 17 patients with MF and ID versus age-, stage-, and race-matched controls as a subset of a comparative analysis of 23 patients with MF with ID (prior lymphoma, recent/current pregnancy, HIV, hypogammaglobulinemia, and prior chemotherapy) versus without ID. Programmed cell death 1 (PD1), programmed death ligand 1 (PDL1), forkhead box p3, and interleukin 17 immunohistochemistry was performed on 12 patients with ID and 10 controls. Patients with ID had more treatment failure (14 of 23 vs 5 of 17 [P = .028]), more treatment failure within 3 years of diagnosis (12 of 23 vs 4 of 17 [P = .050]), more angiocentrism (6 of 12 vs 0 of 10 [P = .005]), larger cells (1.92 ± 0.51 out of 3 vs 1.30 ± 0.48 out of 3 [P = .009]), more cases with at least 10% PD1 positivity (9 of 11 vs 4 of 10 [P = .031]) and at least 10% PDL1 positivity (7 of 12 vs 2 of 10 [P = .042]), and a higher average percentage of PD1 + cells (43.27 ± 40.22 vs 11.2 ± 13.62 [P = .028]). No differences in survival, forkhead box p3 expression, interleukin 17 expression, histologic depth, ulceration, granulomatous changes, or syringotropism were seen. This was a small single-center study with heterogeneous immunodeficiencies. ID correlated with worse outcomes and increased PD1 and PDL1 expression in MF. Patients with MF and ID may be candidates for immune checkpoint inhibitor therapy, pending further investigation. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. [Analysis of clinical features and allergic status of asthmatic patients with positive serum mycosis-specific IgE].

    Science.gov (United States)

    Mou, Yan; Ye, Ling; Gong, Ying; Zhang, Zhi-feng; Jin, Mei-ling

    2013-08-01

    To improve understanding of the clinical characteristics and diagnosis of allergic bronchopulmonary mycosis (ABPM). We retrospectively analyzed the clinical data, including clinical symptoms, laboratory tests, pulmonary function tests and chest CT imaging of 95 asthmatic patients with positive serum mycosis-specific IgE from January 2010 to September 2012 in Zhongshan Hospital Affiliated to Fudan University. Of the 95 patients, 59 cases met the diagnostic criteria of ABPM. There were 34 males and 25 females, with a mean age of (53 ± 4) years and a duration of asthma for (21 ± 4) years. Thirty-six cases showed mycosis hypersensitivity (MH). There were 10 males and 26 females, with a mean age of (46 ± 6) years and a duration of asthma for (16 ± 5) years. Clinical symptoms such as wheeze (52 vs 21, χ(2) = 11.159, P = 0.001), cough (54 vs 27, χ(2) = 4.859, P = 0.030) and expectoration (43 vs 9, χ(2) = 25.731, P = 0.000) were more common in the ABPM group compared to the MH group.In the ABPM group, 58 were A. fumigatus-specific IgE antibody positive, 34 Penicillium-specific IgE antibody positive and 1 only Penicillium-specific IgE antibody positive.While in the MH group, 15 were A.fumigatus-specific IgE antibody positive, 24 Penicillium-specific IgE antibody positive and 17 only Penicillium-specific IgE antibody positive.In the ABPM group, the percentage of positive fumigatus-specific IgE antibody was higher (58 vs 15, χ(2) = 24.500, P = 0.000), while the percentages of dermatophagoides pteronyssinus(21 vs 20, χ(2) = 3.632, P = 0.045) and Dermatophagoides farinae(17 vs 21, χ(2) = 8.118, P = 0.004) were lower. Total serum IgE [(4395 ± 1437) IU/ml vs (276 ± 133) IU/ml, T = 4.384, P = 0.000], peripheral eosinophil percentage[(12.56 ± 1.20)% vs (1.30 ± 0.15)%, t = 8.175, P = 0.000] and count [(2.09 ± 0.43)×10(9)/L vs (0.19 ± 0.04)×10(9)/L, t = 7.032, P = 0.000] were higher in the ABPM group as compared to the MH group.FEV1% slightly declined in the ABPM

  12. TP53 Gene Status Affects Survival in Advanced Mycosis Fungoides

    DEFF Research Database (Denmark)

    Wooler, Gitte; Melchior, Linea; Ralfkiaer, Elisabeth

    2016-01-01

    significance in MF. In this study, we have optimized the protocol for Sanger sequencing of TP53 using DNA extracted from archival paraffin-embedded biopsies. Of 19 samples from patients with stage IIB MF or higher, 31% harbored mutations in TP53. Overall survival of the patients with mutated TP53...

  13. Multiple courses of high-dose total skin electron beam therapy in the management of mycosis fungoides

    International Nuclear Information System (INIS)

    Becker, Mark; Hoppe, Richard T.; Knox, Susan J.

    1995-01-01

    Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam therapy. The mean interval between the first and the second courses of therapy was 41.3 months. Patients were restaged prior to commencement of their second course of high-dose total skin electron beam therapy, resulting in upstaging in six. The second course of therapy resulted in six complete responses and nine partial responses. Twelve of these patients have since died, 1 is lost to follow-up, and 2 are living with disease. The long-term side effects in the two living patients include pigmentation changes, alopecia, and diffuse xerosis. Conclusion: Delivery of two courses of total skin electron beam therapy is technically feasible, tolerable, and efficacious. The dose to the total skin was reduced for the second course of therapy in all cases. The criteria used to screen patients included initial good response to total skin electron treatment, long disease-free interval, exhaustion of other therapeutic modalities, and generalized skin involvement at relapse. Long-term toxicities were mild in severity and generally consisted of generalized xerosis, scattered

  14. Systemic mycosis caused by Trichophyton spp. in an olive ridley sea turtle (Lepidochelys olivacea): an immunohistochemical study.

    Science.gov (United States)

    Oros, J; Calabuig, P; Arencibia, A; Camacho, M; Jensen, He

    2011-03-01

    A sub-adult female olive ridley sea turtle (Lepidochelys olivacea) was found floating off the coast of Gran Canaria, Canary Islands, Spain. The turtle was lethargic and weak, and died one day after it was found. Necropsy was performed and selected samples of lung and liver were routinely processed for histopathological and immunohistological studies. Grossly, round, ulcerative lesions were observed on the rear flippers. The liver, spleen, coelomic wall, gastric serosa, lungs and urinary bladder were covered by various amounts of fibrin and small granulomas. Histopathologically, a severe fibrinous and granulomatous polyserositis (liver, spleen, stomach, urinary bladder, coelomic wall), severe fibrinous pleuritis and severe multifocal granulomatous pneumonia were diagnosed. Numerous fungal hyphae were observed associated with the lesions. Specific monoclonal and heterologously absorbed polyclonal antibodies served as the primary reagents for identification of aspergillosis, candidiasis, fusariosis, geotricosis, dermatophytosis, scedosporiosis, and zygomycosis. All hyphae were identified as Trichophyton spp., because a strong and uniform reactivity was obtained only with an heterologously absorbed polyclonal antibody raised against somatic antigens of Trichophyton spp. Systemic mycosis caused by Trichophyton spp. There are no known previous reports of Trichophyton spp. causing skin disease or systemic mycotic infection in sea turtles. The usefulness of immunohistochemistry for identifying fungi in sea turtles is reinforced.

  15. Characterization of unconventional electron fields for the treatment of mycosis fungoides using the total skin irradiation technique

    Energy Technology Data Exchange (ETDEWEB)

    González, M. A. Pagnan, E-mail: miguelangel.pagnan@hotmail.com; Mitsoura, E., E-mail: meleni@uaemex.mx [Medical Physics Graduate Programme, Universidad Autónoma del Estado de México, Facultad de Medicina, Paseo Tollocan esquina Jesús Carranza Colonia Moderna de la Cruz, C.P. 50180, Toluca, Estado de México (Mexico); Oviedo, J.O. Hernández [The American British Cowdray Medical Center, Centro de Cáncer, Calle Sur 136, no. 116, Colonia las Américas, C.P. 01120, México, D.F. (Mexico); Vázquez, D. R. Ruesga, E-mail: druesga@yahoo.com.mx [Hospital General de México Dr. Eduardo Liceaga, Dr. Balmis 148, Colonia Doctores, C.P. 06726, México, D.F. (Mexico)

    2014-11-07

    Mycosis fungoides is a cutaneous lymphoma that accounts for 2–3% of all lymphomas. Several clinical studies have demonstrated the effectiveness of TSEBT (Total Skin Electron Beam Therapy) in patients with mycosis fungoides. It is important to develop this technique and make it available to a larger number of patients in Mexico. Because large fields for electron TSEBT are required in order to cover the entire body of the patient, beam characterization at conventional treatment distances is not sufficient and a calibration distance of 500cm or higher is required. Materials and methods: Calibration of radiochromic Gafchromic® EBT2 film (RCF) for electrons was performed in a solid water phantom (Scanditronix Wellhöfer) at a depth of 1.4cm and a Source Axis Distance (SAD) of 100cm. A polynomial fit was applied to the calibration curve, in order to obtain the equation relating dose response with optical density. The spatial distribution is obtained in terms of percentage of the dose, placing 3×3cm samples of RCF on the acrylic screen, which is placed in front of the patient in order to obtain maximum absorbed dose on the skin, covering an area of 200×100cm{sup 2}. The Percentage Depth Dose (PDD) curve was obtained placing RCF samples at depths of 0, 1, 1.2, 1.4, 1.5, 2, 3, 4, 5, 6, 7, 8 and 9cm in the solid water phantom, irradiated with an ELEKTA SINERGY Linear Accelerator electron beam, with an energy of 6 MeV, at a Source Skin Distance (SSD) of 500cm, with 1000MU = 100Gy, with a cone of 40×40cm and gantry angle of 90°. The RCFs were scanned on a flatbed scanner (EPSON EXPRESSION 10000 XL) and the images were processed with the ImageJ program using a region of interest (ROI) of 1×1cm{sup 2}. Results: The relative spatial dose distribution and the percentage depth dose for a SSD of 500±0.5cm, over an area of 200×100cm{sup 2} was obtained, resulting to an effective maximum dose depth (Z{sub ref}) for electrons of 1.4±0.05cm. Using the same experimental data

  16. Clinical significance and molecular characterization of nonsporulating molds isolated from the respiratory tracts of bronchopulmonary mycosis patients with special reference to basidiomycetes.

    Science.gov (United States)

    Singh, Pradeep Kumar; Kathuria, Shallu; Agarwal, Kshitij; Gaur, Shailendra Nath; Meis, Jacques F; Chowdhary, Anuradha

    2013-10-01

    Nonsporulating molds (NSMs), especially basidiomycetes, have predominantly been reported as human pathogens responsible for allergic and invasive disease. Their conventional identification is problematic, as many isolates remain sterile in culture. Thus, inconclusive culture reports might adversely affect treatment decisions. The clinical significance of NSMs in pulmonary mycoses is poorly understood. We sequenced the internal transcribed spacer (ITS) region and D1/D2 domain of the larger subunit (LSU) of 52 NSMs isolated from respiratory specimens. The basidiomycetes were the predominant NSMs, of which Schizophyllum commune was the most common agent in allergic bronchopulmonary mycosis (ABPM), followed by Ceriporia lacerata in invasive fungal disease. Porostereum spadiceum, Phanaerochaete stereoides, Neosartorya fischeri, and Marasmiellus palmivorus were the other molds observed. Application of ITS and LSU region sequencing identified 92% of the isolates. The antifungal susceptibility data revealed that all basidiomycetes tested were susceptible to amphotericin B and resistant to caspofungin, fluconazole, and flucytosine. Except for 3 isolates of S. commune and a solitary isolate of M. palmivorus, all basidiomycetes had low MICs for itraconazole, posaconazole, and voriconazole. Basidiomycetes were isolated from patients with ABPM, invasive pulmonary mycosis/pneumonia, or fungal balls. In addition, the majority of the basidiomycetes were isolated from patients with chronic respiratory disorders who were sensitized to one of the basidiomycetous fungi and demonstrated precipitating antibodies against the incriminating fungi, indicating an indolent tissue reaction. Thus, isolation of basidiomycetes from the lower respiratory tract could be significant, and it is important to monitor these patients in order to prevent subsequent lung damage.

  17. Stage design

    International Nuclear Information System (INIS)

    Shacter, J.

    1975-01-01

    A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage

  18. [Mucormycosis. An emergent mycosis].

    Science.gov (United States)

    Tiraboschi, Iris; Bravo, Martín; Fernández, Norma; Stecher, Daniel; Melero, Marcelo; Lasala, María

    2012-01-01

    Mucormycosis is an opportunistic infection caused by fungi of the order Mucorales. It is characterized by rapid progression and high morbidity and mortality in the absence of early diagnosis and prompt treatment. It was an infrequent disease, but in recent years, its incidence appears to have increased. The aim of this paper is to report the cases of mucormycosis diagnosed from 1982 to 2010 at the Hospital de Clinicas José de San Martín, University of Buenos Aires. We diagnosed 10 cases of mucormycosis; the first three between 1982 and 2004 and the last 7 between 2005 and 2010. The incidence from 1980 to 2004 was 0.13 patient-years and the frequency 0.1/10 000 discharges (95% CI 0.00- 0.3). In the period 2005 to 2010, the incidence was 0.86 patients per year with 1.1/10 000 discharges (95% CI 0.5-2.4). There was a pulmonary mucormycosis case (in a patient treated with corticosteroids) and nine rhinocerebral cases, two in neutropenic and seven in diabetic patients. The diagnosis was made by observation of cenocytic hyphae in 10/10 patients. Mucorales were recovered in 8/9 cultures (5 Rhizopus spp and 3 Mucor spp.). In one case diagnosis of pulmonary mucormycosis was made post-mortem. Nine patients were treated with amphotericin B deoxycholate (in 3 patients supplemented with liposomal amphotericin B) and surgery. Three patients underwent hyperbaric chamber. Seven patients had favorable outcome. In conclusion, mucormycosis is a rare disease, but its incidence has increased over the past five years. A good evolution of the patients is linked to early diagnosis and treatment.

  19. Trading stages

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2012-01-01

    because they are hard to use and interpret, and tools for age and stage structured populations are missing. We present easily interpretable expressions for the sensitivities and elasticities of life expectancy to vital rates in age-stage models, and illustrate their application with two biological......Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

  20. Staging atmospheres

    DEFF Research Database (Denmark)

    Bille, Mikkel; Bjerregaard, Peter; Sørensen, Tim Flohr

    2015-01-01

    The article introduces the special issue on staging atmospheres by surveying the philosophical, political and anthropological literature on atmosphere, and explores the relationship between atmosphere, material culture, subjectivity and affect. Atmosphere seems to occupy one of the classic...

  1. The Amazing COS FUV (1320 - 1460 A) Spectrum of (lambda) Vel (K4Ib-II)

    Science.gov (United States)

    Carpenter, Kenneth

    2010-01-01

    The FUV spectrum (1320-1460 A) of the K4 lb-11 supergiant (lambda) Vel was observed with the Cosmic Origins Spectrograph (COS) on HST, as part of the Ayres and Redfield Cycle 17 SNAP program "SNAPing Coronal Iron". This spectrum covers a region not previously recorded in (lambda) Vel at high resolution and, in a mere 20 minutes of exposure, reveals a treasure trove of information. It shows a wide variety of strong emission lines, superposed on a bright continuum, with contributions from both atomic and molecular species. Multiple absorptions, including numerous Ni II and Fe II lines, are visible over this continuum, which is likely generated in the chromosphere of the star. Evidence of the stellar wind is seen in the P Cygni profiles of the CII lines near 1335 A and the results of fluorescence processes are visible throughout the region. The spectrum has remarkable similarities to that of (alpha) Boo (K1.5 III), but significant differences as well, including substantial FUV continuum emission, reminiscent of the M2 Iab supergiant (alpha) Ori, but minus the CO fundamental absorption bands seen in the spectrum of the latter star. However, fluoresced CO emission is present, as in the K-giant stars (alpha) Boo and (alpha) Tau (K5 III). The presence of hot plasma in the atmosphere of the star, indicated by previous GHRS observations of Si III] and C III] lines near 1900 A and FUSE observations of O VI 1032 A, is further confirmed by the detection in this COS spectrum of the Si IV UV 1 lines near 1400 A, though both lines are contaminated by overlying fluorescent H2 emission. We present the details of this spectrum, in comparison with stars of similar temperature or luminosity and discuss the implications for the structure of, and the radiative processes active in, the outer atmospheres of these stars.

  2. Staging Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    In recent years, the social sciences have taken a “mobilities turn.” There has been a developing realisation that mobilities do not “just happen.” Mobilities are carefully and meticulously designed, planned and staged (from above). However, they are equally importantly acted out, performed and li......, the book asks: what are the physical, social, technical, and cultural conditions to the staging of contemporary urban mobilities?...... that mobility is more than movement between point A and B. It explores how the movement of people, goods, information, and signs influences human understandings of self, other and the built environment. Moving towards a new understanding of the relationship between movement, interaction and environments...

  3. Comparison of seropositivity of human T lymphotropic virus type 1 in mycosis fungoides patients and normal volunteers: A case-control study and review of literature

    Directory of Open Access Journals (Sweden)

    Seirafi Hassan

    2009-01-01

    Full Text Available Background: There have been controversial reports about the possible association between mycosis fungoides (MF, its leukemic variant Sιzary syndrome (SS and human T lymphotropic virus type 1 (HTLV-1 in different geographical regions. Aims: The purpose of this study was to explore any association between MF and presence of HTLV-1 infection in Iran. Methods: In a case-control setting, 150 clinically and histopathologically proven MF patients had been admitted to the tertiary referral skin center during a 10-year period and another 150 normal volunteers had been compared with each other for the presence of HTLV-1 infection. Enzyme-linked immunosorbent assay (ELISA was used to detect antibodies against HTLV-1, and positive results were confirmed with western blotting. Results: Only three MF patients had HTLV-1 infection, whereas two cases of normal subjects had the infection ( P > 0.05. The only three seropositive MF patients were male and from North-Eastern Iran . Conclusion: This study showed that MF does not correlate with HTLV-1 infection in Iran.

  4. Clinical potential of mechlorethamine gel for the topical treatment of mycosis fungoides-type cutaneous T-cell lymphoma: a review on current efficacy and safety data

    Directory of Open Access Journals (Sweden)

    Liner K

    2018-01-01

    Full Text Available Kendall Liner,1 Celeste Brown,2 Laura Y McGirt3 1Division of Dermatology, Medical College of Georgia at Augusta Health, Augusta, GA, USA; 2School of Medicine, University of North Carolina at Chapel Hill, Carolinas Medical Center, Charlotte, NC, USA; 3Department of Hematology/Oncology, Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC, USA Abstract: Nitrogen mustard is a chemotherapeutic agent that has a well-documented safety and efficacy profile in the treatment of cutaneous T-cell lymphoma. Development of nitrogen mustard formulations and treatment regimens has been studied extensively over the last 40 years. In the last 5 years, a new gel formulation has been developed that is associated with a decrease in delayed hypersensitivity reactions. The authors in this review found that while the gel formulation may result in a decrease of allergic contact dermatitis, this advantage has been replaced by a higher number of irritant contact reactions and a decrease in complete response rate. The gel formulation has a complete response rate of 13.8%, which is a decrease in efficacy when compared to aqueous-based preparations of similar concentrations. Keywords: mycosis fungoides, nitrogen mustard, mechlorethamine gel, cutaneous T-cell lymphoma, CTCL, Valchlor®

  5. Micose fungóide hipopigmentar com 20 anos de evolução Hypopigmented mycosis fungoides with 20 years evolution

    Directory of Open Access Journals (Sweden)

    Rodrigo Pereira Duquia

    2005-04-01

    Full Text Available A micose fungóide hipopigmentar é uma forma rara de linfoma cutâneo de células T, em que lesões hipopigmentadas ocorrem na ausência de lesões clássicas dessa neoplasia. Na literatura latino-americana existem apenas três casos; relata-se aqui o caso de um homem negro, de 29 anos com lesões há 20 anos O tratamento é semelhante ao de outros tipos de linfomas T cutâneos, sendo o psoraleno mais ultravioleta A (Puva e a mostarda nitrogenada tópica os mais relatados.Hypopigmented mycosis fungoides is a rare variant of the cutaneous T-cell lymphoma, in which hypopigmented lesions are seen without the classical lesions. Only three cases are found in the Latin-American literature. We report the case of a 29-year-old black male patient, who first presented with these lesions 20 years ago. The treatment is similar to the classical forms of the disease: psoralen plus ultraviolet A (PUVA and topical nitrogen mustard are most often used.

  6. Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.

    Science.gov (United States)

    Cousty, M; Tricaud, C; De Beauregard, T; Picandet, V; Bizon-Mercier, C; Tessier, C

    2016-01-09

    The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques. British Veterinary Association.

  7. Total skin electron beam therapy followed by adjuvant psoralen/ultraviolet-a light in the management of patients with T1 and T2 cutaneous T-cell lymphoma (mycosis fungoides)

    International Nuclear Information System (INIS)

    Quiros, Peter A.; Jones, Glenn W.; Kacinski, Barry M.; Braverman, Irwin M.; Heald, Peter W.; Edelson, Richard L.; Wilson, Lynn D.

    1997-01-01

    Purpose: Patients with mycosis fungoides [cutaneous T-cell lymphoma (CTCL)] may benefit from adjuvant therapy after completing total skin electron beam therapy (TSEBT). We report the results for (T1(T2)) CTCL patients treated with adjuvant oral psoralen plus ultraviolet light (PUVA) with respect to overall survival (OS), disease-free survival (DFS), salvage of recurrence, and toxicity. Methods and Materials: Between 1974 and 1993, TSEBT was administered to a total of 213 patients with CTCL. Records were reviewed retrospectively, and a total of 114 patients were identified as having T1 or T2 disease. Radiotherapy was provided via a 6-MeV linac to a total of 36 Gy, 1 Gy/day, 4 days/week, for 9 weeks. Beginning in 1988, patients were offered adjuvant PUVA within 2 months of completing TSEBT. This was started at 0.5-2 J/m 2 , 1-2 treatments/week, with a taper over 3-6 months. Therapy then continued once per month. There were 39 T1 and 75 T2 patients. Six T1 (15%) and eight T2 (11%) patients were treated with adjuvant PUVA. A further 49% of the 114 patients received adjuvant systemic therapy, 3% received spot external beam, 4% received adjuvant ECP, 2% received topical nitrogen mustard, 22% received a combination of therapies exclusive of PUVA, and 9% received no adjuvant therapy. Patients were balanced in all subgroups based on pre-TSEBT therapy. The median age of the cohort was 58 (range 20-88), with a median follow-up time of 62 months (range 3-179). Results: Within 1 month after completing of TSEBT, 97% of T1, and 87% of T2 patients had achieved a complete remission. Stratified by adjuvant therapy, none of six T1 and one of eight T2 patients who received adjuvant PUVA failed within the first 3 years after completion of TSEBT. A total of 43% of the T1 and T2 patients receiving other or no adjuvant treatment failed within the same time course. The 5-year OS for the entire cohort was 85%. Those who received PUVA had a 5-year OS of 100% versus a 5-year OS for the non

  8. Nuclear volume and prognosis in ovarian cancer

    DEFF Research Database (Denmark)

    Mogensen, O.; Sørensen, Flemming Brandt; Bichel, P.

    1992-01-01

    The prognostic value of the volume-weighted mean nuclear volume (MNV) was investigated retrospectively in 100 ovarian cancer patients with FIGO-stage IB-II (n = 51) and stage III-IV (n = 49) serous tumors. No association was demonstrated between the MNV and the survival or between the MNV and two...... of five additional parameters: age and amount of residual tumor. However, both in stage IB-II and stage III-IV carcinomas, the MNV increased significantly with increasing tumor grade and DNA-index. Furthermore, FIGO-stage IB-II patients had significantly smaller nuclei than patients with stage III...

  9. Total skin electron beam and non-myeloablative allogeneic hematopoietic stem-cell transplantation in advanced mycosis fungoides and Sezary syndrome.

    Science.gov (United States)

    Duvic, Madeleine; Donato, Michele; Dabaja, Bouthaina; Richmond, Heather; Singh, Lotika; Wei, Wei; Acholonu, Sandra; Khouri, Issa; Champlin, Richard; Hosing, Chitra

    2010-05-10

    Transformed mycosis fungoides (MF) and Sézary syndrome (SS) are currently incurable. We studied the safety and efficacy of total skin electron beam with allogeneic hematopoietic stem-cell transplantation (HSCT) in patients with cutaneous T-cell lymphoma (CTCL). Nineteen patients with advanced CTCL (median age, 50 years; four prior therapies) underwent total skin electron beam radiation followed by allogeneic HSCT between July 2001 and July 2008. Sixteen patients were conditioned with fludarabine (125 mg/m(2)) and melphalan (140 mg/m(2)) plus thymoglobulin (for mismatched donors). Graft-versus-host disease (GVHD) prophylaxis was with tacrolimus/mini methotrexate. Eighteen patients experienced engraftment, and one died as a result of sepsis on day 16. Median time to recovery of absolute neutrophil count (ANC) was 12 days. Fifteen achieved full donor chimerism, 12 had acute GVHD, and 12 were treated for chronic GVHD. The overall intent-to-treat response was 68%, and the complete response rate was 58%. Four of six patients died in complete remission as a result of bacterial sepsis (n = 2), chronic GVHD and fungal infection (n = 1), or lung cancer (n = 1); only two died as a result of progressive disease. Eight experienced relapse in skin; five regained complete response with reduced immunosuppression or donor lymphocyte infusions. Eleven of 13 are currently in complete remissions, with median follow-up of 19 months (range, 1.3 to 8.3 years). Median overall survival has not been reached. Total skin electron beam followed by allogeneic stem-cell transplantation merits additional evaluation for a selected group of patients with refractory, advanced, cutaneous T-cell lymphoma with evidence for graft-versus-tumor effect.

  10. High soluble CD30, CD25 and IL-6 may identify patients with worse survival in CD30+ cutaneous lymphomas and early mycosis fungoides

    Science.gov (United States)

    Kadin, Marshall E.; Pavlov, Igor; Delgado, Julio C.; Vonderheid, Eric C.

    2011-01-01

    Histopathology alone cannot predict outcome of patients with CD30+ primary cutaneous lymphoproliferative disorders (CD30CLPD) and early mycosis fungoides (MF). To test the hypothesis that serum cytokines/cytokine receptors provide prognostic information in these disorders, we measured soluble CD30 (sCD30), sCD25, and selected cytokines in cell cultures and sera of 116 patients with CD30CLPD and 96 patients with early MF followed up to 20 years. Significant positive correlation was found between sCD30 levels and sCD25, CD40L, IL-6, and IL-8, suggesting CD30+ neoplastic cells secrete these cytokines, but not Th2 cytokines. In vitro studies confirmed sCD30, sCD25, IL-6 and IL-8 are secreted by CD30CLPD-derived cell lines. CD30CLPD patients with above normal sCD30 and sCD25 had worse overall and disease-related survivals, but only sCD30 retained significance in Cox models that included advanced age. High sCD30 also identified patients with worse survival in early MF. Increased IL-6 and IL-8 correlated with poor disease-related survival in CD30CLPD patients, We conclude that: (1) neoplastic cells of some CD30CLPD patients do not resemble Th2 cells, (2) high serum sCD30, sCD25, IL-6, and perhaps IL-8 levels may provide prognostic information useful for patient management. PMID:22071475

  11. Understanding cancer staging

    Science.gov (United States)

    ... detailed information about the cancer stage. TNM Staging System The most common system for staging cancer in the form of solid tumor is the TNM system. Most providers and cancer centers use it to stage ...

  12. Human T-cell lymphotropic virus type 1 provirus and phylogenetic analysis in patients with mycosis fungoides and their family relatives.

    Science.gov (United States)

    Shohat, M; Shohat, B; Mimouni, D; Pauli, G; Ellerbrok, H; David, M; Hodak, E

    2006-08-01

    Mycosis fungoides (MF) is a cutaneous T-cell lymphoma of unknown aetiology. A pathogenic role of human T-cell lymphotropic virus type 1 (HTLV-1) has been suggested but remains controversial. To determine whether MF is linked to HTLV-1. Blood samples were collected from 60 patients, 15 family relatives of patients with MF (MFRs), 20 healthy controls and 10 patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The presence of HTLV-1 antibodies in serum was tested by the Western blot rp21e-enhanced test. DNA was extracted from the blood with the Qiagen blood kit. We used 500 ng of DNA either in conventional HTLV-1-specific polymerase chain reaction (PCR) or in real-time PCR using primers sk43 and sk44 together with a tax-specific fluorescent probe. In Western blot, antibodies against three to four HTLV-1 antigens were detected in 52% of patients with MF. All of the patients with HAM/TSP were positive, while only 7% of the MFRs and none of the 20 healthy controls reacted with HTLV-1 antigens in Western blot. One of 60 patients with MF and one of 15 MFRs were positive in HTLV-1 PCR. These two PCR-positive samples which were quantified in real-time PCR showed that fewer than five in 10(6) cells were HTLV-1 infected. We succeeded in amplifying and sequencing the 5' end of the provirus from the blood of the PCR-positive MFR by seminested PCR. A positive result was also obtained in this test. Phylogenetic tree analyses revealed a high homology of this sequence with other HTLV-1 sequences from the Middle East. The above PCR-positive MFR was the brother of a PCR-negative patient with MF. These findings demonstrate that HTLV-1 is probably not the aetiological agent of MF. However, it may play a role in immunosuppression and in the spreading of the disease.

  13. Invasive cranial mycosis our experiences

    Directory of Open Access Journals (Sweden)

    Tapas Kumbhkar

    2013-01-01

    Full Text Available Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses. Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection.

  14. Host Defence to Pulmonary Mycosis

    Directory of Open Access Journals (Sweden)

    Christopher H Mody

    1999-01-01

    Full Text Available OBJECTIVE: To provide a basic understanding of the mechanisms of host defense to pathogenic fungi. This will help physicians understand why some patients are predisposed to fungal infections and update basic scientists on how microbial immunology applies to fungal disease.

  15. Prostate cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000397.htm Prostate cancer staging To use the sharing features on this ... trials you may be able to join How Prostate Cancer Staging is Done Initial staging is based on ...

  16. Between Stage and Screen

    NARCIS (Netherlands)

    Tornqvist, Egil

    1996-01-01

    Ingmar Bergman is worldwide known as a film and stage director. Yet no-one has attempted to compare his stage and screen activities. In Between stage and screen Egil Tornqvist examines formal and thematical correspondences and differences between a number of Bergman's stage, screen, and radio

  17. Breast cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

  18. Seven Stages of Alzheimer's

    Science.gov (United States)

    ... Dementias . Learn more: Daily Care and Behaviors Severe Alzheimer's disease (late-stage) Get support Late-stage care decisions can be some of the hardest families face. Connect with other caregivers who have been through the process on our ...

  19. Stages of Adolescence

    Science.gov (United States)

    ... Español Text Size Email Print Share Stages of Adolescence Page Content Article Body Adolescence, these years from puberty to adulthood, may be roughly divided into three stages: early adolescence, generally ages eleven to fourteen; middle adolescence, ages ...

  20. Beyond Erikson's Eight Stages.

    Science.gov (United States)

    Whitney, Ruth

    1979-01-01

    Erik Erikson has described eight stages of the healthy personality. This essay offers a revised version of the eight stages. Although most individuals develop through the eight stages, each is personally unique because patterns of fluctuation between safety and growth differ from one individual to another. (Author)

  1. Cervical Cancer Stage IIIA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

  2. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

  3. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

  4. Cervical Cancer Stage IIIB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIB Add to My Pictures View /Download : ... 1425x1326 View Download Large: 2850x2651 View Download Title: Cervical Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing ...

  5. Cervical Cancer Stage IB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

  6. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  7. European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome - Update 2017

    DEFF Research Database (Denmark)

    Trautinger, Franz; Eder, Johanna; Assaf, Chalid

    2017-01-01

    the authors through a series of consecutive consultations in writing and a round of discussion. Recommended treatment options are presented according to disease stage, whenever possible categorised into first- and second-line options and supported with levels of evidence as devised by the Oxford Centre...... for Evidence-Based Medicine (OCEBM). Skin-directed therapies are still the most appropriate option for early-stage MF, and most patients can look forward to a normal life expectancy. For patients with advanced disease, prognosis is still grim, and only for a highly selected subset of patients, prolonged...

  8. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    Science.gov (United States)

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  9. Multiple stage railgun

    International Nuclear Information System (INIS)

    Aaland, K.; Hawke, R.S.; Scudder, J.K.

    1982-01-01

    A multiple stage magnetic railgun accelerator for accelerating a projectile by movement of a plasma arc along the rails. The railgun is divided into a plurality of successive rail stages which are sequentially energized by separate energy sources as the projectile moves through the bore of the railgun. Propagation of energy from an energized rail stage back towards the breech end of the railgun can be prevented by connection of the energy sources to the rails through isolation diodes. Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails into electrically isolated rail sections. In such case means are used to extinguish the arc at the end of each energized stage and a fuse or laser device is used to initiate a new plasma arc in the next energized rail stage

  10. Turbine stage model

    International Nuclear Information System (INIS)

    Kazantsev, A.A.

    2009-01-01

    A model of turbine stage for calculations of NPP turbine department dynamics in real time was developed. The simulation results were compared with manufacturer calculations for NPP low-speed and fast turbines. The comparison results have shown that the model is valid for real time simulation of all modes of turbines operation. The model allows calculating turbine stage parameters with 1% accuracy. It was shown that the developed turbine stage model meets the accuracy requirements if the data of turbine blades setting angles for all turbine stages are available [ru

  11. Staging of cutaneous melanoma

    NARCIS (Netherlands)

    P. Mohr (P.); A.M.M. Eggermont (Alexander); A. Hauschild (Axel); A. Buzaid (A.)

    2009-01-01

    textabstractThe American Joint Committee on Cancer (AJCC) staging of cutaneous melanoma is a continuously evolving system. The identification of increasingly more accurate prognostic factors has led to major changes in melanoma staging over the years, and the current system described in this review

  12. Staging for vulvar cancer.

    Science.gov (United States)

    Hacker, Neville F; Barlow, Ellen L

    2015-08-01

    Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  13. Staging for vaginal cancer.

    Science.gov (United States)

    Rajaram, Shalini; Maheshwari, Amita; Srivastava, Astha

    2015-08-01

    Vaginal cancer is a rare cancer comprising about 3% of all gynecologic cancers. Primary vaginal cancer should be carefully assigned as spread from cervix, vulva, and other metastatic tumors to vagina can occur. Although vaginal cancer traditionally occurs in older postmenopausal women, the incidence of high-risk human papillomavirus (HPV)-induced cancers is increasing in younger women. Squamous cell carcinoma is still the most common histopathologic type followed by adenocarcinoma. With decreasing use of diethylstilbestrol in pregnancy, non-diethylstilbestrol-associated cancers are described. The Federation Internationale de Gynecologie et d'Obstetrique (FIGO) staging of vaginal cancer (2009) follows the same rules as cervical cancer; it is clinically staged and allows the use of routine investigative modalities for staging. Although FIGO encourages the use of advanced imaging modalities, such as computed tomography, magnetic resonance imaging (MRI), and positron emission tomography (PET), to guide therapy, the imaging findings may not be used to change or reassign the stage. TNM staging is the pathologic staging system proposed by the American Joint Committee on Cancer, and information available from examination of the resected specimen, including pelvic and inguinal lymph nodes, may be used for staging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Engell, Hans Christian

    1986-01-01

    In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...... the second procedure, when operations were staged less than 3 weeks apart. A correlation between these hypertensive episodes and the occurrence of new neurologic symptoms could not be shown. However, as this correlation has been proved in several other reports, bilateral carotid endarterectomy is advised...... to be staged at least 3 weeks apart. In addition, a conservative attitude towards contralateral asymptomatic lesions is proposed....

  15. Staging of lung cancer.

    Science.gov (United States)

    de Groot, Patricia M; Carter, Brett W; Betancourt Cuellar, Sonia L; Erasmus, Jeremy J

    2015-06-01

    Primary lung cancer is the leading cause of cancer mortality in the world. Thorough clinical staging of patients with lung cancer is important, because therapeutic options and management are to a considerable degree dependent on stage at presentation. Radiologic imaging is an essential component of clinical staging, including chest radiography in some cases, computed tomography, MRI, and PET. Multiplanar imaging modalities allow assessment of features that are important for surgical, oncologic, and radiation therapy planning, including size of the primary tumor, location and relationship to normal anatomic structures in the thorax, and existence of nodal and/or metastatic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Staging Mobilities / Designing Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    2015-01-01

    In recent years, urban research has taken a ‘mobilities turn’. There has been a developing realisation that mobilities do not ‘just happen.’ Mobilities are carefully and meticulously designed, planned and staged (from above). However, they are equally importantly acted out, performed and lived...... asks: what are the physical, social, technical, and cultural conditions to the staging of contemporary urban mobilities? The theoretical framing in the Staging mobilities book is applied to four in-depth cases in the accompanying volume Designing mobilities.This book explore how places, sites...

  17. Stages of Colon Cancer

    Science.gov (United States)

    ... types of surgery : Local excision or simple polypectomy . Resection and anastomosis . This is done when the tumor is too ... stage I colon cancer usually includes the following: Resection and anastomosis . Use our clinical trial search to find NCI- ...

  18. Stages of Labor

    Science.gov (United States)

    ... Moms Need Blog News & Media News Videos Mission stories Ambassadors Spotlights Tools & Resources Frequently asked media questions ... can be born. This stage can last as short as 20 minutes or as long as several ...

  19. Multiple Stages 2

    DEFF Research Database (Denmark)

    Andreasen, John

    Multiple stages 2: theatrical futures, set design, community plays, cultural capitals, democracy & drama, WWII dramas, performance on adoption, promenade about emigration, qualities in political theatre, performance analysis, dramaturgical education, Toulmin Variations...

