Second Stage (S-II) Arrives at Marshall Space Flight Center For Testing

Science.gov (United States)

2004-01-01

The business end of a Second Stage (S-II) slowly emerges from the shipping container as workers prepare to transport the Saturn V component to the testing facility at MSFC. The Second Stage (S-II) underwent vibration and engine firing tests. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Two technicians apply insulation to S-II second stage

Science.gov (United States)

1964-01-01

Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Extended Cancer Education for Longer-Term Survivors in Primary Care for Patients With Stage I-II Breast or Prostate Cancer or Stage I-III Colorectal Cancer

Science.gov (United States)

2017-11-15

Stage I Breast Cancer; Stage I Colorectal Cancer AJCC v6 and v7; Stage I Prostate Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage II Colorectal Cancer AJCC v7; Stage II Prostate Cancer; Stage IIA Breast Cancer; Stage IIA Colorectal Cancer AJCC v7; Stage IIA Prostate Cancer; Stage IIB Breast Cancer; Stage IIB Colorectal Cancer AJCC v7; Stage IIB Prostate Cancer; Stage IIC Colorectal Cancer AJCC v7; Stage III Colorectal Cancer AJCC v7; Stage IIIA Colorectal Cancer AJCC v7; Stage IIIB Colorectal Cancer AJCC v7; Stage IIIC Colorectal Cancer AJCC v7

Patterns of Pelvic Radiotherapy in Patients with Stage II/III Rectal Cancer

International Nuclear Information System (INIS)

Fitzgerald, T. L.; Zervos, E.; Wong, J. H.; Fitzgerald, T. L.; Zervos, E.; Wong, J. H.; Fitzgerald, T. L.; Zervos, E.; Wong, J. H.

2013-01-01

High-level evidence supports adjuvant radiotherapy for rectal cancer. We examined the influence of socio demographic factors on patterns of adjuvant radiotherapy for resected Stage II/III rectal cancer. Methods. Patients undergoing surgical resection for stage II/III rectal cancer were identified in SEER registry. Results. A total of 21,683 patients were identified. Majority of patients were male (58.8%), white (83%), and with stage III (54.9%) and received radiotherapy (66%). On univariate analysis, male gender, stage III, younger age, year of diagnosis, and higher socioeconomic status (SES) were associated with radiotherapy. Radiotherapy was delivered in 84.4% of patients <50; however, only 32.8% of those are >80 years. Logistic regression demonstrated a significant increase in the use of radiotherapy in younger patients who are 50 (OR, 10.3), with stage III (OR, 1.21), males (OR, 1.18), and with higher SES. Conclusions. There is a failure to conform to standard adjuvant radiotherapy in one-third of patients, and this is associated with older age, stage II, area-level of socioeconomic deprivation, and female sex.

Brachytherapy for elderly patients with stage II tongue cancer

International Nuclear Information System (INIS)

Kimura, Tomoki; Hirokawa, Yutaka; Fujita, Minoru; Murakami, Yuji; Kenjo, Masahiro; Kaneyasu, Yuko; Ito, Katsuhide

2003-01-01

In treatment choices of stage II (T2N0M0) tongue cancer, brachytherapy is less invasive and superior in function preservation, therefore its role is more important in elderly patients. The aim of this study was to evaluate treatment results and morbidity of brachytherapy for elderly patients with stage II tongue cancer. Between 1980 and 2001, 198 patients with stage II tongue cancer were treated with brachytherapy at Hiroshima University Hospital. Patient ages ranged from 21 to 89 years old (median: 62 years old). Patients were divided into three groups as follows: 119 patients younger than 65 years old (Non-Elderly group), 53 patients between 65 and 75 years old (Junior Elderly group), and 26 patients 75 years or older (Senior Elderly group). Radiotherapy was performed in 101 patients with brachytherapy alone, and in 97 patients with brachytherapy and external radiotherapy. Chemotherapy was also performed in 77 patients. Follow-up period ranged from 4 to 243 months (median: 55 months). The 5-year local control rate was 85% in the Non-Elderly group, 85% in the Junior Elderly group and 81% in the Senior Elderly group. There was no significant difference among these groups. The 5-year cause-specific survival rate was 85%, 81% and 70% respectively. The Senior Elderly group showed poorer cause-specific survival rate than the other two groups (p=0.03). There was also a tendency of higher incidence of neck metastasis and low salvage rate by neck dissection in the Senior Elderly group. Although the Senior Elderly group showed poorer cause-specific survival rate, the local control rate was similar to those of the other two groups. Brachytherapy is an effective treatment option for elderly patients with stage II tongue cancer. (author)

Radiation therapy for stage I and II testicular seminoma

International Nuclear Information System (INIS)

Latini, P.; Aristei, C.; Maranzano, E.; Checcaglini, F.; Panizza, M.B.; Perrucci, E.; Bellucci, M.C.

1988-01-01

From june 1977 through june 1987, 46 patients (36 evaluable) affected by stage I and II non-bulky testicular seminoma were treated with postoperative telecobaltotherapy (TCT). In stage I seminomas, radiotherapy was extended to the omolateral iliac and the para-aortic areas (total dose: 30 Gy over 4 weeks). In stage II seminomas, the subdiaphragmatic lymph nodes were irradiated with 40-45 Gy over 5-6 weeks; after an interval of one month the subdiaphragmatic lymph nodes were irradiated again with a total dose of 25 Gy over 3.5 weeks. Minimal follow-up lasted two years and maximum ten years (average:5.5%) recurrences occurred, but salvage radiotherapy and salvage chemotherapy respectively allowed a complete permanent remission. One patient died from a different neoplasia with no evidence of testicular involvement. The 5-year actuarial survival is 96.6±3.4. In 20% of the patients the side effects were nausea and/or vomiting, easily controlled. No late complications were observed

Second Stage (S-II) Plays Key Role in Apollo missions

Science.gov (United States)

1970-01-01

This photograph of the Saturn V Second Stage (S-II) clearly shows the cluster of five powerful J-2 engines needed to boost the Apollo spacecraft into earth orbit following first stage separation. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression.

Science.gov (United States)

Ramos-Jorge, Joana; Alencar, Bruna Mota; Pordeus, Isabela Almeida; Soares, Maria Eliza da Consolação; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Paiva, Saul Martins

2015-04-01

The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children. © 2014 Eur J Oral Sci.

The European Dioxin Emission Inventory. Stage II. Final report

Energy Technology Data Exchange (ETDEWEB)

Quass, U.; Fermann, M.; Broeker, G.

2001-07-01

For Stage II of the European Dioxin Project the following objectives were set: - Amendment of existing emission data collected for most relevant emission sources in order to reduce uncertainties of emission estimates. Collecting first emission data from countries not yet performing dioxin emission measurement programs. Extending the inventory of dioxin emissions to ambient air produced in Stage I by a complementary study on emissions to land and water. Extending the regional scope of data collection to countries in Central Europe. The report of Stage II of the European Dioxin Project is presented in 3 Volumes. Volume 1 contains an overview on the background and approach of different activities carried out and on the results obtained. These results are put into a broader view regarding the dioxin reduction measures in Europe leading to conclusions and recommendation for future work. Volume 2 of the report contains a detailed presentation of the sub-projects carried out. The chapters of Volume 2 are structured in a similar manner and start with a short summary in order to allow for a fast cross-reading. In the case of the desk-top studies an overview of the main results or statements is given. Regarding emission measurements details on the experimental set-up and the facilities being investigated are presented. Volume 3 contains a re-evaluation of the dioxin emission inventory presented for the most relevant sources types in the Stage I report. New data gathered from the projects of Stage II as well as from independent activities in the European countries are considered for a revision of the 1995 emission estimates. Additionally, based on current trends and activities the PCDD/F emissions for the years 2000 and 2005 are estimated. Finally, an attempt is made to evaluate the PCDD/F emission reduction rates which might be possible to achieve by the year 2005 compared to 1985. (orig.)

Radiotherapy for stage I-II non-small cell lung cancer

International Nuclear Information System (INIS)

Okamoto, Yoshiaki; Murakami, Masao; Mizowaki, Takashi; Nakajima, Toshifumi; Kuroda, Yasumasa

1999-01-01

Surgery has been regarded as the standard treatment for patients with non-small cell lung cancer in the early stage, while radiotherapy has become an effective alternative for medically inoperable patients and those who refuse surgery. We reviewed the records of 31 patients with stage I-II non-small cell lung cancer treated by radiotherapy between 1980 and 1997. There were 15 patients in stage I and 16 in stage II. The variables analyzed for influence on cause-specific survival and loco-regional control were: age, performance status, clinical stage, tumor size, tumor site, radiation field, radiation dose, and combination with chemotherapy. The overall and cause-specific 1-, 2-, 3-, and 5-years survival rates were 71% and 77%; 63% and 73%; 34% and 48%; and 17% and 32%, respectively. Five-year survival rate for patients with peripheral tumor in the lung was 72%, with 70% loco-regional control, while the 5-year survival rate of patients whose tumor originated in the central region was 20%, with 25% loco-regional control. These differences had marginal significance on univariate analysis (P=0.07), but only tumor site (central vs peripheral) showed marginal significant influence on cause-specific survival (P=0.08) and loco-regional control (P=0.07) on multivariate analysis. There were no fatal complications, including radiation-induced myelopathy. The present series showed satisfactory results with definitive radiotherapy for patients with medically inoperable stage I-II non-small cell lung cancer, with results similar to those in recent reports of radiotherapy. The only significant variable was that patients with peripheral tumors had a better prognosis than patients with central tumors. (author)

Curcumin and Cholecalciferol in Treating Patients With Previously Untreated Stage 0-II Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

Science.gov (United States)

2018-01-26

Contiguous Stage II Small Lymphocytic Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Stage 0 Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia

78 FR 34303 - Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline...

Science.gov (United States)

2013-06-07

... Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline Vapor Recovery Program..., 2009, for the purpose of removing Stage II vapor control requirements for new and upgraded gasoline... Piping for Stage II Vapor Recovery, for all new or improved gasoline tanks. In addition, rule 15A-02D...