  20. Stages of Esophageal Cancer

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat esophageal cancer. A plastic ...

  1. Stages of Anal Cancer

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat anal cancer. Chemotherapy Chemotherapy ...

  2. Stages of Penile Cancer

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat penile cancer. Chemotherapy Chemotherapy ...

  3. Staging interrail mobilities

    DEFF Research Database (Denmark)

    Jensen, Martin Trandberg; Gyimóthy, Szilvia; Jensen, Ole B.

    2016-01-01

    This article applies the multiscalar ‘staging mobilities’ framework from the emergent subfield of mobilities design to analyse an enduring European rail travel phenomenon, interrail. This discussion extends and contributes to tourism mobilities research. Second, the article enriches previous...

  4. Stage-specific mortality of Baltic cod ( Gadus morhua L.) eggs

    DEFF Research Database (Denmark)

    Wieland, Kai; Hinrichsen, H.H.; Grønkjær, P.

    2000-01-01

    rates were 7.2% (eggs IA/IB), 38.7% (eggs (IB/II), 25.6% (eggs II/III), 40.0% (eggs III/IV), and 42.3% (eggs IV/early larvae). The cumulative mortality until hatch amounted to 99.9%. Results from hydrodynamic modelling, however, indicated that the drifter's trajectory was influenced by wind stress....... Hence, the mortality rates might be biased despite the short sampling intervals; a modification of the sampling design is recommended for future studies....

  5. Stages of ores formation

    International Nuclear Information System (INIS)

    Khasanov, A.Kh.

    1988-01-01

    Deposit formation (especially endogenous) is the complicated, multi-stage and long process. Establishment of deposit formation succession, age-specific correlations of minerals and aggregates have a high importance at solving genetic questions. Studying of minerals correlations and mineral aggregates, succession of their crystallization and other observations let restore the history of deposit formation, pick up in it different on duration and physical and chemical conditions stages

  6. Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

    Science.gov (United States)

    2017-05-03

    Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  7. Staging of extrahepatic cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yong Eun; Choi, Jin-Young [Yonsei University College of Medicine, Department of Diagnostic Radiology, Research Institute of Radiological Science, Seoul (Korea); Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Diagnostic Radiology, Research Institute of Radiological Science, Seoul (Korea); Yonsei University College of Medicine, Institute of Gastroenterology, Yonsei (Korea); Yonsei University Health System, Department of Diagnostic Radiology, Seoul (Korea); Park, Young Nyun [Yonsei University College of Medicine, Institute of Gastroenterology, Yonsei (Korea); Yonsei University College of Medicine, Department of Pathology, Yonsei (Korea); Lee, Yoon-Hee [Yonsei University College of Medicine, Department of Pathology, Yonsei (Korea)

    2008-10-15

    Preoperative staging of extrahepatic cholangiocarcinoma is important in determining the best treatment plan. Several classification systems have been suggested to determine the operability and extent of surgery. Longitudinal tumor extent is especially important in extrahepatic cholangiocarcinoma because operative methods differ depending on the tumor extent. The Bismuth-Corlette classification system provides useful information when planning for surgery. However, this classification system is not adequate for selecting surgical candidates. Anatomic variation of the bile duct and gross morphology of the tumor must be considered simultaneously. Lateral spread of the tumor can be evaluated based on the TNM staging provided by American Joint Committee on Cancer (AJCC). However, there is a potential for ambiguity in the distinction of T1 and T2 cancer from one another. In addition, T stage does not necessarily mean invasiveness. Blumgart T staging is helpful for the assessment of resectability with the consideration of nodal status and distant metastasis as suggested by the AJCC cancer staging system. Computed tomography (CT) and magnetic resonance imaging (MRI) are the primary tools used in the assessment of longitudinal and lateral spread of a tumor when determining respectability. Diagnostic laparoscopy and positron emission tomography (PET) may play additional roles in this regard. (orig.)

  8. Shortened telomere length is demonstrated in T-cell subsets together with a pronounced increased telomerase activity in CD4 positive T cells from blood of patients with mycosis fungoides and parapsoriasis.

    Science.gov (United States)

    Wu, K D; Hansen, E R

    2001-10-01

    We have recently demonstrated that telomerase activity is increased and telomere length shortened in lymphocytes from peripheral blood of patients with cutaneous T-cell lymphoma. In order to determine which cell type has increased telomerase activity and shortened telomere length, CD4+, CD8+, CLA+ CD3+ and CLA- CD3+ T cells were isolated from peripheral blood of 25 patients, including 15 patients with mycosis fungoides and 10 patients with parapsoriasis. Eleven healthy individuals were used as controls; CD19+ B cells were separated from each individual as an internal control. The results showed that the increased telomerase activity was significantly predominating in the CD4+ T-cell subset. Significantly shortened telomere length was found in CD4+ and CD8+ T-cell subsets from the patients compared with the same cell subsets obtained from healthy individuals. However, no difference was observed between the subsets; CD19+ B cells collected from patients and healthy control individuals had similar telomerase activity and telomere length which was significantly different from the values found in T cells. The telomere length was significantly shorter in CLA+ CD3+ subset than in CLA- CD3+ subset. Interestingly, increased telomerase activity and shortened telomere length was also detected in CD4+ T cells from patients with parapsoriasis indicating that alteration of telomerase activity and telomere length in CD4+ T cells is an early event in the pathogenesis of cutaneous T-cell lymphoma. Thus, the results indicate that a significant high level of telomerase activity and shortened telomere length frequently occur in T cells of patients with CTCL and may reflect tumorigenesis.

  9. Composers on stage

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

    A trend on the scene of contemporary music is composers going on stage, performing their pieces themselves. Within a discourse of popular music, this is more the rule than exception, but when it comes to the context of contemporary scored music, the historical and aesthetic context differs......, and something quite different is undergoing. This paper intends to discuss three examples of performances in which the composer’s appearance on stage was an important part of the piece, - both when it came to the role as a performer and as an individual person – as representer and presenter. The paper intends...... to rise the following questions: What happens to the status of the author, when he suddenly (re-)appears on stage? How is this appearance to be understood in both a contemporary and historical context: Is it the musical virtuous appearing again, are we witnessing musical works turning...

  10. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

    Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation...... and public private innovation partnerships. Based on a case study of a collaborative design process in a large electronics company the paper points to the key importance of staging and navigation of collaborative innovation process. Staging and navigation is presented as a combined activity: 1) to translate...

  11. Are stage IV vestibular schwannomas preoperatively different from other stages?

    Science.gov (United States)

    Tringali, Stéphane; Dubreuil, Christian; Zaouche, Sandra; Ferber-Viart, Chantal

    2008-01-01

    The aim of this study was to focus on the clinical and paraclinical symptoms of patients suffering from Stage IV vestibular schwannomas (VSs). In this prospective study, we included 734 patients who have VS and candidates for operation. Patients were classified as having Stage I, II, III, or IV tumors according to Tos criteria as evaluated by magnetic resonance imaging. PREOPERATIVE CLINICAL EVALUATION: We recorded the occurrence of complaints (%) and duration (yr) of hearing loss, tinnitus, and balance disorder. Preoperative paraclinical evaluation included pure-tone (PTA) and speech audiometry, auditory brainstem response (ABR) patterns, and vestibular deficit at videonystamography (VNG). Continuous variables were compared between Stage IV and other stages using analysis of variance. Qualitative variables expressed as a percentage of presence were compared between Stage IV and other stages using percentage comparison. Quantitative Parameters. Patients with Stage IV VS were significantly younger as compared with patients with other stages. Stage IV hearing loss was greater compared with other stages at 250 and 500 Hz but smaller at 2,000 and 8,000 Hz. We found no difference in the loss of PTA between Stage IV and the other stages. Speech discriminancy score was smaller in Stage IV. The durations of hearing loss, tinnitus, and balance disorders were similar whatever the tumor stage. Auditory brainstem response patterns showed no difference in Wave III latency between Stage IV VS and other stages, whereas Wave V latency and V-I interval were higher in Stage IV. Both ABR threshold and VNG caloric deficit were higher in Stage IV VS compared with other stages. Qualitative Parameters. The percentage of patients with Stage IV was lower than that with Stages II and III. The percentage of men and women was similar in all stages. The occurrence of hearing loss was similar in all stages, whereas that of tinnitus was lower in Stage IV compared with Stages I and II. In

  12. End-stage kidney disease

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000500.htm End-stage kidney disease To use the sharing features on this page, please enable JavaScript. End-stage kidney disease (ESKD) is the last stage of long-term ( ...

  13. Stage theta pinch experiments

    International Nuclear Information System (INIS)

    Linford, R.K.; Downing, J.N.; Gribble, R.F.; Jacobson, A.R.; Platts, D.A.; Thomas, K.S.

    1975-01-01

    The Staged Theta Pinch program is designed to study the technological and physics problems associated with producing fat plasmas and separating the implosion heating from the adiabatic compression. Several methods of implosion heating are discussed. Circuit diagrams and theoretical magnetic field behavior are described for the STP and resonant heating experiments. (MOW)

  14. "Stage 40" Handbook.

    Science.gov (United States)

    Mill River Union High School, North Clarendon, VT.

    The policies, purposes, and guidelines of "Stage 40," an educational repertory company for students, are presented in this paper, which also explains how the company functions. The paper discusses the company's history, the relationship between the company and academics, and the responsibilities of a company member. Letters by the board…

  15. World Stage Design

    Index Scriptorium Estoniae

    2005-01-01

    12-19. III Torontos rahvusvaheline lavakujunduse, kostüümi ning valgus- ja helikujunduse näitus, mis toimub samaaegselt OISTATi (International Organization of Scenographers, Theatre Architects and Technicians) maailmakongressiga ja USITT (United States Institute for Theatre Technology) üritustega (konverents, Stage Expo). Eestit esindab lavakujunduse kategoorias Lilja Blumenfeld-Luhse

  16. Linac project - actual stage

    International Nuclear Information System (INIS)

    Carlin Filho, N.

    1990-01-01

    The actual development stage of Pelletron accelerator to study heavy ion reactions, nuclear structures and applied nuclear physics is presented. The construction of acceleration systems able to provide beams of several mass and energies up to 20 MeV/A, is discussed, describing acceleration structures and implemented systems. (M.C.K.)

  17. stage/page/play

    DEFF Research Database (Denmark)

    context. Contributors: Per Brask, Dario Fo, Jette Barnholdt Hansen, Pil Hansen, Sven Åke Heed, Ulla Kallenbach, Sofie Kluge, Annelis Kuhlmann, Kela Kvam, Anna Lawaetz, Bent Flemming Nielsen, Franco Perrelli, Magnus Tessing Schneider, Antonio Scuderi. stage/page/play is published as a festschrift...

  18. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

    Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation...... and public private innovation partnerships. Based on a case study of a collaborative design process in a large electronics company the paper points to the key importance of staging and navigation of collaborative innovation process. Staging and navigation is presented as a combined activity: 1) to translate...... the diverse matters of concern into a coherent product or service concept, and 2) in the same process move these diverse holders of the matters of concern into a translated actor network which carry or support the concept....

  19. Staging Sociotechnical Spaces

    DEFF Research Database (Denmark)

    Clausen, Christian; Yoshinaka, Yutaka

    2007-01-01

    The management of innovation and product development is increasingly facing complex challenges of staging design processes across heterogeneous organisational spaces, with multiple actor-concerns and sources of knowledge. This paper addresses how insights from the Actor-Network Theory and political...... process theory may contribute to a reflexive understanding of design as the staging of socio-technical relations and processes cutting across boundaries of diverse organisational, political and knowledge domains. This idea is pursued through the notion of ‘socio-technical spaces’. Socio-technical space...... of product development. The concept of socio-technical spaces is further illustrated through actual examples from industry dealing with early conceptualisation in product development and the role played by management concepts in the configuration of spaces....

  20. Calibration of Nanopositioning Stages

    Directory of Open Access Journals (Sweden)

    Ning Tan

    2015-12-01

    Full Text Available Accuracy is one of the most important criteria for the performance evaluation of micro- and nanorobots or systems. Nanopositioning stages are used to achieve the high positioning resolution and accuracy for a wide and growing scope of applications. However, their positioning accuracy and repeatability are not well known and difficult to guarantee, which induces many drawbacks for many applications. For example, in the mechanical characterisation of biological samples, it is difficult to perform several cycles in a repeatable way so as not to induce negative influences on the study. It also prevents one from controlling accurately a tool with respect to a sample without adding additional sensors for closed loop control. This paper aims at quantifying the positioning repeatability and accuracy based on the ISO 9283:1998 standard, and analyzing factors influencing positioning accuracy onto a case study of 1-DoF (Degree-of-Freedom nanopositioning stage. The influence of thermal drift is notably quantified. Performances improvement of the nanopositioning stage are then investigated through robot calibration (i.e., open-loop approach. Two models (static and adaptive models are proposed to compensate for both geometric errors and thermal drift. Validation experiments are conducted over a long period (several days showing that the accuracy of the stage is improved from typical micrometer range to 400 nm using the static model and even down to 100 nm using the adaptive model. In addition, we extend the 1-DoF calibration to multi-DoF with a case study of a 2-DoF nanopositioning robot. Results demonstrate that the model efficiently improved the 2D accuracy from 1400 nm to 200 nm.

  1. Alterações oculares em micose fungóide associada com vírus linfotrópico de células t humanas tipo I Ocular fidings in mycosis fungoides associated with human t-lymphotropic virus type I

    Directory of Open Access Journals (Sweden)

    Epaminondas de Souza Mendes Junior

    2010-10-01

    Full Text Available São relatados dois casos da associação de micose fungóide e HTLV-I. Os achados oftalmológicos observados foram, no caso 1: ceratopatia ponteada e ceratoconjuntivite seca e; no caso 2: ceratoconjuntivite seca, espessamento e nódulos difusos em bordas palpebrais. A associação de micose fungóide e HTLV-I nos dois casos sugere envolvimento deste vírus na etiopatogenia da doença. Maior conhecimento e realização de estudos bem controlados poderão ser úteis na determinação precisa desta hipótese.Two cases of mycosis fungoides associated with HTLV-I are reported. The ophthalmological findings were, in the first case, punctate keratopathy and keratoconjunctivitis sicca, and in the second case, keratoconjunctivitis sicca, thickening and difuse nodulos on eyelid margin. The association of mycosis fungoides and HTLV-I in these cases suggests involvement of this agent in the pathogenesis of the disease.

  2. Nuclear Cryogenic Propulsion Stage

    Science.gov (United States)

    Houts, Michael G.; Borowski, S. K.; George, J. A.; Kim, T.; Emrich, W. J.; Hickman, R. R.; Broadway, J. W.; Gerrish, H. P.; Adams, R. B.

    2012-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced NEP.

  3. Fire on Stage

    Directory of Open Access Journals (Sweden)

    Nicholas Daly

    2017-12-01

    Full Text Available The nineteenth century theatre was fire-prone, to say the least. Across the century there were more than 1,100 major conflagrations in the world’s theatres, and countless smaller fires. In Great Britain almost every theatre seems to have burned down at some point. And yet, despite, or perhaps in part because of, this appalling record, fires were a staple feature of stage spectacle. Some plays placed them at the very centre of the entertainment, and as the century went on stage fires became more and more elaborate. Actual or simulated conflagrations were conjured up using a diverse array of technologies, some of them very simple, some depending on the most recent scientific discoveries. Here, I give a short tour of these technologies and their use in the plays of the period, and suggest some of the pleasures that they offered. While onstage flames could draw people in, offering an experience of immersive suspense, for instance, they also interrupted the dramatic flow, reminding audiences that they were seeing a performance, getting something for their money. To this extent, we are reminded that nineteenth-century drama provided something of a mixed and spectacular ‘theatre of attractions’, closer at times to the circus than to the novel.

  4. The principles of cancer staging.

    Science.gov (United States)

    Brierley, James; Gospodarowicz, Mary; O'Sullivan, Brian

    2016-01-01

    The anatomic disease extent or tumour stage of a cancer at diagnosis as a determinant of prognosis is discussed. The importance of cancer stage in individual patient prognosis and determination of treatment is reviewed as well as its value in research and cancer control activities. The conflict between the need for stability of cancer stage definitions over time and the need to evolve with advances in medicine are examined. The e cancer elearning modules on Cancer Stage are introduced.

  5. Allergic Bronchopulmonary Mycosis Caused by Cladosporidium

    Science.gov (United States)

    2017-05-23

    bronchoalveolar lavage ( BAL ). Case Presentation: A 58 year-old female was evaluated in the pulmonary clinic for worsening episodes of cough, chest...improved her symptoms, which returned after stopping the medication. During her prior admission, she underwent bronchoscopy with BAL which demonstrated...thick mucus plugs and extensive endobronchial inflammation. Endobronchial brushings and BAL showed inflammatory cells with 6% eosinophils, but all

  6. Micoses sistêmicas: fatores associados ao óbito em pacientes com infecção pelo vírus da imunodeficiência humana, Cuiabá, Estado de Mato Grosso, 2005-2008 Systemic mycosis: factors associated with death among patients infected with the human immunodeficiency virus, Cuiabá, State of Mato Grosso, Brazil, 2005-2008

    Directory of Open Access Journals (Sweden)

    Luciano Correa Ribeiro

    2009-12-01

    Full Text Available A prevalência de micose sistêmica entre 1.300 pacientes portadores de HIV/Aids de Cuiabá, Mato Grosso foi de 4,6%, no período de 2005-2008. As espécies de fungos isoladas foram o Cryptococcus neoformans (50%, Cryptococcus gattii (1,6%, Cryptococcus spp (6,6%, Histoplasma capsulatum (38,3% e Paracoccidioides brasiliensis (3,3%. Óbito foi registrado em 32 (53,3% pacientes, sendo a criptococose a principal causa. A contagem de linfócitos T CD4+ foi baixa e semelhante entre os pacientes que sobreviveram ou faleceram por micose sistêmica. O etilismo (OR:8,2; IC95%: 1,4-62,1; p=0,005 e o nível médio de desidrogenase lática [758 (182 U/L vs 416 (268 U/L; pBetween 2005 and 2008, the prevalence of systemic mycosis among 1,300 HIV/AIDS patients in Cuiabá, Mato Grosso, was 4.6%. The fungus species isolated were Cryptococcus neoformans in 50%, Cryptococcus gattii in 1.6%, Cryptococcus spp in 6.6%, Histoplasma capsulatum in 38.3% and Paracoccidioides brasiliensis in 3.3%. Death was recorded in the cases of 32 patients (53.3%, and cryptococcosis was the main cause. The CD4+ T lymphocyte count was low and similar among patients who survived or died due to systemic mycosis. The factors independently associated with the deaths of these patients were alcoholism (OR: 8.2; 95% CI: 1.4-62.1; p = 0005 and the mean level of lactate dehydrogenase [758 (182 U/l vs. 416 (268 U/l; p < 0001]. The findings showed that systemic mycosis was highly lethal among the patients with HIV/AIDS in Cuiabá and suggested that clinical-laboratory characteristics such as alcoholism and early elevation of lactate dehydrogenase may be factors relating to worse prognosis under these conditions.

  7. Science on stage

    Science.gov (United States)

    Ciceri, Piera

    2017-04-01

    Pictures and diaries of the legendary Antarctic Expedition of sir E. Shackleton and his crew aboard the Endurance (1914/16) have become the starting point to learn about Natural Science, Earth Science and Climate Change. Students, 12 years old, were involved in hands on activities, took part to a network project, used interactive virtual labs, talked to university researchers on Skype and became the writers of a play. The theater was the place to act the story of Shackleton's expedition, to "stage" some scientific experiments and to tell to the audience about ice cores, climate change, physical and geographical characteristic of polar regions, thermal phenomena related to adaptations of polar animals, solar radiation at different latitude, day/night duration. The project was carried out from teachers of science, letters, geography and English in collaboration with the "Piccolo Teatro di Milano", the association "Scienza Under 18", researchers of the "Byrd Polar and Climate Research Center of Ohio State University" and of "M. Zucchelli Station" based in Antarctica. In our opinion drama activities improve both verbal and non-verbal communication skills and soft skills such as teamwork, responsibility and commitment. To be able to write and to act, students need a deep understanding of contents. To have an audience different from their own teachers and classmates and to interact with university researchers offer real tasks. The project aims to develop a relevant skill for the students: to become awareness citizens in a changing word.

  8. Science on stage

    CERN Document Server

    2005-01-01

    During the opening ceremony, the audience was dazzled by a juggling show involving dramatic light effects. They also took away with them a teacher's sheet explaining some of the scientific concepts involved in juggling. Science teachers can sometimes be quite humorous when it comes to explaining serious matters, as those who took part in the 'Science on Stage' festival held at CERN from 21 to 25 November were able to see for themselves. The 500 or so participants from 27 different countries, mostly science teachers but also some university lecturers, science outreach specialists and students, had the opportunity to share their experience of the teaching of science. They also attended presentations and shows, took part in workshops and visited a fair with stands offering ideas on how to make school science lessons more appealing. The festival, organised by the EIROforum (a partnership between CERN, EFDA, ESA, ESO, EMBL, ESRF and ILL), marked the end of two years of projects for the promotion of science in vir...

  9. Staged membrane oxidation reactor system

    Science.gov (United States)

    Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

    2012-09-11

    Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

  10. Staged Repository Development Programmes

    International Nuclear Information System (INIS)

    Isaacs, T

    2003-01-01

    Programs to manage and ultimately dispose of high-level radioactive wastes are unique from scientific and technological as well as socio-political aspects. From a scientific and technological perspective, high-level radioactive wastes remain potentially hazardous for geological time periods-many millennia-and scientific and technological programs must be put in place that result in a system that provides high confidence that the wastes will be isolated from the accessible environment for these many thousands of years. Of course, ''proof'' in the classical sense is not possible at the outset, since the performance of the system can only be known with assurance, if ever, after the waste has been emplaced for those geological time periods. Adding to this challenge, many uncertainties exist in both the natural and engineered systems that are intended to isolate the wastes, and some of the uncertainties will remain regardless of the time and expense in attempting to characterize the system and assess its performance. What was perhaps underappreciated in the early days of waste management and repository program development were the unique and intense reactions that the institutional, political, and public bodies would have to repository program development, particularly in programs attempting to identify and then select sites for characterization, design, licensing, and ultimate development. Reactions in most nations were strong, focused, unrelenting, and often successful in hindering, derailing, and even stopping national repository programs. The reasons for such reactions and the measures to successfully respond to them are still evolving and continue to be the focus of many national program and political leaders. Adaptive Staging suggests an approach to repository program development that reflects the unique challenges associated with the disposal of high-level radioactive waste. The step-wise, incremental, learn-as-you-go approach is intended to maximize the

  11. Second stage gasifier in staged gasification and integrated process

    Science.gov (United States)

    Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

    2015-10-06

    A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

  12. Control of stage by stage changing linear dynamic systems

    Directory of Open Access Journals (Sweden)

    Barseghyan V.R.

    2012-01-01

    Full Text Available In this paper, the control problems of linear dynamic systems stage by stage changing and the optimal control with the criteria of quality set for the whole range of time intervals are considered. The necessary and sufficient conditions of total controllability are also stated. The constructive solving method of a control problem is offered, as well as the definitions of conditions for the existence of programmed control and motions. The explicit form of control action for a control problem is constructed. The method for solving optimal control problem is offered, and the solution of optimal control of a specific target is brought.

  13. Two-Stage Centrifugal Fan

    Science.gov (United States)

    Converse, David

    2011-01-01

    Fan designs are often constrained by envelope, rotational speed, weight, and power. Aerodynamic performance and motor electrical performance are heavily influenced by rotational speed. The fan used in this work is at a practical limit for rotational speed due to motor performance characteristics, and there is no more space available in the packaging for a larger fan. The pressure rise requirements keep growing. The way to ordinarily accommodate a higher DP is to spin faster or grow the fan rotor diameter. The invention is to put two radially oriented stages on a single disk. Flow enters the first stage from the center; energy is imparted to the flow in the first stage blades, the flow is redirected some amount opposite to the direction of rotation in the fixed stators, and more energy is imparted to the flow in the second- stage blades. Without increasing either rotational speed or disk diameter, it is believed that as much as 50 percent more DP can be achieved with this design than with an ordinary, single-stage centrifugal design. This invention is useful primarily for fans having relatively low flow rates with relatively high pressure rise requirements.

  14. Firebag stages 3 and 4

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Heather [Suncore Energy (Canada)

    2011-07-01

    In this presentation, Suncor Energy Inc. outlines the current and projected future status of their growth in the oil production industry. Under a new partnership with Total, Suncor has seen growth of 10% in its oil sands operations. Firebag stages 3 and 4 were fully sanctioned in 2008 for 125kbbl/day as a feed source for the Voyageur upgrader in 2010/2012. Although the projects were suspended in 2009, due to difficulties in the economy, safety strategies were put in place and the projects were subsequently restarted. Suncor's aim was to meet new expectations with respect to safety, timing, and costs. Currently, construction of Stage 3 is near completion, with most of the plant in turnover and start-up mode. Stage 4 construction is also making good progress with new safety plans, workforce planning, and repeat contractors. Future plans include the completion of stages 3 and 4, scheduling and strategy for stages 5 and 6, and program approaches for key elements of growth (engineering, construction, and labor shortages).

  15. DIRECT COUPLED PROGRESSIVE STAGE PULSE COUNTER APPARATUS

    Science.gov (United States)

    Kaufman, W.M.

    1962-08-14

    A progressive electrical pulse counter circuit was designed for the counting of a chain of input pulses of random width and/or frequency. The circuit employs an odd and even pulse input line alternately connected to a series of directly connected bistable counting stages. Each bistable stage has two d-c operative states which stage, when in its rnrtial state, prevents the next succeeding stage from changing its condition when the latter stage is pulsed. Since only altennate stages are pulsed for each incoming pulse, only one stage will change its state for each input pulse thereby providing prog essive stage by stage counting. (AEC)

  16. PET in lung cancer staging

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, R. E. [Duke University Medical Center, Dept. of Radiology, Durham, NC (United States)

    2001-09-01

    The primary clinical application of FDG-PET is in the evaluation of patients with lung cancer and includes diagnosis, staging and restaging of non-small cell lung cancer. PET has a very high accuracy (sensitivity=97%, specificity=78%) for characterizing nodules that are indeterminate by chest radiograph and computed tomography. The major utility of PET in the evaluation of patients with lung cancer is the staging of the entire body. PET is more accurate than the conventional imaging modalities of CT and bone scans in the detection of metastatic disease. PET is accurate in the staging of the mediastinum, adrenal glands, and the skeletal system. PET is not as accurate in the detection of brain metastases because of their small size and the normal cortical accumulation.

  17. Resposta in vitro de fungos agentes de micoses cutâneas frente aos antifúngicos sistêmicos mais utilizados na dermatologia In vitro response of cutaneous mycosis fungal agents to the most widely used systemic antifungals in dermatology

    Directory of Open Access Journals (Sweden)

    Lívia Maria Martins de Almeida

    2009-07-01

    Full Text Available FUNDAMENTOS - A alta frequência das micoses cutâneas justifica a necessidade de avaliar a possível contribuição da determinação do perfil de susceptibilidade aos antifúngicos in vitro. OBJETIVO - Avaliar se existe variabilidade nos isolados fúngicos quanto à susceptibilidade in vitro de fungos filamentosos, previamente isolados de micoses cutâneas, frente aos antifúngicos fluconazol, cetoconazol, itraconazol e terbinafina. MÉTODOS - Os fungos foram isolados e identificados por meio da metodologia clássica e o teste de susceptibilidade aos antifúngicos foi realizado segundo o método de microdiluição em caldo, de acordo com protocolo preconizado pelo Clinical Laboratory Standards Institute (CLSI, documento M38-A. RESULTADOS - Das 80 amostras de fungos filamentosos identificadas, o gênero Trichophyton representou 81%. As quatro drogas analisadas apresentaram grande variação nos gêneros Trichophyton e Microsporum. O gênero Fusarium foi resistente a todas as drogas testadas. A terbinafina foi o antimicótico mais eficaz contra a maioria dos isolados fúngicos. CONCLUSÃO - Houve uma grande variabilidade nos perfis de resposta aos antifúngicos testados. O estabelecimento de um método-teste de referência permitirá ao clínico maior objetividade na escolha de uma terapia adequada.BACKGROUND - The high frequency of cutaneous mycosis justify the need to evaluate the possible contribution of in vitro profile of susceptibility to antifungal agents. OBJECTIVE - To evaluate whether there is variability in in vitro susceptibility by filamentous fungi, previously isolated from cutaneous mycosis, to fluconazole, ketoconazole, itraconazole and terbinafine. METHODS - Fungi were isolated and identified by classical methods and the antifungal susceptibility test was performed using the method of broth microdilution, according to a protocol recommended by the Clinical Laboratory Standards Institute (CLSI, through M38-A document. RESULTS

  18. Early stage fuel cell funding

    International Nuclear Information System (INIS)

    Bergeron, C.

    2004-01-01

    'Full text:' Early stage venture funding requires an in depth understanding of both current and future markets as well as the key technical hurdles that need to be overcome for new technology to commercialize into successful products for mass markets. As the leading fuel cell and hydrogen investor, Chrysalix continuously reviews global trends and new technologies, evaluates them with industry leaders worldwide and tries to match them up with the best possible management teams when selecting its early stage investments. Chrysalix Energy Limited Partnership is an early-stage venture capital firm focusing on fuel cell and related fueling technology companies and is a private equity joint venture between Ballard Power Systems, BASF Venture Capital, The BOC Group, The Boeing Company, Duke Energy, Mitsubishi Corporation and Shell Hydrogen. Operating independently, Chrysalix offers a unique value proposition to its clients throughout the business planning, start-up and operations phases of development. Chrysalix provides early-stage funding to new companies as well as management assistance, technological knowledge, organized networking with industry players and experience in the management of intellectual property. (author)

  19. Stages of neuronal network formation

    Science.gov (United States)

    Woiterski, Lydia; Claudepierre, Thomas; Luxenhofer, Robert; Jordan, Rainer; Käs, Josef A.

    2013-02-01

    Graph theoretical approaches have become a powerful tool for investigating the architecture and dynamics of complex networks. The topology of network graphs revealed small-world properties for very different real systems among these neuronal networks. In this study, we observed the early development of mouse retinal ganglion cell (RGC) networks in vitro using time-lapse video microscopy. By means of a time-resolved graph theoretical analysis of the connectivity, shortest path length and the edge length, we were able to discover the different stages during the network formation. Starting from single cells, at the first stage neurons connected to each other ending up in a network with maximum complexity. In the further course, we observed a simplification of the network which manifested in a change of relevant network parameters such as the minimization of the path length. Moreover, we found that RGC networks self-organized as small-world networks at both stages; however, the optimization occurred only in the second stage.

  20. Metrics for Stage Lighting Technology.

    Science.gov (United States)

    Cooper, Gloria S., Ed; Magisos, Joel H., Ed.

    Designed to meet the job-related metric measurement needs of stage lighting technology students, this instructional package is one of five for the arts and humanities occupations cluster, part of a set of 55 packages for metric instruction in different occupations. The package is intended for students who already know the occupational terminology,…

  1. Stages of Merkel Cell Carcinoma

    Science.gov (United States)

    ... tissue. Merkel cells are in the layer of basal cells at the deepest part of the epidermis and are connected to nerves. Merkel cell carcinoma tends to grow quickly and to metastasize (spread) at an early stage . It usually spreads first to nearby lymph nodes and then may spread to lymph nodes or ...

  2. When science takes centre stage

    CERN Multimedia

    2005-01-01

    The teachers at 'Science on stage' are not emotionally attached to their chalk. Neither are they are weary old men who sport tweed jackets with elbow-patches and enter into conversation with their blackboards. Actually, 'Science on stage' teachers are far from the cliché of the boring physics teacher who can only inspire yawns from his pupils. Some present the basic principles of mechanics using a bicycle, others explain chemistry with examples from everyday life. The most audacious of them go so far as to explain the Doppler effect by means of a play in which Einstein dreams about jumping cows... These are but a few of the activities and plays that will be shown during the EIROforum1 Science on Stage Festival (organised by 7 European scientific organisations including CERN), to be held from 21 to 25 November at CERN, Geneva. This festival is dedicated to the teaching science in order to make it more attractive. After the first edition 'Physics on Stage' which was held in 2000 at CERN, the laboratory agai...

  3. Operation of staged membrane oxidation reactor systems

    Science.gov (United States)

    Repasky, John Michael

    2012-10-16

    A method of operating a multi-stage ion transport membrane oxidation system. The method comprises providing a multi-stage ion transport membrane oxidation system with at least a first membrane oxidation stage and a second membrane oxidation stage, operating the ion transport membrane oxidation system at operating conditions including a characteristic temperature of the first membrane oxidation stage and a characteristic temperature of the second membrane oxidation stage; and controlling the production capacity and/or the product quality by changing the characteristic temperature of the first membrane oxidation stage and/or changing the characteristic temperature of the second membrane oxidation stage.

  4. Survival Advantage Associated with Decrease in Stage at Detection from Stage IIIC to Stage IIIA Epithelial Ovarian Cancer

    Science.gov (United States)

    Lefringhouse, Jason; Pavlik, Edward; Miller, Rachel; DeSimone, Christopher; Ueland, Frederick; Kryscio, Richard; van Nagell, J. R.

    2014-01-01

    Objective. The aim of this study was to document the survival advantage of lowering stage at detection from Stage IIIC to Stage IIIA epithelial ovarian cancer. Methods. Treatment outcomes and survival were evaluated in patients with Stage IIIA and Stage IIIC epithelial ovarian cancer treated from 2000 to 2009 at the University of Kentucky Markey Cancer Center (UKMCC) and SEER institutions. Results. Cytoreduction to no visible disease (P < 0.0001) and complete response to platinum-based chemotherapy (P < 0.025) occurred more frequently in Stage IIIA than in Stage IIIC cases. Time to progression was shorter in patients with Stage IIIC ovarian cancer (17 ± 1 months) than in those with Stage II1A disease (36 ± 8 months). Five-year overall survival (OS) improved from 41% in Stage IIIC patients to 60% in Stage IIIA patients treated at UKMCC and from 37% to 56% in patients treated at SEER institutions for a survival advantage of 19% in both data sets. 53% of Stage IIIA and 14% of Stage IIIC patients had NED at last followup. Conclusions. Decreasing stage at detection from Stage IIIC to stage IIIA epithelial ovarian cancer is associated with a 5-year survival advantage of nearly 20% in patients treated by surgical tumor cytoreduction and platinum-based chemotherapy. PMID:25254047

  5. Staging N0 oral cancer

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Sørensen, Jens Ahm; Grupe, Peter

    2005-01-01

    PURPOSE: To compare sentinel lymph node biopsy, magnetic resonance imaging (MRI), Doppler ultrasonography, and palpation as staging tools in patients with T1/T2 N0 cancer of the oral cavity. MATERIAL AND METHODS: Forty consecutive patients were enrolled (17 F and 23 M, aged 32-90 years), 24 T1...... and 16 T2 cN0 squamous cell carcinoma of the oral cavity. Palpation was carried out by two observers prior to inclusion. MRI, gray-scale and Doppler ultrasonography were performed. Lymphoscintigraphies were done after peritumoral injections of 99mTc labelled rheniumsulphide nanocolloid, followed......%, but the sensitivity of MRI 36% was low. The specificities were 100%, 85%, and 93%, respectively. By combined sentinel lymph node biopsy and ultrasonography the overall sensitivity could have been 100%. CONCLUSION: Sentinel lymph node biopsy improved staging of patients with small N0 oral cancers. Combined sentinel...

  6. Sleep stages, memory and learning.

    Science.gov (United States)

    Dotto, L

    1996-04-15

    Learning and memory can be impaired by sleep loss during specific vulnerable "windows" for several days after new tasks have been learned. Different types of tasks are differentially vulnerable to the loss of different stages of sleep. Memory required to perform cognitive procedural tasks is affected by the loss of rapid-eye-movement (REM) sleep on the first night after learning occurs and again on the third night after learning. REM-sleep deprivation on the second night after learning does not produce memory deficits. Declarative memory, which is used for the recall of specific facts, is not similarly affected by REM-sleep loss. The learning of procedural motor tasks, including those required in many sports, is impaired by the loss of stage 2 sleep, which occurs primarily in the early hours of the morning. These findings have implications for the academic and athletic performance of students and for anyone whose work involves ongoing learning and demands high standards of performance.

  7. Acute pancreatitis: staging with CT

    International Nuclear Information System (INIS)

    Gialeli, E.; Petrocheilou, G.; Georgaki, S.; Tzemailas, I.; Adraktas, A.; Charilas, G.; Patsiogiannis, V.

    2012-01-01

    Full text: Introduction: Computed Tomography (CT) is the imaging modality of choice for the diagnosis and staging of acute pancreatitis and its complications. Objectives and tasks: The purpose of this presentation is to demonstrate the findings in CT images which are useful for staging acute pancreatitis according to Balthazar, their significance and restrictions. Materials and methods: CT images from patients who were referred to our Department for an abdominal CT scan for the diagnosis or/and staging of acute pancreatitis were retrospectively studied. Results: In acute pancreatitis, CT helps to stage the severity of inflammatory process, to detect pancreatic necrosis and to depict local complications. CT severity index (CTSI), which was proposed by Balthazar et al, combines the grade of pancreatitis with the extent of pancreatic necrosis assigning points to the patients in order to find the severity index which scales from 0-10. More points are given for a higher grade of pancreatitis and for more extensive necrosis. Types of pancreatitis according to CTSI are: interstitial (Balthazar grade A-C), exudative (Balthazar grade D or E), necrotising (Balthazar grade E, CTSI:10) and central gland necrotising. Patients with pancreatitis but no collections or necrosis have an interstitial (mild) pancreatitis. In exudative pancreatitis there is normal enhancement of the entire pancreas associated with extensive peripancreatic collections. Necrotizing (severe) pancreatitis is characterized by protacted clinical course, high incidence of local complications and high mortality rate. Central gland necrosis is a subtype of necrotizing pancreatitis. Conclusions: The combination of CT imaging and clinical and laboratory evaluation allows the early diagnosis of acute pancreatitis. Acute pancreatitis may vary from a mild uneventful disease to a severe life-threatening illness with multisystemic organ failure. Thus, it is crucial to identify patients who are at high risk of severe

  8. Images of gastric cancer stages

    International Nuclear Information System (INIS)

    Castro Aragon, I.M.