Segmental mastectomy and radiotherapy as treatment of stage II breast cancer

International Nuclear Information System (INIS)

Faria, S.L.; Chiminazzo Junior, H.; Schlupp, W.R.; Cunha, L.S.M. da

1987-01-01

The treatment of operable breast cancer with segmental mastectomy and radiotherapy has been described since decade 30. Many recent prospective and retrospective studies have shown the efficacy of this conservative management, particularly in stage I. There are still doubts in its use in stage II. (Author) [pt

Result of Radiation Therapy for Stage I, II Non-Hodgkin Lymphoma

International Nuclear Information System (INIS)

Lee, Kyu Chan; Kim, Chul Yong; Choi, Myung Sun

1993-01-01

A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients(43/69, 62.3%) were Stage I and 26 patients (26/69, 37.7%) were Stage II, and B symptom was found in 10.1%(7/69). Local control rate for all patients was 88.4%(61/69), with 80% (12/15) for nodal lymphoma and 90.7%(49/54) for extra nodal lymphoma. The total failure rate was 34.8%(24/69). Five of 24 (20.8%) patients who were failed developed local failure only, 12.5%(3/24) local failure with distant failure, and distant failure only were found in 66.7%(16/24). Between nodal lymphoma and extra nodal lymphoma, there was no significant survival difference, but extra nodal lymphoma showed higher incidence

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)

Stage I/II endometrial carcinomas: preoperative radiotherapy: results

International Nuclear Information System (INIS)

Maingon, P.; Belichard, C.; Horiot, J.C.; Barillot, I.; Fraisse, J.; Collin, F.

1996-01-01

The AIM of this retrospective study is to analyse the indications and the results of treatment of endometrial carcinomas by preoperative radiotherapy. MATERIAL: From 1976 to 1995, 183 patients FIGO stage I or II were treated by preoperative radiotherapy consisting in 95 cases of external radiotherapy (XRT) and brachytherapy (BT) followed by surgery (S) and, in 88 cases of BT alone before surgery, XRT was indicated in cases of grade 2 or 3 and/or cervical involvement. METHODS: XRT was delivered with a 4-fields technique to 40 Gy in 20 fractions with a medial shielding at 30 Gy. BT was done with low dose rate Cs137 and Fletcher-Suit-Delclos applicators with two intra-uterine tubes and vaginal ovoieds. Complications were scored using the French-Italian syllabus. RESULTS: Five-year actuarial survival rates per stage are: Ia=91%, Ib=83%, II=71%, and per grade: G1=80%, G2=79%, G3=90%. Failures were pelvic in 5/183 (2.7%), vaginal in 4 cases (2%) and nodal in 2 cases (1%). Twelve patients developed metastases (6.5%). Complications were analysed during the radiotherapy, after the surgery and with unlimited follow-up. After BT/S, 12 grade 1, 1 grade 2 and 1 grade 3 complications were observed. In the group of patients treated by RT/BT/S, 22 grade 1, 11 grade 2, 4 grade 3 occurred. There is no statistical correlation between complications and parameters of treatment (XRT, hwt, HWT, reference dose to the bladder and rectum, dose rate of brachytherapy). SUMMARY: Preoperative irradiation is an effective and safe treatment of high risk stage I/II endometrial carcinomas. Results seem independent of the pathology grade

Short Course Vaginal Cuff Brachytherapy in Treating Patients With Stage I-II Endometrial Cancer

Science.gov (United States)

2018-04-17

Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage I Uterine Corpus Cancer; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Uterine Corpus Carcinosarcoma; Uterine Corpus Sarcoma

Risk of recurrence in patients with colon cancer stage II and III

DEFF Research Database (Denmark)

Bockelman, C.; Engelmann, Bodil E.; Kaprio, T.

2015-01-01

Background. Adjuvant chemotherapy is established routine therapy for colon cancer (CC) patients with radically resected stage III and 'high-risk' stage II disease. The decision on recommending adjuvant chemotherapy, however, is based on data from older patient cohorts not reflecting improvements...

[Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

Science.gov (United States)

Grard, C; Desmytterre, J; Vinckier, L; Hatron, P Y; Roux, J P; Warembourg, H; Devulder, B

1990-03-01

The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of the Walking Index for Spinal Cord Injury II (WISCI-II) in children with Spinal Cord Injury (SCI).

Science.gov (United States)

Calhoun Thielen, C; Sadowsky, C; Vogel, L C; Taylor, H; Davidson, L; Bultman, J; Gaughan, J; Mulcahey, M J

2017-05-01

Mixed methods were used in this study. The appropriateness of the levels of the Walking Index for Spinal Cord Injury II (WISCI-II) for application in children was critically reviewed by physical therapists using the Modified Delphi Technique, and the inter- and intra-rater reliability of the WISCI-II in children was evaluated. To examine the construct validity, and to establish reliability of the WISCI-II related to its use in children with spinal cord injury (SCI). United States of America. Using a Modified Delphi Technique, physical therapists critically reviewed the WISCI-II levels for pediatric utilization. Concurrently, ambulatory children under age 18 years with SCI were evaluated using the WISCI-II on two occasions by the same therapist to establish intra-rater reliability. One trial was photographed and de-identified. Each photograph was reviewed by four different physical therapists who gave WISCI-II scores to establish inter-rater reliability. Summary and descriptive statistics were used to calculate the frequency of yes/no responses for each WISCI-II level question and to determine the percent agreement for each question. Inter- and intra-rater reliability was calculated using interclass correlation coefficients (ICCs) with 95% confidence intervals (CI). Construct validity was confirmed after one Delphi round during which at least 80% agreement was established by 51 physical therapists on the appropriateness of the WISCI-II levels for children. Fifty-two children with SCI aged 2-17 years completed repeated WISCI-II assessments and 40 de-identified photographs were scored by four physical therapists. Intra- and inter-rater reliability was high (ICC=0.997, CI=0.995-0.998 and ICC=0.97, CI=0.95-0.98, respectively). This study demonstrates support for the use of the WISCI-II in ambulatory children with SCI. This study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey

Prognostic importance of VEGF-A haplotype combinations in a stage II colon cancer population

DEFF Research Database (Denmark)

Kjaer-Frifeldt, Sanne; Fredslund, Rikke; Lindebjerg, Jan

2012-01-01

To investigate the prognostic effect of three VEGF-A SNPs, -2578, -460 and 405, as well as the corresponding haplotype combinations, in a unique population of stage II colon cancer patients.......To investigate the prognostic effect of three VEGF-A SNPs, -2578, -460 and 405, as well as the corresponding haplotype combinations, in a unique population of stage II colon cancer patients....

Breast carcinoma conservative treatment. Stages I and II

International Nuclear Information System (INIS)

Monti, C.R.

1990-01-01

From 1981 to 1988, 265 patients with breast cancer stages I and II (UICC-1987), were evaluated after conservative treatment with quadrantectomy plus axillectomy, radiotherapy and chemotherapy. After surgical treatment, the patients were submitted to radiation therapy in the breast. One hundred and fifty six (58,8%) patients were submitted to adjuvant chemotherapy. The median clinical follow-up period was 42.8 months with a minimum of 24 and a maximum of 99 months. Six (2,3%) patients presented local recurrence and 48 (18,1%) presented distant metastasis. After five years the total survival rate was 89,7% and the disease free survival rate was 75% in the same period. The study did not show significant differences among the clinical stages classified after surgery and the use of adjuvant chemotherapy did not influence the results of the many stages. (author). 194 refs, 33 figs, 6 tabs

Diagnosis and Treatment of Intussusception in Children

Directory of Open Access Journals (Sweden)

O.V. Spakhi

2016-08-01

Full Text Available Intussusception is the most common form of acquired gastrointestinal obstruction in children. The aim is to study the features of clinical course and treatment strategy for intussusception in children and to analyze limitations of diagnostic, clinical and special research methods. Materials and methods of the study. The analysis of treatment outcomes has been carried out in 272 children in pediatric surgery clinic from 2004 to 2015. We have developed the objective criteria for evaluation of intussusception stages that correlate with the degree of endotoxemia, changes in respiratory function and circulation, the disorders of gut motility, as well as ultrasound of the abdominal organs. Results and discussion. Patients with intussusception stage I (233 children had no signs of endotoxemia or they were non-significant. In 10 children we performed surgery, in 4 cases — laporoscopically. Of the 32 patients with stage II, in 8 cases the intussusception was straightened conservatively on the first try. We don’t make a second attempt in children with intussusception stage II. Surgical straightening was perfomed in 24 patients. Intussusception stage III in children (7 patients had signs of third degree endotoxemia. All patients of the third stage of intussusception underwent median laparotomy. In 5 cases we have detected intussusceptum necrosis, and these children were made bowel resection followed by the imposition of final ileostomy and intubation of the small intestine. In the rest (2 of patients, we managed to straighten the intussusceptum, and the gut was recognized as vital. Imposing primary anastomosis after the bowel resection in peritonitis we consider unacceptable. Conclusions. 1. Comprehensive survey of children using laboratory and instrumental methods became the basis for the allocation of 3 stages of intussusception, which correlated with the degree of endotoxemia and impaired bowel functions: stage I — compensated; stage II �

Breast-Conserving Surgery Followed by Radiation Therapy With MRI-Detected Stage I or Stage II Breast Cancer

Science.gov (United States)

2011-12-07

Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Tubular Ductal Breast Carcinoma

PTT functional recovery in early stage II PTTD after tendon balancing and calcaneal lengthening osteotomy.