    1999-01-01

    The present work has the objective to review the importance of the images in the preoperating stage of the gastric cancer. It has been emphasized in the modalities of transabdominal ultrasound as much as endoscopic and TAC since they are most valuable in the stage. Certainly the importance of conventional radiology (gastroduodenal series) is also valuable in the stage of the tumor, specially in considering the depth of the same one. In order to make this overhaul, the recent bibliography was consulted but, specially the published one by Japaneses since they follow a classification and methodology different from the used one in most of the countries that belong to the World-wide Organization of the Health. They made an overhaul of approximately 200 cases of patients who have been diagnosed and treated in the Center of Detection of Gastric Cancer of Cartago. In each case review the file, radiological, sonographic and pathological studies, and the cases were chosen that better illustrated the exposed subjects. (Author) [es

  9. MR staging of endometrial carcinoma

    International Nuclear Information System (INIS)

    Innocenti, P.; Agostini, S.; Erroi, C.; Ambrogetti, D.; Cellerini, A.; Nori, J.

    1991-01-01

    Biopsy is the technique of choice for the definitive diagnosis of endometrial carcinoma. Since lymphatic tumor spread has been demonstrated to depend on the degree of myometrial involvement, the definition of the latter with imaging techniques may significantly affect both pfognosis and therapy. We investigated, by means of MR imaging at 0.5 T, 14 patients with endometrial carcinoma, to assess both tumor stage and myometrial involvement. FIGO staging system was employed, and M parameter evaluated (M0= no myometrial involvement; M1involvement confined to the inner third; M2= Involvement confined to the middle third; M3= involvement of the whole myometrium). Another parameter was the characteristic high signal of the tumor on PD and T2W images. The patients were then operated and MR information was correlated with surgical findings. Overall diagnostic accuracy of MR imaging was 85.7% in tumor staging, and 92.2% in defining M parameter. Tumor spread into adnexa and into cervical canal was poorly demonstrated by MR imaging

  10. Single conversion stage amplifier - SICAM

    Energy Technology Data Exchange (ETDEWEB)

    Ljusev, P.

    2005-12-15

    This Ph.D. thesis presents a thorough analysis of the so called SICAM - SIngle Converter stage AMplifier approach to building direct energy conversion audio power amplifiers. The mainstream approach for building isolated audio power amplifiers today consists of isolated DC power supply and Class D amplifier, which essentially represents a two stage solution, where each of the components can be viewed as separate and independent part. The proposed SICAM solution strives for direct energy conversion from the mains to the audio output, by dedicating the operation of the components one to another and integrating their functions, so that the final audio power amplifier represents a single-stage topology with higher efficiency, lower volume, less board space, lower component count and subsequently lower cost. The SICAM approach is both applicable to non-isolated and isolated audio power amplifiers, but the problems encountered in these two cases are different. Non-isolated SICAM solutions are intended for both AC mains-connected and battery-powered devices. In non-isolated mains-connected SICAMs the main idea is to simplify the power supply or even provide integrated power factor correction (PFC) functions, while still maintaining low component stress and good audio performance by generally decreasing the input voltage level to the Class D audio power amplifier. On the other hand, non-isolated battery-powered SICAMs have to cope with the ever changing battery voltage and provide output voltage levels which are both lower and higher than the battery voltage, while still being simple and single-stage energy conversion solutions. In isolated SICAMs the isolation transformer adjusts the voltage level on the secondary side to the desired level, so the main challenges here are decreasing the size of the magnetic core and reducing the number and size of bulky reactive components as much as possible. The main focus of this thesis is directed towards the isolated SICAMs and

  11. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  12. [Initial stages of steel biocorrosion].

    Science.gov (United States)

    Zhigletsova, S K; Rodin, V B; Kobelev, V S; Aleksandrova, N V; Rasulova, G E; Kholodenko, V P

    2000-01-01

    Initial stages of corrosion of mild steel induced by Klebsiela rhinoscleromatis BO2 were studied in various media. The effect of the microorganism was detected 8-10 h after inoculation. The number of viable cells were virtually unchanged within one month in all media, but the corrosive activity of the strain decreased. The corrosive activity of microorganisms can be determined by spectrophotometry even only after incubation for 24 h. At a low level of organic substrate, even strong colonization with microorganisms does not inevitably result in a significant damage to metals.

  13. Staging Urban Experiences in Suburbia

    DEFF Research Database (Denmark)

    Jantzen, Christian; Vetner, Mikael

    2009-01-01

    Urban design provides props, requisites and decors for staging the users' performances in space. Design may facilitate or impede specific ways of moving around, interacting with objects and other people, feeling, learning and sense making.The actual design may very well contradict the explicit...... intentions of decision makers when commissioning, financing or planning new urban environments. Our case, the building of a new city centre for the Dutch city of Almere, illustrates this point. The project was supervised by Rem Koolhaas (OMA) and aimed at branding the city as a truly urban environment...

  14. Preadaptive Stage for Flight Origin

    Directory of Open Access Journals (Sweden)

    Bogdanovich I. A.

    2017-04-01

    Full Text Available Bipedalism as a preadaptive stage for bird’s flight is considered. We attribute the formation of full bipedalism in bird ancestors with pelvic limbs transition from segmental to parasagittal position. This transition was fast enough. We can assume that the pectoral limbs freed from the support remained while laterally spaced and gave set of transformations with different degrees of reduction. Thus morphologically “winglike” version of the thoracic limbs could appear. Parasagittal pelvic limbs allowed birds ancestors fast and maneuverable running, while the movements of free and highly movable thoracic limbs (feathered unrelated to flight provided dynamic stability of the animal. In addition, their fluttering movements facilitate hopping from one branch to another and the descent from the trees. On the bottom branches protobirds could jump with perching just by the pelvic anisodactyl limbs, not by thoracic as had supposed earlier. Active interaction of the primary simple feathers with air as well as its protective function could become an impetus for their transformation into differentiated structures. Unlike gliding (as preadaptive stage for active flight bipedalism with free feathered forelimbs provides per se parallel development of two autonomous enough locomotor systems of birds (flight and terrestrial locomotion and extensive adaptive radiation of representatives of the class.

  15. A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

    International Nuclear Information System (INIS)

    Jebaraj, Isaac; Chacko, Binita Riya; Chiramel, George Koshy; Matthai, Thomas; Parameswaran, Apurve

    2013-01-01

    This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1), the stage of early discal calcification (stage 2), the stage of fibrous ankylosis (stage 3), and the stage of bony ankylosis (stage 4). To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease

  16. Early stages of Ostwald ripening

    Science.gov (United States)

    Shneidman, Vitaly A.

    2013-07-01

    The Becker-Döring (BD) nucleation equation is known to predict a narrow double-exponential front (DEF) in the distribution of growing particles over sizes, which is due to early transient effects. When mass conservation is included, nucleation is eventually exhausted while independent growth is replaced by ripening. Despite the enormous difference in the associated time scales, and the resulting demand on numerics, within the generalized BD model the early DEF is shown to be crucial for the selection of the unique self-similar Lifshitz-Slyozov-Wagner asymptotic regime. Being preserved till the latest stages of growth, the DEF provides a universal part of the initial conditions for the ripening problem, regardless of the mass exchange mechanism between the nucleus and the matrix.

  17. The Nuclear Cryogenic Propulsion Stage

    Science.gov (United States)

    Houts, Michael G.; Kim, Tony; Emrich, William J.; Hickman, Robert R.; Broadway, Jeramie W.; Gerrish, Harold P.; Doughty, Glen; Belvin, Anthony; Borowski, Stanley K.; Scott, John

    2014-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP). Nuclear propulsion can be affordable and viable compared to other propulsion systems and must overcome a biased public fear due to hyper-environmentalism and a false perception of radiation and explosion risk.

  18. Stage at diagnosis and ovarian cancer survival

    DEFF Research Database (Denmark)

    Maringe, Camille; Walters, Sarah; Butler, John

    2012-01-01

    We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival.......We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival....

  19. Interconnected Levels of Multi-Stage Marketing

    DEFF Research Database (Denmark)

    Vedel, Mette; Geersbro, Jens; Ritter, Thomas

    2012-01-01

    must not only decide in general on the merits of multi-stage marketing for their firm, but must also decide on which level they will engage in multi-stage marketing. The triadic perspective enables a rich and multi-dimensional understanding of how different business relationships influence each other......Multi-stage marketing gains increasing attention as knowledge of and influence on the customer's customer become more critical for the firm's success. Despite this increasing managerial relevance, systematic approaches for analyzing multi-stage marketing are still missing. This paper conceptualizes...... different levels of multi-stage marketing and illustrates these stages with a case study. In addition, a triadic perspective is introduced as an analytical tool for multi-stage marketing research. The results from the case study indicate that multi-stage marketing exists on different levels. Thus, managers...

  20. Stages of Ovarian Low Malignant Potential Tumors

    Science.gov (United States)

    ... tests or procedures are used for staging. Staging laparotomy (a surgical incision made in the wall of ... treatment. Two types of standard treatment are used: Surgery The type of surgery (removing the tumor in ...

  1. Early-stage mantle cell lymphoma

    DEFF Research Database (Denmark)

    Dabaja, B S; Zelenetz, A D; Ng, A K

    2017-01-01

    Background: Mantle cell lymphoma (MCL) rarely presents as early-stage disease, but clinical observations suggest that patients who present with early-stage disease may have better outcomes than those with advanced-stage disease. Patients and methods: In this 13-institution study, we examined...

  2. Stages of tuberculous meningitis: a clinicoradiologic analysis

    International Nuclear Information System (INIS)

    Sher, K.; Firdaus, A.; Bullo, N.; Kumar, S.; Abbasi, A.

    2013-01-01

    Objective: To determine the frequencies and percentages of various clinicoradiologic variables of tuberculosis meningitis (TBM) with reference to British Medical Research Council (BMRC) staging of the disease. Study Design: A case series. Place and Duration of Study: Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, from October 2010 to September 2011. Methodology: The study included 93 adult patients with the diagnosis of tuberculous meningitis (TBM) at the study place. Patients were divided in three groups according to British Medical Research Council (BMRC) staging of TBM. Different clinical and radiological findings were analyzed at different stages of the disease. Data was analyzed using SPSS (Statistical Package of Social Sciences) version 11.0. Results: A majority of patients were found to be in stage-II disease at the time of admission. History of illness at the time of admission was more than 2 weeks in 50% of stage-I patients but around 80% in stage-II and stage-III patients. Neck stiffness was the most commonly reported finding in all stages. Cranial nerve palsies were higher in stage-III (75%) than in stage-II (43%) and in stage-I (24%) patients. Hydrocephalus and basal enhancement was the most frequently reported radiographic abnormalities. Conclusion: Duration of illness and cranial nerve palsies are important variables in the diagnosis of TBM stages and if TBM is suspected, empiric treatment should be started immediately without bacteriologic proof to prevent morbidity and mortality. (author)

  3. Two-Stage Series-Resonant Inverter

    Science.gov (United States)

    Stuart, Thomas A.

    1994-01-01

    Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

  4. Stage control of tablets manufacturing

    Directory of Open Access Journals (Sweden)

    L. I. Kucherenko

    2014-08-01

    Full Text Available Today in Ukraine tuberculosis is the wide-spread infectious disease causing the death in most cases; about 700 thousand persons are suffering from it. In Ukraine epidemic of tuberculosis is progressing and spreading. In spite of all protective measures three inhabitants of our country contract tuberculosis per hour, every hour one patient dies and in common about 1.5% of the population is ill with tuberculosis. Isoniazid is antituberculous drug of the first line and it is the most effective one. Chemotherapy of tuberculosis requests long-lasting administration of antituberculous drugs that causes high risk of side effects. To prevent or lessen side effects of antituberculous medicines antioxidants use in complex therapy is perspective. Fulfilled investigations showed efficacy of combining two medical substances – isoniazid andthiotriazolin – in one dosage form. Objective.The aim of our investigation is working out the methods of standardization, in particularquantitative determination of isoniazid andthiotriazolin content in tablet mass by high-performance liquid chromatography (HPLC. Materials and Methods.During in-process investigations combined tableted remedy containing isoniazid andthiotriazolin and proper amount of adjuvants has been developed (it contains active substances isoniazid – 0.2 g,thiotriazolin – 0.05 g and adjuvants up to the 0.4 g of the tablet. During stage control of tablets manufacturingspecial attention is paid to the control of tablet mass quality. Especially it concerns quantitative determination of active substances in it. More and more attention is paid to modern physical-chemical methods of standardization in up-to-date analysis of drug products, such as ultraviolet spectrometry, high-performance liquid chromatography (HPLC etc. In previous scientific investigations we proved the possibility of standardization of active substances artificial compound by HPLC method and optimal conditions of analysis performing

  5. Two stage turbine for rockets

    Science.gov (United States)

    Veres, Joseph P.

    1993-01-01

    The aerodynamic design and rig test evaluation of a small counter-rotating turbine system is described. The advanced turbine airfoils were designed and tested by Pratt & Whitney. The technology represented by this turbine is being developed for a turbopump to be used in an advanced upper stage rocket engine. The advanced engine will use a hydrogen expander cycle and achieve high performance through efficient combustion of hydrogen/oxygen propellants, high combustion pressure, and high area ratio exhaust nozzle expansion. Engine performance goals require that the turbopump drive turbines achieve high efficiency at low gas flow rates. The low mass flow rates and high operating pressures result in very small airfoil heights and diameters. The high efficiency and small size requirements present a challenging turbine design problem. The shrouded axial turbine blades are 50 percent reaction with a maximum thickness to chord ratio near 1. At 6 deg from the tangential direction, the nozzle and blade exit flow angles are well below the traditional design minimum limits. The blade turning angle of 160 deg also exceeds the maximum limits used in traditional turbine designs.

  6. Acting Antarctica: science on stage

    Science.gov (United States)

    Ciceri, Piera; Tizzoni, Paola; Pierro, Luigia

    2016-04-01

    Key-words: Polar science, Earth science, Theatre, Hands on activities The legendary Antarctic Expedition of sir E. Shackleton and his crew of 27 aboard the Endurance (1914/16) trapped in the Antarctic ice has become the starting point to learn about Polar Science and Climate Change. While the students were involved into this incredible adventure by the astonishing images of the Australian photographer Frank Hurley (who joined the crew), they discovered the world in which this story happened. Students were then involved in hands-on activities and role plays and have become the writers of the play "Uomini a scienza ai confini del mondo". They act the story of Shackelton's expedition and they tell at the same time to the audience about ice pack, ice cores and their role in understanding the past of the climate, physical and geographical characteristic of polar regions, thermal phenomena related to adaptations of polar animals, solar radiation at different latitude, day/night duration. The theater was the place to "stage" some scientific experiments and to explain the current research carried out in polar regions and their importance in climate change studies and to stress some similarities between Antarctica and space. The project was carried out from teachers of science, letters and geography and was born in collaboration with the "Piccolo Teatro di Milano" and the association "Science Under 18" with the support of a professional actor and director and was played for other schools at "EXPO 2015" in Milano (Italy). In our opinion drama activities improve reading comprehension, and both verbal and non-verbal communication skills. To be able to write and to act, students need a deep understanding of contents. Arts, including theatre, are a good key to involve emotionally students. To have an audience different from their own teachers and classmates offers a real task and the opportunity to play and let grow real skills.

  7. One-Stage and Bayesian Two-Stage Optimal Designs for Mixture Models

    OpenAIRE

    Lin, Hefang

    1999-01-01

    In this research, Bayesian two-stage D-D optimal designs for mixture experiments with or without process variables under model uncertainty are developed. A Bayesian optimality criterion is used in the first stage to minimize the determinant of the posterior variances of the parameters. The second stage design is then generated according to an optimality procedure that collaborates with the improved model from first stage data. Our results show that the Bayesian two-stage D-D optimal design...

  8. Pantex staging study near-term alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Madden, M.S.; Adickes, M.D.; Hostick, C.J.; Nealey, S.M.; Smith, B.W.

    1992-12-01

    As the result of bilateral treaties to reduce the number of weapons in the nuclear stockpile, the US Department of Energy must now address the requirements for additional storage of the plutonium components (pits) from the retired weapons at Pantex until the components' final disposition. Because of the critical need to take action, Pantex has initiated two related efforts: Project Stage Right and this Staging Study. While support of Project Stage Right is a key objective of this study, the scope covers a broader range of activities and aspects of the pit staging problem. This study provides estimates of worker radiation exposures under the current scenario as well as estimated radiation exposure for workers under four alternative staging scenarios. An important objective of this study also identifies and recommends for future study other activities related to staging where radiation safety and overall efficiency can be improved.

  9. Pantex staging study near-term alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Madden, M.S.; Adickes, M.D.; Hostick, C.J.; Nealey, S.M.; Smith, B.W.

    1992-12-01

    As the result of bilateral treaties to reduce the number of weapons in the nuclear stockpile, the US Department of Energy must now address the requirements for additional storage of the plutonium components (pits) from the retired weapons at Pantex until the components` final disposition. Because of the critical need to take action, Pantex has initiated two related efforts: Project Stage Right and this Staging Study. While support of Project Stage Right is a key objective of this study, the scope covers a broader range of activities and aspects of the pit staging problem. This study provides estimates of worker radiation exposures under the current scenario as well as estimated radiation exposure for workers under four alternative staging scenarios. An important objective of this study also identifies and recommends for future study other activities related to staging where radiation safety and overall efficiency can be improved.

  10. Compact 6-DOF Stage for Optical Adjustments

    Science.gov (United States)

    Shafaat, Syed; Chang, Daniel

    2008-01-01

    The figure depicts selected aspects of a six-degree-of-freedom (6-DOF) stage for mechanical adjustment of an optical component. The six degrees of freedom are translations along the Cartesian axes (x, y, and z) and rotations about these axes (theta x, theta y, and theta z, respectively). Relative to prior such stages, this stage offers advantages of compactness, stability, and robustness, plus other advantages as described below. The stage was designed specifically as part of a laser velocimeter and altimeter in which light reflected by a distant object is collected by a Cassegrainian telescope and focused into a single-mode, polarization-maintaining optical fiber. The stage is used to position and orient the input end of the optical fiber with respect to the focal point of the telescope. Stages like this one can also be adapted for use in positioning and orienting other optical components, including lenses, prisms, apertures, and photodetectors.

  11. Trading Stages: Life Expectancies in Structured Populations

    Science.gov (United States)

    Tuljapurkar, Shripad; Coulson, Tim; Horvitz, Carol

    2012-01-01

    Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied because they are hard to use and interpret, and tools for age and stage structured populations are missing. We present easily interpretable expressions for the sensitivities and elasticities of life expectancy to vital rates in age-stage models, and illustrate their application with two biological examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography. PMID:22664576

  12. Numerical simulation of radial compressor stage

    Science.gov (United States)

    Syka, T.; Luňáček, O.

    2013-04-01

    Article describes numerical simulations of air flow in radial compressor stage in NUMECA CFD software. In simulations geometry variants with and without seals are used. During tasks evaluating was observed seals influence on flow field and performance parameters of compressor stage. Also is described CFDresults comparison with results from design software based on experimental measurements and monitoring of influence of seals construction on compressor stage efficiency.

  13. Numerical simulation of radial compressor stage

    OpenAIRE

    Luňáček O.; Syka T.

    2013-01-01

    Article describes numerical simulations of air flow in radial compressor stage in NUMECA CFD software. In simulations geometry variants with and without seals are used. During tasks evaluating was observed seals influence on flow field and performance parameters of compressor stage. Also is described CFDresults comparison with results from design software based on experimental measurements and monitoring of influence of seals construction on compressor stage efficiency.

  14. Numerical simulation of radial compressor stage

    Directory of Open Access Journals (Sweden)

    Luňáček O.

    2013-04-01

    Full Text Available Article describes numerical simulations of air flow in radial compressor stage in NUMECA CFD software. In simulations geometry variants with and without seals are used. During tasks evaluating was observed seals influence on flow field and performance parameters of compressor stage. Also is described CFDresults comparison with results from design software based on experimental measurements and monitoring of influence of seals construction on compressor stage efficiency.

  15. Stage character of the oxidation of dialkylthiophenes

    Energy Technology Data Exchange (ETDEWEB)

    Volkov, M.N.; Kazakova, O.A.

    1988-07-20

    The reasons for the stage character of the oxidation of dialkylthiophenes catalyzed by a cobalt bromide catalyst are examined. The stage character of oxidation is due to the deactivation of the catalyst by the corresponding alcohol formed during oxidation. At the first stage of the process only the products from oxidation of the /alpha/-alkyl group, i.e., the corresponding ketone, ester, and thiophenecarboxylic acid, are formed. The rate constants for their formation were calculated.

  16. Life cycle analysis in preliminary design stages

    OpenAIRE

    Agudelo , Lina-Maria; Mejía-Gutiérrez , Ricardo; Nadeau , Jean-Pierre; PAILHES , Jérôme

    2014-01-01

    International audience; In a design process the product is decomposed into systems along the disciplinary lines. Each stage has its own goals and constraints that must be satisfied and has control over a subset of design variables that describe the overall system. When using different tools to initiate a product life cycle, including the environment and impacts, its noticeable that there is a gap in tools that linked the stages of preliminary design and the stages of materialization. Differen...

  17. Experiments for Multi-Stage Processes

    DEFF Research Database (Denmark)

    Tyssedal, John; Kulahci, Murat

    2015-01-01

    Multi-stage processes are very common in both process and manufacturing industries. In this article we present a methodology for designing experiments for multi-stage processes. Typically in these situations the design is expected to involve many factors from different stages. To minimize...... the required number of experimental runs, we suggest using mirror image pairs of experiments at each stage following the first. As the design criterion, we consider their projectivity and mainly focus on projectivity 3 designs. We provide the methodology for generating these designs for processes with any...

  18. Anti-ICOS Monoclonal Antibody MEDI-570 in Treating Patients With Relapsed or Refractory Peripheral T-cell Lymphoma Follicular Variant or Angioimmunoblastic T-cell Lymphoma

    Science.gov (United States)

    2018-03-19

    Follicular T-Cell Lymphoma; Grade 1 Follicular Lymphoma; Grade 2 Follicular Lymphoma; Grade 3a Follicular Lymphoma; Recurrent Angioimmunoblastic T-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Mature T- and NK-Cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides; Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory Angioimmunoblastic T-Cell Lymphoma; Refractory Follicular Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Stage IB Mycosis Fungoides AJCC v7; Stage II Mycosis Fungoides AJCC v7; Stage III Cutaneous T-Cell Non-Hodgkin Lymphoma; Stage III Mycosis Fungoides AJCC v7; Stage IV Cutaneous T-Cell Non-Hodgkin Lymphoma; Stage IV Mycosis Fungoides AJCC v7

  19. Technology and staging effects on two-stage-to-orbit systems

    Science.gov (United States)

    Wilhite, Alan W.

    1991-01-01

    Horizontal takeoff and landing two-stage systems with an airbreathing first stage and rocket second stage are evaluated for staging Mach numbers that range from 5 to 14. All systems are evaluated with advanced technologies being developed in the NASP Program and sized to the same mission requirements. With these advanced technologies, the two-stage systems are heavier than the single stage. The weights of the two-stage systems are closely related to staging. Using a rocket on the first stage to accelerate from the turboramjet limit of Mach 6 to Mach 10 signiificantly decreases dry weight as compared to the Mach 6-staged system. The optimum dry weight staging Mach number for the scramjet two-stage system is Mach 12. At a 40 percent weight growth (current technology level), the scramjet two-stage systems are half the weight and less sensitive to weight changes than the single stage, but still require substantial technology development in the areas of inlets, nozzles, ramjet propulsion, active cooling, and high-temperature structures.

  20. Comparison of new AJCC staging system with old AJCC staging system in nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Se Mie; Wu, Hong Gyun; Park, Charn II [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2000-12-01

    This study was designed to examine the reliability of the new version of the AJCC staging system (1997) of nasopharyngeal carcinoma in comparison with the AJCC staging system of 1992. Between 1983 and 1996, 185 patients with histologically proven nasopharyngeal carcinoma were treated with radiation therapy at the Department of Therapeutic Radiology Seoul National University Hospital. For these patients, AJCC staging system of 1992 was compared with the 1997 version, by reviewing hospital records, computed tomography (CT) and/or magnetic resonance imaging (MRI). 5-year overall survival rates according to the 1992 and 1997 AJCC staging systems were 100%, and 100% at stage I; 100%, and 68.8% at stage ll;61.4%, and 63.8% at stage III; 61.1%, and 63.2% at stage IV. 5-year overall survival rates of each classification showed significant differences between stages (p=0.0049 for the old version, p=0.01 for the new), but no significant difference was found between the staging systems except at stage II. The new AJCC staging system allows staging as reliably as the 1992 version, but the adequacy of the newly modified staging classification should be confirmed by further clinical examination.

  1. Diagnóstico laboratorial de micoses superficiais e cutâneas: comparação dos métodos do hidróxido de potássio e do calcofluor white Laboratory diagnosis of superficial and cutaneous mycosis: a comparison of the potassium hydroxide and calcofluor white methods

    Directory of Open Access Journals (Sweden)

    Keith Werneck Brasil

    2003-10-01

    Full Text Available FUNDAMENTOS: As micoses superficiais e cutâneas têm surgido com grande prevalência no Hospital de Clínicas da Universidade Federal do Paraná. OBJETIVOS: Avaliar o método do calcofluor white (CFW mediante comparação com o método do hidróxido de potássio (KOH. MÉTODOS: Foram analisadas 74 amostras de raspados de pele, unha, couro cabeludo e cabelo de 62 pacientes de ambos os sexos em diferentes idades. O material foi coletado nos Ambulatórios de Dermatologia, Dermatopediatria e Pronto Atendimento do Hospital de Clínicas da Universidade Federal do Paraná, entre outubro de 1995 e março de 1996. Os espécimes foram analisados por ambos os métodos e comparados no presente trabalho. Os resultados obtidos foram submetidos à análise estatística do Qui-quadrado. RESULTADOS: Os resultados obtidos indicaram o CFW tão efetivo quanto o KOH. O hidróxido de potássio apresentou 38 (51% resultados positivos e 36 (49% negativos. O calcofluor white foi positivo em 35 (47% amostras e negativo em 39 (53%. CONCLUSÃO: Os dados revelaram igual eficácia entre os métodos avaliados; no entanto, o método do calcofluor white necessita de um laboratório equipado com microscópio de imunofluorescência.BACKGROUND: Superficial and cutaneous mycosis have appeared with great prevalence at the Clinical Hospital of the Parana State Federal University. OBJECTIVES: To evaluate the calcofluor white method (CFW in comparison with the potassium hydroxide method (KOH. METHODS: 74 samples of skin, nail, scalp and hair scrapings were analyzed in 62 male and female patients of different ages. The material was collected at the Dermatology, and Dermatopediatric Clinics and Emergency Department of the Federal University of Parana State Clinical Hospital from October 1995 to March 1996. The specimens were analysed by both methods, and compared in this study. The results were submitted to Qui-square statistical analysis. RESULTS: The results obtained indicated CFW was

  2. One-stage and two-stage penile buccal mucosa urethroplasty

    Directory of Open Access Journals (Sweden)

    G. Barbagli

    2016-03-01

    Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

  3. Gene expression in early stage cervical cancer

    NARCIS (Netherlands)

    Biewenga, Petra; Buist, Marrije R.; Moerland, Perry D.; van Thernaat, Emiel Ver Loren; van Kampen, Antoine H. C.; ten Kate, Fiebo J. W.; Baas, Frank

    2008-01-01

    Objective. Pelvic lymph node metastases are the main prognostic factor for survival in early stage cervical cancer, yet accurate detection methods before surgery are lacking. In this study, we examined whether gene expression profiling can predict the presence of lymph node metastasis in early stage

  4. Indeterminate Pulmonary Nodules at Colorectal Cancer Staging

    DEFF Research Database (Denmark)

    Nordholm-Carstensen, Andreas; Wille-Jørgensen, Peer A; Jorgensen, Lars N

    2013-01-01

    This study aimed to estimate the prevalence of indeterminate pulmonary nodules and specific radiological and clinical characteristics that predict malignancy of these at initial staging chest computed tomography (CT) in patients with colorectal cancer. A considerable number of indeterminate...... pulmonary nodules, which cannot readily be classified as either benign or malignant, are detected at initial staging chest CT in colorectal cancer patients....

  5. Interrelations among SMED Stages: A Causal Model

    Directory of Open Access Journals (Sweden)

    José Roberto Díaz-Reza

    2017-01-01

    Full Text Available Mexico has received a lot of foreign investment that has brought in a wide range of novel production philosophies, such as Single Minute Exchange of Dies (SMED. Despite its popularity and reported effectiveness, Mexican companies often quit SMED implementation as they consider it challenging. This usually happens when organizations are not familiarized enough with each one of the SMED stages or do not know how they are interrelated. In this article the interrelations among the different SMED implementation stages by means of a structural equations model are analyzed. Data for constructing the model were gathered from a survey administered to 250 employees from the Mexican maquiladora industry. The survey assessed the importance of 14 activities belonging to the four SMED stages. The descriptive analyses of these stages were conducted and integrated into a structural equations model as latent variables, to find their level of dependency. The model was constructed using WarpPLS 5 software, and direct, indirect, and total effects among variables are analyzed and validated. Results from the model revealed that Stage 1 of SMED implementation, known as the Identification Stage, has both direct and indirect effects on all the other SMED stages, being the most important stage.

  6. Investigation of vanadium catalyst regeneration stages

    International Nuclear Information System (INIS)

    Tsarev, Yu.V.; Il'in, A.P.; Shirokov, Yu.G.

    1995-01-01

    Regeneration stages of vanadium catalyst: dissolution of spent catalyst in alkaline solution of potassium vanadate, precipitation and aging of hydrosilica gel, which passed to solution, have been studied experimentally. The influence of the stages on final activity and thermal stability of regenerated contact masses has been considered. 10 refs., 4 figs., 2 tabs

  7. Two-stage repair in hypospadias

    Directory of Open Access Journals (Sweden)

    K N Haxhirexha

    2008-01-01

    Full Text Available We provide the reader with a nonsystematic review concerning the use of the two-stage approach in hypospadias repairs. A one-stage approach using the tubularized incised plate urethroplasty is a well-standardized approach for the most cases of hypospadias. Nevertheless, in some primary severe cases, in most hypospadias failures and in selected patients with balanitis xerotica obliterans a two-stage approach is preferable. During the first stage the penis is straightened, if necessary and the urethral plate is substituted with a graft of either genital (prepuce or extragenital origin (oral mucosa or postauricular skin. During the second stage, performed around 6 months later, urethroplasty is accomplished by graft tubulization. Graft take is generally excellent, with only few cases requiring an additional inlay patch at second stage due to graft contracture. A staged approach allows for both excellent cosmetic results and a low morbidity including an overall 6% fistula rate and 2% stricture rate. Complications usually occur in the first year after the second stage and are higher in secondary repairs. Complications tend to decrease as experience increases and use of additional waterproofing layers contributes to reduce the fistula rate significantly. Long-term cosmetic results are excellent, but voiding and ejaculatory problems may occur in as much as 40% of cases if a long urethral tube is constructed. The procedure has a step learning curve but because of its technical simplicity does not require to be confined only to highly specialized centers.

  8. The construction of two-stage tests

    NARCIS (Netherlands)

    Adema, Jos J.

    1988-01-01

    Although two-stage testing is not the most efficient form of adaptive testing, it has some advantages. In this paper, linear programming models are given for the construction of two-stage tests. In these models, practical constraints with respect to, among other things, test composition,

  9. Bevalac injector final stage RF amplifier upgrades

    International Nuclear Information System (INIS)

    Howard, D.; Calvert, J.; Dwinell, R.; Lax, J.; Lindner, A.; Richter, R.; Ridgeway, W.

    1991-01-01

    With the assistance of the DOE In-house Energy Management Program, the Bevalac injector final stage RF amplifier systems have been successfully upgraded to reduce energy consumption and operating costs. This recently completed project removed the energy-inefficient plate voltage modulator circuits that were used in conjunction with the final stage RF amplifiers. Construction, design, and operating parameters are described in detail

  10. Transesophageal Ultrasonography for Lung Cancer Staging

    DEFF Research Database (Denmark)

    Konge, Lars; Annema, Jouke; Vilmann, Peter

    2013-01-01

    Accurate mediastinal nodal staging is essential for patients with resectable non-small-cell lung cancer and is achieved by combined endobronchial ultrasound and transesophageal endoscopic ultrasound (EUS). Training requirements for EUS-guided fine-needle aspiration (FNA) for lung cancer staging...

  11. The IASLC Lung Cancer Staging Project

    DEFF Research Database (Denmark)

    Chansky, Kari; Detterbeck, Frank C; Nicholson, Andrew G

    2017-01-01

    INTRODUCTION: Revisions to the TNM stage classifications for lung cancer, informed by the international database (N = 94,708) of the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee, need external validation. The objective was to externally v...

  12. Teacher Concerns and Teacher Life Stages

    Science.gov (United States)

    Mok, Yan Fung

    2005-01-01

    This article examines teaching concerns at successive life stages among teachers with up to twenty years' or more teaching experience. Three concern stages are discerned. Nine common concern factors were found from factor-analysing thirty-three concern items. Results show that student discipline, relations with students, and students' learning and…

  13. Experiments for Multi-Stage Processes

    DEFF Research Database (Denmark)

    Tyssedal, John; Kulahci, Murat

    2015-01-01

    the required number of experimental runs, we suggest using mirror image pairs of experiments at each stage following the first. As the design criterion, we consider their projectivity and mainly focus on projectivity 3 designs. We provide the methodology for generating these designs for processes with any......Multi-stage processes are very common in both process and manufacturing industries. In this article we present a methodology for designing experiments for multi-stage processes. Typically in these situations the design is expected to involve many factors from different stages. To minimize...... number of stages and also show how to identify and estimate the effects. Both regular and non-regular designs are considered as base designs in generating the overall design....

  14. Sequential scintigraphic staging of small cell carcinoma

    International Nuclear Information System (INIS)

    Bitran, J.D.; Bekerman, C.; Pinsky, S.

    1981-01-01

    Thirty patients with small cell carcinoma (SCC) of the lung were sequentially staged following a history and physical exam with liver, bran, bone, and gallium-67 citrate scans. Scintigraphic evaluation disclosed 7 of 30 patients (23%) with advanced disease, stage IIIM1. When Gallium-67 scans were used as the sole criteria for staging, they proved to be accurate and identified six of the seven patients with occult metastatic disease. Gallium-67 scans proved to be accurate in detecting thoracic and extrathoracic metastases in the 30 patients with SCC, especially within the liver and lymph node-bearing area. The diagnostic accuracy of gallium-67 fell in regions such as bone or brain. Despite the limitations of gallium-67 scanning, the authors conclude that these scans are useful in staging patients with SCC and should be the initial scans used in staging such patients

  15. Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, S.; Bischoff, A.; Budach, V. [Charite Berlin (Germany). Dept. of Radiooncology; Koehler, C.; Roth, C.; Schneider, A. [Charite Berlin (Germany). Dept. of Gynecology; Fueller, J.; Wendt, T. [Jena Univ. (Germany). Dept. of Radiooncology

    2007-09-15

    Purpose: To evaluate the impact of transperitoneal laparoscopic staging on choice of subsequent therapy including oncologic outcome and toxicity of chemoradiation after surgical staging. Patients and Methods: 101 patients with cervical cancer FIGO IB1-IVB underwent chemoradiation after transperitoneal laparoscopic staging. Results: 101 women (FIGO IB1-IVB) were laparoscopically staged. In 68/101 patients, pelvic and/or paraaortic lymph node metastases were confirmed histologically. Only 17/101 patients (17%) retained their original FIGO stage after laparoscopy. Laparoscopic staging and chemoradiation were well tolerated. Laparoscopic debulking of tumor-involved lymph nodes resulted in significantly improved overall survival. Conclusion: In patients with cervical cancer, laparoscopic staging led to an upstaging of 83% of cases with significant impact on therapeutic strategies. Nodal debulking prior to chemoradiation improves the prognosis of node positive women. Pretherapeutic laparoscopic staging should be the basis of the primary chemoradiation in patients with cervical cancer. (orig.)

  16. Sensitivity of Coastal Environments and Wildlife to Spilled Oil: Hudson River: STAGING (Staging Site Points)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains human-use resource data for staging sites along the Hudson River. Vector points in this data set represent locations of possible staging areas...

  17. Tools for Reactive Distillation Column Design: Graphical and Stage-to-Stage Computation Methods

    DEFF Research Database (Denmark)

    Sanchez Daza, O.; Cisneros, Eduardo Salvador P.; Hostrup, Martin

    2001-01-01

    Based on the element mass balance concept, a graphical design method and a stage-to-stage multicomponent design method for reactive distillation columns have been developed. For distillation columns comprising reactive and non-reactive stages, a simple design strategy based on reactive and non......-reactive bubble point calculations is proposed. This strategy tracks the conversion and temperature between the feed and the end stages of the column. An illustrative example highlights the verification of the design strategy through rigorous simulation....

  18. Assessment of Stage 35 With APNASA

    Science.gov (United States)

    Celestina, Mark L.; Mulac, Richard

    2009-01-01

    An assessment of APNASA was conducted at NASA Glenn Research Center under the Fundamental Aeronautics Program to determine their predictive capabilities. The geometry selected for this study was Stage 35 which is a single stage transonic compressor. A speedline at 100% speed was generated and compared to experimental data at 100% speed for two turbulence models. Performance of the stage at 100% speed and profiles of several key aerodynamic parameters are compared to the survey data downstream of the stator in this report. In addition, hub leakage was modeled and compared to solutions without leakage and the available experimental data.

  19. Classification, staging and radiotherapy of bronchial carcinoma

    International Nuclear Information System (INIS)

    Noordijk, E.M.

    1983-01-01

    This thesis reports a study performed to evaluate the stage classification of bronchial carcinoma published by Thomas in 1963. The study was done in the radiotherapy department of a teaching hospital, and had three parts: a comparative analysis of the classifications and stage divisions described in the literature on bronchial carcinoma; an evaluation of the theoretical basis of the classification system introduced by Thomas as well as of the practical applicability of the division into stages, with respect to the assessment of the prognosis and the choice of therapy; and an analysis of various aspects of irradiation as well as of a number of prognostic factors in bronchial carcinoma. (Auth.)

  20. Nonlinear stage of Z-pinch instability

    International Nuclear Information System (INIS)

    Garanin, S.F.; Chernyshev, Yu.D.

    1987-01-01

    Nonlinear development of MHD instability of constriction type for Z-pinch with completely skinned current is considered. The two-dimensional numerical calculations of the constriction show that its development enters the stage described by automodel solution, when the constriction length is fixed and plasma compression takes place in an isentropic way. At the perturbation wave length small, as compared with pinch radius, the stage is preceded by a stage reduced to nonlinear Rayleigh-Taylor instability. For that case dynamics of the motion of magnetic field ''bubbles'' and plasma ''jets'' is considered. It is shown that plasma jets escaping from the pinch region do not close the pinch from current source

  1. Comparing Stage Presence and Virtual Reality Presence

    Directory of Open Access Journals (Sweden)

    Sebastian Xavier Samur

    2016-05-01

    Full Text Available Reflecting on the impending release of new Head Mounted Display virtual reality (VR technologies, the article examines definitions and techniques for digital presence, and compares them with research into stage presence. It opens with an outline of definitions of digital presence, comparing them with Cormac Power’s fictional, auratic, and literal modes of presence in performance. The article then looks at techniques used in VR and on stage to achieve presence. Finally, performance examples that use virtual reality technologies are presented. The article concludes that even if the technology falls short, discourse on digital presence is useful in providing insights into presence on stage.

  2. Developmental Stages in School Computer Use: Neither Marx Nor Piaget.

    Science.gov (United States)

    Lengel, James G.

    Karl Marx's theory of stages can be applied to computer use in the schools. The first stage, the P Stage, comprises the entry of the computer into the school. Computer use at this stage is personal and tends to center around one personality. Social studies teachers are seldom among this select few. The second stage of computer use, the D Stage, is…

  3. Impact of postharvest processing on the fungal population contaminating African walnut shells (Tetracarpidium conophorum Mull. Arg) at different maturity stages and potential mycotoxigenic implications.

    Science.gov (United States)

    Nkwonta, Chikere G; Medina, Angel; Del Carmen Alamar, Maria; Terry, Leon A

    2015-02-02

    African walnut (Tetracarpidium conophorum Mull. Arg) is commonly processed by boiling or toasting and consumed as a snack or used as a thickener in many West African soup preparations. The nuts are usually exposed to both high temperatures and high relative humidity in open markets which predisposes them to fungal growth. Hence, the dangers of spore inhalation and resultant mycosis cannot be over-emphasized as retailers and consumers are always in direct contact with these nuts during harvest, processing and consumption. So far, there is no reported research on potential mycotoxin contamination of African walnut and whether this risk might be accentuated by processing. African walnut, at early and late maturity stages, were processed by toasting, boiling or left unprocessed before being stored at 25°C and 37°C, respectively under controlled relative humidity for 7days. Nuts were cracked and shell pieces cultured in malt extract agar (MEA) and Dichloran Glycerol 18 (DG18) media and incubated at 25°C for 7days. Results revealed that potential mycotoxigenic species - Aspergillus section Nigri, Aspergillus flavus/parasiticus, Fusarium spp. and Penicillium spp. - were frequently isolated. When compared with unprocessed nuts, toasting completely prevented fungal contamination in shell pieces from nuts in the non-stored (NSN) group at the early maturity stage, while boiling significantly reduced the level of contamination to about 58% (pAflatoxins - G1 (AFG1), B1 (AFB1), G2 (AFG2), and B2 (AFB2) were produced by 20 isolates with both AFG1 and AFB1 being predominant at concentration ranges 4.33-32,200 and 4.20-22,700ng/g plug weight, respectively. No ochratoxin A (OTA) was detected out of 23 isolates analysed. From these findings, it is suggested that toasting of nuts, preferably at early maturity is a safer processing option than boiling in terms of prevention of possible fungal growth on nut shells and risk of mycotoxin contamination. Copyright © 2014 Elsevier B

  4. Design considerations for single-stage and two-stage pneumatic pellet injectors

    International Nuclear Information System (INIS)

    Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

    1988-09-01

    Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs

  5. Schizophyllum commune-induced allergic fungal rhinosinusitis and sinobronchial mycosis

    Directory of Open Access Journals (Sweden)

    Toshiaki Tsukatani

    2015-06-01

    Full Text Available We present 32- and 38-year-old males with Schizophyllum commune-induced allergic fungal rhinosinusitis (AFRS. S. commune-induced AFRS was diagnosed by clinical and radiographic findings, positive specific IgE antibodies against S. commune as measured by the ImmunoCAP system, and sequencing analysis of the fungus. Our two cases with S. commune-induced AFRS for the first time showed evidence for type 1 hypersensitivity to S. commune as determined by using specific IgE antibodies against S. commune, and the fungus was identified by sequence analysis.

  6. Are alcohol intake and smoking associated with mycosis fungoides?

    DEFF Research Database (Denmark)

    Suárez-Varela, M.M.M.; Olsen, J.; Kærlev, L.

    2001-01-01

    cases of MF and 2899 controls. Wine intake had no protective effect; on the contrary the consumption of more than 24 g of alcohol per day was associated with a high risk of MF (odds ratio (OR)=3.02, 95% confidence interval (CI), 1.34-6.79), after adjusting for centre, country, age, sex and education....... There was a dose-dependent increase in the risk of MF with increased smoking habits, albeit the observed trend was not statistically significant. A combined exposure to high tobacco and alcohol use yielded a significantly increased risk factor for MF (P=0.0073). Alcohol intake was associated with MF....

  7. Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

    Science.gov (United States)

    Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

    2018-02-01

    Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT. We identified all patients at a single large academic hospital who had undergone creation of either a one-stage or two-stage BVT between January 2007 and January 2015. Data evaluated included patient demographics, comorbidities, medication use, reasons for abandonment, and interventions performed to maintain patency. Costs were derived from the literature, and effectiveness was expressed in quality-adjusted life-years (QALYs). We analyzed primary and secondary functional patency outcomes as well as survival during follow-up between one-stage and two-stage BVT procedures using multivariate Cox proportional hazards models and Kaplan-Meier analysis with log-rank tests. The incremental cost-effectiveness ratio was used to determine cost savings. We identified 131 patients in whom 57 (44%) one-stage BVT and 74 (56%) two-stage BVT fistulas were created among 8 different vascular surgeons during the study period that each performed both procedures. There was no significant difference in the mean age, male gender, white race, diabetes, coronary disease, or medication profile among patients undergoing one- vs two-stage BVT. After fistula transposition, the median follow-up time was 8.3 months (interquartile range, 3-21 months). Primary patency rates of one-stage BVT were 56% at 12-month follow-up, whereas primary patency rates of two-stage BVT were 72% at 12-month follow-up. Patients undergoing two-stage BVT also had significantly higher rates of secondary functional patency at 12 months (57% for one-stage BVT vs 80% for two-stage BVT) and 24 months (44% for one-stage BVT vs 73% for two-stage BVT) of follow-up (P < .001 using log-rank test). However, there was no significant difference

  8. Shakespeare on the High School Stage.

    Science.gov (United States)

    Schlusberg, Julian S.

    1981-01-01

    Describes activities involved in the planning and production of Shakespeare's "Othello" in a high school. Outlines methods used to develop strong student motivation and involvement in class and on stage. (JMF)

  9. Treatment Options (by Stage) for Colon Cancer

    Science.gov (United States)

    ... types of surgery : Local excision or simple polypectomy . Resection and anastomosis . This is done when the tumor is too ... stage I colon cancer usually includes the following: Resection and anastomosis . Use our clinical trial search to find NCI- ...

  10. Laparoscopic ultrasonography for staging of gastrointestinal malignancy

    NARCIS (Netherlands)

    Gouma, D. J.; de Wit, L. T.; Nieveen van Dijkum, E.; van Delden, O.; Bemelman, W. A.; Rauws, E. A.; van Lanschot, J. J.; Obertop, H.

    1996-01-01

    BACKGROUND: Diagnostic laparoscopy has been used frequently as a preoperative staging procedure for different gastrointestinal malignancies. The assessment of solid abdominal organs and retroperitoneal ingrowth or detection of lymph-node metastasis is limited, however. A recent development,

  11. Treatment Options by Stage (Esophageal Cancer)

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat esophageal cancer. A plastic ...

  12. Treatment Options by Stage (Penile Cancer)

    Science.gov (United States)

    ... the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat penile cancer. Chemotherapy Chemotherapy ...

  13. Staged Financing in Venture capital market.

    OpenAIRE

    Damania, Priti

    2009-01-01

    The report shows the venture capital decision making in staged financing from a real option perspective. The report also describes entrepreneur-venture capital relationship from a prisoner's dilemma approach.

  14. Konkurss "Sony Jazz Stage" otsib uusi talente

    Index Scriptorium Estoniae

    2006-01-01

    The Contemporary Music Centre'i korraldatavast konkursist "Sony Jazz Stage 2006". Võistlus toimub vokaali ja bassi (basskitarri või kontrabassi) kategoorias (The Contemporary Music Centre'i posti-või meiliaadress - vt. www.jazzkaar.ee)

  15. INNOVATION DIFFUSION THEORY MAIN DEVELOPMENT STAGES

    Directory of Open Access Journals (Sweden)

    S. V. Lisafiev

    2011-01-01

    Full Text Available Abstract: Main innovation diffusion development theory stages are: Rogers model of moving new products to the market including characteristics of its segments; mathematic substantiation of this model by Bass; Moor model taking into account gaps between adjacent market segments; Goldenberg model making it possible to predict sales drops at new product life cycle initial stages. It is reasonable to use this theory while moving innovative products to the market.

  16. Theory of Economic Development (Secondary Stage)

    OpenAIRE

    Mashkoor, Aasim; Ahmed, Ovais

    2015-01-01

    This is a secondary stage of theory of economic development. This research study is covering the secondary phase of development which rules the tactical plans of the main strategy. In this stage, the social and economical demands varies from country to country and we have developed the theory according to the Pakistani economic conditions. It requires great a lot of technical and strategic analysis to chose the accurate plans accordingly.

  17. Comparisons of single-stage and two-stage approaches to genomic selection.

    Science.gov (United States)

    Schulz-Streeck, Torben; Ogutu, Joseph O; Piepho, Hans-Peter

    2013-01-01

    Genomic selection (GS) is a method for predicting breeding values of plants or animals using many molecular markers that is commonly implemented in two stages. In plant breeding the first stage usually involves computation of adjusted means for genotypes which are then used to predict genomic breeding values in the second stage. We compared two classical stage-wise approaches, which either ignore or approximate correlations among the means by a diagonal matrix, and a new method, to a single-stage analysis for GS using ridge regression best linear unbiased prediction (RR-BLUP). The new stage-wise method rotates (orthogonalizes) the adjusted means from the first stage before submitting them to the second stage. This makes the errors approximately independently and identically normally distributed, which is a prerequisite for many procedures that are potentially useful for GS such as machine learning methods (e.g. boosting) and regularized regression methods (e.g. lasso). This is illustrated in this paper using componentwise boosting. The componentwise boosting method minimizes squared error loss using least squares and iteratively and automatically selects markers that are most predictive of genomic breeding values. Results are compared with those of RR-BLUP using fivefold cross-validation. The new stage-wise approach with rotated means was slightly more similar to the single-stage analysis than the classical two-stage approaches based on non-rotated means for two unbalanced datasets. This suggests that rotation is a worthwhile pre-processing step in GS for the two-stage approaches for unbalanced datasets. Moreover, the predictive accuracy of stage-wise RR-BLUP was higher (5.0-6.1%) than that of componentwise boosting.

  18. Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine

    Science.gov (United States)

    Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

    2015-01-01

    This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design.

  19. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

    Directory of Open Access Journals (Sweden)

    Bumpers Harvey L

    2011-05-01

    Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  20. Radiotherapy for stage IV oropharyngeal cancer

    International Nuclear Information System (INIS)

    Nakamura, Kaori; Akimoto, Tetsuo; Motegi, Atsushi

    2008-01-01

    Fifty-seven patients with stage IVA-B oropharyngeal cancer treated by definitive radiotherapy in our facility from January 1993 to August 2005 were retrospectively analyzed. The age of the patients was 34-84 (median 62) years old. Thirty-four were male and 14 were female. Subsite of the tumor was anterior: 16, lateral: 39, posterior: 1, and superior: 1. Forty-nine patients were treated with chemotherapy. Induction chemotherapy (ICT) was done in 25 patients, ICT+concurrent chemoradiotherapy (CCRT) in 15 patients, and CCRT in 9 patients. A dose of 60-82 Gy (median 72 Gy) by hyperfractionated radiotherapy, at 1.2 Gy/fraction twice a day, was delivered in 37 patients, and 60-72 Gy (median 66 Gy) with a conventional daily fractionation in 20 patients. Salvage surgery was performed in 5 patients as a part of primary treatment after radiotherapy. The 5-year cause-specific survival rate and disease-free survival rate were 52.9% and 51.4%, respectively. By univariate analysis, the impact of age, sex, T-stage, N-stage, histological differentiation, chemotherapy and fractionation of radiation therapy on survivals were evaluated. T-stage, N-stage and histological differentiation were significantly covariate correlated with survival. The treatment results were not satisfactory. Further investigation of the treatment strategy to improve the treatment outcome of advanced oropharyngeal cancer is desired. (author)

  1. Stage of Alcohol and Drug Use among Young Adults.

    Science.gov (United States)

    Werch, Chudley E.; And Others

    1994-01-01

    This study examined stages of drug habit acquisition and change among college students, basing the proposed stages of drug use on the Multi-Component Motivational Stages prevention model. Surveys indicated the model helped explain the stages of substance use. The proportion of youths at each stage differed by type of drug. (SM)

  2. Article mounting and position adjustment stage

    Science.gov (United States)

    Cutburth, Ronald W.; Silva, Leonard L.

    1988-01-01

    An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole.

  3. Early stage malignant phyllodes tumor case report.

    Science.gov (United States)

    Wolbert, Thao; Leigh, Emilia C N; Barry, Rahman; Traylor, Jack R; Legenza, Mary

    2018-01-01

    Malignant phyllodes tumor of the breast is an extremely rare entity usually presenting with similar clinical features with those of benign fibroadenoma. Due to its scarcity and clinical presentation, it is quite difficult for clinicians to suspect and diagnose the disease at its early stage. There is currently no consensus regarding adjunctive radiotherapy, hormonal therapy and systemic chemotherapy recommended for malignant phyllodes tumors. This report presents a case of early-stage malignant phyllodes tumor treated by lumpectomy only without adjunctive chemoradiation therapy, but with an excellent outcome. Early diagnosis and staging with high suspicion are crucial in malignant phyllodes tumor patients since they do not only improve the overall outcome of the disease after lumpectomy only but they also decrease morbidity and mortality with adjunctive chemoradiation therapy. This case report has been reported in line with the SCARE criteria (Agha et al., 2016 [1]). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  4. The Stages of Implementing the Accounting Outsourcing

    Directory of Open Access Journals (Sweden)

    Liakhovych Halyna I.

    2017-04-01

    Full Text Available The article is aimed at substantiating the procedure for implementing the accounting outsourcing, determining its stages and phases, and to address the problematic issues that arise through the main phases. The general sequence of outsourcing of accounting functions has been disclosed. It has been proposed to allocate preparatory, technological and performance stages in the course of the accounting outsourcing process. It has been found that determining the procedure and organization of the transition to accounting outsourcing is crucial in ensuring its efficiency, so that greater emphasis is placed on the first stage. A sequence of actions in the substantiation of choice for outsourcing as a form of accounting organization has been determined. The list of criteria of choice from the enterprises-outsourcers for accounting record-keeping has been clarified.

  5. Comparative myoanatomy of cycliophoran life cycle stages

    DEFF Research Database (Denmark)

    Neves, Ricardo C.; Cunha, Maria R.; Funch, Peter

    2010-01-01

    The metazoan phylum Cycliophora includes small cryptic epibionts that live attached to the mouthparts of clawed lobsters. The life cycle is complex, with alternating sexual and asexual generations, and involves several sessile and free-living stages. So far, the morphological and genetic...... on the dorsal side, whereas on the ventral side, longitudinal muscles and a V-shaped muscle structure are present. These muscles are complemented by additional dorsoventral muscles. The mesodermal muscle fibers attach to the cuticle via the epidermis in all life cycle stages studied herein. The musculature...... of the female is similar to that of the Pandora larva of Symbion americanus and includes dorsoventral muscles and longitudinal muscles that run in the dorsal and ventral body region. Overall, our results reveal striking similarities in the muscular arrangement of the life cycle stages of both Symbion species. J...

  6. Alignment Stage for a Cryogenic Dilatometer

    Science.gov (United States)

    Dudik, Matthew; Moore, Donald

    2005-01-01

    A three-degree-of-freedom alignment stage has been designed and built for use in a cryogenic dilatometer that is used to measure thermal strains. The alignment stage enables precise adjustments of the positions and orientations of optical components to be used in the measurements and, once adjustments have been completed, keeps the components precisely aligned during cryogenic-dilatometer operations that can last as long as several days. The alignment stage includes a case, a circular tilt/tip platform, and a variety of flexural couplings between the case and the platform, all machined from a single block of the low-thermal-expansion iron/nickel alloy Invar, in order to minimize effects of temperature gradients and to obtain couplings that are free of stiction and friction. There are three sets of flexural couplings clocked at equal angles of 120 degrees around the platform, constituting a three-point kinematic support system.

  7. Low Cost, Upper Stage-Class Propulsion

    Science.gov (United States)

    Vickers, John

    2015-01-01

    The low cost, upper stage-class propulsion (LCUSP) element will develop a high strength copper alloy additive manufacturing (AM) process as well as critical components for an upper stage-class propulsion system that will be demonstrated with testing. As manufacturing technologies have matured, it now appears possible to build all the major components and subsystems of an upper stage-class rocket engine for substantially less money and much faster than traditionally done. However, several enabling technologies must be developed before that can happen. This activity will address these technologies and demonstrate the concept by designing, manufacturing, and testing the critical components of a rocket engine. The processes developed and materials' property data will be transitioned to industry upon completion of the activity. Technologies to enable the concept are AM copper alloy process development, AM post-processing finishing to minimize surface roughness, AM material deposition on existing copper alloy substrate, and materials characterization.

  8. Mars Ascent Vehicle-First Stage Motor

    Science.gov (United States)

    Dankanich, John; Doudrick, Scott; Williams, Jacob

    2015-01-01

    This project is development effort of a first stage solid motor based on a two-stage solid motor Mars Ascent Vehicle (MAV) design for the robotic Mars Sample Return (MSR) mission (fig. 1). The MSR MAV has been studied for decades and multiple concepts have been shown to meet the mission objectives as posed.1 However, there remains significant uncertainty with the MAV requirements. The sample container and sample cache itself is immature. Additionally, MAV-specific requirements ranging from full three-axis controlled and strict communication requirements to minimal capability concepts are still under consideration. Given the maturity of the overall mission requirements, the MAV has been limited to a large number of parametric analyses and paper studies. Recently, a Jet Propulsion Laboratory study highlighted the flexibility of a two-stage solid motor concept. The MAV itself is driven by the constraints of the Entry, Decent, and Landing (EDL) system. Within the EDL constraints, there is a range of MAV options ranging in complexity from simple spun upper stage options to higher capability three-axis controlled solutions. There are also options to trade the ratio of mission (Delta)V between the first and second stage. Finally, sensitivity studies also indicated that solid motors with a high percentage of off-load flexability only had minor impact on the total system mass over a single point design optimized motor. This flexibility in the first stage motor has allowed NASA to mature the design of the motor beyond parametric analyses and start to address known design challenges of the motor.

  9. The thesis of stages fourteen years later

    Science.gov (United States)

    Beeby, C. E.

    1980-12-01

    The author indicates the changes and additions he would make to his book ` The Quality of Education in Developing Countries' (1966) if he were re-writing it in 1980. He would make clearer that his primary interest is in a continuum of change, the process of growth of a school system, and that the `stages' are only a convenient non-mathematical artifact to make the thesis more useful to administrators and planners. In the light of more recent developments and experiences, he now gives new stress to the pluralism of objectives at the stage of Meaning, and discusses the political, social, cultural and financial reasons why a country may choose not to take the difficult step from stage III to stage IV. Recent forms of alternative education, particularly those embodying plans for lifelong education, offer some hope of bypassing his thesis of stages. More consideration is given to constraints other than that of teacher qualification, though the difficulty of changing the skills, habits, attitudes and purposes in the teaching profession remain the chief obstacle to qualitative growth. Particular attention is paid to `crash' programmes where processes that are, by their very nature, successive are compressed into simultaneous or almost simultaneous ones. Some implications of the thesis of stages for teacher training are briefly dealt with. Regarding the application of the thesis to secondary education, he maintains that a better model of growth would be one based on the capacity of secondary education to respond to the changing economic and social demands of the community. Finally, he suggests three methods of testing his hypotheses and pleads that more consideration be given to building up a body of educational, theory based on the experience of developing countries over the past three decades.

  10. The Lower Depths on the German Stage

    Directory of Open Access Journals (Sweden)

    Svetlana M. Demkina

    2018-03-01

    Full Text Available This article examines the stage history of M. Gorky’s play The Lower Depths in Germany. The author discusses German stage history of Gorky’s work against the social background and in the context of major artistic tendencies of the 20 th century. Steady interest in Gorky as a playwright in Germany is due to the acute social importance and universality of the problems reflected in his dramas. Bearing on the archive materials of the Gorky Museum, the essay explores interpretations of Gorky’s cult drama The Lower Depths in the work of European stage directors, acclaimed reformers of theatrical art. A significant part of the “Gorky and German Theater” section of the Gorky Museum (IWL RAS is devoted to The Lower Depths. Two series of photographs represent the first German staging of Nachtasyl (German translation of The Lower Depths. The performance of Max Reinhardt and Richard Vallentin in Berlin Kleines Theater on January 10–23, 1903, had great success and good takings. After the premiere, attention to the personality of Gorky in Europe increased; he became the most popular Sovietauthor. When Nazi came to power, they banned Gorky’s work in Germany: he reappeared on the German stage only after the World War II. In the late 1960s, on the wave of Gorky’s centenary (1968, world theatres ran a series of performances based on his plays. The 1970s were marked by a renewal of interest to Gorky the playwright. The Lower Depths was staged in Europe, the USA, and the UK. Both directors and critics perceived Gorky’s dramaturgy in the context of works of his contemporaries — Shaw, Ibsen, Hauptmann, Tolstoy, Chekhov.

  11. Pelvic irradiation for stage II ovarian carcinoma

    International Nuclear Information System (INIS)

    Terada, K.Y.; Morley, G.W.; Roberts, J.A.

    1988-01-01

    Over a 20-year period, 34 patients with FIGO stage II ovarian carcinoma were treated with postoperative pelvic irradiation at the University of Michigan. Complications of radiation treatment were minimal. The overall actuarial disease-free 5-year survival was 53%. This was not significantly different for substages IIA, IIB, or IIC. Patients with well-differentiated tumors had a significantly better survival than patients with moderate or poorly differentiated tumors (P less than 0.05). The implications for managing stage II ovarian carcinoma are discussed

  12. Clinical presentation and staging of Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Gallamini, Andrea; Hutchings, Martin; Ramadan, Safaa

    2016-01-01

    In the present chapter the authors present a brief overview of the diagnostic methods proposed over time for Hodgkin lymphoma (HL) spread detection, moving from surgical procedures, through standard radiological and functional imaging techniques to the present state of the art for HL staging....... The main body of the review will be dedicated to the recently published guidelines for lymphoma staging (including HL) agreed by the experts during the 12th International Congress for Malignant Lymphoma in Lugano. The recommendations of the panel on how to integrate flurodeoxyglucose positron emission...

  13. RESIDUAL RISK ASSESSMENT: GAS DISTRIBUTION STAGE ...

    Science.gov (United States)

    This document describes the residual risk assessment for the Gas Distribution Stage 1 souce category. For stationary sources, section 112 (f) of the Clean Air Act requires EPA to assess risks to human health and the environment following implementation of technology-based control standards. If these technology-based control standards do not provide an ample margin of safety, then EPA is required to promulgate addtional standards. This document describes the methodology and results of the residual risk assessment performed for the Gas Distribution Stage 1 source category. The results of this analyiss will assist EPA in determining whether a residual risk rule for this source category is appropriate.

  14. Surveillance in stage I testicular cancer

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Petersen, Peter Meidahl; Rørth, Mikael

    2003-01-01

    Treatment results on 695 stage I testicular cancer patients followed with surveillance are described. Seminoma (SGCT) was present in 394 patients and nonseminoma (NSGCT) in 301 patients. Relapses were detected in 155 patients (22%), in 69 patients with SGCT (17%) and 86 with NSGCT (29%). In patie......Treatment results on 695 stage I testicular cancer patients followed with surveillance are described. Seminoma (SGCT) was present in 394 patients and nonseminoma (NSGCT) in 301 patients. Relapses were detected in 155 patients (22%), in 69 patients with SGCT (17%) and 86 with NSGCT (29...

  15. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L; Carde, P; Mauch, P

    1992-01-01

    In early stage Hodgkin's disease the optimal choice of treatment for the individual patient is still an unresolved issue. So far, twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out worldwide. The preliminary results of a global...... be reduced, and that the stress of experiencing a relapse is avoided in many patients. The major argument against the use of chemotherapy up front is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may...

  16. Architecture and Stages of the Experience City

    DEFF Research Database (Denmark)

    This book presents more than 41 articles on ‘Architecture and Stages of the Experience City'. The aim of the book is to investigate current challenges related to architecture, art and city life in the ‘Experience City' and it is presenting cutting edge knowledge and experiences within the following...... themes: Experience City Making Digital Architecture Stages in the Experience City The City as a Learning Lab Experience City Architecture Performative Architecture Art and Performance Urban Catalyst and Temporary Use...

  17. Surveillance for Stage I Nonseminoma Testicular Cancer

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Gundgaard, Maria Gry; Mortensen, Mette Saksø

    2014-01-01

    PURPOSE: To describe treatment results in a large cohort with stage I nonseminoma germ cell cancer (NSGCC) treated in a surveillance program. PATIENTS AND METHODS: From January 1, 1984, to December 31, 2007, 1,226 patients with stage I NSGCC, including high-risk patients with vascular invasion....... Relapses after 5 years were seen in 0.5% of the whole cohort or in 1.6% of relapsing patients. The majority of relapses (94.4%) belonged to the good prognostic group according to the International Germ Cell Cancer Collaborative Group classification. The disease-specific survival at 15 years was 99...

  18. [Treatment of early stage Hodgkin disease

    DEFF Research Database (Denmark)

    Specht, Lena; Carde, P.; Mauch, P.

    1993-01-01

    In early stage Hodgkin's disease the optimal choice of treatment is still an unresolved issue. Twenty-two randomized trials of radiotherapy alone versus radiotherapy plus combination chemotherapy have been carried out world-wide. The preliminary results of a global meta-analysis of these trials...... a relapse is avoided in many patients. The major argument against early chemotherapy is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may be kept at a minimum. Recently, trials have been carried out...

  19. Psychosexual Intervention in Patients With Stage I-III Gynecologic or Breast Cancer

    Science.gov (United States)

    2017-04-12

    Ovarian Sarcoma; Ovarian Stromal Cancer; Stage I Uterine Sarcoma; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Epithelial Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IA Primary Peritoneal Cavity Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Epithelial Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IB Primary Peritoneal Cavity Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Epithelial Cancer; Stage IC Ovarian Germ Cell Tumor; Stage IC Primary Peritoneal Cavity Cancer; Stage II Endometrial Carcinoma; Stage II Gestational Trophoblastic Tumor; Stage II Uterine Sarcoma; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Cervical Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage III Gestational Trophoblastic Tumor; Stage III Uterine Sarcoma; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Cervical Cancer; Stage IIIA Endometrial Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Cervical Cancer; Stage IIIB Endometrial Carcinoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Endometrial Carcinoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell

  20. Staging in Patients with Small-Cell Lung Carcinoma; PET-CT versus Standard Staging Procedures

    Directory of Open Access Journals (Sweden)

    Burcu Yalçın

    2016-12-01

    Full Text Available Objective: The most important factor for accurate treatment of patients with small cell lung carcinoma (SCLC is accuracy of the initial staging. The aim of this study was to determine how often patients, staged as local or local-advanced disease by standard staging procedures (SSPs, would be staged to have a metastatic disease based on the findings of the positron emission tomography–computed tomography (PET-CT scan. Methods: Patients with SCLC who were staged as I, II, or III disease by SSPs (according to the American Joint Committee on Cancer Staging, 7th edition formed the study population. SSPs included computed tomography of chest, abdomen, brain (or magnetic resonance imaging of brain, and bone scintigraphy. These patients were re-staged with 18F-FDG PET-CT scan. Results: Between 2013 and 2015, 27 patients were prospectively studied. Of these patients, 92.5% were male and the median age was 61. Among 27 patients, distant metastasis was detected by PET-CT in 7 (25.9% patients. Two of 7 patients were determined as stage IIIA by SSPs and 5 of 17 patients that were determined as stage IIIB by SSPs were upstaged to metastatic disease by PET-CT. All of the 7 patients had bone metastasis by PET-CT. But bone metastasis could not be detected with bone scintigraphy. Conclusion: PET-CT detected distant metastasis in one quarter of SCLC stage III patients by SSPs. Patients who staged local-advanced SCLC with CT of the chest have to be assessed by PET-CT for extracranial distant metastasis.

  1. Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia

    NARCIS (Netherlands)

    Wei, Yishul; Colombo, Michele A; Ramautar, Jennifer R; Blanken, Tessa F; van der Werf, Ysbrand D; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; Van Someren, Eus J W

    2017-01-01

    Study Objectives: Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features

  2. Treatment results in women with clinical stage I and pathologic stage II endometrial carcinoma

    NARCIS (Netherlands)

    Jobsen, J.J.; Schutter, E.M.J.; Meerwaldt, J.H.; van der Palen, Jacobus Adrianus Maria; van der Sijde, R.; Naudin ten Cate, L.

    2001-01-01

    The aim of this study is to report survival and results of therapy and possible prognostic factors in women with pathologic stage II endometrial carcinoma. Forty-two patients with pathologic stage II endometrial carcinoma were treated at the department of Radiation Oncology of the Medisch Spectrum

  3. Pressure-induced staging transitions and stage disorder in dilute potassium-graphite intercalation compounds

    International Nuclear Information System (INIS)

    Fischer, J.E.; Kim, H.J.

    1987-01-01

    We extend our previous study of high-pressure staging transitions and stage disorder to dilute potassium-graphite intercalation compounds, using the Hendricks-Teller analysis of elastic neutron scattering (00L) profiles measured at 300 K over a broad q range. The dilute regime begins at a concentration [K]/[C]approx. <1/33, all samples in this regime behaving qualitatively the same at high pressure. A continuous transition starts immediately near P = 0, leading to a well-ordered higher stage with no apparent connection to in-plane density or structure. This is stable only over a small range, transforming abruptly at slightly higher P to a still higher stage or stage mixture, the index of which is consistent with the specific in-plane density imposed by commensurate 2 x 2 lockin. Disorder generally increases with average stage index (i.e., with increasing P or decreasing [K]/[C] ratio), consistent with the theory of Kirczenow. Disorder in the most dilute samples is better represented by a skewed distribution of many stage packages than by a random mixture of two or three different stage cells

  4. Comparison between a two-stage and single-stage digesters when ...

    African Journals Online (AJOL)

    Phenol is a pollutant found in many industrial wastewaters, which diminishes biogas formation in anaerobic digesters. In this study, a two-stage (acidogenic and methanogenic) anaerobic digester (TSAD) was compared to a single stage digester (SSD), in treating a synthetic wastewater contaminated with phenol.

  5. Hypofractionated Radiation Therapy in Treating Patients With Stage 0-IIB Breast Cancer

    Science.gov (United States)

    2017-12-05

    Ductal Breast Carcinoma In Situ; Invasive Breast Carcinoma; Stage 0 Breast Cancer; Stage I Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer

  6. Behaviorism and the Stages of Scientific Activity

    Science.gov (United States)

    Moore, J.

    2010-01-01

    Following from an earlier analysis by B. F. Skinner, the present article suggests that the verbal processes in science may usefully be viewed as following a three-stage progression. This progression starts with (a) identification of basic data, then moves to (b) description of relations among those data, and ultimately concludes with (c) the…

  7. Two stage-type railgun accelerator

    International Nuclear Information System (INIS)

    Ogino, Mutsuo; Azuma, Kingo.

    1995-01-01

    The present invention provides a two stage-type railgun accelerator capable of spiking a flying body (ice pellet) formed by solidifying a gaseous hydrogen isotope as a fuel to a thermonuclear reactor at a higher speed into a central portion of plasmas. Namely, the two stage-type railgun accelerator accelerates the flying body spiked from a initial stage accelerator to a portion between rails by Lorentz force generated when electric current is supplied to the two rails by way of a plasma armature. In this case, two sets of solenoids are disposed for compressing the plasma armature in the longitudinal direction of the rails. The first and the second sets of solenoid coils are previously supplied with electric current. After passing of the flying body, the armature formed into plasmas by a gas laser disposed at the back of the flying body is compressed in the longitudinal direction of the rails by a magnetic force of the first and the second sets of solenoid coils to increase the plasma density. A current density is also increased simultaneously. Then, the first solenoid coil current is turned OFF to accelerate the flying body in two stages by the compressed plasma armature. (I.S.)

  8. [Second stage of labor: Does accelerations matter?].

    Science.gov (United States)

    Martí-Gamboa, S; Rodríguez-Lázaro, L; Redrado-Giménez, O; Ruiz-Sada, J; Castón-Mateo, S

    2016-05-01

    Accelerations role during the second stage of labor has not been studied and current classification system NICHD downplays its presence. The objective of this study is to determine validity for acidemia detection of the loss of accelerations during the second stage of labor. This is a one year retrospective case-control study of 102 neonates with acidemia defined as an umbilical cord gas pH≤7.10 compared to 100 non acidemic controls. The last thirty minutes of CTG were evaluated by two obstetricians blind to clinical and outcome data that classified tracings into categories according to NICHD definitions, determining the presence or absence of accelerations. Validity of NICHD categories and absence of accelerations were calculated. 85% of fetuses presented a category II tracing in the last 30 minutes of labor. Absence of accelerations was associated with neonatal acidemia (ORa 4.43). Category II tracings were not associated with acidemia after adjusting for confounding factors.Validity of the absence of accelerations during the second stage of labor was higher in terms of sensitivity (80.3%), specificity (54%) and global value (67%) to that of the presence of a category II tracing (96%, 24% and 60% respectively) in this period. The absence of accelerations during the second stage of labor shows a bigger validity for neonatal acidemia than the presence of a category II tracing.

  9. Erikson Psychosocial Stage Inventory: A Factor Analysis

    Science.gov (United States)

    Gray, Mary McPhail; And Others

    1986-01-01

    The 72-item Erikson Psychosocial Stage Inventory (EPSI) was factor analyzed for a group of 534 university freshmen and sophomore students. Seven factors emerged, which were labeled Initiative, Industry, Identity, Friendship, Dating, Goal Clarity, and Self-Confidence. Item's representing Erikson's factors, Trust and Autonomy, were dispersed across…

  10. Capacitor blocks for linear transformer driver stages.

    Science.gov (United States)

    Kovalchuk, B M; Kharlov, A V; Kumpyak, E V; Smorudov, G V; Zherlitsyn, A A

    2014-01-01

    In the Linear Transformer Driver (LTD) technology, the low inductance energy storage components and switches are directly incorporated into the individual cavities (named stages) to generate a fast output voltage pulse, which is added along a vacuum coaxial line like in an inductive voltage adder. LTD stages with air insulation were recently developed, where air is used both as insulation in a primary side of the stages and as working gas in the LTD spark gap switches. A custom designed unit, referred to as a capacitor block, was developed for use as a main structural element of the transformer stages. The capacitor block incorporates two capacitors GA 35426 (40 nF, 100 kV) and multichannel multigap gas switch. Several modifications of the capacitor blocks were developed and tested on the life time and self breakdown probability. Blocks were tested both as separate units and in an assembly of capacitive module, consisting of five capacitor blocks. This paper presents detailed design of capacitor blocks, description of operation regimes, numerical simulation of electric field in the switches, and test results.

  11. Staging "Swissness": Inter- and Intracultural Theatre Translation

    Science.gov (United States)

    Wilkinson, Jane

    2005-01-01

    This paper examines the choice to translate plays from "Hochdeutsch" (the standard form of the German language) into local dialect in German-speaking Switzerland. It first looks at the creative process of translating for the amateur stage and then at the reasons behind the choice to translate. It argues that this choice reflects a desire…

  12. Laparoscopic ultrasonography for abdominal tumor staging

    NARCIS (Netherlands)

    van Delden, O. M.; de Wit, L. T.; Nieveen van Dijkum, E. J.; Reeders, J. W.; Gouma, D. J.