Science.gov (United States)

Brilhault, Jean; Noël, Vincent

2012-10-01

The decision to offer surgery for Stage II posterior tibial tendon deficiency (PTTD) is a difficult one since orthotic treatment has been documented to be a viable alternative to surgery at this stage. Taking this into consideration we limited our treatment to bony realignment by a lengthening calcaneus Evans osteotomy and tendon balancing. The goal of the study was to clinically evaluate PTT functional recovery with this procedure. The patient population included 17 feet in 13 patients. Inclusion was limited to early Stage II PTTD flatfeet with grossly intact but deficient PTT. Deficiency was assessed by the lack of hindfoot inversion during single heel rise test. The surgical procedure included an Evans calcaneal opening wedge osteotomy with triceps surae and peroneus brevis tendon lengthening. PTT function at follow up was evaluated by an independent examiner. Evaluation was performed at an average of 4 (range, 2 to 6.3) years. One case presented postoperative subtalar pain that required subtalar fusion. Every foot could perform a single heel rise with 13 feet having active inversion of the hindfoot during elevation. The results of this study provide evidence of PTT functional recovery without augmentation in early Stage II. It challenges our understanding of early Stage II PTTD as well as the surgical guidelines recommending PTT augmentation at this specific stage.

Postoperative radiotherapy for stage II and III rectal cancer

International Nuclear Information System (INIS)

Qian Liting; Song Yongwen; Liu Xinfan; Yu Zihao; Qian Tunan; Li Yexiong

2003-01-01

Objective: To evaluate the impact of postoperative adjuvant radiotherapy, compared with surgery alone for rectal cancer. Methods: From January 1994 to October 1997, 192 patients with stage II or III rectal cancer were treated by radical resection and postoperative radiotherapy (Group S + R) and 51 patients with the same stage lesions underwent surgery alone (Group S). The median dose of radiation was 50(32-62) Gy. Kaplan-Meier method and Log-rank test were used for analysis. Results: The 5-year overall and disease-free survival rates were 60.3% and 58.3%, respectively. The overall 5-year survival rate was 59.4% in Group S + R and 64.7% in Group S, and the 5-year disease-free survival rates were 57.0% and 66.4%, respectively. There were no significant differences between either group (P=0.601 and P=0.424). The disease-free survival was not significantly prolonged in Group S + R as compared with that of Group S. The local recurrence rate was evidently reduced in Group S + R (15.8% v 26.8%, P=0.043). Conclusion: Local recurrence is a major cause of morbidity and mortality in rectal cancer. Postoperative radiotherapy, though reduces the incidence of local recurrence, does not improve the survival in the treatment of stage II and III diseases

Resistance Torque Based Variable Duty-Cycle Control Method for a Stage II Compressor

Science.gov (United States)

Zhong, Meipeng; Zheng, Shuiying

2017-07-01

The resistance torque of a piston stage II compressor generates strenuous fluctuations in a rotational period, and this can lead to negative influences on the working performance of the compressor. To restrain the strenuous fluctuations in the piston stage II compressor, a variable duty-cycle control method based on the resistance torque is proposed. A dynamic model of a stage II compressor is set up, and the resistance torque and other characteristic parameters are acquired as the control targets. Then, a variable duty-cycle control method is applied to track the resistance torque, thereby improving the working performance of the compressor. Simulated results show that the compressor, driven by the proposed method, requires lower current, while the rotating speed and the output torque remain comparable to the traditional variable-frequency control methods. A variable duty-cycle control system is developed, and the experimental results prove that the proposed method can help reduce the specific power, input power, and working noise of the compressor to 0.97 kW·m-3·min-1, 0.09 kW and 3.10 dB, respectively, under the same conditions of discharge pressure of 2.00 MPa and a discharge volume of 0.095 m3/min. The proposed variable duty-cycle control method tracks the resistance torque dynamically, and improves the working performance of a Stage II Compressor. The proposed variable duty-cycle control method can be applied to other compressors, and can provide theoretical guidance for the compressor.

78 FR 58184 - Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline...

Science.gov (United States)

2013-09-23

...] Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline Vapor... measures for new and upgraded gasoline dispensing facilities in the State. The September 18, 2009, SIP... .0953), entitled Vapor Return Piping for Stage II Vapor Recovery, for all new or improved gasoline tanks...

Prognostic value of stem cell quantification in stage II colon cancer.

Directory of Open Access Journals (Sweden)

Maria Angeles Vaz

Full Text Available BACKGROUND: Cancer stem cells (CSCs are a subset of tumor cells with capacity to self-renew and generate the diverse cells that make up the tumor. The aim of this study is to evaluate the prognostic value of CSCs in a highly homogeneous population of stage II colon cancer. METHODS: One hundred stage II colon cancer patients treated by the same surgical team between 1977 and 2005 were retrospectively analyzed. None of the patients received adjuvant chemotherapy. Inmunohistochemistry expression of CD133, NANOG and CK20 was scored, using four levels: 50% positivity. Kaplan-Meier analysis and log rank test were used to compare survival. RESULTS: The average patient age was 68 years (patients were between 45-92 years of age and median follow up was 5.8 years. There was recurrent disease in 17 (17%; CD133 expression (defined by >10% positivity was shown in 60% of the tumors, in 95% for NANOG and 78% for CK20. No correlation was found among expression levels of CD133, NANOG or CK20 and relapse-free survival (RFS or overall survival (OS. However, a statistical significant correlation was found between established pathological prognostic factors and RFS and OS. CONCLUSIONS: Stem Cell quantification defined by CD133 and NANOG expression has no correlation with RFS or OS in this cohort of Stage II colon cancer.

Excisional biopsy, auxillary node dissection and definitive radiotherapy for Stages I and II breast cancer

International Nuclear Information System (INIS)

Danoff, B.F.; Pajak, T.F.; Solin, L.J.; Goodman, R.L.

1985-01-01

From 1977 to 1982, 189 patients with clinical Stage I and II breast cancer underwent excisional biopsy and auxillary node dissection followed by definitive radiotherapy at the University of Pennsylvania. One hundred and nine patients had T 1 lesions and 80 had T 2 lesions. Histologically negative nodes were found in 136 patients (72%) and histologically positive nodes in 53 patients. Median follow-up from the completion of radiotherapy was 26 months. The four year actuarial disease free survival is 82% for pathologic Stage I and 70% for pathologic Stage II. Cosmesis was judged to be good to excellent in 90% and fair in 9%. Complications included arm edema (7%), symptomatic pneumonitis (1%), rib fractures (1%), pericarditis (1%) and pleural effusion (1%). Primary radiotherapy for Stages I and II breast cancer produces a local-regional control rate of 95% and good to excellent cosmesis in 90% of the patients. While these results are preliminary, they compare favorably with other reported series

Saturn V Second Stage (S-II) Ready for Static Test

Science.gov (United States)

1965-01-01

Two workers are dwarfed by the five J-2 engines of the Saturn V second stage (S-II) as they make final inspections prior to a static test firing by North American Space Division. These five hydrogen -fueled engines produced one million pounds of thrust, and placed the Apollo spacecraft into earth orbit before departing for the moon. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Regulatory activity based risk model identifies survival of stage II and III colorectal carcinoma.

Science.gov (United States)

Liu, Gang; Dong, Chuanpeng; Wang, Xing; Hou, Guojun; Zheng, Yu; Xu, Huilin; Zhan, Xiaohui; Liu, Lei

2017-11-17

Clinical and pathological indicators are inadequate for prognosis of stage II and III colorectal carcinoma (CRC). In this study, we utilized the activity of regulatory factors, univariate Cox regression and random forest for variable selection and developed a multivariate Cox model to predict the overall survival of Stage II/III colorectal carcinoma in GSE39582 datasets (469 samples). Patients in low-risk group showed a significant longer overall survival and recurrence-free survival time than those in high-risk group. This finding was further validated in five other independent datasets (GSE14333, GSE17536, GSE17537, GSE33113, and GSE37892). Besides, associations between clinicopathological information and risk score were analyzed. A nomogram including risk score was plotted to facilitate the utilization of risk score. The risk score model is also demonstrated to be effective on predicting both overall and recurrence-free survival of chemotherapy received patients. After performing Gene Set Enrichment Analysis (GSEA) between high and low risk groups, we found that several cell-cell interaction KEGG pathways were identified. Funnel plot results showed that there was no publication bias in these datasets. In summary, by utilizing the regulatory activity in stage II and III colorectal carcinoma, the risk score successfully predicts the survival of 1021 stage II/III CRC patients in six independent datasets.