    1998-01-01

    In recent years, laparoscopic ultrasonography has been introduced as an adjunct to diagnostic laparoscopy for staging of tumors of the upper gastrointestinal tract, liver, biliary tree, and pancreas. It has proved feasible to visualize most anatomic structures in the upper abdomen consistently and

  13. Development Stages and Curriculum: A Japanese Perspective.

    Science.gov (United States)

    Abiko, Tadahiko

    2002-01-01

    Discusses contemporary psychologists' criticism of Jean Piaget's developmental theory; reviews research in brain science, psychology, history, and the experiences of teachers; proposes a new theory of developmental stages based on children's shifting interests; discuses implications of "shifting interest center theory" for school…

  14. Staging and treatment of ovarian carcinoma

    International Nuclear Information System (INIS)

    De Palo, G.; Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan

    1989-01-01

    The staging and treatment of ovarian cancer is reviewed with special attention to developments during the last decade. Pathways of spread, presurgical and surgical staging are described and discussed, as are the biologic characters of the different histologic subtypes. Principles of surgery, endoperitoneal and external radiotherapy, single-drug and multiple-drug systemic chemotherapy (therapeutic and adjuvant), intraperitoneal chemotherapy, second-line chemotherapy, hormone therapy and the use of biologic response modifiers are reported and discussed with background of recent clinical trials. It is concluded that considerable progress has been made concerning diagnosis, staging and treatment of ovarian cancer. The proportion of cases in advanced stages has thus decreased and the survival rate increased. However, it is also obvious that the long-term prognosis for patients with advanced disease has not significantly improved over the last 10 years, despite introduction of multiple-drug regimens with high initial response rates. Ovarian cancer remains the most important gynecologic cause of death in the Western countries. (orig.)

  15. Stage- vs. Channel-strip Metaphor

    DEFF Research Database (Denmark)

    Gelineck, Steven; Korsgaard, Dannie Michael; Büchert, Morten

    2015-01-01

    . They do this using (1) a small physical mixing controller and (2) using an iPad app, which implements a simple stage metaphor interface. We measure how accurately they are able to replicate mixes in terms of volume and panning and how fast they are at doing so. Results reveal that performance...

  16. Optimization, an Important Stage of Engineering Design

    Science.gov (United States)

    Kelley, Todd R.

    2010-01-01

    A number of leaders in technology education have indicated that a major difference between the technological design process and the engineering design process is analysis and optimization. The analysis stage of the engineering design process is when mathematical models and scientific principles are employed to help the designer predict design…

  17. Stage 2 tool user’s manual.

    Science.gov (United States)

    2017-08-01

    The purpose of the Permitted Overweight Truck Corridor Analysis Tool (referred to in this document as the Stage 2 Tool) is to evaluate existing or to create new proposed overweight (OW) truck corridors to estimate the permitted OW truck, pavement, br...

  18. Terminal-stage prognostic analysis in candidemia.

    Science.gov (United States)

    Takuma, Takahiro; Shoji, Hisashi; Niki, Yoshihito

    2015-05-01

    Candidemia has an extremely high mortality rate but is not always the direct cause of death. Therefore, determining the effect of candidemia on death is extremely difficult. We investigated prognostic factors in patients with culture-proven candidemia at 2 Japanese university teaching hospitals from April 2009 through May 2013. To examine the effects of comorbid conditions, the Charlson comorbidity index was determined, and patients were subjectively classified into 3 clinical prognostic stages (terminal [death expected within 1 month], semiterminal [death expected within 6 months], and nonterminal [expected to live more than 6 months]). The Cox proportional hazard model was used for univariate and multivariate analyses of factors possibly affecting survival. On univariate analysis, factors identified as associated with an increased mortality rate were: admission to an internal medicine department, Candida glabrata, immunosuppression, hypotension, hypoxemia, and a terminal prognostic stage. Factors associated with a decreased mortality rate were: serum albumin, endophthalmitis investigation, and nonterminal prognostic stage. The mortality rate was significantly related to the prognostic stage on multivariate analysis (P candidemia. More important than candidemia in causing the deaths of patients with candidemia were the patients' background and comorbidity status. Therefore, rigorous methods should be used when investigating causes of death in terminally ill patients with candidemia. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Uprated OMS engine for upper stage propulsion

    Science.gov (United States)

    Boyd, William C.

    1986-01-01

    The results of a pre-development component demonstration program on the use of a gas generator-driven turbopump that increases the Space Shuttle's Orbital Maneuvering Engine (OME) operating pressure are given. Tests and analysis confirm the the capability of the concept to meet or exceed performance and life requirements. Storable propellant upper stage concepts are also discussed.

  20. Treatment Options by Stage (Merkel Cell Carcinoma)

    Science.gov (United States)

    ... tissue. Merkel cells are in the layer of basal cells at the deepest part of the epidermis and are connected to nerves. Merkel cell carcinoma tends to grow quickly and to metastasize (spread) at an early stage . It usually spreads first to nearby lymph nodes and then may spread to lymph nodes or ...

  1. Researching the life stages of medicines: Introduction

    NARCIS (Netherlands)

    van der Geest, S.; Chamberlain, K.

    2011-01-01

    This introduction presents the concept of ‘biography’ or ‘life stages’ of medicines as an ordering principle and analytical tool for the study of medicines as social, commercial and symbolic objects. The first stages, production and marketing, which have been largely neglected by social scientists,

  2. Staging of bronchogenic carcinoma by computerized tomography

    International Nuclear Information System (INIS)

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

    1981-01-01

    It was possible to check the information obtained by CT scanning in 36 patients out of 49 who had been subjected to computerized tomography, in respect of the extension of the primary tumour (T stage), and in 25 patients in respect of the degree of mediastinal lymphatic node involvement (N stage). In all 49 patients, the presence of bronchogenic carcinoma had been safely established. In 97% of the cases, assessment of the extension of the primary tumour was found to be correct. Assessment of the N stage, however, is more problematic, since detection of mediastinal lymphatic nodes by computerized tomography does not necessarily tell us something about their metastatic involvement. If all recognizable lymphatic nodes are interpreted as potential metastases, we have no false negative but 61% false positive results because of the frequency of postinflammatory or anthracotic lymphatic nodes. In case of exclusive assessment of lymphatic node enlargement above 1 cm diameter, the rate of metastatic nodes increases considerably (83%). Computerized tomography is definitely superior to all roentgenological methods in assessing the stage of a bronchogenic carcinoma; hence, it could occupy a key position in determining the diagnostic and therapeutic approach in patients with this disease. (orig.) [de

  3. The developmental stages of Pseudodiaptomus hessei (Copepoda ...

    African Journals Online (AJOL)

    1988-06-15

    Jun 15, 1988 ... reared in the laboratory. These were correlated with animals collected in the field. Nauplii were measured from the anterior margin to the tip of the caudal region, excluding spines. Copepodids were measured from the anterior border to the end of the caudal rami. The upper size limit reported for each stage ...

  4. Optimization of multi-stage pyrolysis

    International Nuclear Information System (INIS)

    Oyedun, Adetoyese Olajire; Lam, Ka Leung; Gebreegziabher, Tesfaldet; Hui, Chi Wai

    2013-01-01

    Pyrolysis process is considered as a beneficial option in waste treatment largely due to the products generated and the energy recovery when compared to other methods. In the conventional pyrolysis process, heat is continually supplied to the reactor until the final pyrolysis temperature is attained. The reactor is then maintained isothermally at this temperature until the pyrolysis is completed. This technique does not take into consideration the mechanism of the pyrolysis which involves both exothermic and endothermic reaction and the opportunity of gaining some processing benefits is often ignored. Multi-stage pyrolysis which is an approach to carry out pyrolysis with multiple heating stages in order to gain certain processing benefits has been introduced in our earlier works. 22.5% energy reduction was achieved in our past work with a 100% increase in completion time. This work therefore proposes the optimization of the operating parameters in multi-stage pyrolysis in order to limit the increase in completion time and also reduces the overall energy. This innovative approach can achieve a range of 24.7%–37.9% reduction in energy usage with 37%–50% increase in completion time depending on the heating rate for each heating stages. This approach has also been used for charcoal production

  5. TREATMENT FOR STAGE I TESTICULAR SEMINOMA

    Directory of Open Access Journals (Sweden)

    E. A. Burova

    2014-07-01

    Full Text Available Overall survival is about 100% in patients with stage I germinogenic testicular tumors after orchifuniculectomy, which is achieved, by applying alternative adjuvant approaches. The use of approaches, such as a follow-up, chemo- and radiotherapy, may be recommended in seminoma. The paper shows the advantages and disadvantages of these methods.

  6. Space Launch System Upper Stage Technology Assessment

    Science.gov (United States)

    Holladay, Jon; Hampton, Bryan; Monk, Timothy

    2014-01-01

    The Space Launch System (SLS) is envisioned as a heavy-lift vehicle that will provide the foundation for future beyond low-Earth orbit (LEO) exploration missions. Previous studies have been performed to determine the optimal configuration for the SLS and the applicability of commercial off-the-shelf in-space stages for Earth departure. Currently NASA is analyzing the concept of a Dual Use Upper Stage (DUUS) that will provide LEO insertion and Earth departure burns. This paper will explore candidate in-space stages based on the DUUS design for a wide range of beyond LEO missions. Mission payloads will range from small robotic systems up to human systems with deep space habitats and landers. Mission destinations will include cislunar space, Mars, Jupiter, and Saturn. Given these wide-ranging mission objectives, a vehicle-sizing tool has been developed to determine the size of an Earth departure stage based on the mission objectives. The tool calculates masses for all the major subsystems of the vehicle including propellant loads, avionics, power, engines, main propulsion system components, tanks, pressurization system and gases, primary structural elements, and secondary structural elements. The tool uses an iterative sizing algorithm to determine the resulting mass of the stage. Any input into one of the subsystem sizing routines or the mission parameters can be treated as a parametric sweep or as a distribution for use in Monte Carlo analysis. Taking these factors together allows for multi-variable, coupled analysis runs. To increase confidence in the tool, the results have been verified against two point-of-departure designs of the DUUS. The tool has also been verified against Apollo moon mission elements and other manned space systems. This paper will focus on trading key propulsion technologies including chemical, Nuclear Thermal Propulsion (NTP), and Solar Electric Propulsion (SEP). All of the key performance inputs and relationships will be presented and

  7. Potential for opportunity recognition along the stages of entrepreneurship

    OpenAIRE

    Wasdani, Kishinchand; Mathew, Mary

    2014-01-01

    The study primarily verifies whether ORP differs in stages of entrepreneurship and aims at identifying factors that influence ORP in different stages of entrepreneurship. The stages of entrepreneurship include pre-stage (individuals planning to start ventures), early-stage (entrepreneurs with ventures less than 3 years old) and late-stage (entrepreneurs with ventures more than 3 years in existence). The factors that were studied include personal factors (cognitive style, self-efficacy and mot...

  8. Meta-analysis of Gaussian individual patient data: Two-stage or not two-stage?

    Science.gov (United States)

    Morris, Tim P; Fisher, David J; Kenward, Michael G; Carpenter, James R

    2018-04-30

    Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis. Arguments for one-stage analysis have typically noted that a wider range of models can be fitted and overall estimates may be more precise. The two-stage side has emphasised that the models that can be fitted in two stages are sufficient to answer the relevant questions, with less scope for mistakes because there are fewer modelling choices to be made in the two-stage approach. For Gaussian data, we consider the statistical arguments for flexibility and precision in small-sample settings. Regarding flexibility, several of the models that can be fitted only in one stage may not be of serious interest to most meta-analysis practitioners. Regarding precision, we consider fixed- and random-effects meta-analysis and see that, for a model making certain assumptions, the number of stages used to fit this model is irrelevant; the precision will be approximately equal. Meta-analysts should choose modelling assumptions carefully. Sometimes relevant models can only be fitted in one stage. Otherwise, meta-analysts are free to use whichever procedure is most convenient to fit the identified model. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  9. Initial Staging of Hodgkin’s Disease

    Science.gov (United States)

    Chiaravalloti, Agostino; Danieli, Roberta; Caracciolo, Cristiana Ragano; Travascio, Laura; Cantonetti, Maria; Gallamini, Andrea; Guazzaroni, Manlio; Orlacchio, Antonio; Simonetti, Giovanni; Schillaci, Orazio

    2014-01-01

    Abstract The objective of this study was to compare the diagnostic accuracy of positron emission tomography/low-dose computed tomography (PET/ldCT) versus the same technique implemented by contrast-enhanced computed tomography (ceCT) in staging Hodgkin’s disease (HD). Forty patients (18 men and 22 women, mean age 30 ± 9.6) with biopsy-proven HD underwent a PET/ldCT study for initial staging including an unenhanced low-dose computed tomography for attenuation correction with positron emission tomography acquisition and a ceCT, performed at the end of the PET/ldCT scan, in the same exam session. A detailed datasheet was generated for illness locations for separate imaging modality comparison and then merged in order to compare the separate imaging method results (PET/ldCT and ceCT) versus merged results positron emission tomography/contrast-enhanced computed tomography (PET/ceCT). The nodal and extranodal lesions detected by each technique were then compared with follow-up data that served as the reference standard. No significant differences were found at staging between PET/ldCT and PET/ceCT in our series. One hundred and eighty four stations of nodal involvement have been found with no differences in both modalities. Extranodal involvement was identified in 26 sites by PET/ldCT and in 28 by PET/ceCT. We did not find significant differences concerning the stage (Ann Arbor). Our study shows a good concordance and conjunction between PET/ldCT and ceCT in both nodal and extranodal sites in the initial staging of HD, suggesting that PET/ldCT could suffice in most of these patients. PMID:25121354

  10. Worldwide Esophageal Cancer Collaboration: pathologic staging data.

    Science.gov (United States)

    Rice, T W; Chen, L-Q; Hofstetter, W L; Smithers, B M; Rusch, V W; Wijnhoven, B P L; Chen, K L; Davies, A R; D'Journo, X B; Kesler, K A; Luketich, J D; Ferguson, M K; Räsänen, J V; van Hillegersberg, R; Fang, W; Durand, L; Cecconello, I; Allum, W H; Cerfolio, R J; Pera, M; Griffin, S M; Burger, R; Liu, J-F; Allen, M S; Law, S; Watson, T J; Darling, G E; Scott, W J; Duranceau, A; Denlinger, C E; Schipper, P H; Lerut, T E M R; Orringer, M B; Ishwaran, H; Apperson-Hansen, C; DiPaola, L M; Semple, M E; Blackstone, E H

    2016-10-01

    We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 13,300 patients, 5,631 had squamous cell carcinoma, 7,558 adenocarcinoma, 85 adenosquamous carcinoma, and 26 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (51%), little weight loss (1.8 kg), 0-2 ECOG performance status (83%), and a history of smoking (70%). Cancers were pT1 (24%), pT2 (15%), pT3 (50%), pN0 (52%), pM0 (93%), and pG2-G3 (78%); most involved distal esophagus (71%). Non-risk-adjusted survival for both squamous cell carcinoma and adenocarcinoma was monotonic and distinctive across pTNM. Survival was more distinctive for adenocarcinoma than squamous cell carcinoma when pT was ordered by pN. Survival for pTis-1 adenocarcinoma was better than for squamous cell carcinoma, although monotonic and distinctive for both. WECC pathologic staging data is improved over that of the 7th edition, with more patients studied and patient and cancer variables collected. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient, cancer, and treatment characteristics, and should direct 9th edition data collection. However, the role of pure pathologic staging as the principal point of reference for esophageal cancer staging is waning. © 2016 International Society for Diseases of the Esophagus.

  11. Method and system for dual resolution translation stage

    Science.gov (United States)

    Halpin, John Michael

    2014-04-22

    A dual resolution translation stage includes a stage assembly operable to receive an optical element and a low resolution adjustment device mechanically coupled to the stage assembly. The dual resolution stage also includes an adjustable pivot block mechanically coupled to the stage assembly. The adjustable pivot block includes a pivot shaft. The dual resolution stage further includes a lever arm mechanically coupled to the adjustable pivot block. The lever arm is operable to pivot about the pivot shaft. The dual resolution stage additionally includes a high resolution adjustment device mechanically coupled to the lever arm and the stage assembly.

  12. A comparison of tumor motion characteristics between early stage and locally advanced stage lung cancers

    International Nuclear Information System (INIS)

    Yu, Z. Henry; Lin, Steven H.; Balter, Peter; Zhang Lifei; Dong Lei

    2012-01-01

    Purpose: With the increasing use of conformal radiation therapy methods for non-small cell lung cancer (NSCLC), it is necessary to accurately determine respiratory-induced tumor motion. The purpose of this study is to analyze and compare the motion characteristics of early and locally advanced stage NSCLC tumors in a large population and correlate tumor motion with position, volume, and diaphragm motion. Methods and materials: A total of 191 (94 early stage, 97 locally advanced) non-small cell lung tumors were analyzed for this study. Each patient received a four-dimensional CT scan prior to receiving radiation treatment. A soft-tissue-based rigid registration algorithm was used to track the tumor motion. Tumor volumes were determined based on the gross tumor volume delineated by physicians in the end of expiration phase. Tumor motion characteristics were correlated with their standardized tumor locations, lobe location, and clinical staging. Diaphragm motion was calculated by subtracting the diaphragm location between the expiration and the inspiration phases. Results: Median, max, and 95th percentile of tumor motion for early stage tumors were 5.9 mm, 31.0 mm, and 20.0 mm, which were 1.2 mm, 12 mm, and 7 mm more than those in locally advanced NSCLC, respectively. The range of motion at 95th percentile is more than 50% larger in early stage lung cancer group than in the locally advanced lung cancer group. Early stage tumors in the lower lobe showed the largest motion with a median motion of 9.2 mm, while upper/mid-lobe tumors exhibited a median motion of 3.3 mm. Tumor volumes were not correlated with motion. Conclusion: The range of tumor motion differs depending on tumor location and staging of NSCLC. Early stage tumors are more mobile than locally advanced stage NSCLC. These factors should be considered for general motion management strategies when 4D simulation is not performed on individual basis.

  13. The microorganisms in chronically infected end-stage and non-end-stage cystic fibrosis patients

    DEFF Research Database (Denmark)

    Rudkjøbing, Vibeke B; Thomsen, Trine R; Alhede, Morten

    2011-01-01

    Patients suffering from cystic fibrosis (CF) develop chronic lung infections because of highly viscous mucus, where bacteria can form biofilms. In this study, we investigated the microorganisms present in the lungs of end-stage and non-end-stage patients using standard culturing techniques......RNA gene analysis (J Clin Microbiol 2011, 49: 4352). Conversely, the non-end-stage patients were found to harbor several species by culturing. PNA FISH confirmed heterogeneous microbiota and showed that the bacteria were located in monospecies aggregates with no apparent physical interaction between...

  14. A trial of the three-stage light-gas gun with a preheating stage

    Science.gov (United States)

    Kondo, K.; Hironaka, Y.; Ito, H.; Sugiura, H.; Ozaki, S.; Takeba, A.; Katayama, M.

    1996-05-01

    A three-stage light-gas gun having a preheating and filling stage of gas was designed and installed in order to independently regulate the initial energy of the light gas. Although the operation and the performance of gun become so complicated, the computer simulations for the gun indicate many advantages, e.g., a scale of the gun much decreases in comparison with a conventional two-stage light-gas gun at the same value of the maximum obtainable projectile velocity.

  15. Accuracy of preoperative CT T staging of renal cell carcinoma: which features predict advanced stage?

    International Nuclear Information System (INIS)

    Bradley, A.J.; MacDonald, L.; Whiteside, S.; Johnson, R.J.; Ramani, V.A.C.

    2015-01-01

    Aims: To characterise CT findings in renal cell carcinoma (RCC), and establish which features are associated with higher clinical T stage disease, and to evaluate patterns of discrepancy between radiological and pathological staging of RCC. Materials and methods: Preoperative CT studies of 92 patients with 94 pathologically proven RCCs were retrospectively reviewed. CT stage was compared with pathological stage using the American Joint Committee on Cancer (AJCC), 7 th edition (2010). The presence or absence of tumour necrosis, perinephric fat standing, thickening of Gerota's fascia, collateral vessels were noted, and correlated with pT stage. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) for predicting pT stage ≥pT3a were derived separately for different predictors using cross-tabulations. Results: Twenty-four lesions were pathological stage T1a, 21 were T1b, seven were T2a, 25 were T3a, 11 were T3b, four were T3c, and two were T4. There were no stage T2b. Sixty-three (67%) patients had necrosis, 27 (29%) thickening of Gerota's fascia (1 T1a), 25 had collateral vessels (0 T1a), 28 (30%) had fat stranding of <2 mm, 20 (21%) of 2–5mm and one (1%) of >5 mm. For pT stage ≥pT3a, the presence of perinephric fat stranding had a sensitivity, specificity, PPV and NPV of 74%, 65%, 63%, and 76%, respectively. Presence of tumour necrosis had a sensitivity, specificity, PPV, and NPV of 81%, 44%, 54%, and 72%, respectively. Thickening of Gerota's fascia had a sensitivity, specificity, PPV, and NPV of 52%, 90%, 81% and 70%, respectively; and enlarged collateral vessels had a sensitivity, specificity, PPV, and NPV value of 52%, 94%, 88%, and 71% respectively. Conclusion: The presence of perinephric stranding and tumour necrosis were not reliable signs for pT stage >T3a. Thickening of Gerota's fascia and the presence of collateral vessels in the peri- or paranephric fat had 90% and 94% specificity, with 82% and 88

  16. Detailed experimental results for laser acceleration staging

    Directory of Open Access Journals (Sweden)

    W. D. Kimura

    2001-10-01

    Full Text Available Detailed experimental results of staging two laser-driven, relativistic electron accelerators are presented. During the experiment called STELLA (staged electron laser acceleration, an inverse free-electron laser (IFEL is used to modulate the electron energy, thereby, causing ∼3 fs microbunches to form separated by the laser wavelength at 10.6 μm (equivalent to a 35 fs period. A second IFEL accelerates the electrons depending upon the phase of the microbunches entering the second IFEL with respect to the laser beam driving the second IFEL. The data presented includes electron energy spectra as a function of the phase delay and laser power driving the first IFEL. Also shown is a comparison with the computer model, which includes space charge and misalignment effects.

  17. Whole organism blood stage vaccines against malaria.

    Science.gov (United States)

    Stanisic, Danielle I; Good, Michael F

    2015-12-22

    Despite a century of research focused on the development and implementation of effective control strategies, infection with the malaria parasite continues to result in significant morbidity and mortality worldwide. An effective malaria vaccine is considered by many to be the definitive solution. Yet, after decades of research, we are still without a vaccine that is capable of inducing robust, long lasting protection in naturally exposed individuals. Extensive sub-unit vaccine development focused on the blood stage of the malaria parasite has thus far yielded disappointing results. There is now a renewed focus on whole parasite vaccine strategies, particularly as they may overcome some of the inherent weaknesses deemed to be associated with the sub-unit approach. This review discusses the whole parasite vaccine strategy focusing on the blood stage of the malaria parasite, with an emphasis on recent advances and challenges in the development of killed and live attenuated vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Bladder Involvement in Stage I Endometriosis.

    Science.gov (United States)

    Brady, Paula C; Missmer, Stacey A; Laufer, Marc R

    2017-08-01

    Endometriosis-the ectopic implantation of endometrial-like tissue-affects 10% of adolescent females and adults. Bladder involvement, causing dysuria and hematuria, occurs in a very small number of endometriosis patients. The patient presented at age 12 years with dysuria and pelvic pain. Laparoscopy revealed stage I endometriosis. Postoperatively, she reported persistent dysuria and passage of tissue in her urine. Cystoscopy showed diffuse erythema; urine cytology revealed glandular and spindle cells suggestive of endometriosis. She was transitioned from oral contraceptives to an intranasal gonadotropin-releasing hormone agonist, with symptom resolution. Intravesicular endometriosis coinciding with stage I disease supports a mechanism of endometriosis dissemination other than direct bladder infiltration. Patients with endometriosis who complain of urinary symptoms warrant assessment, because intravesicular bladder involvement cannot be excluded using pelviscopy. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. Malignant lymphomas - survey, classification and staging

    International Nuclear Information System (INIS)

    Pfannmueller, E.

    1984-01-01

    Malignant lymphomas are lympho-proliferative diseases in which the well-defined clinical pattern of Hodgkin's disease is contrasted by the heterogeneous group of lymphomas of the non-Hodgkin type. A simplified form of the sub-classification of Hodgkin's disease suggested in 1966 by Lukes and Butler, has found world-wide recognition. However, no generally accepted classification scheme has been evolved so far for the histological classification of other lymphomas, and this leads to considerable difficulties when comparing the therapy results from different centres. Precise histological classification and accurate staging before onset of therapy enable well-defined pronoses and therapy planning in line with case requirements. Radiological methods (X-ray chest, sonography, computed tomography, lymphography, scintigraphy etc.) are important in diagnosis required for accurate staging. (orig.) [de

  20. Staging Lung Cancer: Current Controversies and Strategies

    Directory of Open Access Journals (Sweden)

    Riyad Karmy-Jones

    1997-01-01

    Full Text Available A consistent approach to staging is required for the rational management of lung cancer. This paper was prepared at the request of the Standards Committee of the Canadian Thoracic Society, and reviews and discusses the relative merits of the available methods of staging. Whichever methods are chosen by a particular institution, the following points must be stressed. No patient can be considered automatically "unresectable" when chest radiography and/ or computed tomography demonstrate adenopathy or only suggest local invasion. Clinical and/or radiographical evidence suggesting extensive local or metastatic disease should be evaluated as completely as possible before subjecting the patient to a possible "nontherapeutic" thoracotomy. Finally, in some cases thoracotomy is required to decide whether the lesion is "completely" resectable.

  1. Computerized tomography and staging of bladder tumors

    International Nuclear Information System (INIS)

    Wozniak, A.; Luongo, A.; Nogueira, A.

    1982-01-01

    Computed Tomography (CT) has been employed in 13 patients with bladder tumors; 8 of them subsequently underwent surgery. Concordance between CT and pathological staging ranged in 90% of accurate results. Our data are discussed and compared to those of other authors in the literature. Staging was carried out according to the International Union Against Cancer. CT proved to be very accurate in the assessment of local and regional spread of tumor, limphatic progression and early detection of ureteral obstruction, as well as diagnosis of distant metastasis in selected patients. In poor candidates for surgery CT provided invaluable data to be used for localizing fields of radiation therapy. CT is a very well tolerated procedure, it is therefore suitable in subsequent treatment control. (Author) [pt

  2. Early diagnosis of early stage lung cancer

    Directory of Open Access Journals (Sweden)

    Andrej Debeljak

    2005-11-01

    Full Text Available Background: For the detection of premalignant changes of bronchial mucosa and early stages of lung cancer frequent chest X-ray, spiral low dose computed tomography, fluorescence bronchoscopy, sputum cytology (also with automated systems with genetic and molecular changes in the sputum cells and bronchial mucosa were used. These screening methods of the high-risk groups for lung cancer achieved: earlier diagnosis of lung cancer in lower stage, higher operability, longer 5-year survival, but without mortality reduction.Conclusions: In the clinical practice we can examine higher risk groups for lung cancer in randomised control trials with multimodality approach: frequent chest low-dose fast spiral computed tomography, sputum cytology with genetic and molecular examinations and fluorescence bronchoscopy. Smoking cessation remains the best means to achieve mortality reduction from lung cancer.

  3. THE TWO STAGE CRYSTAL COLLIMATOR FOR RHIC

    International Nuclear Information System (INIS)

    FLILLER, R.P. III; DREES, A.; GASSNER, D.; HAMMONS, L.; MCINTYRE, G.; TRBOJEVIC, D.; BIRYUKOV, V.; CHESNOKOV, Y.; TEREKHOV, V.

    2001-01-01

    The use of a two stage crystal collimation system in the RHIC yellow ring is examined. The system includes a copper beam scraper and a bent silicon crystal. While scrapers were installed in both of the RHIC rings before the year 2000 run, the crystal is installed for the 2001 run in one ring only, forming a two stage collimation system there. We present simulations of the expected channeling through the bent silicon crystal for both protons and gold ions with various beam parameters. This gives a picture of the particle losses around the ring, and the expected channeling efficiency. These results are then used to optimize the beam parameters in the area of the crystal to obtain maximum channeling efficiency, minimize out-scattering in the secondary collimator, and reduce beam halo

  4. Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development.

    Science.gov (United States)

    Roberts, Graham J; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S

    2015-11-01

    The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean (x¯), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. Worldwide Esophageal Cancer Collaboration: clinical staging data.

    Science.gov (United States)

    Rice, T W; Apperson-Hansen, C; DiPaola, L M; Semple, M E; Lerut, T E M R; Orringer, M B; Chen, L-Q; Hofstetter, W L; Smithers, B M; Rusch, V W; Wijnhoven, B P L; Chen, K N; Davies, A R; D'Journo, X B; Kesler, K A; Luketich, J D; Ferguson, M K; Räsänen, J V; van Hillegersberg, R; Fang, W; Durand, L; Allum, W H; Cecconello, I; Cerfolio, R J; Pera, M; Griffin, S M; Burger, R; Liu, J-F; Allen, M S; Law, S; Watson, T J; Darling, G E; Scott, W J; Duranceau, A; Denlinger, C E; Schipper, P H; Ishwaran, H; Blackstone, E H

    2016-10-01

    To address uncertainty of whether clinical stage groupings (cTNM) for esophageal cancer share prognostic implications with pathologic groupings after esophagectomy alone (pTNM), we report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for clinically staged patients from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted data using variables with standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 22,123 clinically staged patients, 8,156 had squamous cell carcinoma, 13,814 adenocarcinoma, 116 adenosquamous carcinoma, and 37 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (18.5-25 mg/kg 2 , 47%), little weight loss (2.4 ± 7.8 kg), 0-1 ECOG performance status (67%), and history of smoking (67%). Cancers were cT1 (12%), cT2 (22%), cT3 (56%), cN0 (44%), cM0 (95%), and cG2-G3 (89%); most involved the distal esophagus (73%). Non-risk-adjusted survival for squamous cell carcinoma was not distinctive for early cT or cN; for adenocarcinoma, it was distinctive for early versus advanced cT and for cN0 versus cN+. Patients with early cancers had worse survival and those with advanced cancers better survival than expected from equivalent pathologic categories based on prior WECC pathologic data. Thus, clinical and pathologic categories do not share prognostic implications. This makes clinically based treatment decisions difficult and pre-treatment prognostication inaccurate. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient characteristics, cancer categories, and treatment characteristics and should direct 9th edition data collection. © 2016 International Society for Diseases of the Esophagus.

  6. Initial stages of solidification of eutectic alloys

    International Nuclear Information System (INIS)

    Lemaignan, Clement

    1980-01-01

    The study of the various initial stages of eutectic solidification - i.e. primary nucleation, eutectic structure formation and stable growth conditions - was undertaken with various techniques including low angle neutron diffusion, in-situ electron microscopy on solidifying alloys and classical metallography. The results obtained allow to discuss the effect of metastable states during primary nucleation, of surface dendrite during eutectic nucleation and also of the crystallographic anisotropy during growth. (author) [fr

  7. Ecology of Postlarval Stages of Chigger Mites.

    Science.gov (United States)

    1985-12-05

    overwintering in the deutonymphal stage is increased fecundity in the newly emerged adult females. This phenomenon has been observed in Spodoptera littoralis...1981. Ecology and evolution of physiological time in insects. Am. Nat. 117: 1-23. Wagner, T. L., H. Wu, P. J. H. Sharpe, R. M. Schoolfield, and R. N...evidence for the early evolution of E. alfreddugesi in tropical soils where 25 0 C is the prevailing soil temperature year round (Chap. 1, Fig. 13

  8. EVALUATION OF LIVER FAILURE STAGE IN CHILDREN

    Directory of Open Access Journals (Sweden)

    G. V. Volynets

    2013-01-01

    Full Text Available Aim: to develop a system of evaluation of liver failure stage in children based on the International classification of functioning, disability and health (ICF. Patients and methods: based on the retrospective analysis of 14 biochemical markers, characterizing hepatic role in proteins, lipids and carbohydrates metabolism, of 115 children without liver diseases, 15 children who died of liver failure and 220 patients with various hepatic disorders, being followed-up in the SCCH of RAMS, a score system of evaluation of liver failure stage in children as an additional diagnostic tool was developed. Each of the biochemical markers was assessed according to the 5-point rating scale in dependence of its changes intensity. Results: the sum of points was considered to be a criterion of liver failure stage. According to the ICF recommendations, decrease of points on 0–4% (54–56 points corresponds with absence of liver failure; 5–24% (43–53 points — as mild dysfunction, 25–49% (29–42 points — as moderate; 50-95% (3–28 points — as severe; and 96–100% (0-2 points — as absolute failure. Conclusions: score system of evaluation of liver failure stage can be applied at any step of diagnostics and treatment of children of any age, due to independence of the used markers from the age. It can be used in assessment of the severity of disorder in dynamics, in determination of the prognosis and as criterion of indications to liver transplantation, as well as during medico-social examination.

  9. Staged tendon grafts and soft tissue coverage

    Directory of Open Access Journals (Sweden)

    David Elliot

    2011-01-01

    Full Text Available The objective of the two-staged flexor tendon method is to improve the predictability of final results in difficult problems dealing with tendon reconstruction. This article reviews the evolution and benefits of this procedure. It also considers the use of the technique to help deal with problems requiring pulley and skin reconstruction simultaneously with re-constituting the flexor tendon system.

  10. Radiologic techniques in staging malignant lymphoma

    International Nuclear Information System (INIS)

    Strijk, S.P.

    1987-01-01

    The main subject of this thesis is the evaluation of radiologic techniques in staging patients with newly diagnosed and untreated malignant lymphoma, or restaging patients with recurrent disease after a period of complete remission. Lymphography and, more recently, CT are available to examine the infradiaphragmatic nodes. CT also offers the possibility to examine other organ systems in the abdomen, and to visualize more lymph-node regions than lymphography. In ch. 2 and 4 the diagnostic performance of CT and lymphography in HD and NHL respectively are discussed. Literature data are summarized, and own results are given. The main goal is to determine whether the two methods are overlapping, competitive or complementary, and to answer the question what would be required for optimal staging. Staging laparotomy showed the unreliability of non-invasive examination methods for determining the presence or absence of lymphoma in the spleen. In ch. 3 and 5 the results of CT-based estimations of size of the spleen in relation to its histologic state, in patients with HD and NHL respectively are presented. The chest can be examined for lymphoma by conventional radiography, conventional tomography or computed tomography (CT). In ch. 6 the literature is reviewed, and the results with our patients are presented. The diagnostic performance of each examination is evaluated, and the results are analysed to define the most desirable approach in the examination of the chest for staging purposes. In ch. 7 the uncommon radiologic observation of calcification in lymph nodes, afflicted with HD and NHL is described. The literature is reviewed, and the clinical significance is indicated. 180 refs.; 22 figs.; 24 tabs

  11. Two-stage Security Controls Selection

    OpenAIRE

    Yevseyeva, Iryna; Basto-Fernandes, V.; van Moorsel, Aad; Janicke, Helge; Emmerich, M. T. M.

    2016-01-01

    Open Access article To protect a system from potential cyber security breaches and attacks, one needs to select efficient security controls, taking into account technical and institutional goals and constraints, such as available budget, enterprise activity, internal and external environment. Here we model the security controls selection problem as a two-stage decision making: First, managers and information security officers define the size of security budget. Second, the budget is distri...

  12. Two-stage nonrecursive filter/decimator

    International Nuclear Information System (INIS)

    Yoder, J.R.; Richard, B.D.

    1980-08-01

    A two-stage digital filter/decimator has been designed and implemented to reduce the sampling rate associated with the long-term computer storage of certain digital waveforms. This report describes the design selection and implementation process and serves as documentation for the system actually installed. A filter design with finite-impulse response (nonrecursive) was chosen for implementation via direct convolution. A newly-developed system-test statistic validates the system under different computer-operating environments

  13. Suicide in the Early Stage of Schizophrenia

    OpenAIRE

    Ventriglio, Antonio; Gentile, Alessandro; Bonfitto, Iris; Stella, Eleonora; Mari, Massimo; Steardo, Luca; Bellomo, Antonello

    2016-01-01

    Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects w...

  14. Intravital Microscopy for Identifying Tumor Vessels in Patients With Stage IA-IV Melanoma That is Being Removed by Surgery

    Science.gov (United States)

    2017-06-05

    Recurrent Melanoma; Stage IA Skin Melanoma; Stage IB Skin Melanoma; Stage IIA Skin Melanoma; Stage IIB Skin Melanoma; Stage IIC Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma; Stage IV Skin Melanoma

  15. Acceptance and Commitment Therapy in Improving Well-Being in Patients With Stage III-IV Cancer and Their Partners

    Science.gov (United States)

    2018-02-06

    Malignant Female Reproductive System Neoplasm; Malignant Hepatobiliary Neoplasm; Partner; Stage III Breast Cancer; Stage III Cervical Cancer; Stage III Colorectal Cancer; Stage III Lung Cancer; Stage III Prostate Cancer; Stage III Skin Melanoma; Stage III Uterine Corpus Cancer; Stage IIIA Breast Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colorectal Cancer; Stage IIIA Lung Carcinoma; Stage IIIA Skin Melanoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Breast Cancer; Stage IIIB Cervical Cancer; Stage IIIB Colorectal Cancer; Stage IIIB Lung Carcinoma; Stage IIIB Skin Melanoma; Stage IIIB Uterine Corpus Cancer; Stage IIIC Breast Cancer; Stage IIIC Colorectal Cancer; Stage IIIC Skin Melanoma; Stage IIIC Uterine Corpus Cancer; Stage IV Breast Cancer; Stage IV Cervical Cancer; Stage IV Colorectal Cancer; Stage IV Lung Cancer; Stage IV Prostate Cancer; Stage IV Skin Melanoma; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVA Colorectal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Cervical Cancer; Stage IVB Colorectal Cancer; Stage IVB Uterine Corpus Cancer

  16. Mindfulness Meditation or Survivorship Education in Improving Behavioral Symptoms in Younger Stage 0-III Breast Cancer Survivors (Pathways to Wellness)

    Science.gov (United States)

    2018-02-15

    Cancer Survivor; Early-Stage Breast Carcinoma; Stage 0 Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  17. Staging of rectal cancer by transrectal US

    International Nuclear Information System (INIS)

    Choi, Bo Whan; Ryu, Sie Tae; Park, Ki Soon; Lee, Yul; Chung, Soo Young

    1994-01-01

    To evaluate the accuracy of preoperative staging of rectal cancer by transrectal US(7.5MHz linear array transducer), 17 cases with primary rectal cancer who were examined by transrectal US and histopathologically proven, were analyzed. We correlated the sonographic features of the depth of rectal wall invasion, perirectal fat infiltration and perirectal lymph node metastasis with histopathologic findings. The tumor staging was analyzed according to the TNM classification. The depth of rectal wall invasion was in accordance with histopathologic findings in 15 of 17 cases (accuracy:88.2%). The sensitivity and specificity of transrectal US in predicting perirectal lymph node metastasis were 20% and 75%, respectively (accuracy : 58.8%). The sensitivity and specificity in predicting perirectal fat infiltration were 92.9% and 100%, respectively (accuracy : 94%). Perirectal fat infiltration and depth of rectal wall invasion were preoperatively diagnosed with relatively high accuracy, while perirectal lymph node metastasis with low accuracy. In conclusion, transrectal US is a useful imaging modality for preoperative staging of rectal cancer

  18. Suicide in the Early Stage of Schizophrenia

    Science.gov (United States)

    Ventriglio, Antonio; Gentile, Alessandro; Bonfitto, Iris; Stella, Eleonora; Mari, Massimo; Steardo, Luca; Bellomo, Antonello

    2016-01-01

    Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects with subthreshold psychotic experiences. Factors associated with the risk of suicide in the early phase of schizophrenia are previous suicidal attempts and social aspects: the lack of social support and stable relationships, social drift after the first episode, and social impairment. Also, several psychotic symptoms (suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations) and substance abuse are associated with higher risk of suicide. It has been described that perfectionism and good levels of insight among individuals who have recently developed psychotic symptoms are significantly associated with higher numbers of suicidal attempts. Moreover, recent evidences show that prefrontal cortex-based circuit dysfunction may be related to suicide in the early stage of schizophrenia. This narrative review summarizes available evidences on suicide in the early stage of schizophrenia and deals with issues to be further studied and discussed. PMID:27445872

  19. Hepatocellular carcinoma: early-stage management challenges

    Directory of Open Access Journals (Sweden)

    Erstad DJ

    2017-06-01

    Full Text Available Derek J Erstad,1 Kenneth K Tanabe2–4 1Department of Surgery, Massachusetts General Hospital, 2Harvard Medical School, 3Division of Surgical Oncology, 4Massachusetts General Hospital Cancer Center, Massachusetts General Hospital, Boston, MA, USA Abstract: Hepatocellular carcinoma (HCC is a major cause of cancer death and is increasing in incidence. This review focuses on HCC surveillance and treatment of early-stage disease, which are essential to improving outcomes. Multiple societies have published HCC surveillance guidelines, but screening efforts have been limited by noncompliance and overall lack of testing for patients with undiagnosed chronic liver disease. Treatment of early-stage HCC has become increasingly complex due to expanding therapeutic options and better outcomes with established treatments. Surgical indications for HCC have broadened with improved preoperative liver testing, neoadjuvant therapy, portal vein embolization, and perioperative care. Advances in post-procedural monitoring have improved efficacies of transarterial chemoembolization and radiofrequency ablation, and novel therapies involving delivery of radiochemicals are being studied in small trials. Finally, advances in liver transplantation have allowed for expanded indications beyond Milan criteria with non-inferior outcomes. More clinical trials evaluating new therapies and multimodal regimens are necessary to help clinicians design better treatment algorithms and improve outcomes. Keywords: hepatocellular carcinoma, hepatitis, surveillance, Barcelona clinic liver cancer, staging, cirrhosis, hepatectomy, hepatic resection, locoregional therapy, radiofrequency ablation, transarterial chemoembolization, liver transplantation

  20. Cutaneous T-Cell Lymphoma Early Stage

    Directory of Open Access Journals (Sweden)

    Anna Vasku

    2010-01-01

    A total of 89 Czech patients with CTCL (including 23 patients with large plaque parapsoriasis were compared to 198 controls of similar age and sex distribution, without personal or family history of chronic skin diseases and without personal history of malignancy. The three selected polymorphisms in the promoter of MMP-2 gene (−1575G/A, −1306C/T, and −790T/G were determined using the PCR-based methodology with RFLP. In our cohort, the associated GGCCTT MMP-2 promoter genotype was highly significantly more frequent in CTCL-Ia stage patients compared to patients with parapsoriasis, the tests having high sensitivity and specificity (78%, 83%, resp.. To conclude, use of associated MMP-2 promoter genotype as a DNA marker might make it possible to distinguish between the patients with parapsoriasis and those with CTCL stage Ia, which could substantially improve possibilities of clinical diagnostics, therapy design, and prognosis of this serious condition in the early stages.

  1. Surgical treatment of advanced stage Freiberg disease

    Directory of Open Access Journals (Sweden)

    Emin Özkul

    2014-09-01

    Full Text Available Objective: Freiberg disesase is an avascular necrosis of the 2nd and 3rd metatarsal head and which kind of surgical option to be used is controversial in symptomatic patients. In this study the results of the advanced stage Freiberg’s disease patients, who were treated with surgery were evaluated. Methods: 12 patients (8 female, 4 male whose pain could not be solved with conservative method and underwent surgery (6 debridement, 3 osteotomy, 3 excision of the metatarsal head were included in this study. Themean age of the patients 19.1 (range 13- 31 and the mean follow-up 30.8(range 25-94 months. According to the Smillie classification 3 patients had type 5, 8 patients had type 4 and 1 patient had type 3 osteonecrosis. The results of the patients were evaluated according to Lesser Metatarsophalangeal-Interphalangeal Scale. Results: According to Lesser MetatarsophalangealInterphalangeal Scale 3 patients (%25 had excellent, 6 patients (%50 had good and 3 patients had poor results were obtained. 2 of 3 patients with poor results were type 5, and 1 patient was type 4 and all three patients underwent joint debridement. Conclusion:The method of surgical treatment of Freiberg disease determined according to the stage of the disease. Debridement alone in the treatment of patients with late stage is not enough, it should be combined with other methods.

  2. Prognostic factors in stage IB gastric cancer.

    Science.gov (United States)

    Aoyama, Toru; Yoshikawa, Takaki; Fujikawa, Hirohito; Hayashi, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Yamada, Takanobu; Hasegawa, Shinichi; Tsuchida, Kazuhito; Yukawa, Norio; Oshima, Takashi; Oba, Mari S; Morita, Satoshi; Rino, Yasushi; Masuda, Munetaka

    2014-06-07

    To identify the subset of patients with stage IB gastric cancer with an unfavorable prognosis. Overall survival (OS) rates were examined in 103 patients with stage IB (T1N1M0 and T2N0M0) gastric cancer between January 2000 and December 2011. Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model. The OS rates of patients with T1N1 and T2N0 cancer were 89.2% and 94.1% at 5-years, respectively. Both univariate and multivariate analyses demonstrated that tumor location was the only significant prognostic factor. The OS rate was 81.8% at 5-years when the tumor was located in the upper third of the stomach and was 95.5% at 5-years when the tumor was located in the middle or lower third of the stomach (P = 0.0093). These data may suggest that tumor location is associated with survival in patients with stage IB gastric cancer.

  3. Indications for staging laparoscopy in pancreatic cancer

    Science.gov (United States)

    De Rosa, Antonella; Cameron, Iain C.; Gomez, Dhanwant

    2015-01-01

    Background To identify indications for staging laparoscopy (SL) in patients with resectable pancreatic cancer, and suggest a pre-operative algorithm for staging these patients. Methods Relevant articles were reviewed from the published literature using the Medline database. The search was performed using the keywords ‘pancreatic cancer’, ‘resectability’, ‘staging’, ‘laparoscopy’, and ‘Whipple's procedure’. Results Twenty four studies were identified which fulfilled the inclusion criteria. Of the published data, the most reliable surrogate markers for selecting patients for SL to predict unresectability in patients with CT defined resectable pancreatic cancer were CA 19.9 and tumour size. Although there are studies suggesting a role for tumour location, CEA levels, and clinical findings such as weight loss and jaundice, there is currently not enough evidence for these variables to predict resectability. Based on the current data, patients with a CT suggestive of resectable disease and (1) CA 19.9 ≥150 U/mL; or (2) tumour size >3 cm should be considered for SL. Conclusion The role of laparoscopy in the staging of pancreatic cancer patients remains controversial. Potential predictors of unresectability to select patients for SL include CA 19.9 levels and tumour size. PMID:26776846

  4. Suicide in the Early Stage of Schizophrenia.

    Science.gov (United States)

    Ventriglio, Antonio; Gentile, Alessandro; Bonfitto, Iris; Stella, Eleonora; Mari, Massimo; Steardo, Luca; Bellomo, Antonello

    2016-01-01

    Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects with subthreshold psychotic experiences. Factors associated with the risk of suicide in the early phase of schizophrenia are previous suicidal attempts and social aspects: the lack of social support and stable relationships, social drift after the first episode, and social impairment. Also, several psychotic symptoms (suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations) and substance abuse are associated with higher risk of suicide. It has been described that perfectionism and good levels of insight among individuals who have recently developed psychotic symptoms are significantly associated with higher numbers of suicidal attempts. Moreover, recent evidences show that prefrontal cortex-based circuit dysfunction may be related to suicide in the early stage of schizophrenia. This narrative review summarizes available evidences on suicide in the early stage of schizophrenia and deals with issues to be further studied and discussed.

  5. Exercise in Targeting Metabolic Dysregulation in Stage I-III Breast or Prostate Cancer Survivors

    Science.gov (United States)

    2017-09-12

    Cancer Survivor; No Evidence of Disease; Obesity; Overweight; Prostate Carcinoma; Sedentary Lifestyle; Stage I Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage III Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  6. Aspectos epidemiológicos das micoses dos pés em um time chinês de futebol Aspectos epidemiologicos de las micosis de los pies en un equipo chino de fútbol Epidemiological aspects of the feet mycosis in a Chinese soccer team

    Directory of Open Access Journals (Sweden)

    Kátia Sheylla Malta Purim

    2006-02-01

    culture of the skin and nail's squamas from their feet, as well as to a histopathologic study of the ungual fragment. The results found were: twelve cases (54.5% did not present mycosis; 5 cases (22.72% presented isolated onychomycosis, and 5 cases (22.72% presented onychomycosis associated to tinea pedis, having as major isolated agent the Trichophyton rubrum. The predisposing agents pointed by athletes included: bath in a public place (85%, sports practice (76%, use of closed shoes (70%, contact with pets (63%, and irregular feet hygiene (50%. CONCLUSION: The frequency of the onychomycosis in Chinese athletes was higher than in the general population. The most frequent agent found it was the Trichophyton rubrum. The individual habits may contribute to the acquisition of these fungal infections added to the direct trauma provoked by the shoe and the ball, as well as to the physical contact during the trainings and games that may favor the cutaneous and ungual injuries.

  7. Collaboration with Pharma Will Introduce Nanotechnologies in Early Stage Drug Development | FNLCR Staging

    Science.gov (United States)

    The Frederick National Lab has begun to assist several major pharmaceutical companies in adopting nanotechnologies in early stage drug development, when the approach is most efficient and cost-effective. For some time, the national lab’s Nanotechno

  8. Treatment Options By Stage (Ovarian Germ Cell Tumors)

    Science.gov (United States)

    ... IIA, stage IIB, and stage IIC. Stage IIA : Cancer has spread to the uterus and/or fallopian tubes (the long slender tubes ... which eggs pass from the ovaries to the uterus). Stage IIB : Cancer has spread to other tissue within the pelvis . ...

  9. Hybrid staging of a Lysholm positive displacement engine with two Westinghouse two stage impulse Curtis turbines

    Energy Technology Data Exchange (ETDEWEB)

    Parker, D.A.

    1982-06-01

    The University of California at Berkeley has tested and modeled satisfactorly a hybrid staged Lysholm engine (positive displacement) with a two stage Curtis wheel turbine. The system operates in a stable manner over its operating range (0/1-3/1 water ratio, 120 psia input). Proposals are made for controlling interstage pressure with a partial admission turbine and volume expansion to control mass flow and pressure ratio for the Lysholm engine.

  10. [Comparison research on two-stage sequencing batch MBR and one-stage MBR].

    Science.gov (United States)

    Yuan, Xin-Yan; Shen, Heng-Gen; Sun, Lei; Wang, Lin; Li, Shi-Feng

    2011-01-01

    Aiming at resolving problems in MBR operation, like low nitrogen and phosphorous removal efficiency, severe membrane fouling and etc, comparison research on two-stage sequencing batch MBR (TSBMBR) and one-stage aerobic MBR has been done in this paper. The results indicated that TSBMBR owned advantages of SBR in removing nitrogen and phosphorous, which could make up the deficiency of traditional one-stage aerobic MBR in nitrogen and phosphorous removal. During steady operation period, effluent average NH4(+) -N, TN and TP concentration is 2.83, 12.20, 0.42 mg/L, which could reach domestic scenic environment use. From membrane fouling control point of view, TSBMBR has lower SMP in supernatant, specific trans-membrane flux deduction rate, membrane fouling resistant than one-stage aerobic MBR. The sedimentation and gel layer resistant of TSBMBR was only 6.5% and 33.12% of one-stage aerobic MBR. Besides high efficiency in removing nitrogen and phosphorous, TSBMBR could effectively reduce sedimentation and gel layer pollution on membrane surface. Comparing with one-stage MBR, TSBMBR could operate with higher trans-membrane flux, lower membrane fouling rate and better pollutants removal effects.

  11. A Novel Inflammation-Based Stage (I Stage in Patients with Resectable Esophageal Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Peng-Cheng Chen

    2016-01-01

    Full Text Available Background. Inflammation plays a key role in cancer. In the current study, we proposed a novel inflammation-based stage, named I stage, for patients with resectable esophageal squamous cell carcinoma (ESCC. Methods. Three hundred and twenty-three patients with resectable ESCC were enrolled in the current study. The I stage was calculated as follows: patients with high levels of C-reactive protein (CRP (>10 mg/L, neutrophil-to-lymphocyte ratio (NLR (>3.5, and platelet-count-to-lymphocyte ratio (PLR (>150 were defined as I3. Patients with two, one, or no abnormal value were defined as I2, I1, or I0, respectively. The prognostic factors were evaluated by univariate and multivariate analyses. Results. There were 112 patients for I0, 97 patients for I1, 66 patients for I2, and 48 patients for I3, respectively. The 5-year cancer-specific survival (CSS in patients with I0, I1, I2, and I3 was 50.0%, 30.9%, 18.2%, and 8.3%, respectively (I0 versus I1, P=0.002; I1 versus I2, P=0.012; I2 versus I3, P=0.020. Multivariate analyses revealed that I stage was an independent prognostic factor in patients with resectable ESCC (P<0.001. Conclusion. The inflammation-based stage (I stage is a novel and useful predictive factor for CSS in patients with resectable ESCC.

  12. Results of the Utah-Arizona stage-by-stage migrations

    Science.gov (United States)

    Ellis, D.H.; Mellon, C.; Kinloch, M.; Dolbeare, T.; Ossi, D.P.

    2001-01-01

    In an effort to find a safer means of teaching cranes new migration routes, each year (in 1998 and 1999) we transported a group of greater sandhill cranes (Grus canadensis tabida) stage-by-stage, in a horse trailer, with stops for brief flights at about 30-km intervals, along a 1300-1400-km fall migration route from Fish Springs National Wildlife Refuge (Fish Springs) in west-central Utah to the vicinity of Gila Bend, Arizona. Thereafter, we released them into a wild flock of sandhill cranes. All stage-by-stage birds were hand-reared with both a plastic crane decoy (to encourage them to roost in water) and a costume-draped humanoid form (called a scare-eagle and used for its namesake purpose). When these 2 teaching aids were placed in water, our cranes readily roosted nearby. All but 4 of our cranes proved cooperative (i.e., catchable at each of the ca 25-36 stops) during the migration. All were efficiently released into a wild flock and experienced good survival. The stage-by-stage method proved to be a safe means of transporting cranes south and giving them experience along the route. Some cranes apparently learned their route from the limited experience afforded by releasing them at intervals, and the 1999 cranes have made repealed migrations to or near our chosen northern terminus. However, after 1 winter in our chosen area, the birds have moved elsewhere to winter.

  13. Multi-stage fuel cell system method and apparatus

    Science.gov (United States)

    George, Thomas J.; Smith, William C.

    2000-01-01

    A high efficiency, multi-stage fuel cell system method and apparatus is provided. The fuel cell system is comprised of multiple fuel cell stages, whereby the temperatures of the fuel and oxidant gas streams and the percentage of fuel consumed in each stage are controlled to optimize fuel cell system efficiency. The stages are connected in a serial, flow-through arrangement such that the oxidant gas and fuel gas flowing through an upstream stage is conducted directly into the next adjacent downstream stage. The fuel cell stages are further arranged such that unspent fuel and oxidant laden gases too hot to continue within an upstream stage because of material constraints are conducted into a subsequent downstream stage which comprises a similar cell configuration, however, which is constructed from materials having a higher heat tolerance and designed to meet higher thermal demands. In addition, fuel is underutilized in each stage, resulting in a higher overall fuel cell system efficiency.

  14. Interconnected levels of multi-stage marketing: A triadic approach

    OpenAIRE

    Vedel, Mette; Geersbro, Jens; Ritter, Thomas

    2012-01-01

    Multi-stage marketing gains increasing attention as knowledge of and influence on the customer's customer become more critical for the firm's success. Despite this increasing managerial relevance, systematic approaches for analyzing multi-stage marketing are still missing. This paper conceptualizes different levels of multi-stage marketing and illustrates these stages with a case study. In addition, a triadic perspective is introduced as an analytical tool for multi-stage marketing research. ...

  15. Two-stage dental implants inserted in a one-stage procedure : a prospective comparative clinical study

    NARCIS (Netherlands)

    Heijdenrijk, Kees

    2002-01-01

    The results of this study indicate that dental implants designed for a submerged implantation procedure can be used in a single-stage procedure and may be as predictable as one-stage implants. Although one-stage implant systems and two-stage.

  16. Gamma-Secretase/Notch Signalling Pathway Inhibitor RO4929097, Paclitaxel, and Carboplatin Before Surgery in Treating Patients With Stage II or Stage III Triple-Negative Breast Cancer

    Science.gov (United States)

    2015-09-03

    Estrogen Receptor Negative; HER2/Neu Negative; Progesterone Receptor Negative; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-Negative Breast Carcinoma

  17. Port Pirie rare earths plant stage 3

    International Nuclear Information System (INIS)

    1990-08-01

    SX Holdings Limited intends to establish a rare earths plant at Port Pirie, South Australia. The proposal involves three stages of development, Stage 3 being to develop a monazite cracking plant and associated rare earths separation facility with the capacity to process up to 8,000 t/a of monazite-type ores. The proposed initial capacity is 4,000 t/a. This Draft Environmental Impact Statement relates to Stage 3 and is based on a monazite processing capacity of 8,000 t/a. The justification of the project is given in terms of use and the market for rare earths, the economic and environmental benefits of the proposal, the site selection process, site rehabilitation, and the consequences of not proceeding. A detailed description of the project is given, including the treatment process, site development and facilities, the supply of raw materials, product and waste handling, transport and storage, plant commissioning, operation and decommissioning, construction and staffing. The environmental issues entailed in the proposed development are discussed and include social effects, land use and infrasturcture considerations, risk management and transport. Occupational and environmental radiation issues, including assessments of exposure pathways and doses, management and monitoring, disposal of monosite residue are also discussed. It is estimated that the effects of disposal of 2,330 t/year of radioactive slurry in the sub-aerial tailing disposal system at Olympic Dam will be negligible. Moreover, the gamma dose increases would not result in any significant increase in occupational exposures. 38 refs., tabs., ills

  18. Prospective Cohort Study Depending on the Use of Palliative Care for Advanced Stage of Cancer Patients

    Science.gov (United States)

    2017-09-05

    Stage IV Breast Cancer; Stage IV Pancreatic Cancer; Stage IV Colon Cancer; Stage IV Gastric Cancer; Stage IV Lung Cancer; Stage IV Liver Cancer; Malignant Hematologic Neoplasm; Biliary Cancer Metastatic; Pediatric Leukemia; Pediatric Lymphoma; Pediatric Brain Tumor; Pediatric Solid Tumor

  19. RESEARCH OF EARLY STAGES OF MODELING

    Directory of Open Access Journals (Sweden)

    Andrey Borisovich Nikolaev

    2017-05-01

    Full Text Available In represented article the questions of estimate of accuracy of an average integral characteristics of random process in the course of imitation modeling is considered. For the purposes of analytical treatment of initial stage of modeling a conditionally nonstationary Gaussian process is analyzed as stationary Gaussian process with boundary prehistory. A model of approximant autocorrelation function is recommended. Analytical expression for variance and mathematical expectation of average integral estimation are obtained. Statistical estimation efficiency criterion, the probability of belonging to correct parameter interval is introduced. Dependences of closeness in estimation statistics clearing interval at transient behavior are researched for various types of processes.

  20. Staging constructions of authenticity in organizational change

    DEFF Research Database (Denmark)

    Dupret, Katia

    2018-01-01

    that are emotionally charged. Through a socio-material perspective this paper seeks to explore how change processes in organizations challenges the idea of authentic leadership as a merely individual ability or personality trait and suggest that the authentic leader is distributed into the practices of change....... The paper explores how staged organizational change where authentic role-play and scripts from everyday life combined with meta-reflection and feedback construct new forms of reflection where its ethical side-effects should be discussed....

  1. The staging area concept for item control

    International Nuclear Information System (INIS)

    Williams, R.A.

    1984-01-01

    Accounting for special nuclear material contained in fabricated nuclear fuel rod items has been completely automated at the Westinghouse Nuclear Fuel Division facility in Columbia, South Carolina. Experience with the automated system has shown substantial difficulty in maintaining current knowledge of the precise locations of rods pulled out of the ''normal'' processing cycle. This has been resolved by creation of two tightly controlled staging areas for handling and distribution of all ''deviant'' rods by two specially trained expeditors. Thus, coupling automated data collection with centralized expert handling and distribution has created a viable system for control of large numbers of fuel rods in a major fabrication plant

  2. Breast cancer relapse stage I and II

    International Nuclear Information System (INIS)

    Perez Braojos, Ines; Diaz Gestoso, Yadira; Franco Odio, Sonia; Samuel Gonzalez, Victor

    2009-01-01

    Breast cancer has always been the most common malignancy in women and is the leading cause of death in women, study relapses Stages I and II therapeutic guidelines applied in the service Mastology the 1985 - 1989, was our first objective, the database used was Clinical history, which gave us all the material necessary, treatments were: In tumors up to 3 cm node-conserving surgery plus treatment N0 with ionizing radiation on the breast tangential C0G0 in tumors greater than 3 cm or less with N1 was modified radical mastectomy according to node status for the study of the part and the receiver adjuvant treatment conducted. (Author)

  3. Staging Events of Collaborative Design and Learning

    DEFF Research Database (Denmark)

    Binder, Thomas; Brandt, Eva; Horgen, Turid

    1998-01-01

    In this paper we will focus on events where collaborating parties get together to further the design work, and on how these events get staged in time and space. Our consern is the micro-organisation of time and space, which we find is poorly explored in the literature on product development. We...... open the paper by provisionally placing this concern within the debate on engineering design and product development. We argue that seeing the process of product development as a chain of events, each propelling the design work-and deliberately designing such events, with a clear focus on space, time...... for facilitating collaborative design....

  4. Stages in the energetics of baroclinic systems

    Science.gov (United States)

    Orlanski, Isidoro; Sheldon, John P.

    1995-10-01

    The results from several idealized and case studies are drawn together to form a comprehensive picture of "downstream baroclinic evolution" using local energetics. This new viewpoint offers a complementary alternative to the more conventional descriptions of cyclone development. These additional insights are made possible largely because the local energetics approach permits one to define an energy flux vector which accurately describes the direction of energy dispersion and quantifies the role of neighboring systems in local development. In this view, the development of a system's energetics is divided into three stages. In Stage 1, a pre-existing disturbance well upstream of an incipient trough loses energy via ageostrophic geopotential fluxes directed downstream through the intervening ridge, generating a new energy center there. In Stage 2, this new energy center grows vigorously, at first due to the convergence of these fluxes, and later by baroclinic conversion as well. As the center matures, it begins to export energy via geopotential fluxes to the eastern side of the trough, initiating yet another energy center. In Stage 3, this new energy center continues to grow while that on the western side of the trough decays due to a dwinding supply of energy via fluxes from the older upstream system and also as a consequence of its own export of energy downstream. As the eastern energy center matures, it exports energy further downstream, and the sequence begins anew. The USA "Blizzard of'93" is used as a new case study to test the limits to which this conceptual sequence might apply, as well as to augment the current limited set of case studies. It is shown that, despite the extraordinary magnitude of the event, the evolution of the trough associated with the Blizzard fits the conceptual picture of downstream baroclinic evolution quite well, with geopotential fluxes playing a critical rôle in three respects. First, fluxes from an old, decaying system in the

  5. A 2-MJ staged explosive generator

    Science.gov (United States)

    Chare, E. C.; Kaye, R. J.; Cowan, M.

    A self contained, three stage explosive generator is described. The system has produced 2 MJ of magnetic energy in a 40 nH load with a peak VI product of 0.2 TW. Current in the load rises from zero to peak value in 50 (SIGMA)s, the later part of the rise is approximately exponential with 10 (SIGMA)s e-fold time. Support equipment (power supply, initial energy capacitor bank, detonator firing units, delay generators, and Freon gas supply) can be protected from destructive effects of the explosive generators and reused.

  6. Stages in the economic globalization of tourism

    DEFF Research Database (Denmark)

    Hjalager, Anne Mette

    2007-01-01

    globalizing process. Outsourcing, transnational ownership structures and investments, cross-border marketing collaborations, the purchase and sale of knowhow, and the free movement of labor are developments not confined to manufacturing alone, but are also highly relevant for the modernization of tourism......There is more to the globalization of tourism than cross-border flows of customers and purchasing power. This paper distinguishes four stages and different manifestations of the globalization of the tourism industry, and shows that it, like many other business systems, is undergoing an irrevocable....... It and media logics are converging, and the scene is global. New policies that proactively include the potentials of its globalization are called for....

  7. Two-stage precipitation of cerium trifluoride

    International Nuclear Information System (INIS)

    Luerkens, D.W.

    1984-04-01

    Cerium was used as a surrogate for plutonium in studies of the solubility and precipitation of the trifluoride salt. Cerium trifluoride was precipitated using a two-stage precipitation system. A series of precipitation experiments were used to identify the significant process variables affecting precipitate characteristics. A mathematical precipitation model was developed which is based on the formation of cerium fluoride complexes. The precipitation model relates all process variables, in a single equation, to a single parameter which can be used to control particle characteristics. 11 references, 9 figures, 8 tables

  8. SEM hot stage sintering of UO2

    International Nuclear Information System (INIS)

    Miller, D.J.

    1976-06-01

    The sintering of hyperstoichiometric uranium dioxide powder compacts, in the hot stage of a scanning electron microscope, was continuously monitored using 16 mm time lapse movies. From alumina microspheres placed on the surface of the compacts, shrinkage measurements were obtained. Converting shrinkage measurements into densification profiles indicates that a maximum densification rate is reached at a critical density, independent of the constant heating rates. At temperatures above 1350 0 C, the movement of the reference microspheres made shrinkage measurements impossible. It is believed the evolution of UO 3 gas from hyperstoichiometric UO 2 is the cause of this limitation

  9. Changes of endocrine and ultrasound markers as ovarian aging in modifying the Stages of Reproductive Aging Workshop (STRAW) staging system with subclassification of mid reproductive age stage.

    Science.gov (United States)

    Ding, Ting; Luo, Aiyue; Jiang, Jingjing; Du, Xiaofang; Yang, Shuhong; Lai, Zhiwen; Shen, Wei; Lu, Yunping; Ma, Ding; Wang, Shixuan

    2013-01-01

    To demonstrate the changes of ovarian aging markers across the Stages of Reproductive Aging Workshop (STRAW) stages and modify it with subclassification of mid reproductive age stage (MR). Healthy females were classified according to the STRAW system. Serum basal FSH, LH, E2, and anti-Müllerian hormone (AMH) were detected, FSH/LH ratio calculated, and antral follicle counts (AFCs) determined in follicular phase. Progression through the whole STRAW stages under MR stage subdivided is associated with elevations in FSH, LH, FSH/LH ratio and decreases in E2, AMH and AFCs (p age in MR stage. 0.982 ng/ml AMH and 3 antral follicles (low level of MR 25-30 years) were set as cutoffs to distinguish MR stage into early mid reproductive age (EMR) and late mid reproductive age (LMR) stages. The women in EMR stage compared with LMR could retrieve more oocytes in IVF treatment (p stage, demonstrating disparate reproductive aging period with reduced ovarian reserve in young age across the STRAW stages.

  10. Intravital Microscopy in Evaluating Patients With Primary Peritoneal, Fallopian Tube, or Stage IA-IV Ovarian Cancer

    Science.gov (United States)

    2017-12-28

    Fallopian Tube Carcinoma; Primary Peritoneal Carcinoma; Stage I Ovarian Cancer; Stage IA Ovarian Cancer; Stage IB Ovarian Cancer; Stage IC Ovarian Cancer; Stage II Ovarian Cancer; Stage IIA Ovarian Cancer; Stage IIB Ovarian Cancer; Stage IIC Ovarian Cancer; Stage III Ovarian Cancer; Stage IIIA Ovarian Cancer; Stage IIIB Ovarian Cancer; Stage IIIC Ovarian Cancer; Stage IV Ovarian Cancer

  11. Ash related behaviour in staged and non-staged combustion of biomass fuels and fuel mixtures

    International Nuclear Information System (INIS)

    Becidan, Michaël; Todorovic, Dusan; Skreiberg, Øyvind; Khalil, Roger A.; Backman, Rainer; Goile, Franziska; Skreiberg, Alexandra; Jovovic, Aleksandar; Sørum, Lars

    2012-01-01

    The fate of selected elements (with focus on the important players in corrosion i.e. Na, K, Pb, Zn, Cl and S) are investigated for three biomasses (wood, demolition wood and coffee waste) and six mixtures of these as pellets both with and without air staging in a laboratory reactor. In order to get a complete overview of the combustion products, both online and offline analytical methods are used. Information is collected about: flue gas composition, particle (fly ash) size distribution and composition, bottom ash composition and melting properties. The main findings are: (1) complex interactions are taking place between the mixed fuels during combustion; (2) the mode of occurrence of an element as well as the overall structure of the fuel are important for speciation; (3) the pelletisation process, by bringing chemical elements into intimate contact, may affect partitioning and speciation; (4) staging and mixing might simultaneously have positive and negative effects on operation; (5) staging affects the governing mechanisms of fly ash (aerosols) formation. -- Highlights: ► Complex interactions are taking place between the mixed fuels during combustion. ► The mode of occurrence of an element as well as the overall structure of the fuel are important for speciation. ► The pelletisation process, by bringing chemical elements into intimate contact, may affect partitioning and speciation. ► Staging and mixing might simultaneously have positive and negative effects on operation. ► Staging affects the governing mechanisms of fly ash (aerosols) formation.

  12. The cost of unresectable stage III or stage IV melanoma in Italy

    Directory of Open Access Journals (Sweden)

    Maio Michele

    2012-11-01

    Full Text Available Abstract Background In recent decades, melanoma incidence has been increasing in European countries; in 2006, there were approximately 60,000 cases leading to 13,000 deaths. Within Europe there is some geographical variation in the incidence of melanoma, with the highest rates reported in Scandinavia (15 cases per 100,000 inhabitants per year and the lowest in the Mediterranean countries (5 to 7 cases per 100,000 inhabitants per year. Methods The present article is based on the information collected in the MELODY study (MELanoma treatment patterns and Outcomes among patients with unresectable stage III or stage IV Disease: a retrospective longitudinal survey. In that study, the medical charts of patients were reviewed to document current treatment patterns and to analyse information on patients, disease characteristics and healthcare resource utilization related to the treatment of advanced melanoma regarding patients who presented with a diagnosis of malignant melanoma (stage I to IV at participating sites between 01 July, 2005 and 30 June, 2006. Results Summarizing, though the length of the follow-up period varies among sample patients, an amount of the yearly cost per patient can be estimated, dividing the average per patient total cost (€ 5.040 by the average follow-up duration (17.5 months and reporting to one year; on these grounds, unresectable stage III or stage IV melanoma in Italy would cost € 3,456 per patient per year.

  13. Assessment of skeletal maturation using mandibular second molar maturation stages.

    Science.gov (United States)

    Goyal, S; Goyal, S; Gugnani, N

    2014-01-01

    To investigate the relationship between cervical vertebrae maturation and mandibular second molar calcification stages. The study was designed as a retrospective, descriptive and crosssectional research project. Pre-treatment lateral cephalograms and panoramic radiographs of 99 males and 110 females in the age range of 7 to 18 years 7 months were evaluated with Demirjian Index (DI) and cervical vertebrae maturation indicators (CVMI) of Hassel and Farman. A null hypothesis was proposed that there is no relation between CVMI and DI. A highly significant association (Pearson's contingency coefficient 0.713 for males and 0.863 for females) was found between DI and CVMI. In males, the DI stage E corresponded to stage 2 of CVMI (pre-peak of pubertal growth spurt) and DI stages F and G corresponded to stages 3 and 4 of CVMI (peak of pubertal growth spurt). DI stage H was associated with stages 5 and 6 of CVMI (end of pubertal growth spurt). In females, the DI stages C, D corresponded to CVMI stages 1, 2; DI stages E, F with CVMI stages 3, 4; DI stages G, H with CVMI stages 5, 6. Mandibular second molar calcification stages can be used as indicators for assessment of skeletal maturity.

  14. Stage-specific predictive models for breast cancer survivability.

    Science.gov (United States)

    Kate, Rohit J; Nadig, Ramya

    2017-01-01

    Survivability rates vary widely among various stages of breast cancer. Although machine learning models built in past to predict breast cancer survivability were given stage as one of the features, they were not trained or evaluated separately for each stage. To investigate whether there are differences in performance of machine learning models trained and evaluated across different stages for predicting breast cancer survivability. Using three different machine learning methods we built models to predict breast cancer survivability separately for each stage and compared them with the traditional joint models built for all the stages. We also evaluated the models separately for each stage and together for all the stages. Our results show that the most suitable model to predict survivability for a specific stage is the model trained for that particular stage. In our experiments, using additional examples of other stages during training did not help, in fact, it made it worse in some cases. The most important features for predicting survivability were also found to be different for different stages. By evaluating the models separately on different stages we found that the performance widely varied across them. We also demonstrate that evaluating predictive models for survivability on all the stages together, as was done in the past, is misleading because it overestimates performance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Oral cancer staging established by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogério Ribeiro de Paiva

    2011-12-01

    Full Text Available The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T, metastasis to regional lymph nodes (N and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05 between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer.

  16. Reliability of cervical vertebral maturation staging.

    Science.gov (United States)

    Rainey, Billie-Jean; Burnside, Girvan; Harrison, Jayne E

    2016-07-01

    Growth and its prediction are important for the success of many orthodontic treatments. The aim of this study was to determine the reliability of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. A group of 20 orthodontic clinicians, inexperienced in CVM staging, was trained to use the improved version of the CVM method for the assessment of mandibular growth with a teaching program. They independently assessed 72 consecutive lateral cephalograms, taken at Liverpool University Dental Hospital, on 2 occasions. The cephalograms were presented in 2 different random orders and interspersed with 11 additional images for standardization. The intraobserver and interobserver agreement values were evaluated using the weighted kappa statistic. The intraobserver and interobserver agreement values were substantial (weighted kappa, 0.6-0.8). The overall intraobserver agreement was 0.70 (SE, 0.01), with average agreement of 89%. The interobserver agreement values were 0.68 (SE, 0.03) for phase 1 and 0.66 (SE, 0.03) for phase 2, with average interobserver agreement of 88%. The intraobserver and interobserver agreement values of classifying the vertebral stages with the CVM method were substantial. These findings demonstrate that this method of CVM classification is reproducible and reliable. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  17. Visualizing the Early Stages of Phagocytosis.

    Science.gov (United States)

    Rashidfarrokhi, Ali; Richina, Veronica; Tafesse, Fikadu G

    2017-02-03

    The mammalian body is equipped with various layers of mechanisms that help to defend itself from pathogen invasions. Professional phagocytes of the immune system - such as neutrophils, dendritic cells, and macrophages - retain the innate ability to detect and clear such invading pathogens through phagocytosis 1 . Phagocytosis involves choreographed events of membrane reorganization and actin remodeling at the cell surface 2 , 3 . Phagocytes successfully internalize and eradicate foreign molecules only when all stages of phagocytosis are fulfilled. These steps include recognition and binding of the pathogen by pattern recognition receptors (PRRs) residing at the cell surface, formation of phagocytic cup through actin-enriched membranous protrusions (pseudopods) to surround the particulate, and scission of the phagosome followed by phagolysosome maturation that results in the killing of the pathogen 3 , 4 . Imaging and quantification of various stages of phagocytosis is instrumental for elucidating the molecular mechanisms of this cellular process. The present manuscript reports methods to study the different phases of phagocytosis. We describe a microscope-based approach to visualize and quantify the binding, phagocytic cup formation, and the internalization of particulate by phagocytes. As phagocytosis occurs when innate receptors on phagocytic cells encounter ligands on a target particle bigger than 0.5 µm, the assays we present here comprise the use of pathogenic fungi Candida albicans and other particulates such as zymosan and IgG-coated beads.