Non-Surgical Breast-Conserving Treatment (KORTUC-BCT Using a New Radiosensitization Method (KORTUC II for Patients with Stage I or II Breast Cancer

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Yasuhiro Ogawa

2015-11-01

Full Text Available The purpose of the present study was to establish a non-surgical breast-conserving treatment (BCT using KORTUC II radiosensitization treatment. A new radiosensitizing agent containing 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (a CD44 ligand has been developed for intra-tumoral injection into various tumors. This new method, named KORTUC II, was approved by our local ethics committee for the treatment of breast cancer and metastatic lymph nodes. A total of 72 early-stage breast cancer patients (stage 0, 1 patient; stage I, 23; stage II, 48 were enrolled in the KORTUC II trial after providing fully informed consent. The mean age of the patients was 59.7 years. A maximum of 6 mL (usually 3 mL for tumors of less than approximately 3 cm in diameter of the agent was injected into breast tumor tissue twice a week under ultrasonographic guidance. For radiotherapy, hypofraction radiotherapy was administered using a tangential fields approach including an ipsilateral axillary region and field-in-field method; the energy level was 4 MV, and the total radiation dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added three times. Treatment was well tolerated with minimal adverse effects in all 72 patients. No patients showed any significant complications other than mild dermatitis. A total of 24 patients under 75 years old with stage II breast cancer underwent induction chemotherapy (EC and/or taxane prior to KORTUC II treatment, and 58 patients with estrogen receptor-positive tumors also received hormonal therapy following KORTUC II. The mean duration of follow-up as of the end of September 2014 was 51.1 months, at which time 68 patients were alive without any distant metastases. Only one patient had local recurrence and died of cardiac failure at 6.5 years. Another one patient had bone metastases. For two of the 72 patients, follow-up ended after several months following KORTUC II treatment. In conclusion, non

Ezrin expression combined with MSI status in prognostication of stage II colorectal cancer.

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Khadija Slik

Full Text Available Currently used factors predicting disease recurrence in stage II colorectal cancer patients are not optimal for risk stratification. Thus, new biomarkers are needed. In this study the applicability of ezrin protein expression together with MSI status and BRAF mutation status were tested in predicting disease outcome in stage II colorectal cancer. The study population consisted of 173 stage II colorectal cancer patients. Paraffin-embedded cancer tissue material from surgical specimens was used to construct tissue microarrays (TMAs with next-generation technique. The TMA-slides were subjected to following immunohistochemical stainings: MLH1, MSH2, MSH6, PMS2, ezrin and anti-BRAF V600E antibody. The staining results were correlated with clinicopathological variables and survival. In categorical analysis, high ezrin protein expression correlated with poor disease-specific survival (p = 0.038. In univariate analysis patients having microsatellite instabile / low ezrin expression tumors had a significantly longer disease-specific survival than patients having microsatellite stable / high ezrin expression tumors (p = 0.007. In multivariate survival analysis, the presence of BRAF mutation was associated to poor overall survival (p = 0.028, HR 3.29, 95% CI1.14-9.54. High ezrin protein expression in patients with microsatellite stable tumors was linked to poor disease-specific survival (p = 0.01, HR 5.68, 95% CI 1.53-21.12. Ezrin protein expression is a promising biomarker in estimating the outcome of stage II colorectal cancer patients. When combined with microsatellite status its ability in predicting disease outcome is further improved.

Fulvestrant and/or Anastrozole in Treating Postmenopausal Patients With Stage II-III Breast Cancer Undergoing Surgery

Science.gov (United States)

2018-04-06

Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Treatment results of radiotherapy for medically inoperable stage I/II non-small cell lung cancer

International Nuclear Information System (INIS)

Zhang Li; Wang Lvhua; Zhang Hongxing; Chen Dongfu; Xiao Zefen; Wang Mei; Feng Qinfu; Liang Jun; Zhou Zongmei; Ou Guangfei; Lv Jima; Yin Weibo

2008-01-01

Objective: To retrospectively analyze treatment results of radiotherapy for medically inoperable stage I/II non-small cell lung cancer. Methods: Between Jan. 2000 and Dec. 2005, fifty-eight such patients were enrolled into the database analysis, including 37 with clinical stage I and 21 with stage II disease. Fifty patients received radiotherapy alone and eight with radiotherapy and chemotherapy. Forty- three patients were treated with 3-D conformal radiotherapy (3D-CRT) and 15 with conventional radiotherapy. Results: The 1-, 2- and 3-year overall survival rates were 85%, 54% and 30%, and the median survival time was 26.2 months for the whole group. The corresponding figures were 88%, 60%, 36% and 30.8 months for cancer-specific survival; 84%, 64%, 31% and 30.8 months for Stage I disease; 81%, 47%, 28% and 18.8 months for Stage II disease; 95%, 57%, 33% and 30.8 months for 3D-CRT group and 53%, 44%, 24% and 15.3 months for conventional radiotherapy group. By logrank test, tumor volume, pneumonitis of Grade II or higher and weight loss more than 5% showed statistically significant impact on overall survival. Tumor volume was the only independent prognostic factor in Cox multivariable regression. Pneumonitis and esophagitis of Grade II or higher were 16% and 2%, respectively. Age and lung function before treatment had a significant relationship with pneumonitis. Failure included the local recurrence (33%) and distant metastasis (21%). There was no difference between the treatment modalities and failure sites. Conclusions: For medically inoperable early stage non-small cell lung cancer patients, tumor volume is the most important prognostic factor for overall survival. The conformal radiotherapy marginally improves the survival. The age and pulmonary function are related to the incidence of treatment induced pneumonitis. (authors)

Evaluation of Oral Hygiene in Patients with Generalized Periodontitis of II Degree and Stage II Hypertension

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Tetiana Vivcharenko

2016-12-01

Conclusions. The level of oral hygiene in patients of both groups was low due to incorrect selection of personal hygiene products or their untimely replacement. In patients with generalized periodontitis of II degree and stage II hypertension, the level of oral hygiene was lower than in somatically healthy persons: the worse status of oral cavity hygiene – the more pronounced changes in the periodontal tissues. We can suppose that high blood pressure affects the status of the oral cavity, creates a higher risk and exacerbates the periodontal diseases.

Second-stage transsphenoidal approach (TSA) for highly vascular pituicytomas in children.

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Kim, Young Gyu; Park, Young Seok

2015-06-01

A pituicytoma in the sellar area is extremely rare in children and, due to its highly vascularized nature, can be difficult to address using the transsphenoid approach (TSA) to surgery. Here, we report a rare case of a pituicytoma that was completely removed from a child through a staged operation using the TSA. A 13-year-old girl was admitted with a 1-year history of visual disturbance and amenorrhea. Visual field examination showed left total blindness and right temporal hemianopsia. Laboratory results revealed hormonal levels all within normal ranges. Brain magnetic resonance imaging (MRI) showed a homogeneous, highly enhancing sellar and suprasellar mass, typically suggestive of a pituitary adenoma. TSA surgery revealed the tumor had a rubbery-firm consistency, hypervascularity, and profuse bleeding. We removed the tumor partially and planned a second-stage operation. Gross total removal is the treatment of choice for this type of tumor. Attempted resection of these presumed adenomas or meningiomas using the TSA often results in unexpectedly heavy intraoperative bleeding due to the high vascularity of this rare tumor, making surgery challenging, especially in children where the tumor is within a relatively narrow corridor. While pituicytomas are a rare differential diagnosis for sellar or parasellar tumors in children, total removal by second-stage TSA surgery is indicated in the case of profuse bleeding or uncertainty of biopsy. Following first-stage TSA surgery and pathologic confirmation of pituicytoma, the strategy is typically gross total removal during second-stage TSA surgery. Although very rare in children, a pituicytoma should be included in the differential diagnosis of a mass in the sellar area if the tumor is highly enhancing or very vascular. Second-stage TSA surgery is another strategy when the pathology is not clear during the first-stage TSA surgery.

Outcome of radiotherapy for localized stage I E and II E nasal NK/T cell lymphoma

International Nuclear Information System (INIS)

Jin Jing; Li Yexiong; Yao Bo; Fang Hui; Liu Xinfan; Zhou Liqiang; Lv Ning; Yu Zihao

2006-01-01

Objective: With the optimal therapy remains unclear for nasal NK/T cell lymphoma, the aim of this study is to analyze the outcome of radiotherapy as primary treatment for localized stage I E and II E diseases. Methods: Between January. 1983 and December 2003, 105 patients with stage I E and II E primary nasal NK/T cell lymphoma were retrospectively reviewed. According to the Ann Arbor Staging System, there were 83 stage I E and 22 stage II E. Stage I E was subdivided into limited stage I E confined to the nasal cavity (37 patients), or extensive stage I E with an extension beyond the nasal cavity (46 patients). Thirty-one patients received radiotherapy alone. Thirty-four patients were treated with radiotherapy followed by 2-4 cycles of chemotherapy. Thirty-seven patients were treated with chemotherapy followed by radiotherapy and 3 with chemotherapy alone. Of 83 patients with stage I E disease, 26 were primarily treated with radiotherapy alone, 30 with. radiotherapy followed by chemotherapy, and 27 with chemotherapy followed by radiotherapy. Results: The five-year overall survival (OS) and progression-free survival rates (PIS) for all patients was 71% and 59%, respectively. The 5-year OS for stage I E and stage II E was 78% and 46% (P<0.01), while the 5-year PFS for stage I E and stage II E was 63% and 40%, respectively (P<0.01). Patients with limited stage I E had a better OS and PFS than those with extensive stage I E, with 5-year OS and PFS of 82% and 80% versus 75% and 45%, respectively. Complete response (CR) was achieved in 91 (87%) patients after radiotherapy and/or chemotherapy. Initial radiotherapy resulted in a superior CR as compared to initial chemotherapy, with 54 of 65 (83%) patients achieving CR with initial radiotherapy, versus only 8 of 40 (20%) with initial chemotherapy. For 102 patients who received radiotherapy with or without chemotherapy, the outcome of primary, treatment with radiotherapy alone was compared to that of CMT. Five-year OS and

Treatment results of Stage I and II oral tongue cancer with interstitial brachytherapy: maximum tumor thickness is prognostic of nodal metastasis

International Nuclear Information System (INIS)

Matsuura, Kanji; Hirokawa, Yutaka; Fujita, Minoru; Akagi, Yukio; Ito, Katsuhide

1998-01-01

Purpose: To evaluate the prognostic importance of T classification and maximum tumor thickness (MTT) on the treatment results of Stage I and II oral tongue cancer treated with interstitial brachytherapy. Methods and Materials: Between January 1981 and December 1993, 173 cases were eligible for this retrospective analysis. Of 173 patients, 75 were classified as Stage I and 98 as Stage II: maximum tumor length ranged from 6 to 40 mm. MTT, which ranged from 2 to 38 mm, was measured with ultrasonography and/or palpation. Brachytherapy was performed with iridium hairpins or radium needles following external irradiation in 66 patients, or exclusively in 107 patients. Results: The 5-year local recurrence rates were Stage I, 7%; Stage II, 22%; MTT < 8 mm, 8%; and MTT ≥ 8 mm, 28%. The 5-year regional recurrence rates were Stage I, 15%; Stage II, 29%; MTT < 8 mm, 18%; and MTT ≥ 8 mm, 31%, respectively. The 5-year local recurrence rates of the patients with Stage I and MTT < 8 mm of the brachytherapy only group were significantly better than those of Stage II and MTT ≥ 8 mm (5% and 6% vs. 16% and 24%). The 5-year regional recurrence rates of the patients with Stage I and MTT < 8 mm of the brachytherapy-only group were significantly better than those of Stage II and MTT ≥ 8 mm (14% and 16% vs. 34% and 46%). There was no significant difference in the 5-year regional recurrence rates between the two groups of Stage I and Stage II, MTT < 8 mm. However, there was a significant difference in the 5-year regional recurrence rates between the two groups of MTT ≥ 8 mm (p < 0.005). Conclusions: For patients with Stage I and II oral tongue cancer, tumor thickness as well as T classification were prognostic for nodal metastasis and prognosis. Patients with MTT ≥ 8 mm are more likely to fail in the neck region. These findings suggest that MTT should be considered along with T stage in determining strategies for Stage I and II oral tongue cancer

Adjuvant chemotherapy is associated with improved survival in patients with stage II colon cancer.

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Casadaban, Leigh; Rauscher, Garth; Aklilu, Mebea; Villenes, Dana; Freels, Sally; Maker, Ajay V

2016-11-15

The role of adjuvant chemotherapy in patients with stage II colon cancer remains to be elucidated and its use varies between patients and institutions. Currently, clinical guidelines suggest discussing adjuvant chemotherapy for patients with high-risk stage II disease in the absence of conclusive randomized controlled trial data. To further investigate this relationship, the objective of the current study was to determine whether an association exists between overall survival (OS) and adjuvant chemotherapy in patients stratified by age and pathological risk features. Data from the National Cancer Data Base were analyzed for demographics, tumor characteristics, management, and survival of patients with stage II colon cancer who were diagnosed from 1998 to 2006 with survival information through 2011. Pearson Chi-square tests and binary logistic regression were used to analyze disease and demographic data. Survival analysis was performed with the log-rank test and Cox proportional hazards regression modeling. Propensity score weighting was used to match cohorts. Among 153,110 patients with stage II colon cancer, predictors of receiving chemotherapy included age clinically relevant OS was associated with the receipt of adjuvant chemotherapy in all patient subgroups regardless of high-risk tumor pathologic features (poor or undifferentiated histology, colon cancer evaluated to date, improved OS was found to be associated with adjuvant chemotherapy regardless of treatment regimen, patient age, or high-risk pathologic risk features. Cancer 2016;122:3277-3287. © 2016 American Cancer Society. © 2016 American Cancer Society.

Ages and Stages Questionnaire used to measure cognitive deficit in children born extremely preterm

DEFF Research Database (Denmark)

Klamer, Anja; Lando, Ane; Pinborg, Anja

2005-01-01

AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence--Revised.......AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence...

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)

Roentgenological criteria od assessment of stages of hydronephrosis in children

International Nuclear Information System (INIS)

Pavlova, M.K.

1988-01-01

A new parenchymatous index was proposed in order to raise the resolving power of excretory urography, and 3 stages of hydronephrosis were defined on the basis of quantitative indices. X-ray criteria were defined to prevent surgery in a group of children with the initial stage of disease. A group of patients with the terminal stage of hydronephrosis was subdivided into 2 groups: 1) sparing operation, 2) nephrectomy

Effect of anti-VEGF treatment on retinopathy of prematurity in Zone II Stage 3+

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Xiu-Mei Yang

2018-04-01

Full Text Available AIM: To evaluate the effect of intravitreal ranibizumab injection for retinopathy of prematurity (ROP in Zone II Stage 3+. METHODS: Data was collected for ROP patients with Zone II Stage 3+ who received intravitreal ranibizumab injections between October 2014 and Janu­ary 2017 at the Department of Ophthalmology in our hospital. No prior laser or other intravitreal treatment was done. Prior to the intervention and at each follow-up visit, fundus examination was performed. Gestational age at birth, sex, birth weight, ROP zone, ROP stage, post menstrual age (PMA at treatment, and follow-up pe­riod were recorded. The final clinical status of the retina was evaluated for each patient. The primary outcome mea­sures included ROP recurrences requiring re-treatment, complete or incomplete peripheral vascularization. RESULTS: Eighty-six eyes of 46 premature infants with Zone II Stage 3+ ROP were enrolled in the study. The mean gestational age at birth was 28.18±1.67 (range: 25 to 33wk and the mean birth weight was 1070.57±226.85 (range: 720.00 to 1650.00 g. The mean PMA at treatment was 38.32±2.99 (range: 32.29 to 46.00wk. Seventy-one eyes (82.56% were treated success­fully with intravitreal ranibizumab as monotherapy. Fifteen eyes (17.44% developed recurrent disease. The mean interval between the treatment and retreatment was 5.96±3.22 (range: 1.86 to 11.71wk. All eyes vascularized into zone III at the end of the study and among them 62 eyes (72.09% achieved complete vascu­larization. CONCLUSION: Intravitreal ranibizumab injection is an effective treatment in Zone II Stage 3+ ROP patients. More patients with longer follow-up duration are necessary to confirm the safety and efficacy of this treatment.

High clusterin expression correlates with a poor outcome in stage II colorectal cancers.

LENUS (Irish Health Repository)

Kevans, David

2012-02-01

The role of clusterin in tumor growth and progression remains unclear. Overexpression of cytoplasmic clusterin has been studied in aggressive colon tumors; however, no correlation between clusterin expression and survival in colorectal cancer has been identified to date. We assessed levels of clusterin expression in a group of stage II colorectal cancer patients to assess its utility as a prognostic marker. The study included 251 patients with stage II colorectal cancer. Tissue microarrays were constructed and immunohistochemistry done and correlated with clinical features and long term outcome. Dual immunofluorescence and confocal microscopy were used with terminal deoxynucleotidyl-transferase-mediated dUTP nick-end labeling probes and clusterin antibody to assess the degree of co localization. Percentage epithelial cytoplasmic staining was higher in tumor compared with nonadjacent normal mucosa (P < 0.001). Within the stromal compartment, percentage cytoplamic staining and intensity was lower in tumor tissue compared with normal nonadjacent mucosa (P < or = 0.001). Survival was significantly associated with percentage epithelial cytoplasmic staining (P < 0.001), epithelial cytoplasmic staining intensity (P < 0.001), percentage stromal cytoplasmic staining (P = 0.002), and stromal cytoplasmic staining intensity (P < 0.001). Clusterin levels are associated with poor survival in stage II colorectal cancer.