  18. Invasive cervical carcinoma (Stages IB-IIB)

    International Nuclear Information System (INIS)

    Sironi, S.; Zanello, A.; Rodighiero, M.G.; Vanzulli, A.; Del Maschio, A.; Taccagni, G.L.; Belloni, C.

    1991-01-01

    In the patients with invasive cervical carcinoma, the accurate assessment of parametrial invasion greatly affects the therapeutic choice between surgery and radiation therapy. As a matter of fact, surgery is usually performed only in the patients with carcinoma confined to the cervix, whereas those with parametrial involvement, or more advanced stages, are treated with radiation therapy. This prospective study was aimed at investigating the comparative adequecy of CT and MR imaging in assessing parametrial status in the patients with invasive cervical cancer. Twenty-one consecutive patients, with histologic diagnosis of cervical carcinoma, were investigated. All of them were clinically considered as having invasive cervical cancer (FIGO stage IB-IIB) and subsequently underwent surgery. In all cases, detailed histology of the parametrium was obtained. Pathological data were compared with CT and MR findings in all cases. As for assessing parametrial involvement by cancer, CT had 62% accuracy, 63% sensitivity, and 60% specificity, versus MR imaging 81% accuracy, 69% sensitivity, and 80% specificify. Therefore, MR imaging appears to be superior to CT in assessing the parametrial status of patients with invasive cervical carcinoma; the method yields valuable information for treatment planning

  19. Stage 2 carcinoma of the cervix

    International Nuclear Information System (INIS)

    Abayomi, O.

    1990-01-01

    This is a retrospective analysis of the results of 24 patients with bulky stage 2 carcinoma of the cervix treated with full course irradiation followed by adjunctive surgery between 1975 and 1980. A review of the surgical specimens following irradiation showed that 12 patients had no residual cancer, five had only microscopic foci of cancer, and five had extensive residual cancer. Two patients had unresectable persistent cancer. Six patients had histological evidence of lymph node metastases prior to irradiation. The surgical-pathological findings following irradiation had important prognostic implications. All five patients with extensive residual cancer in the surgical specimen recurred, 2 of 5 patients with only microscopic foci of residual cancer and, none of the 12 patients with no residual cancer in the resected specimens developed a recurrence. Lymph node involvement was not associated with an increased incidence of recurrence. Most patients with residual cancer following full course irradiation recurred locally. Thus the addition of adjunctive surgery following full course irradiation did not significantly improve the treatment results of patients with bulky stage 2 carcinoma of the cervix. (author). 14 refs.; 2 figs

  20. Delayed Single Stage Perineal Posterior Urethroplasty

    International Nuclear Information System (INIS)

    Ali, S.; Shahnawaz; Shahzad, I.; Baloch, M. U.

    2015-01-01

    Objective: To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Methodology: Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Results: Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patients age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3 percentage) experienced recurrent stricture during first 10 months. Five (16.6 percentage) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6 percentage) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3 percentage with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Conclusion: Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures. (author)

  1. Two-Stage Modelling Of Random Phenomena

    Science.gov (United States)

    Barańska, Anna

    2015-12-01

    The main objective of this publication was to present a two-stage algorithm of modelling random phenomena, based on multidimensional function modelling, on the example of modelling the real estate market for the purpose of real estate valuation and estimation of model parameters of foundations vertical displacements. The first stage of the presented algorithm includes a selection of a suitable form of the function model. In the classical algorithms, based on function modelling, prediction of the dependent variable is its value obtained directly from the model. The better the model reflects a relationship between the independent variables and their effect on the dependent variable, the more reliable is the model value. In this paper, an algorithm has been proposed which comprises adjustment of the value obtained from the model with a random correction determined from the residuals of the model for these cases which, in a separate analysis, were considered to be the most similar to the object for which we want to model the dependent variable. The effect of applying the developed quantitative procedures for calculating the corrections and qualitative methods to assess the similarity on the final outcome of the prediction and its accuracy, was examined by statistical methods, mainly using appropriate parametric tests of significance. The idea of the presented algorithm has been designed so as to approximate the value of the dependent variable of the studied phenomenon to its value in reality and, at the same time, to have it "smoothed out" by a well fitted modelling function.

  2. Concept of white light in stage lighting

    Science.gov (United States)

    Rinaldi, Mauricio R.

    2002-06-01

    In perceiving objects, generally we see them in a white light situation. But, actually, there is not an absolute white, in such a manner that the different light sources have a determined kind of white, what it is known as color temperature. Even the white light may be of different kinds (different color temperature), the individual mind tends to perceive it as the same kind of white, that is to say, there is in our mind a psychological function by which we operate an integration in the perception in order to do the object perceptually invariable. On the other hand, it is a common practice in stage lighting to use color light sources. It is a well known phenomenon that a color of light produces a change in the object color perception. However, when we go to theater, we see the objects as having their real color, even if the lighting is not white. In this paper the concept of white light in stage lighting is presented, showing its possibilities of aesthetical expression.

  3. CT in the staging of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    McLoud, T.C.; Kosiuk, J.P.; Templeton, P.A.; Shepard, J.O.; Moore, E.H.; Mathisen, D.J.; Wain, J.C.; Grillo, H.C.

    1989-01-01

    The authors previously presented a study of the accuracy of CT in the staging of bronchogenic carcinoma by means of correlative lymph node mapping and sampling in 85 patients. This study has now been extended to include 143 patients. Abnormal nodes (greater than or equal to 1 cm) were localized according to the ATS classification of regional lymph node mapping. One hundred thirty-eight patients underwent mediastinoscopy and 116, thoracotomy. In each case, lymph node groups 2R, 4R, 2L, 4L (paratracheal), 7 (subcarinal), and 5 (aorticopulmonary) underwent biopsy on the appropriate sides. Hilar nodes were resected with the surgical specimen. A total of 554 nodes were sampled. Overall sensitivity of CT for all the lymph node groups was similar to the previous study and was 40.5% with a specificity of 84.2%. Sensitivity was highest for group 5 (83%), and lowest for the subcarinal area (25%) (group 7). Specificity ranged from 71% for 10R hilar nodes to 90% for the subcarinal nodes. The positive predictive value was 34% and the negative predictive value was 87%. This study corroborates the authors' previous results and shows that when careful correlation of individual lymph nodes groups identified on CT is done with those sampled at surgery, the accuracy of CT in staging bronchogenic carcinoma is limited

  4. Mingle with Teachers in Physics on Stage

    CERN Multimedia

    2000-01-01

    'Physics on Stage' is an international festival where 450 physics educators from 22 European countries will gather at CERN from 6 to 10 November to show how fascinating and entertaining physics can be. In a week-long event innovative methods of teaching physics and demonstrations of the fun that lies in physics will be presented in a fair, in spectacular performances, and presentations. The performances of Physics on Stage will be held in the Amphitheatre but unfortunately the seats will be all taken by the delegates. However, a live transmission will be organised so CERN staff can watch the event on screen in the following locations: For Monday 6 November in the LHC Amphitheatre all day. For Tuesday 7 November in the LHC Amphitheatre and the SL Amphitheatre. For Wednesday 8 November in the LHC and PS Amphitheatres. For Thursday 9 November in the LHC and SL and after 12.00 in the PS Amphitheatre too. Because of the event the main restaurant will be closed on Thursday 9 November after 14.00. So plan you...

  5. The stages of modernism in Serbian music

    Directory of Open Access Journals (Sweden)

    Milin Melita

    2006-01-01

    Full Text Available In order to consider this topic, it was first necessary to discuss certain problems of terminology and periodisation relating to musical modernism in general. It is already familiar the extent to which the terms "new music", "modernist", "contemporary" and "avant-garde" music have been used interchangeably, as synonyms. For this reason, it was first important to outline the period of musical modernism as almost generally accepted, which is regarded as an epoch comprising three different periods: (I period of early modernism (1890–1918, announced by a break with later romanticism and a turn towards French Impressionism, Austro-German Expressionism and Russian "folkloric Expressionism"; (II period of "classical modernism"(1919–1945 that witnessed a diffusion of neo-classicism and serialism; (III period of "high modernism" (1946–1972 characterized by highly experimental compositional techniques such as integral serialism and aleatoricism. In relation to this, avant-garde movements are seen as radically innovative and subversive tendencies within this modernist epoch, and while certain postmodernist ideas can be recognized as early as the 1950s, postmodernism as a movement hadn’t gained its full potency until the 1970s. Since then, it has assumed different forms of existence as well as having assimilated a continued form of ‘modernist project’. The second part of the article proposes a periodisation of Serbian musical modernism, which is divided into four stages. The first stage (1908–1945 was a period where elements of Impressionism and German expressionism were creatively introduced into the works of several leading composers (Petar Konjović, Stevan Hristić, Miloje Milojević, Josip Slavenski, Marko Tajčević. The second stage (1929–1945 was marked by a group of composers who studied in Prague and assimilated certain progressive compositional techniques such as free tonality, atonality dodecaphony, microtonality and athematicism

  6. Comparison of single-stage and temperature-phased two-stage anaerobic digestion of oily food waste

    International Nuclear Information System (INIS)

    Wu, Li-Jie; Kobayashi, Takuro; Li, Yu-You; Xu, Kai-Qin

    2015-01-01

    Highlights: • A single-stage and two two-stage anaerobic systems were synchronously operated. • Similar methane production 0.44 L/g VS added from oily food waste was achieved. • The first stage of the two-stage process became inefficient due to serious pH drop. • Recycle favored the hythan production in the two-stage digestion. • The conversion of unsaturated fatty acids was enhanced by recycle introduction. - Abstract: Anaerobic digestion is an effective technology to recover energy from oily food waste. A single-stage system and temperature-phased two-stage systems with and without recycle for anaerobic digestion of oily food waste were constructed to compare the operation performances. The synchronous operation indicated the similar ability to produce methane in the three systems, with a methane yield of 0.44 L/g VS added . The pH drop to less than 4.0 in the first stage of two-stage system without recycle resulted in poor hydrolysis, and methane or hydrogen was not produced in this stage. Alkalinity supplement from the second stage of two-stage system with recycle improved pH in the first stage to 5.4. Consequently, 35.3% of the particulate COD in the influent was reduced in the first stage of two-stage system with recycle according to a COD mass balance, and hydrogen was produced with a percentage of 31.7%, accordingly. Similar solids and organic matter were removed in the single-stage system and two-stage system without recycle. More lipid degradation and the conversion of long-chain fatty acids were achieved in the single-stage system. Recycling was proved to be effective in promoting the conversion of unsaturated long-chain fatty acids into saturated fatty acids in the two-stage system.

  7. Two-Stage Adaptive Optimal Design with Fixed First-Stage Sample Size

    Directory of Open Access Journals (Sweden)

    Adam Lane

    2012-01-01

    Full Text Available In adaptive optimal procedures, the design at each stage is an estimate of the optimal design based on all previous data. Asymptotics for regular models with fixed number of stages are straightforward if one assumes the sample size of each stage goes to infinity with the overall sample size. However, it is not uncommon for a small pilot study of fixed size to be followed by a much larger experiment. We study the large sample behavior of such studies. For simplicity, we assume a nonlinear regression model with normal errors. We show that the distribution of the maximum likelihood estimates converges to a scale mixture family of normal random variables. Then, for a one parameter exponential mean function we derive the asymptotic distribution of the maximum likelihood estimate explicitly and present a simulation to compare the characteristics of this asymptotic distribution with some commonly used alternatives.

  8. A proposed staging system and stage-specific interventions for familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Lynch, Patrick M; Morris, Jeffrey S; Wen, Sijin

    2016-01-01

    BACKGROUND: It is not possible to accurately count adenomas in many patients with familial adenomatous polyposis (FAP). Nevertheless, polyp counts are critical in evaluating each patient's response to interventions. However, the U.S. Food and Drug Administration no longer recognizes the decrease...... classification scheme for lower GI tract polyposis. METHODS: Twenty-four colonoscopy or sigmoidoscopy videos were reviewed by 26 clinicians familiar with diagnosis and treatment of FAP. The reviewers independently assigned a stage to a case using the proposed system and chose a stage-specific intervention...... in the review of individual cases of polyposis. Therefore, reliable and clinically relevant means for measuring trial outcomes can be developed. Outlier cases showing wide scatter in stage assignment call for individualized attention and may be inappropriate for enrollment in clinical trials for this reason....

  9. Health insurance and stage at diagnosis of laryngeal cancer: does insurance type predict stage at diagnosis?

    Science.gov (United States)

    Chen, Amy Y; Schrag, Nicole M; Halpern, Michael; Stewart, Andrew; Ward, Elizabeth M

    2007-08-01

    To examine whether patients with no insurance or Medicaid are more likely to present with advanced-stage laryngeal cancer. Retrospective cohort study from the National Cancer Database, 1996-2003. Hospital-based practice. Patients with known insurance status diagnosed as having invasive laryngeal cancer at Commission on Cancer facilities (N = 61 131) were included. Adjusted and unadjusted logistic regression models analyzed the likelihood of presenting at a more advanced stage. Overall stage of laryngeal cancer (early vs advanced) and tumor size (T stage) at diagnosis. Patients with advanced-stage laryngeal cancer at diagnosis were more likely to be uninsured (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.79-2.15) or covered by Medicaid (OR, 2.40; 95% CI, 2.21-2.61) compared with those with private insurance. Similarly, patients were most likely to present with the largest tumors (T4 disease) if they were uninsured (OR, 2.92; 95% CI, 2.60-3.28) or covered by Medicaid (OR, 3.97; 95% CI, 3.56-4.34). Patients who were black, between ages 18 and 56 years, and who resided in zip codes with low proportions of high school graduates or low median household incomes were also more likely to be diagnosed as having advanced disease and/or larger tumors. Individuals lacking insurance or having Medicaid are at greatest risk for presenting with advanced laryngeal cancer. Results for the Medicaid group may be influenced by the postdiagnosis enrollment of uninsured patients. It is important to consider the impact of insurance coverage on stage at diagnosis and associated morbidity, mortality, quality of life, and costs.

  10. A Novel Inflammation-Based Stage (I Stage Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Jian-Pei Li

    2016-11-01

    Full Text Available Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS, modified GPS (mGPS and C-reactive protein/Albumin (CRP/Alb ratio, platelet–lymphocyte ratio (PLR, and neutrophil–lymphocyte ratio (NLR, have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC. In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR. The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03 and PLR (>146.2 were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves analyzed by receiver operating characteristics (ROC curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR = 2.093; 95% Confidence interval (CI: 1.222–3.587; p = 0.007 and PLR (HR: 2.003; 95% CI: 1.177–3.410; p = 0.010 were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively (p < 0.001. The I stage had a higher area under the curve value (0.670 compared with other systemic inflammation

  11. [Complications of surgical stage of treatment in patients with cancer of cervix uteri stage IIB].

    Science.gov (United States)

    Kryzhanivs'ka, A Ie

    2013-11-01

    The results of treatment of 127 patients, suffering cervix uteri cancer stage IIB in period of 1998 - 2012 yrs, were analyzed. Complications of surgical stage of the combined treatment have had occurred in 40.9% patients, including 40.5% patients, to whom neoadjuvant chemotherapy was conducted and in 41.5%--radiation therapy (RTH). The main postoperative complications--retroperitoneal lymphatic cysts--were revealed in 35.4% patients. The factors, raising the risk of postoperative complications occurrence, are following: the primary tumor spreading, metastatic affection of lymphatic nodes of pelvic cavity, preoperative conduction of RTH or chemotherapy.

  12. Upper Stage Engine Composite Nozzle Extensions

    Science.gov (United States)

    Valentine, Peter G.; Allen, Lee R.; Gradl, Paul R.; Greene, Sandra E.; Sullivan, Brian J.; Weller, Leslie J.; Koenig, John R.; Cuneo, Jacques C.; Thompson, James; Brown, Aaron; hide

    2015-01-01

    Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and United States Air Force (USAF) requirements, as well as broader industry needs. Recent and on-going efforts at the Marshall Space Flight Center (MSFC) are aimed at both (a) further developing the technology and databases for nozzle extensions fabricated from specific CC materials, and (b) developing and demonstrating low-cost capabilities for testing composite nozzle extensions. At present, materials development work is concentrating on developing a database for lyocell-based C-C that can be used for upper stage engine nozzle extension design, modeling, and analysis efforts. Lyocell-based C-C behaves in a manner similar to rayon-based CC, but does not have the environmental issues associated with the use of rayon. Future work will also further investigate technology and database gaps and needs for more-established polyacrylonitrile- (PAN-) based C-C's. As a low-cost means of being able to rapidly test and screen nozzle extension materials and structures, MSFC has recently established and demonstrated a test rig at MSFC's Test Stand (TS) 115 for testing subscale nozzle extensions with 3.5-inch inside diameters at the attachment plane. Test durations of up to 120 seconds have been demonstrated using oxygen/hydrogen propellants. Other propellant combinations, including the use of hydrocarbon fuels, can be used if desired. Another test capability being developed will allow the testing of larger nozzle extensions (13.5- inch inside diameters at the attachment plane) in environments more similar to those of actual oxygen/hydrogen upper stage engines. Two C-C nozzle extensions (one lyocell-based, one PAN-based) have been fabricated for testing with the larger

  13. Two-stage unilateral versus one-stage bilateral single-port sympathectomy for palmar and axillary hyperhidrosis†

    Science.gov (United States)

    Ibrahim, Mohsen; Menna, Cecilia; Andreetti, Claudio; Ciccone, Anna Maria; D'Andrilli, Antonio; Maurizi, Giulio; Poggi, Camilla; Vanni, Camilla; Venuta, Federico; Rendina, Erino Angelo

    2013-01-01

    OBJECTIVES Video-assisted thoracoscopic sympathectomy is currently the best treatment for palmar and axillary hyperhidrosis. It can be performed through either one or two stages of surgery. This study aimed to evaluate the operative and postoperative results of two-stage unilateral vs one-stage bilateral thoracoscopic sympathectomy. METHODS From November 1995 to February 2011, 270 patients with severe palmar and/or axillary hyperhidrosis were recruited for this study. One hundred and thirty patients received one-stage bilateral, single-port video-assisted thoracoscopic sympathectomy (one-stage group) and 140, two-stage unilateral, single-port video-assisted thoracoscopic sympathectomy, with a mean time interval of 4 months between the procedures (two-stage group). RESULTS The mean postoperative follow-up period was 12.5 (range: 1–24 months). After surgery, hands and axillae of all patients were dry and warm. Sixteen (12%) patients of the one-stage group and 15 (11%) of the two-stage group suffered from mild/moderate pain (P = 0.8482). The mean operative time was 38 ± 5 min in the one-stage group and 39 ± 8 min in the two-stage group (P = 0.199). Pneumothorax occurred in 8 (6%) patients of the one-stage group and in 11 (8%) of the two-stage group. Compensatory sweating occurred in 25 (19%) patients of the one-stage group and in 6 (4%) of the two-stage group (P = 0.0001). No patients developed Horner's syndrome. CONCLUSIONS Both two-stage unilateral and one-stage bilateral single-port video-assisted thoracoscopic sympathectomies are effective, safe and minimally invasive procedures. Two-stage unilateral sympathectomy can be performed with a lower occurrence of compensatory sweating, improving permanently the quality of life in patients with palmar and axillary hyperhidrosis. PMID:23442937

  14. Autobiographic Performance. Intimacy as a Stage Practice

    Directory of Open Access Journals (Sweden)

    Josefina Alcázar

    2015-11-01

    Full Text Available This essay analyses performance as an expression of the age of intimacy, an age we are currently living through, where self-representation takes on a multiplicity and heterogeneity of registers and strategies. In autobiographic performance the boundary between the public and the private becomes blurred, which is expressive of the transformation of contemporary subjectivity, a search of the experience of living, and an urge to publicise intimacy. It is based on everyday life, the smaller things, not the important issues but the occurrence of the usual as it happens day by day. Performance, or action art, is an art of the self which is framed within this context of revealing one’s intimacy; and this is what makes it akin to several forms of searching for identity and self-knowledge, in which artists put their own subjectivity up on the stage.

  15. Imaging and staging of haemophilic arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Jelbert, A.; Vaidya, S. [Radiology Department, Barts and The London NHS trust, London (United Kingdom); Fotiadis, N., E-mail: nicos.fotiadis@bartsandthelondon.nhs.u [Radiology Department, Barts and The London NHS trust, London (United Kingdom)

    2009-11-15

    Arthropathy is one of the most disabling consequences of haemophilia. The management of this condition has been revolutionized by the introduction of prophylactic treatment with clotting factor replacements. In order for benefits of this treatment to be monitored, the severity of any joint disease needs to be accurately assessed. Diagnostic imaging is used to objectively evaluate haemophilic arthropathy (HA). There are several established scoring systems for grading HA based on conventional radiography and magnetic resonance imaging (MRI). In this review the role of the different imaging methods in the evaluation of HA are discussed, the established staging systems are presented, and an explanation of why MRI is becoming the primary method of joint imaging in HA is provided.

  16. Multiple Imputation in Three or More Stages.

    Science.gov (United States)

    McGinniss, J; Harel, O

    2016-09-01

    Missing values present challenges in the analysis of data across many areas of research. Handling incomplete data incorrectly can lead to bias, over-confident intervals, and inaccurate inferences. One principled method of handling incomplete data is multiple imputation. This article considers incomplete data in which values are missing for three or more qualitatively different reasons and applies a modified multiple imputation framework in the analysis of that data. Included are a proof of the methodology used for three-stage multiple imputation with its limiting distribution, an extension to more than three types of missing values, an extension to the ignorability assumption with proof, and simulations demonstrating that the estimator is unbiased and efficient under the ignorability assumption.

  17. Breakeven Fusion in Staged Z Pinch

    Science.gov (United States)

    Rahman, Hafiz; Ney, Paul; Rostoker, Norman; Wessel, Frank

    2008-03-01

    We are studying the prospect for breakeven thermonuclear fusion considering a Mega joule (MJ) class, 100 ns, impulse generator using a modified version of MACH2, a 2-1/2 D, radiation-code. The load is a cylindrical, xenon plasma shell that implodes radially onto a co-axial, deuterium-tritium plasma target. Optimized plasma density and pinch radius lead to a fusion-energy output that is many times the stored capacitor bank energy. In this ``Staged Z-pinch'' shock fronts form that preheat the DT plasma to several hundred eV, before adiabatic compression. During compression, the Xe liner becomes Rayleigh-Taylor (RT) unstable while the DT target remains stable. Proper selection of the initial pinch radius and plasma density is crucial for optimum implosion efficiency.

  18. Nuclear Cryogenic Propulsion Stage for Mars Exploration

    Science.gov (United States)

    Houts, M. G.; Borowski, S. K.; George, J. A.; Kim, T.; Emrich, W. J.; Hickman, R. R.; Broadway, J. W.; Gerrish, H. P.; Adams, R. B.

    2012-01-01

    The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progress made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP).

  19. Atherosclerosis staging: imaging using FLIM technique

    Science.gov (United States)

    Sicchieri, Leticia B.; Barioni, Marina Berardi; Silva, Mônica Nascimento; Monteiro, Andrea Moreira; Figueiredo Neto, Antonio Martins; Ito, Amando S.; Courrol, Lilia C.

    2014-03-01

    In this work it was used fluorescence lifetime imaging (FLIM) to analyze biochemical composition of atherosclerotic plaque. For this purpose an animal experimentation was done with New Zealand rabbits divided into two groups: a control group of 4 rabbits that received a regular diet for 0, 20, 40 and 60 days; and an experimental group of 9 rabbits, divided in 3 subgroups, that were fed with 1% cholesterol diet for 20, 40 and 60 days respectively. The aortas slices stained with europium chlortetracycline were analyzed by FLIM exciting samples at 440 nm. The results shown an increase in the lifetime imaging of rabbits fed with cholesterol. It was observed that is possible to detect the metabolic changes associated with atherosclerosis at an early stage using FLIM technique exciting the tissue around 440 nm and observing autofluorescence lifetime. Lifetimes longer than 1.75 ns suggest the presence of porphyrins in the tissue and consequently, inflammation and the presence of macrophages.

  20. STAGES OF A STRATEGIC MANAGEMENT MODEL

    Directory of Open Access Journals (Sweden)

    Mihaela – Lavinia CIOBANICA

    2014-06-01

    Full Text Available In the literature dedicated to strategic management there is no unitary vision of the authors regarding the sequence of actions that give content to the respective process and what their stages are. With all existing differences, the visions of different authors nevertheless observe the unitary logic of developing a series of actions. These actions begin with the competitive environment analysis in which the organization operates and with the establishment of its strategic mission and they end with the performance evaluation after the strategy has been applied and, if appropriate, with the reconsidering of this strategy and the making of the necessary corrections to it. Such a basic structure of the process is adopted in most organizations that practice the strategic management. But noticeable differences appear in the degree of the formalization of the process and in the involvement of different managerial levels in the designing and detailing of its components.

  1. Nuclear Cryogenic Propulsion Stage Affordable Development Strategy

    Science.gov (United States)

    Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.

    2014-01-01

    The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.

  2. Imaging and staging of haemophilic arthropathy

    International Nuclear Information System (INIS)

    Jelbert, A.; Vaidya, S.; Fotiadis, N.

    2009-01-01

    Arthropathy is one of the most disabling consequences of haemophilia. The management of this condition has been revolutionized by the introduction of prophylactic treatment with clotting factor replacements. In order for benefits of this treatment to be monitored, the severity of any joint disease needs to be accurately assessed. Diagnostic imaging is used to objectively evaluate haemophilic arthropathy (HA). There are several established scoring systems for grading HA based on conventional radiography and magnetic resonance imaging (MRI). In this review the role of the different imaging methods in the evaluation of HA are discussed, the established staging systems are presented, and an explanation of why MRI is becoming the primary method of joint imaging in HA is provided.

  3. Staging as a Methodological Tool for Anthropology

    Directory of Open Access Journals (Sweden)

    Miren Urquijo

    2017-12-01

    Full Text Available My theatrical background has conditioned my approach to anthropology. This dramaturgical focus in the study of social life has encouraged the articulation of my theatrical and anthropological experience in staging. This paper explains how and why this is a valid tool for anthropology and for the performative study of the gender system, the assessment of the role of normativity and social structure in its representation. I have experimented with and expressed the process of constructing a dramaturgical and anthropological logic as an autobiographical exercise. The social theories which have influenced me include dynamic situationism, dynamic interactionism and constructivist theories which address the body as social fiction. With all of this, I have elaborated an interpretative strategy for the description, analysis and perception of reality. Publishing it means sharing it and submitting it to evaluation.

  4. Coexistence of competing stage-structured populations.

    KAUST Repository

    Fujiwara, Masami

    2011-10-05

    This paper analyzes the stability of a coexistence equilibrium point of a model for competition between two stage-structured populations. In this model, for each population, competition for resources may affect any one of the following population parameters: reproduction, juvenile survival, maturation rate, or adult survival. The results show that the competitive strength of a population is affected by (1) the ratio of the population parameter influenced by competition under no resource limitation (maximum compensatory capacity) over the same parameter under a resource limitation due to competition (equilibrium rate) and (2) the ratio of interspecific competition over intraspecific competition; this ratio was previously shown to depend on resource-use overlap. The former ratio, which we define as fitness, can be equalized by adjusting organisms\\' life history strategies, thereby promoting coexistence. We conclude that in addition to niche differentiation among populations, the life history strategies of organisms play an important role in coexistence.

  5. Staging constructions of authenticity in organizational change

    DEFF Research Database (Denmark)

    Dupret, Katia

    2018-01-01

    that are emotionally charged. Through a socio-material perspective this paper seeks to explore how change processes in organizations challenges the idea of authentic leadership as a merely individual ability or personality trait and suggest that the authentic leader is distributed into the practices of change......Authenticity in organizations has gained increased focus in recent years. Authentic management and leadership are ways to motivate and make sustainable changes in the organization. But authenticity is also strategically worked with in order to serve social and political functions....... The paper explores how staged organizational change where authentic role-play and scripts from everyday life combined with meta-reflection and feedback construct new forms of reflection where its ethical side-effects should be discussed....

  6. Integrated Solar Upper Stage Technical Support

    Science.gov (United States)

    Jaworske, Donald A.

    1998-01-01

    NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test

  7. Stages of educational development? Beeby revisited

    Science.gov (United States)

    Guthrie, Gerard

    1980-12-01

    Beeby's model of stages of educational change in developing countries has been accepted into the educational literature with remarkably little critical analysis. Though valuable for a large number of experiential insights, the author argues that the model has certain weaknesses which should restrict its application. The stages have a teleological bias and are not sufficiently distinct, nor do the labels used for them meet the formal requirements of measuring scales. Furthermore, the model overgeneralizes from the experience of British-tradition South Pacific school systems, and the equation of western teaching with good teaching is an unsupported view which may not be valid in many countries. The most fundamental problem is the lack of clear distinction between empirical issues and the ethical judgements implicit in the formulation. However, the model has a number of positive features well worth building upon, such as its focus on the qualitative aspects of teaching and on qualitative change, the realistic emphasis on the gradualism of such change in practice, and the identification of the teacher as the key change agent in the classroom — a fundamental point often overlooked by innovators. The continua of general and professional education which underlie the teaching styles provide useful hypotheses for empirical analysis of the relationship between teacher education and classroom teaching style, but the association of this education with certain types of teaching style needs careful examination. Stripped of its evaluative connotations, Beeby's interest in qualitative change was a valuable early attempt to move attention in developing countries from linear, quantitative expansion of existing systems to a consideration of what was actually being taught and how. The real lesson to be learned from his work is that education should be paying closer attention to its theoretical propositions.

  8. Staging colorectal cancer with the TNM 7(th)

    DEFF Research Database (Denmark)

    Puppa, Giacomo; Poston, Graeme; Jess, Per

    2013-01-01

    lesions encountered, in particular, during radiological staging of patients with colorectal cancer. In this article the diagnosis of these lesions with multiple imaging modalities, their frequency, significance and relevance to staging and disease management are described in a multidisciplinary way...

  9. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC....... METHODS: We randomly assigned patients who were referred for preoperative staging of NSCLC to either conventional staging plus PET-CT or conventional staging alone. Patients were followed until death or for at least 12 months. The primary end point was the number of futile thoracotomies, defined as any...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

  10. NLV Upper Stage Development and Flight Testing, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The technical innovation proposed here is the design during Phase I of a high performance upper stage for a two-stage "20 / 450" Nanosat Launch Vehicle (NLV) that is...

  11. Composite likelihood and two-stage estimation in family studies

    DEFF Research Database (Denmark)

    Andersen, Elisabeth Anne Wreford

    2002-01-01

    Composite likelihood; Two-stage estimation; Family studies; Copula; Optimal weights; All possible pairs......Composite likelihood; Two-stage estimation; Family studies; Copula; Optimal weights; All possible pairs...

  12. Ages and Career Stages: Considerations in Providing Support for Mid-Late Career Stage Doctoral Students

    Science.gov (United States)

    Robertson, Margaret J.

    2017-01-01

    This article raises two inter-related issues: firstly there is a correlation between the needs of doctoral students that are strongly related to age and career stage; and secondly, because these needs differ according to their demographic, the current discourse of developing work-readiness skills of doctoral students is misplaced for the growing…

  13. One-stage and two-stage penile buccal mucosa urethroplasty

    African Journals Online (AJOL)

    G. Barbagli

    2015-12-02

    Dec 2, 2015 ... there also seems to be a trend of decreasing urethritis and an increase of instrumentation and catheter related strictures in these countries as well [4–6]. The repair of penile urethral strictures may require one- or two- stage urethroplasty [7–10]. Certainly, sexual function can be placed at risk by any surgery ...

  14. [Feedback of ultrasound and RMI in the staging of endometrial carcinoma in early stage].

    Science.gov (United States)

    Buhler, J; Routiot, T; Polet-Lefebvre, K; Morel, O

    2015-04-01

    Endometrial cancer is the most common gynecological cancer in France. The therapeutic management is based on preoperative staging. The recommended imaging examination remains the MRI. This is to evaluate ultrasound and MRI in the staging for localized cancers. This is a retrospective observational study, conducted from July 2012 to July 2014, at the University Hospital of Nancy, on all patients care for endometrial cancer stage I, who underwent a pelvic ultrasound and MRI for the assessment of myometrial infiltration. Twenty-nine patients were included with a mean age of 69 years and a BMI of 30 kg/m(2). Using ultrasound, we have a sensitivity of 58%, a specificity of 100%, a positive predictive value (PPV) of 100%, a negative predictive value (NPV) of 70% and an accuracy of 75%. Using MRI, we have a sensitivity of 83%, a specificity of 100%, a PPV of 83%, a VPN of 88%, and an accuracy of 86%. Transvaginal sonography should be performed before post-menopausal bleeding. It remains possible in the staging of localized cancers. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Applying artificial intelligence to disease staging: Deep learning for improved staging of diabetic retinopathy.

    Directory of Open Access Journals (Sweden)

    Hidenori Takahashi

    Full Text Available Disease staging involves the assessment of disease severity or progression and is used for treatment selection. In diabetic retinopathy, disease staging using a wide area is more desirable than that using a limited area. We investigated if deep learning artificial intelligence (AI could be used to grade diabetic retinopathy and determine treatment and prognosis.The retrospective study analyzed 9,939 posterior pole photographs of 2,740 patients with diabetes. Nonmydriatic 45° field color fundus photographs were taken of four fields in each eye annually at Jichi Medical University between May 2011 and June 2015. A modified fully randomly initialized GoogLeNet deep learning neural network was trained on 95% of the photographs using manual modified Davis grading of three additional adjacent photographs. We graded 4,709 of the 9,939 posterior pole fundus photographs using real prognoses. In addition, 95% of the photographs were learned by the modified GoogLeNet. Main outcome measures were prevalence and bias-adjusted Fleiss' kappa (PABAK of AI staging of the remaining 5% of the photographs.The PABAK to modified Davis grading was 0.64 (accuracy, 81%; correct answer in 402 of 496 photographs. The PABAK to real prognosis grading was 0.37 (accuracy, 96%.We propose a novel AI disease-staging system for grading diabetic retinopathy that involves a retinal area not typically visualized on fundoscopy and another AI that directly suggests treatments and determines prognoses.

  16. On the robustness of two-stage estimators

    KAUST Repository

    Zhelonkin, Mikhail

    2012-04-01

    The aim of this note is to provide a general framework for the analysis of the robustness properties of a broad class of two-stage models. We derive the influence function, the change-of-variance function, and the asymptotic variance of a general two-stage M-estimator, and provide their interpretations. We illustrate our results in the case of the two-stage maximum likelihood estimator and the two-stage least squares estimator. © 2011.

  17. Cognitive phenotypes of sequential staging in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Lulé, Dorothée; Böhm, Sarah; Müller, Hans-Peter; Aho-Özhan, Helena; Keller, Jürgen; Gorges, Martin; Loose, Markus; Weishaupt, Jochen H; Uttner, Ingo; Pinkhardt, Elmar; Kassubek, Jan; Del Tredici, Kelly; Braak, Heiko; Abrahams, Sharon; Ludolph, Albert C

    2018-04-01

    Sequential spread of TDP-43 load in the brain may be a pathological characteristic of amyotrophic lateral sclerosis (ALS). Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) based marker of this pathological feature. Cognitive deficits known to be present in a subset of ALS patients might act as an additional in vivo clinical marker of disease spread. N = 139 patients with ALS were tested with the Edinburgh Cognitive and Behavioural ALS screen (ECAS) in addition to DTI brain measures of pathological spread. Executive function, memory and disinhibited behaviour were selected for Cognitive-Staging criteria, as these cognitive functions are attributed to cerebral areas analogous to the pattern of MRI markers of TDP-43 pathology. ROC curve analyses were performed to define cut-off scores for cognitive stages 2 (executive function), stage 3 (disinhibited behaviour) and stage 4 (memory), and staging was performed according to the cognitive profile subsequently. Associations of Cognitive-Staging (stage 2-4) and MRI-Staging measures were determined. In total, 77 patients (55%) performed below ROC cut-off scores in either executive function or memory or both and/or were reported to have disinhibited behaviour which permitted Cognitive-Staging. The cognitive profile of patients with discrete MRI stages 2-4 correlated significantly with DTI parameters. For those patients with cognitive impairment, there was a high congruency between MRI and Cognitive-Staging with high specificity and sensitivity of executive functions for MRI stage 2, disinhibited behaviour for MRI stage 3 and moderate of memory for MRI stage 4. Cognitive impairment follows specific patterns in ALS and these patterns can be used for Cognitive-Staging with a high specificity compared to MRI-Staging. For the individual, cognitive screening is a fast and easy to apply measurement of cerebral function giving valuable information in a clinical context. Copyright © 2018 Elsevier Ltd. All

  18. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  19. ALGORITHM OF STAGE DEFINITION OF THE ORGANIZATION’S LIFECYCLE

    OpenAIRE

    Ratibor I. Sekirov

    2013-01-01

    Problem of the definition of a current stage of the lifecycle of an organization in practice is considered in the article. The purpose of this research is a development of the algorithm of stage definition of the organization’s lifecycle. The existing approaches to the stage definition of the lifecycle of the organization are considered. As a result of the research the optimal algorithm for stage definition of the organization’s lifecycle was developed.