The Effect of Simvastatin on Breast Cancer Cell Growth in Women With Stage I-II Breast Cancer

Science.gov (United States)

2018-03-02

Invasive Breast Carcinoma; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

2-Hexadecynoic acid inhibits plasmodial FAS-II enzymes and arrests erythrocytic and liver stage Plasmodium infections.

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Tasdemir, Deniz; Sanabria, David; Lauinger, Ina L; Tarun, Alice; Herman, Rob; Perozzo, Remo; Zloh, Mire; Kappe, Stefan H; Brun, Reto; Carballeira, Néstor M

2010-11-01

Acetylenic fatty acids are known to display several biological activities, but their antimalarial activity has remained unexplored. In this study, we synthesized the 2-, 5-, 6-, and 9-hexadecynoic acids (HDAs) and evaluated their in vitro activity against erythrocytic (blood) stages of Plasmodium falciparum and liver stages of Plasmodium yoelii infections. Since the type II fatty acid biosynthesis pathway (PfFAS-II) has recently been shown to be indispensable for liver stage malaria parasites, the inhibitory potential of the HDAs against multiple P. falciparum FAS-II (PfFAS-II) elongation enzymes was also evaluated. The highest antiplasmodial activity against blood stages of P. falciparum was displayed by 5-HDA (IC(50) value 6.6 μg/ml), whereas the 2-HDA was the only acid arresting the growth of liver stage P. yoelii infection, in both flow cytometric assay (IC(50) value 2-HDA 15.3 μg/ml, control drug atovaquone 2.5 ng/ml) and immunofluorescence analysis (IC(50) 2-HDA 4.88 μg/ml, control drug atovaquone 0.37 ng/ml). 2-HDA showed the best inhibitory activity against the PfFAS-II enzymes PfFabI and PfFabZ with IC(50) values of 0.38 and 0.58 μg/ml (IC(50) control drugs 14 and 30 ng/ml), respectively. Enzyme kinetics and molecular modeling studies revealed valuable insights into the binding mechanism of 2-HDA on the target enzymes. All HDAs showed in vitro activity against Trypanosoma brucei rhodesiense (IC(50) values 3.7-31.7 μg/ml), Trypanosoma cruzi (only 2-HDA, IC(50) 20.2 μg/ml), and Leishmania donovani (IC(50) values 4.1-13.4 μg/ml) with generally low or no significant toxicity on mammalian cells. This is the first study to indicate therapeutic potential of HDAs against various parasitic protozoa. It also points out that the malarial liver stage growth inhibitory effect of the 2-HDA may be promoted via PfFAS-II enzymes. The lack of cytotoxicity, lipophilic nature, and calculated pharmacokinetic properties suggests that 2-HDA could be a useful compound to

2-Hexadecynoic Acid Inhibits Plasmodial FAS-II Enzymes and Arrest Erythrocytic and Liver Stage Plasmodium Infections

Science.gov (United States)

Tasdemir, Deniz; Sanabria, David; Lauinger, Ina L.; Tarun, Alice; Herman, Rob; Perozzo, Remo; Zloh, Mire; Kappe, Stefan H.; Brun, Reto; Carballeira, Néstor M.

2010-01-01

Acetylenic fatty acids are known to display several biological activities, but their antimalarial activity has remained unexplored. In this study, we synthesized the 2-, 5-, 6-, and 9-hexadecynoic acids (HDAs) and evaluated their in vitro activity against erythrocytic (blood) stages of Plasmodium falciparum and liver stages of P. yoelii infections. Since the type II fatty acid biosynthesis pathway (PfFAS-II) has recently been shown to be indispensable for liver stage malaria parasites, the inhibitory potential of the HDAs against multiple P. falciparum FAS-II (PfFAS-II) elongation enzymes was also evaluated. The highest antiplasmodial activity against blood stages of P. falciparum was displayed by 5-HDA (IC50 value 6.6. μg/ml), whereas the 2-HDA was the only acid arresting the growth of liver stage P. yoelii infection, in both flow cytometric assay (IC50 value 2-HDA 15.3 μg/ml, control drug atovaquone 2.5 ng/ml) and immunofluorescense analysis (IC50 2-HDA 4.88 μg/ml, control drug atovaquone 0.37 ng/ml). 2-HDA showed the best inhibitory against the PfFAS-II enzymes PfFabI and PfFabZ with IC50 values of 0.38 and 0.58 μg/ml (IC50 control drugs 14 and 30 ng/ml) respectively. Enzyme kinetics and molecular modeling studies revealed valuable insights into the binding mechanism of 2-HDA on the target enzymes. All HDAs showed in vitro activity against Trypanosoma brucei rhodesiense (IC50 values 3.7–31.7 μg/ml), Trypanosoma cruzi (only 2-HDA, IC50 20.2 μg/ml), and Leishmania donovani (IC50 values 4.1–13.4 μg/ml) with generally low or no significant toxicity on mammalian cells. This is the first study to indicate therapeutic potential of HDAs against various parasitic protozoa. It also points out that the malarial liver stage growth inhibitory effect of the 2-HDA may be promoted via PfFAS-II enzymes. The lack of cytotoxicity, lipophilic nature and calculated pharmacokinetic properties suggest that 2-HDA could be a useful compound to study the interaction of fatty

Later learning stages in procedural memory are impaired in children with Specific Language Impairment.

Science.gov (United States)

Desmottes, Lise; Meulemans, Thierry; Maillart, Christelle

2016-01-01

According to the Procedural Deficit Hypothesis (PDH), difficulties in the procedural memory system may contribute to the language difficulties encountered by children with Specific Language Impairment (SLI). Most studies investigating the PDH have used the sequence learning paradigm; however these studies have principally focused on initial sequence learning in a single practice session. The present study sought to extend these investigations by assessing the consolidation stage and longer-term retention of implicit sequence-specific knowledge in 42 children with or without SLI. Both groups of children completed a serial reaction time task and were tested 24h and one week after practice. Results showed that children with SLI succeeded as well as children with typical development (TD) in the early acquisition stage of the sequence learning task. However, as training blocks progressed, only TD children improved their sequence knowledge while children with SLI did not appear to evolve any more. Moreover, children with SLI showed a lack of the consolidation gains in sequence knowledge displayed by the TD children. Overall, these results were in line with the predictions of the PDH and suggest that later learning stages in procedural memory are impaired in SLI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prognostic impact of interhospital variation in adjuvant chemotherapy for patients with Stage II/III colorectal cancer: a nationwide study.

Science.gov (United States)

Arakawa, K; Kawai, K; Tanaka, T; Hata, K; Sugihara, K; Nozawa, H

2018-05-12

Clinical guidelines recommend adjuvant chemotherapy for high-risk patients with Stage II-III colorectal cancer. However, chemotherapeutic administration rates differ significantly between hospitals. We assessed the prognostic benefit of adjuvant chemotherapy in patients with Stage IIb/c colorectal cancer, and the prognostic impact of interhospital variations in the administration of adjuvant chemotherapy for Stage II-III colorectal cancer. We conducted a multicentre, retrospective study of 17 757 patients with Stage II-III colorectal cancer treated between 1997 and 2008 in 23 hospitals in Japan. Hospitals were classified as high-rate (rate > 42.8%) or low-rate (rate ≤ 42.8%), chemotherapy prescribing clinics. The 5-year overall survival (OS) of patients with Stage II-III colorectal cancer receiving adjuvant chemotherapy was significantly higher than for those not receiving adjuvant chemotherapy (85.7% vs 79.2%, P colorectal cancer (both P colorectal cancer who received adjuvant chemotherapy, with patients who were treated in hospitals with high adjuvant chemotherapy rates demonstrating better prognoses. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

[Etiological analysis of 264 cases with chronic kidney disease stage 2 to 5 in children].

Science.gov (United States)

Miao, Qianfan; Shen, Qian; Xu, Hong; Sun, Li; Tang, Xiaoshan; Fang, Xiaoyan; Liu, Haimei; Zhai, Yihui; Bi, Yunli; Wang, Xiang; Chen, Hong

2015-09-01

To study and summarize the etiology of children patients with chronic kidney disease (CKD) stage 2 to 5 seen in Children's Hospital of Fudan University from Jan. 2004 to Dec. 2013. By complying with the NKF-K/DOQI guidelines, we collected data of 264 cases of children patients with CKD stage 2-5 from Jan. 2004 to Dec. 2013 in the medical record system of Children's Hospital of Fudan University. And we retrospectively analyzed their age and CKD stage at first diagnosis, primary diseases, complications, etc. In the collected 264 cases, 52 cases (19.7%) were diagnosed at stage 2, 67 (25.4%) at stage 3, 52 (19.7%) at stage 4 and 93 (35.2%) at stage 5. For disease causes, 116 cases (43.9%) had congenital anomalies of the kidney and urinary tract (CAKUT), 61 cases (23.1%) had glomerular disease, 15 (5.7%) had hereditary kidney disease, 14 (5.3%) had other diseases and in 58 cases (22.0%) the causes of disease were unknown. In the group with age between 0 and 3.0 and 3.1 and 6.0 years, 57.1% (24 cases) and 60.0% (30 cases) had primary disease with CAKUT. In the group with age older than 10 years, 49.2% (30 cases) had primary disease with glomerular disease and 32.0% (32 cases) with unknown causes. The major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT (43.9%), followed by glomerular disease (23.1%). The primary diseases of CKD were significantly different between the 2 age groups. CAKUT was more common in infants and preschool children while for adolescents, glomerular disease was the major cause.

How Applicable Are "Ages and Stages Questionnaires" for Use with Turkish Children?

Science.gov (United States)

Kapci, Emine Gul; Kucuker, Sevgi; Uslu, Runa I.

2010-01-01

The majority of eligible children cannot access early intervention services in Turkey, often because they are not assessed. The authors adapted the "Ages and Stages Questionnaires" (ASQ) for Turkish children ages 3 to 72 months. Study participants consisted of 375 children who were classified as at risk for developmental delays, 564…

Identification of miRNAs associated with recurrence of stage II colorectal cancer

DEFF Research Database (Denmark)

Christensen, Lise Lotte; Tobiasen, Heidi; Schepeler, Troels

2011-01-01

Colorectal cancer (CRC) is one of the leading causes of cancer deaths. Twenty-five percent of the patients radically treated for a stage II CRC (no lymph node or distant metastasis) later develop recurrence and dies from the disease. MicroRNAs (miRNAs) are aberrantly expressed or mutated in human...... target prediction and transcript profiling. Initially, miRNA over-expression in HCT116 cells was followed by transcriptional profiling of transfected cells using GeneChip Human Exon 1.0 ST Arrays. Three in silico predicted miRNA targets showing differential mRNA expression upon miRNA up-regulation were...... cancers, and function either as tumour suppressors or oncogenes. Additionally, they also appear to have both diagnostic and prognostic significance. The aim of the present study was to identify miRNAs associated with recurrence of stage II CRC, followed up by an investigation of how these potential...

Low Expression of TBX4 Predicts Poor Prognosis in Patients with Stage II Pancreatic Ductal Adenocarcinoma

Directory of Open Access Journals (Sweden)

Meijuan Zong

2011-08-01

Full Text Available This study was designed to investigate the expression of the T-box transcription factor 4 (TBX4, a tumor biomarker that was previously identified by proteomics, in pancreatic ductal adenocarcinoma (PDAC and evaluate its clinical utility as a potential prognostic biomarkers for PDAC. The expression of TBX4 was detected in 77 stage II PDAC tumors by immunohistochemistry, and the results were analyzed with regard to clinicopathological characteristics and overall survival. Moreover, Tbx4 promoter methylation status in primary PDAC tumors and normal adjacent pancreas tissues was measured by bisulfite sequencing. Among 77 stage II PDAC tumors, 48 cases (62.3% expressed TBX4 at a high level. No significant correlation between TBX4 expression and other clinicopathological parameters, except tumor grade and liver metastasis recurrence, was found. The survival of patients with TBX4-high expression was significantly longer than those with TBX4-low expression (P = 0.010. In multivariate analysis, low TBX4 expression was an independent prognostic factor for overall survival in patients with stage II PDAC. TBX4 promoter methylation status was frequently observed in both PDAC and normal adjacent pancreas. We conclude that a low level of TBX4 expression suggests a worse prognosis for patients with stage II PDAC. Down-regulation of the TBX4 gene in pancreas is less likely to be regulated by DNA methylation.

Identification and Construction of Combinatory Cancer Hallmark-Based Gene Signature Sets to Predict Recurrence and Chemotherapy Benefit in Stage II Colorectal Cancer.

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Gao, Shanwu; Tibiche, Chabane; Zou, Jinfeng; Zaman, Naif; Trifiro, Mark; O'Connor-McCourt, Maureen; Wang, Edwin

2016-01-01

Decisions regarding adjuvant therapy in patients with stage II colorectal cancer (CRC) have been among the most challenging and controversial in oncology over the past 20 years. To develop robust combinatory cancer hallmark-based gene signature sets (CSS sets) that more accurately predict prognosis and identify a subset of patients with stage II CRC who could gain survival benefits from adjuvant chemotherapy. Thirteen retrospective studies of patients with stage II CRC who had clinical follow-up and adjuvant chemotherapy were analyzed. Respective totals of 162 and 843 patients from 2 and 11 independent cohorts were used as the discovery and validation cohorts, respectively. A total of 1005 patients with stage II CRC were included in the 13 cohorts. Among them, 84 of 416 patients in 3 independent cohorts received fluorouracil-based adjuvant chemotherapy. Identification of CSS sets to predict relapse-free survival and identify a subset of patients with stage II CRC who could gain substantial survival benefits from fluorouracil-based adjuvant chemotherapy. Eight cancer hallmark-based gene signatures (30 genes each) were identified and used to construct CSS sets for determining prognosis. The CSS sets were validated in 11 independent cohorts of 767 patients with stage II CRC who did not receive adjuvant chemotherapy. The CSS sets accurately stratified patients into low-, intermediate-, and high-risk groups. Five-year relapse-free survival rates were 94%, 78%, and 45%, respectively, representing 60%, 28%, and 12% of patients with stage II disease. The 416 patients with CSS set-defined high-risk stage II CRC who received fluorouracil-based adjuvant chemotherapy showed a substantial gain in survival benefits from the treatment (ie, recurrence reduced by 30%-40% in 5 years). The CSS sets substantially outperformed other prognostic predictors of stage 2 CRC. They are more accurate and robust for prognostic predictions and facilitate the identification of patients with stage

[Combination of NAFLD Fibrosis Score and liver stiffness measurement for identification of moderate fibrosis stages (II & III) in non-alcoholic fatty liver disease].

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Drolz, Andreas; Wehmeyer, Malte; Diedrich, Tom; Piecha, Felix; Schulze Zur Wiesch, Julian; Kluwe, Johannes

2018-01-01

Non-alcoholic fatty liver disease (NAFLD) has become one of the most frequent causes of chronic liver disease. Currently, therapeutic options for NAFLD patients are limited, but new pharmacologic agents are being investigated in the course of clinical trials. Because most of these studies are focusing on patients with fibrosis stages II and III (according to Kleiner), non-invasive identification of patients with intermediate fibrosis stages (II and III) is of increasing interest. Evaluation of NAFLD Fibrosis Score (NFS) and liver stiffness measurement (LSM) for prediction of fibrosis stages II/III. Patients with histologically confirmed NAFLD diagnosis were included in the study. All patients underwent a clinical and laboratory examination as well as a LSM prior to liver biopsy. Predictive value of NFS and LSM with respect to identification of fibrosis stages II/III was assessed. 134 NAFLD patients were included and analyzed. Median age was 53 (IQR 36 - 60) years, 55 patients (41 %) were female. 82 % of our patients were overweight/obese with typical aspects of metabolic syndrome. 84 patients (66 %) had liver fibrosis, 42 (50 %) advanced fibrosis. LSM and NFS correlated with fibrosis stage (r = 0.696 and r = 0.685, respectively; p stages II/III. If both criteria were met, probability of fibrosis stage II/III was 61 %. If none of the two criteria was met, chance for fibrosis stage II/III was only 6 % (negative predictive value 94 %). Combination of LSM and NFS enables identification of patients with significant probability of fibrosis stage II/III. Accordingly, these tests, especially in combination, may be a suitable screening tool for fibrosis stages II/III in NAFLD. The use of these non-invasive methods might also help to avoid unnecessary biopsies. © Georg Thieme Verlag KG Stuttgart · New York.

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma

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Guo, Tianhua; Krzystanek, Marcin; Szallasi, Zoltan Imre

2014-01-01

of the 78 patients (6.4%) with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery). The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively...

Identification of 42 Genes Linked to Stage II Colorectal Cancer Metastatic Relapse

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Rabeah A. Al-Temaimi

2016-04-01

Full Text Available Colorectal cancer (CRC is one of the leading causes of cancer mortality. Metastasis remains the primary cause of CRC death. Predicting the possibility of metastatic relapse in early-stage CRC is of paramount importance to target therapy for patients who really need it and spare those with low-potential of metastasis. Ninety-six stage II CRC cases were stratified using high-resolution array comparative genomic hybridization (aCGH data based on a predictive survival algorithm and supervised clustering. All genes included within the resultant copy number aberrations were each interrogated independently at mRNA level using CRC expression datasets available from public repositories, which included 1820 colon cancers, and 167 normal colon tissues. Reduced mRNA expression driven by copy number losses and increased expression driven by copy number gains revealed 42 altered transcripts (29 reduced and 13 increased transcripts associated with metastatic relapse, short disease-free or overall survival, and/or epithelial to mesenchymal transition (EMT. Resultant genes were classified based on gene ontology (GO, which identified four functional enrichment groups involved in growth regulation, genomic integrity, metabolism, and signal transduction pathways. The identified 42 genes may be useful for predicting metastatic relapse in stage II CRC. Further studies are necessary to validate these findings.