  20. Iterative learning control for synchronization of reticle stage and wafer stage in step-and-scan lithographic equipment

    Science.gov (United States)

    Li, Lan-lan; Hu, Song; Zhao, Li-xin; Ma, Ping

    2013-08-01

    Lithographic equipments are highly complex machines used to manufacture integrated circuits (ICs). To make larger ICs, a larger lens is required, which, however, is prohibitively expensive. The solution to this problem is to expose a chip not in one flash but in a scanning fashion. For step-and-scan lithographic equipment (wafer scanner), the image quality is decided by many factors, in which synchronization of reticle stage and wafer stage during exposure is a key one. In this paper, the principle of reticle stage and wafer stage was analyzed through investigating the structure of scanners, firstly. While scanning, the reticle stage and wafer stage should scan simultaneously at a high speed and the speed ratio is 1:4. Secondly, an iterative learning controller (ILC) for synchronization of reticle stage and wafer stage is presented. In the controller, a master-slave structure is used, with the wafer stage acting as the master, and the reticle stage as the slave. Since the scanning process of scanner is repetitive, ILC is used to improve tracking performance. A simple design procedure is presented which allows design of the ILC system for the reticle stage and wafer stage independently. Finally, performance of the algorithm is illustrated by simulated on the virtual stages (the reticle stage and wafer stage).The results of simulation experiments and theory analyzing demonstrate that using the proposed controller better synchronization performance can be obtained for the reticle stage and wafer stage in scanner. Theory analysis and experiment shows the method is reasonable and efficient.

  1. Interactive Tailored Website to Promote Sun Protection and Skin Self-Check Behaviors in Patients With Stage 0-III Melanoma

    Science.gov (United States)

    2017-11-15

    Stage 0 Skin Melanoma; Stage I Skin Melanoma; Stage IA Skin Melanoma; Stage IB Skin Melanoma; Stage II Skin Melanoma; Stage IIA Skin Melanoma; Stage IIB Skin Melanoma; Stage IIC Skin Melanoma; Stage III Skin Melanoma; Stage IIIA Skin Melanoma; Stage IIIB Skin Melanoma; Stage IIIC Skin Melanoma

  2. Posterior tibial tendon insufficiency results at different stages.

    Science.gov (United States)

    Deland, Jonathan T; Page, Alexandra; Sung, Il-Hoon; O'Malley, Martin J; Inda, David; Choung, Steven

    2006-09-01

    The results of surgical treatment of posterior tibial tendon insufficiency (PTTI) may be different at different stages of the disease. No single study has compared the results at different stages. This comparison can be helpful to the patient and physician if the patient asks "What if I wait and the disease progresses, how will my results be different?" A preliminary study comparing results for stage IIa, stage IIb (advanced stage II), and stage III was performed followed by a larger study comparing IIa and IIb with 26 and 22 patients, respectively. American Orthopaedic Foot and Ankle Society (AOFAS) outcome scores as well as radiographs and functional questions were used. Nearly all patients, regardless of stage, felt they were helped by surgical treatment. However, the lowest AOFAS score was in stage III, the most advanced stage investigated in this study. In comparing stage IIa and IIb patients, stage IIb patients had a statistically higher incidence of lateral discomfort. Although statistically significant differences were not found in all comparisons, this study suggests that the results of surgical treatment for PTTI declines with increasing stage or severity of disease.

  3. Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer

    Science.gov (United States)

    ... the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian ... into stage IIA and stage IIB. Stage IIA : Cancer has spread from where it first formed to the uterus and/or the fallopian tubes and/or the ...

  4. Clinical staging of major depressive disorder: an empirical exploration

    NARCIS (Netherlands)

    Verduijn, J.; Milaneschi, Y.; van Hemert, A.M.; Schoevers, R.A.; Hickie, I.B.; Penninx, B.W.J.H.; Beekman, A.T.F.

    2015-01-01

    Objective: Clinical staging has been proposed to supplement psychiatric diagnoses. We examined the construct and predictive validity of a clinical staging model for major depressive disorder (MDD) that distinguishes 8 consecutive stages (0, 1A, 1B, 2, 3A, 3B, 3C, 4) based on symptom severity

  5. Gastric cancer : staging, treatment, and surgical quality assurance

    NARCIS (Netherlands)

    Dikken, Johannes Leen

    2012-01-01

    Research described in this thesis focuses on several aspects of gastric cancer care: staging and prognostication, multimodality treatment, and surgical quality assurance. PART I - STAGING AND PROGNOSTICATION Cancer staging is one of the fundamental activities in oncology.6,7 For over 50 years, the

  6. Second-stage primary Caesarean deliveries: Are maternal ...

    African Journals Online (AJOL)

    For the purpose of this study, the second stage of labour was defined as the full dilation of the cervix between ... For the purposes of comparison, 53 first-stage emergency CSs were obtained from the 120 first-stage CSs by ..... RCOG Clinical Effectiveness Support Unit. The. National Sentinel Caesarean Section Audit Report.

  7. Influence of growth stage at harvest on fermentative characteristics ...

    African Journals Online (AJOL)

    An experiment was conducted to investigate the influence of stage of growth at harvest on fermentative characteristics of Panicum maximum silage. The treatments were three different growth stages (early vegetative, boot and full bloom stage) that were ensiled directly or wilted prior to ensiling. Directly ensiled and wilted ...

  8. Research Productivity by Career Stage among Korean Academics

    Science.gov (United States)

    Jung, Jisun

    2014-01-01

    This study explores Korean academics' changes in research productivity by career stage. Career stage in this study is defined as a specific cohort based on one's length of job experience, with those in the same stage sharing similar interests, values, needs, and tasks; it is categorized into fledglings, maturing academics, established academics,…

  9. Natural History of Progression of Chronic Kidney Disease in Stages ...

    African Journals Online (AJOL)

    Introduction: Patients with chronic kidney disease (CKD) often continue to progress spontaneously towards end stage renal disease (ESRD). In this report we studied the natural history of progression of CKD in a cohort of patients with stage 4 and 5 CKD. Methods: We retrospectively studied a cohort of patients in stage 4 ...

  10. 42 CFR 441.40 - End-stage renal disease.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false End-stage renal disease. 441.40 Section 441.40... General Provisions § 441.40 End-stage renal disease. FFP in expenditures for services described in subpart A of part 440 is available for facility treatment of end-stage renal disease only if the facility...

  11. Implications of inaccurate clinical nodal staging in pancreatic adenocarcinoma.

    Science.gov (United States)

    Swords, Douglas S; Firpo, Matthew A; Johnson, Kirsten M; Boucher, Kenneth M; Scaife, Courtney L; Mulvihill, Sean J

    2017-07-01

    Many patients with stage I-II pancreatic adenocarcinoma do not undergo resection. We hypothesized that (1) clinical staging underestimates nodal involvement, causing stage IIB to have a greater percent of resected patients and (2) this stage-shift causes discrepancies in observed survival. The Surveillance, Epidemiology, and End Results (SEER) research database was used to evaluate cause-specific survival in patients with pancreatic adenocarcinoma from 2004-2012. Survival was compared using the log-rank test. Single-center data on 105 patients who underwent resection of pancreatic adenocarcinoma without neoadjuvant treatment were used to compare clinical and pathologic nodal staging. In SEER data, medium-term survival in stage IIB was superior to IB and IIA, with median cause-specific survival of 14, 9, and 11 months, respectively (P < .001). Seventy-two percent of stage IIB patients underwent resection vs 28% in IB and 36% in IIA (P < .001). In our institutional data, 12.4% of patients had clinical evidence of nodal involvement vs 69.5% by pathologic staging (P < .001). Among clinical stage IA-IIA patients, 71.6% had nodal involvement by pathologic staging. Both SEER and institutional data support substantial underestimation of nodal involvement by clinical staging. This finding has implications in decisions regarding neoadjuvant therapy and analysis of outcomes in the absence of pathologic staging. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Gene expression profiles in stages II and III colon cancers

    DEFF Research Database (Denmark)

    Thorsteinsson, Morten; Kirkeby, Lene T; Hansen, Raino

    2012-01-01

    were retrieved from the Gene Expression Omnibus (GEO) (n¿=¿111) in addition to a Danish data set (n¿=¿37). All patients had stages II and III colon cancers. A Prediction Analysis of Microarray classifier, based on the 128-gene signature and the original training set of stage I (n¿=¿65) and stage IV (n......¿=¿76) colon cancers, was reproduced. The stages II and III colon cancers were subsequently classified as either stage I-like (good prognosis) or stage IV-like (poor prognosis) and assessed by the 36 months cumulative incidence of relapse. RESULTS: In the GEO data set, results were reproducible in stage...... correctly predicted as stage IV-like, and the remaining patients were predicted as stage I-like and unclassifiable, respectively. Stage II patients could not be stratified. CONCLUSIONS: The 128-gene signature showed reproducibility in stage III colon cancer, but could not predict recurrence in stage II...

  13. Simulation and comparison of equilibrium and nonequilibrium stage ...

    African Journals Online (AJOL)

    In the present study, two distinctly different approaches are followed for modelling of reactive distillation column, the equilibrium stage model and the nonequilibrium stage model. These models are simulated with a computer code developed in the present study using MATLAB programming. In the equilibrium stage models, ...

  14. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology.

    Science.gov (United States)

    Glujovsky, Demián; Farquhar, Cindy; Quinteiro Retamar, Andrea Marta; Alvarez Sedo, Cristian Roberto; Blake, Deborah

    2016-06-30

    Advances in cell culture media have led to a shift in in vitro fertilisation (IVF) practice from cleavage stage embryo transfer to blastocyst stage transfer. The rationale for blastocyst transfer is to improve both uterine and embryonic synchronicity and enable self selection of viable embryos, thus resulting in better live birth rates. To determine whether blastocyst stage (day 5 to 6) embryo transfers improve the live birth rate, and other associated outcomes, compared with cleavage stage (day 2 to 3) embryo transfers. We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2016, Issue 4), MEDLINE, EMBASE, PsycINFO, CINAHL, and Bio extracts from inception to 4th April 2016. We also searched registers of ongoing trials and the reference lists of studies retrieved. We included randomised controlled trials (RCTs) which compared the effectiveness of blastocyst versus cleavage stage transfers. We used standard methodological procedures recommended by Cochrane. Our primary outcomes were live birth and cumulative clinical pregnancy rates. Secondary outcomes were clinical pregnancy, multiple pregnancy, high order pregnancy, miscarriage, failure to transfer embryos, and embryo freezing. We assessed the overall quality of the evidence for the main comparisons using GRADE methods. We included 27 RCTs (4031 couples or women).The live birth rate following fresh transfer was higher in the blastocyst transfer group (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.20 to 1.82; 13 RCTs, 1630 women, I(2) = 45%, low quality evidence) following fresh transfer. This suggests that if 29% of women achieve live birth after fresh cleavage stage transfer, between 32% and 42% would do so after fresh blastocyst stage transfer.There was no evidence of a difference between the groups in rates per couple of cumulative pregnancy following fresh and frozen

  15. The Analysis, Optimization, and Simulation of a Two-Stage Tandem Queueing Model with Hyperexponential Service Time at Second Stage

    Directory of Open Access Journals (Sweden)

    Vedat Sağlam

    2015-01-01

    Full Text Available The aim of this paper is to analyze a tandem queueing model with two stages. The arrivals to the first stage are Poisson stream and the service time at this stage is exponential. There is no waiting room at first stage. The service time is hyperexponential and no waiting is allowed at second stage. The transition probabilities and loss probabilities of this model are obtained. In addition, the loss probability at second stage is optimized. Performance measures and the variance of the numbers of customers of this tandem queueing model are found. It is seen that the numbers of customers in first stage and second stage are dependent. Finally we have simulated this queueing model. For different values of parameters, exact values, simulated values, and optimal values of obtained performance measures of this model are numerically shown in tables and graphs.

  16. Evaluation of the I. Stage of decommissioning and implementation of the II. Stage of decommissioning of NPP V1

    International Nuclear Information System (INIS)

    Hrasnova, E.

    2015-01-01

    In this paper author deals with following aspects: 1. Introduction of company Nuclear and Decommissioning Company, plc; 2. Evaluation of the I. stage of decommissioning and implementation of the II. Stage of decommissioning of NPP V1; (author)

  17. Cross-stage immunity for malaria vaccine development.

    Science.gov (United States)

    Nahrendorf, Wiebke; Scholzen, Anja; Sauerwein, Robert W; Langhorne, Jean

    2015-12-22

    A vaccine against malaria is urgently needed for control and eventual eradication. Different approaches are pursued to induce either sterile immunity directed against pre-erythrocytic parasites or to mimic naturally acquired immunity by controlling blood-stage parasite densities and disease severity. Pre-erythrocytic and blood-stage malaria vaccines are often seen as opposing tactics, but it is likely that they have to be combined into a multi-stage malaria vaccine to be optimally safe and effective. Since many antigenic targets are shared between liver- and blood-stage parasites, malaria vaccines have the potential to elicit cross-stage protection with immune mechanisms against both stages complementing and enhancing each other. Here we discuss evidence from pre-erythrocytic and blood-stage subunit and whole parasite vaccination approaches that show that protection against malaria is not necessarily stage-specific. Parasites arresting at late liver-stages especially, can induce powerful blood-stage immunity, and similarly exposure to blood-stage parasites can afford pre-erythrocytic immunity. The incorporation of a blood-stage component into a multi-stage malaria vaccine would hence not only combat breakthrough infections in the blood should the pre-erythrocytic component fail to induce sterile protection, but would also actively enhance the pre-erythrocytic potency of this vaccine. We therefore advocate that future studies should concentrate on the identification of cross-stage protective malaria antigens, which can empower multi-stage malaria vaccine development. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. ROLE OF MRI IN STAGING OF CARCINOMA CERVIX

    Directory of Open Access Journals (Sweden)

    Jaipal R

    2016-03-01

    Full Text Available CONTEXT Cervical carcinoma continues to be staged according to the clinical FIGO classification system which is not accurate. In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix with same parameters as FIGO staging. AIMS In our study, we determined the diagnostic accuracy of MRI in staging carcinoma cervix, adjoining organ infiltration and delineating stage IIA and below from rest of the stages in carcinoma cervix. SETTINGS Study was done in the Department of Radiodiagnosis, in a tertiary care government hospital on 70 female patients diagnosed with carcinoma cervix. DESIGN Hospital based observational study. MATERIALS AND METHODS MRI staging was correlated with surgico-pathological findings when patient underwent surgery. MRI staging was compared to the non-pathological staging when patient underwent radiotherapy or neoadjuvant chemotherapy. STATISTICAL ANALYSIS Univariate and bivariate frequency tables are generated. Sensitivity, specificity and accuracy of MRI in staging of carcinoma cervix are calculated. Interclass correlation is done with Pearson’s correlation co-efficient, p value ≤ 0.05 was considered statistically significant. RESULTS MRI has a sensitivity, specificity, PPV, NPV and accuracy of 88.7%, 87.5%, 98.2%, 50% and 88.6% respectively [with interclass correlation coefficient r=0.982, p<0.01 95% CI (0.972 –0.989] in staging of carcinoma cervix. CONCLUSIONS MRI in staging carcinoma cervix is preferred to clinical FIGO staging for deciding on the treatment modality. However, MRI is not a good modality in detecting carcinoma in situ [stage 0] and stage I of carcinoma cervix.

  19. Improved clinical staging of esophageal cancer with FDG-PET

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Choi, Joon Young; Lee, Kyung Soo; Choi, Yong Soo; Lee, Eun Jeong; Chung, Hyun Woo; Lee, Su Jin; Lee, Kyung Han; Shim, Young Mog; Kim, Byung Tae

    2004-01-01

    Since preoperative staging in esophageal cancer is important in both therapy and prognosis, there had been many efforts to improve its accuracy. Recent studies indicate that whole body FDG-PET has high sensitivity in detection of metastasis in esophageal cancer. Therefore, we added FDG-PET to other conventional methods in staging esophageal cancer to evaluate the usefulness of this method. Subjects were 142 esophageal cancer patients (average 62.3±8.3 yrs) who received CT and PET just before operation. First, we compared N stage and M stage of the CT or PET with those of the post-operative results. Then we compared the stage according to the EUS (T stage) and CT (N and M stage) or EUS (T stage) and CT and PET (N and M stage) to that according to the post-operative results. Among 142 patients, surgical staging of 69 were N0 and 73 were N1. In M staging, 128 were M0 and 14 were M1. Sensitivity, specificity, and accuracy of N staging were 35.6%, 89.9%, 62.0% with CT and 58.9%, 71.0%, 64.7% with PET, respectively. In M staging, 14.3%, 96.9%, 88.7% with CT and 50.0%, 94.5%, 90.1% with PET, respectively. The concordances of [EUS+CT] and [EUS+CT+PET] with post-operative results were 41.2% and 54.6%, respectively and there was significant improvement of staging with additional PET scan (p<0.005). The concordance of [EUS+CT+PET] with post-operative result was significantly increased compared to that of [EUS+CT]. Thus, the addition of FDG-PET with other conventional methods may enable more accurate preoperative staging

  20. Structural analysis at aircraft conceptual design stage

    Science.gov (United States)

    Mansouri, Reza

    . Considering the strength and limitations of both methodologies, the question to be answered in this thesis is: How valuable and compatible are the classical analytical methods in today's conceptual design environment? And can these methods complement each other? To answer these questions, this thesis investigates the pros and cons of classical analytical structural analysis methods during the conceptual design stage through the following objectives: Illustrate structural design methodology of these methods within the framework of Aerospace Vehicle Design (AVD) lab's design lifecycle. Demonstrate the effectiveness of moment distribution method through four case studies. This will be done by considering and evaluating the strength and limitation of these methods. In order to objectively quantify the limitation and capabilities of the analytical method at the conceptual design stage, each case study becomes more complex than the one before.

  1. Circulating Tumor DNA in Predicting Outcomes in Patients With Stage IV Head and Neck Cancer or Stage III-IV Non-small Cell Lung Cancer

    Science.gov (United States)

    2018-01-12

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  2. Uterine cervical cancer. Preoperative staging with magnetic resonance imaging; Zervixkarzinom. Praeoperatives Staging mittels Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Hamm, B. [Charite-Universitaetsmedizin Berlin, Campus Charite Mitte, Klinik fuer Radiologie, Berlin (Germany)

    2011-07-15

    The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Federation International de Gynecologie et d'Obstetrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer. (orig.) [German] Die Therapieplanung beim Zervixkarzinom ist weitgehend von der Stadieneinteilung nach FIGO (Federation International de Gynecologie et d'Obstetrique) abhaengig, die trotz erheblicher Ungenauigkeiten bei der klinischen Stadieneinteilung weiterhin aufgrund klinischer Untersuchungsbefunde erfolgt. Obwohl bildgebende Verfahren nach wie vor fuer die Stadieneinteilung nicht vorgesehen sind, wird im kuerzlich erschienen revidierten Stagingsystem der FIGO zum ersten Mal die Verwendung moderner Schnittbilddiagnostik (MRT und CT) befuerwortet. Die MRT ermoeglicht dank ihres hohen Weichteilkontrasts ein ausgezeichnetes nichtinvasives Staging des Zervixkarzinoms mit direkter Tumordarstellung sowie einer Prognoseabschaetzung anhand

  3. Rapid Two-stage Versus One-stage Surgical Repair of Interrupted Aortic Arch with Ventricular Septal Defect in Neonates

    Directory of Open Access Journals (Sweden)

    Meng-Lin Lee

    2008-11-01

    Conclusion: The outcome of rapid two-stage repair is comparable to that of one-stage repair. Rapid two-stage repair has the advantages of significantly shorter cardiopulmonary bypass duration and AXC time, and avoids deep hypothermic circulatory arrest. LVOTO remains an unresolved issue, and postoperative aortic arch restenosis can be dilated effectively by percutaneous balloon angioplasty.

  4. Stages in the Formation of the Romanian Mental Space

    Directory of Open Access Journals (Sweden)

    POMPEI COCEAN

    2008-01-01

    Full Text Available In the evolution of the Romanian mental space, four distinct stages can be emphasized, each of them bringing its specific contribution to its defining and structuring. These stages are the following: the forerunning, Dacian stage, the 2nd century B.C. - 106 A.D.; the incipient, Dacian-Roman stage, 105 – 275 A.D.; the structuring, proto-Romanian stage, 275 – the 6th and 7th centuries; the Romanian stage of completion and affirmation, the 8th century – nowadays. Each stage is characterized by different forms, in continuous affirmation and improvement, of interrelations between the human communities and the site, of spiritually sublimation of the physical-geographical substratum features, of the territory inhabited by them.

  5. A two stage data envelopment analysis model with undesirable output

    Science.gov (United States)

    Shariff Adli Aminuddin, Adam; Izzati Jaini, Nur; Mat Kasim, Maznah; Nawawi, Mohd Kamal Mohd

    2017-09-01

    The dependent relationship among the decision making units (DMU) is usually assumed to be non-existent in the development of Data Envelopment Analysis (DEA) model. The dependency can be represented by the multi-stage DEA model, where the outputs from the precedent stage will be the inputs for the latter stage. The multi-stage DEA model evaluate both the efficiency score for each stages and the overall efficiency of the whole process. The existing multi stage DEA models do not focus on the integration with the undesirable output, in which the higher input will generate lower output unlike the normal desirable output. This research attempts to address the inclusion of such undesirable output and investigate the theoretical implication and potential application towards the development of multi-stage DEA model.

  6. Augment-type two stage accelerator

    International Nuclear Information System (INIS)

    Ogino, Mutsuo; Azuma, Kingo.

    1995-01-01

    When a flying body accelerated by a gas gun at a first stage enters into an augment rail passing through an introduction tube, an ignition capacitor for initial plasmas is turned ON to apply a voltage between the augment rails. Subsequently, the accelerating gas present behind the flying body is formed into plasmas by a laser, to flow electric current from one of the inner augment rails → plasma armature → the other of the inner augment rails, and additionally accelerate the flying body by Lorentz force formed in this case. Since the plasmas are maintained in a state of higher density than the plasmas obtained by using all of the augment rails, the ignition capacitor for initial plasmas in switched to a power source. As a result, it is possible to flow the maximum current before the plasmas expand, and a large accelerating force and a high magnetic flux density are attained, to improve acceleration performance of the flying body. (N.H.)

  7. Why geodiversity matters in valuing nature's stage.

    Science.gov (United States)

    Hjort, Jan; Gordon, John E; Gray, Murray; Hunter, Malcolm L

    2015-06-01

    Geodiversity--the variability of Earth's surface materials, forms, and physical processes-is an integral part of nature and crucial for sustaining ecosystems and their services. It provides the substrates, landform mosaics, and dynamic physical processes for habitat development and maintenance. By determining the heterogeneity of the physical environment in conjunction with climate interactions, geodiversity has a crucial influence on biodiversity across a wide range of scales. From a literature review, we identified the diverse values of geodiversity; examined examples of the dependencies of biodiversity on geodiversity at a site-specific scale (for geosites <1 km(2) in area); and evaluated various human-induced threats to geosites and geodiversity. We found that geosites are important to biodiversity because they often support rare or unique biota adapted to distinctive environmental conditions or create a diversity of microenvironments that enhance species richness. Conservation of geodiversity in the face of a range of threats is critical both for effective management of nature's stage and for its own particular values. This requires approaches to nature conservation that integrate climate, biodiversity, and geodiversity at all spatial scales. © 2015 Society for Conservation Biology.

  8. Five stages in a practical population policy.

    Science.gov (United States)

    Taylor, C E

    1968-12-01

    A systematic approach to population planning is presented. This should help to provide a basis for decision-making about emphases and priorities. The greatest force for change is the increasing world population. The sharpest controversy is between proponents of family planning, who try to make it possible for parents to have the number of children they want, and proponents of population control, who try to modify the environment so parents will want fewer children. The five developmental stages in the organization of programs are: 1) to meet the existing demand and tell women where to go for birth limitation help; 2) to provide good quality technical service, organization, and follow-up because satisfied users are the best recruiters while unsatisfied persons can produce unfavorable rumors; 3) to improve family planning motivation by caring for the health of mothers and children particularly when high infant mortality must be corrected, (the post-partum period is thought to be the best time to educate mothers); 4) to alter the family's view of its economic prospects and its understanding of financial implications of more children, particularly in underdeveloped countries; 5) to modify socio-cultural factors, such as delayed age at marriage, more education of women, and general discussions of traditional beliefs. Population policy requires long-range planning with phased action.

  9. LENS: Science Scope and Development Stages

    Science.gov (United States)

    Vogelaar, R. Bruce

    2013-04-01

    The Low-Energy Neutrino Spectroscopy (LENS) experiment will resolve the solar metallicity question via measurement of the CNO neutrino flux, as well as test the predicted equivalence of solar luminosity as measured by photon versus neutrinos. The LENS detector uses charged-current interaction of neutrinos on Indium-115 (loaded in a scintillator, InLS) to reveal the complete solar neutrino spectrum. LENS's optically segmented 3D lattice geometry achieves precise time and spatial resolution and unprecedented background rejection and sensitivity for low-energy neutrino events. This first-of-a-kind lattice design is also suited for a range of other applications where high segmentation and large light collection are required (eg: sterile neutrinos with sources, double beta decay, and surface detection of reactor neutrinos). The physics scope, detector design, and logic driving the microLENS and miniLENS prototyping stages will be presented. The collaboration is actively running programs; building, operating, developing, and simulating these prototypes using the Kimballton Underground Research Facility (KURF). New members are welcome to the LENS Collaboration, and interested parties should contact R. Bruce Vogelaar.

  10. STAGE OF TEXTILE RECYCLE WASTE IN ROMANIA

    Directory of Open Access Journals (Sweden)

    TRIPA Simona

    2014-05-01

    Full Text Available Aim of this article is to examine the stage of textile recycle waste in Romania. For this purpose were analyzed the main sources of textile waste from Romania (industry of manufacture of textiles, wearing apparel, leather and related products, imports of textiles, clothing and footwear and imports of second hand clothing and also evolution of the quantity of textile waste in Romania. The benefits (economic and environmental of the collection and recycling of waste and the legislation on the waste management, have determined the diversification and increasing the number and the capacity of recovery and disposal of waste in Romania. We found the most textile waste in Romania was deposited in deposits onto or into land, in the proportion of 18.51%. This proportion is under the EU average of 34.03%, but is much higher than in other European country. Also, has been an increase in the number of incinerators, in the last years. With all of this, the interest in textile waste management in Romania is far from being to the level of European, where are associations who dealing with the collection and recycling of textiles and is achieved a selective collection of textile waste in the points especially designed for this thing. The information for this paper was gathered from literature, from the EUROSTAT database and INSSE database analysis and by Internet.

  11. Baton twirling on an international stage

    CERN Document Server

    Stephanie McClellan

    2013-01-01

    There aren’t many people who can throw a baton in the air, do a backhand spring and catch it with the grace of a dancer. Well, Julie Haffner from the CERN Press Office can. Baton twirling started as her hobby but soon became a passion - leading her team to win the International Baton Twirling Cup.    Gex Twirling Club performing their winning number at the 2013 International Baton Twirling Cup. (Image: Véronique Bellour). There is no telling when or where people will find their passion. For Julie Haffner, it was when she followed her cousin to a baton twirling class at the age of 10. Since that fortuitous day, she has committed herself to the sport and competed on international stages. Very close to rhythmic gymnastics, baton twirling requires skilful coordination and teamwork. Julie’s performances combine the precision of baton manipulation, the grace of a dancer and the strength of a gymnast. The first year in which she competed with the Gex Twirlin...

  12. Three-stage linear, split-Stirling cryocooler for 1 to 2K magnetic cold stage

    International Nuclear Information System (INIS)

    Longsworth, R.C.

    1993-08-01

    A long-life, linear, high efficiency 8K split Stirling cycle cryocooler was designed, built, and tested. The refrigerator is designed for cooling a 50 mW, 1.5K magnetic cold stage. Dual opposed piston compressors are driven by moving-coil linear motors. The three stage expander, although not completed, is also driven by a linear motor and is designed to produce 1 SW at 60K, 4W at 16K, and 1.2W at 8K. The cold regenerator employs a parallel gap construction for high efficiency. The key technology areas addressed include warm and cold flexible suspension bearings and a new cold regenerator geometry for high efficiency at 8K

  13. An essential malaria protein defines the architecture of blood-stage and transmission-stage parasites.

    Science.gov (United States)

    Absalon, Sabrina; Robbins, Jonathan A; Dvorin, Jeffrey D

    2016-04-28

    Blood-stage replication of the human malaria parasite Plasmodium falciparum occurs via schizogony, wherein daughter parasites are formed by a specialized cytokinesis known as segmentation. Here we identify a parasite protein, which we name P. falciparum Merozoite Organizing Protein (PfMOP), as essential for cytokinesis of blood-stage parasites. We show that, following PfMOP knockdown, parasites undergo incomplete segmentation resulting in a residual agglomerate of partially divided cells. While organelles develop normally, the structural scaffold of daughter parasites, the inner membrane complex (IMC), fails to form in this agglomerate causing flawed segmentation. In PfMOP-deficient gametocytes, the IMC formation defect causes maturation arrest with aberrant morphology and death. Our results provide insight into the mechanisms of replication and maturation of malaria parasites.

  14. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

    Directory of Open Access Journals (Sweden)

    Gautham Hegde

    2014-01-01

    Full Text Available Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian′s stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity.

  15. Mechanisms of stage-transcending protection following immunization of mice with late liver stage-arresting genetically attenuated malaria parasites.

    Directory of Open Access Journals (Sweden)

    Brandon K Sack

    2015-05-01

    Full Text Available Malaria, caused by Plasmodium parasite infection, continues to be one of the leading causes of worldwide morbidity and mortality. Development of an effective vaccine has been encumbered by the complex life cycle of the parasite that has distinct pre-erythrocytic and erythrocytic stages of infection in the mammalian host. Historically, malaria vaccine development efforts have targeted each stage in isolation. An ideal vaccine, however, would target multiple life cycle stages with multiple arms of the immune system and be capable of eliminating initial infection in the liver, the subsequent blood stage infection, and would prevent further parasite transmission. We have previously shown that immunization of mice with Plasmodium yoelii genetically attenuated parasites (GAP that arrest late in liver stage development elicits stage-transcending protection against both a sporozoite challenge and a direct blood stage challenge. Here, we show that this immunization strategy engenders both T- and B-cell responses that are essential for stage-transcending protection, but the relative importance of each is determined by the host genetic background. Furthermore, potent anti-blood stage antibodies elicited after GAP immunization rely heavily on FC-mediated functions including complement fixation and FC receptor binding. These protective antibodies recognize the merozoite surface but do not appear to recognize the immunodominant merozoite surface protein-1. The antigen(s targeted by stage-transcending immunity are present in both the late liver stages and blood stage parasites. The data clearly show that GAP-engendered protective immune responses can target shared antigens of pre-erythrocytic and erythrocytic parasite life cycle stages. As such, this model constitutes a powerful tool to identify novel, protective and stage-transcending T and B cell targets for incorporation into a multi-stage subunit vaccine.

  16. Computational study of the first stage of hypersonic ion beam neutralization: The cross neutralization stage

    International Nuclear Information System (INIS)

    Pomot, C.; Dolique, J.M.

    1975-01-01

    A study is made of the first stage of evolution of a hypersonic ion beam in which thermoelectrons are emitted by a heated grid, known as the neutralizer. Downstream from the neutralizer there appears successively as a sheath a range of periodic and quasi-stationary electric field and a front where the electric field oscillates with the plasma frequency. The sheath is self-regulated. Some electrons are trapped in the periodic and stationary electric field. The characteristics of the periodic, quasi-stationary range correspond to those of both an experimental study and one-dimensional time-independent macroscopic theory. This quasi-stationary regime builds up in a time smaller than ω/subp/e -1 and is studied for a few periods ω/subP//sube/ -1 . The subsequent evolution of this state of nonequilibrium is not investigated. The experimental study has shown that, as for the neutralization of a subsonic ion beam, it leads to a field-free, homogeneous medium: a ''synthesized plasma.'' The importance of the first stage described herein, which may be called the gross neutralization stage, is due to the properties of mean neutrality in the current and in the charge insured by the regulating sheath, properties which will be preseved downstream

  17. One-stage vs two-stage cartilage repair: a current review

    Directory of Open Access Journals (Sweden)

    Daniel Meyerkort

    2010-10-01

    Full Text Available Daniel Meyerkort, David Wood, Ming-Hao ZhengCenter for Orthopaedic Research, School of Surgery and Pathology, University of Western Australia, Perth, AustraliaIntroduction: Articular cartilage has a poor capacity for regeneration if damaged. Various methods have been used to restore the articular surface, improve pain, function, and slow progression to osteoarthritis.Method: A PubMed review was performed on 18 March, 2010. Search terms included “autologous chondrocyte implantation (ACI” and “microfracture” or “mosaicplasty”. The aim of this review was to determine if 1-stage or 2-stage procedures for cartilage repair produced different functional outcomes.Results: The main procedures currently used are ACI and microfracture. Both first-generation ACI and microfracture result in clinical and functional improvement with no significant differences. A significant increase in functional outcome has been observed in second-generation procedures such as Hyalograft C, matrix-induced ACI, and ChondroCelect compared with microfracture. ACI results in a higher percentage of patients with clinical improvement than mosaicplasty; however, these results may take longer to achieve.Conclusion: Clinical and functional improvements have been demonstrated with ACI, microfracture, mosaicplasty, and synthetic cartilage constructs. Heterogeneous products and lack of good-quality randomized-control trials make product comparison difficult. Future developments involve scaffolds, gene therapy, growth factors, and stem cells to create a single-stage procedure that results in hyaline articular cartilage.Keywords: autologous chondrocyte implantation, microfracture, cartilage repair

  18. Predation on transmission stages reduces parasitism: sea anemones consume transmission stages of a barnacle parasite.

    Science.gov (United States)

    Fong, Caitlin R; Kuris, Armand M

    2017-06-01

    While parasites serve as prey, it is unclear how the spatial distribution of parasite predators provides transmission control and influences patterns of parasitism. Because many of its organisms are sessile, the rocky intertidal zone is a valuable but little used system to understand spatial patterns of parasitism and elucidate the underlying mechanisms driving these patterns. Sea anemones and barnacles are important space competitors in the rocky intertidal zone along the Pacific coast of North America. Anemones are voracious, indiscriminate predators; thus, they may intercept infectious stages of parasites before they reach a host. We investigate whether a sea anemone protects an associated barnacle from parasitism by Hemioniscus balani, an isopod parasitic castrator. At Coal Oil Point, Santa Barbara, California USA, 29% of barnacles were within 1 cm from an anemone at the surveyed tidal height. Barnacles associated with anemones had reduced parasite prevalence and higher reproductive productivity than those remote from sea anemones. In the laboratory, anemones readily consumed the transmission stage of the parasite. Hence, anemone consumption of parasite transmission stages may provide a mechanism by which community context regulates parasite prevalence at a local scale. Our results suggest predation may be an important process providing parasite transmission control.

  19. Preliminary design of the repository. Stage 2

    International Nuclear Information System (INIS)

    Saanio, T.; Kirkkomaeki, T.; Keto, P.; Kukkola, T.; Raiko, H.

    2007-04-01

    Spent nuclear fuel from Finnish nuclear power plants will be disposed of in deep bedrock in Olkiluoto, Eurajoki. The repository is planned to be excavated at a depth of 400 - 500 metres. Access routes to the repository include a 1:10 inclined access tunnel, and vertical shafts. The fuel is encapsulated in the encapsulation plant above ground and transferred to the repository in the canister lift. Deposition tunnels, central tunnels and technical rooms are excavated at the disposal level. The canisters are deposited in deposition holes that are covered with bentonite blocks. The deposition holes are bored in the floors of the deposition tunnels. The central tunnel system consists of two parallel central tunnels that are inter-connected at certain distances. Two parallel central tunnels improve the fire safety of the rooms and also allow flexible backfilling and closing of the deposition tunnels in stages at the operational phase of the repository. An underground rock characterization facility, ONKALO, is excavated at the disposal level to support and confirm investigations carried out from above ground. ONKALO is designed so that it can later serve as part of the repository. ONKALO excavations were started in 2004. The repository will be excavated in the 2010s and operation will start in 2020. The fifth nuclear power unit makes the operational phase of the repository very long. Parts of the repository will be excavated and closed over the long operational period. The repository can be constructed at one or several levels. The one-storey alternative is the so-called reference alternative in this preliminary design report. The two-storey alternative is also taken into account in the ONKALO designs. The preliminary designs of the repository are presented as located in Olkiluoto. The location of the repository will be revised when more information on the bedrock has been gained. More detailed data of the circumstances will be obtained from above ground investigations

  20. Omicron space habitat—research stage II

    Science.gov (United States)

    Doule, Ondřej; Šálený, Vratislav; Hérin, Benoît; Rousek, Tomáš

    2012-01-01

    The design presented in this paper is in response to the revolution in private space activities, the increasing public interest in commercial flights to space and the utilization of structures such as space hotels or private orbital habitats. The baseline for the Omicron design concept is the Russian Salyut derived space station module. Salyut was the first space station to orbit the Earth. Its unique design and technical features were what made the development of space stations Salyut 1-7, MIR and the International Space Station (ISS) Zwezda service module possible. Due to its versatility and the reliable operating launch vehicle Proton, this space module series has the potential to be adapted for space hotel development. This paper proposes a conceptual design of the space habitat called Omicron, with particular focus on interior design for the microgravity environment. The Omicron concepts address the needs of space tourism with a strong emphasis on the safety and comfort of the spaceflight participants. The Omicron habitat supports three inhabitants in nominal conditions (e.g., two passengers and one astronaut). The habitat provides a flexible interior, facilities and spaces dynamically transforming in order to accommodate various types of activities, which will be performed in an organically formed interior supporting spatial orientation and movement in microgravity. The future development potential of Omicron is also considered. The baseline version is composed solely of one rigid module with an inverted cupola for observations. An alternative version offers more space using an inflatable structure. Finally, a combination of multiple Omicron modules enables the creation of a larger orbital habitat. The Omicron's subsystems support a few days visit by trained passengers. The transport to the habitat would be provided e.g., by the Soyuz TMA spacecraft carried by the Soyuz launch vehicle in the early stage of Omicron's development, before a fully reusable