Role of Adjuvant Radiotherapy for Stage II Thymoma After Complete Tumor Resection

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Chen Yidong; Feng Qinfu; Lu Haizhen; Mao Yousheng; Zhou Zongmei; Ou Guangfei; Wang Mei; Zhao Jun; Zhang Hongxing; Xiao Zefen; Chen Dongfu; Liang Jun; Zhai Yirui; Wang Luhua; He Jie

2010-01-01

Purpose: To determine whether patients with Masaoka stage II thymoma benefit from adjuvant radiation therapy after complete tumor resection. Methods and Materials: A total of 107 patients with stage II thymoma who underwent complete resection of their tumors between September 1964 and October 2006 were retrospectively analyzed. Sixty-six patients were treated with adjuvant radiotherapy, and 41 patients received surgery alone. Results: Eight patients (7.5%) had a relapse of their disease, including two patients (4.5%) who had surgery alone, and 6 patients (9.5%) who had adjuvant radiation therapy. Disease-free survival rates at 5 and 10 years were 92.3% and 82.6%, respectively, for the surgery-plus-radiation group, and 97.6% and 93.1%, respectively, for the group that underwent surgery alone (p = 0.265). Disease-specific survival rates at 5 and 10 years were 96.4% and 89.3%, respectively, for the surgery-plus-radiation group and 97.5% and 97.5% for the surgery group (p = 0.973). On univariate analysis, patients with type B3 thymomas had the lowest disease-free survival rates among all subtypes (p = 0.001), and patients with large thymomas (>7 cm) had lower disease-specific survival rates than those with small tumors (<7 cm) (p = 0.017). On multivariate analysis, histological type (type B3) thymoma was a significant independent prognostic factor. Conclusions: Adjuvant radiotherapy after complete tumor resection for patients with stage II thymoma did not significantly reduce recurrence rates or improve survival rates. Histological type (type B3) thymoma was a significant independent prognostic factor. Further investigation should be carried out using a multicenter randomized or controlled study.

Alternative Dosing of Exemestane Before Surgery in Treating Postmenopausal Patients With Stage 0-II Estrogen Positive Breast Cancer

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2018-04-09

Estrogen Receptor Positive; Postmenopausal; Stage 0 Breast Cancer AJCC v6 and v7; Stage I Breast Cancer AJCC v7; Stage IA Breast Cancer AJCC v7; Stage IB Breast Cancer AJCC v7; Stage II Breast Cancer AJCC v6 and v7; Stage IIA Breast Cancer AJCC v6 and v7; Stage IIB Breast Cancer AJCC v6 and v7

Evaluation of occlusal forces in different stages of children - An exploratory study

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Priya Subramaniam

2018-01-01

Conclusions: There was a difference in the occlusal bite force at different dentition stages. It was significantly higher in males and in the permanent dentition stage. Height and weight can be considered as predictors of occlusal bite force in older children with permanent dentition.

[Analysis of prognostic factors after radical resection in 628 patients with stage II or III colon cancer].

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Qin, Qiong; Yang, Lin; Zhou, Ai-ping; Sun, Yong-kun; Song, Yan; DU, Feng; Wang, Jin-wan

2013-03-01

To analyze the clinicopathologic factors related to recurrence and metastasis of stage II or III colon cancer after radical resection. The clinical and pathological data of 628 patients with stage II or III colon cancer after radical resection from Jan. 2005 to Dec. 2008 in our hospital were retrospectively reviewed and analyzed. The overall recurrence and metastasis rate was 28.5% (179/628). The 5-year disease-free survival (DFS) rate was 70.3% and 5-year overall survival (OS) rate was 78.5%. Univariate analysis showed that age, smoking intensity, depth of tumor invasion, lymph node metastasis, TNM stage, gross classification, histological differentiation, blood vessel tumor embolus, tumor gross pathology, multiple primary tumors, preoperative and postoperative serum concentration of CEA and CA19-9, and the regimen of adjuvant chemotherapy were correlated to recurrence and metastasis of colon cancer after radical resection. Multivariate analysis showed that regional lymph node metastasis, TNM stage, the regimen of postoperative adjuvant chemotherapy, and preoperative serum concentration of CEA and CA19-9 were independent factors affecting the prognosis of colon cancer patients. Regional lymph node metastasis, TNM stage, elevated preoperative serum concentration of CEA and CA19-9, the regimen of postoperative adjuvant chemotherapy with single fluorouracil type drug are independent risk factors of recurrence and metastasis in patients with stage II-III colon cancer after radical resection.

Stage-I osteochondritis dissecans versus normal variants of ossification in the knee in children

International Nuclear Information System (INIS)

Gebarski, Kathleen; Hernandez, Ramiro J.

2005-01-01

Juvenile osteochondritis dissecans (OCD) has a better prognosis than the adult type. We postulated that the excellent prognosis of juvenile OCD could be explained, at least in part, by the erroneous diagnosis of some developmental variants of ossification as stage-I OCD. Knee MRIs of 38 children, ages 7.5-17.7 years (mean and median age 13 years), were retrospectively reviewed to look for features that might separate normal variants of ossification from stage-I OCD. These included age, gender, site, configuration of the lesion, residual cartilaginous model and presence of edema. Twenty-three patients (32 condyles) had ossification defects with intact articular cartilage suggestive of stage-I lesions. No stage-II lesions were seen in the posterior femoral condyles. Accessory ossification centers were seen in 11/16 posterior condyles and 3/16 central condyles. Spiculation of existing ossification was seen in 12/16 posterior condylar lesions and 1/16 central condyles. There was a predominance of accessory ossifications and spiculations in the patients with 10% or greater residual cartilaginous model. No edema signal greater than diaphyseal red-marrow signal was seen in the posterior condyles. Clinical follow-up ranged from 0.5 to 38 months, with clinical improvement in 22 out of 23 patients. Inclusion of normal variants in the stage-I OCD category might explain, in part, the marked difference in published outcome between the juvenile and adult forms of OCD. Ossification defects in the posterior femoral condyles with intact overlying articular cartilage, accessory ossification centers, spiculation, residual cartilaginous model, and lack of bone-marrow edema are features of developmental variants rather than OCD. (orig.)

Optimization of treatment of children with 3 stage Hodgkin's disease

International Nuclear Information System (INIS)

Kobikov, S.Kh.

1989-01-01

147 children younger than 15 years suffering from the 3rd stage of Hodgkins children is performed using gamma therapeutic Rocus type devices and betatron (B5M-25) and linear accelerator (LUEh-25) of 15-27.5 MeV energy electrons. Immediate and delayed treatment results are evaluated. Unfavourable clinical factors effecting the recurrence frequency are revealed. Inconsistence of supporting chemotherapy in the reduction of the number of recurrents is confirmed

Breast carcinoma conservative treatment. Stages I and II; Tratamento conservador do carcinoma mamario. Estadios I e II

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Monti, C.R.

1990-12-31

From 1981 to 1988, 265 patients with breast cancer stages I and II (UICC-1987), were evaluated after conservative treatment with quadrantectomy plus axillectomy, radiotherapy and chemotherapy. After surgical treatment, the patients were submitted to radiation therapy in the breast. One hundred and fifty six (58,8%) patients were submitted to adjuvant chemotherapy. The median clinical follow-up period was 42.8 months with a minimum of 24 and a maximum of 99 months. Six (2,3%) patients presented local recurrence and 48 (18,1%) presented distant metastasis. After five years the total survival rate was 89,7% and the disease free survival rate was 75% in the same period. The study did not show significant differences among the clinical stages classified after surgery and the use of adjuvant chemotherapy did not influence the results of the many stages. (author). 194 refs, 33 figs, 6 tabs.

Breast carcinoma conservative treatment. Stages I and II; Tratamento conservador do carcinoma mamario. Estadios I e II

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Monti, C R

1991-12-31

From 1981 to 1988, 265 patients with breast cancer stages I and II (UICC-1987), were evaluated after conservative treatment with quadrantectomy plus axillectomy, radiotherapy and chemotherapy. After surgical treatment, the patients were submitted to radiation therapy in the breast. One hundred and fifty six (58,8%) patients were submitted to adjuvant chemotherapy. The median clinical follow-up period was 42.8 months with a minimum of 24 and a maximum of 99 months. Six (2,3%) patients presented local recurrence and 48 (18,1%) presented distant metastasis. After five years the total survival rate was 89,7% and the disease free survival rate was 75% in the same period. The study did not show significant differences among the clinical stages classified after surgery and the use of adjuvant chemotherapy did not influence the results of the many stages. (author). 194 refs, 33 figs, 6 tabs.

TUBERCULOSIS IN CHILDREN IN THE RUSSIAN FEDERATION AT THE PRESENT STAGE

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A. V. Mordyk

2014-01-01

Full Text Available The literature review presents data on peculiarities of tuberculosis epidemiology, incidence rate and clinical pattern in children in the Russian Federation. Over the last 5 years, the age structure of the children developing tuberculosis has significantly changed: the share of children of small and preschool age increased, whereas the share of 7-14-year-old children decreased. Tuberculosis of thoracic lymph nodes predominates in the structure of clinical forms of tuberculosis of respiratory organs in children; small forms predominate, which indicates improvement of diagnostic capabilities. However, a rather large number of children with calcination stage of the tubercular process is observed. Further improvement of early detection of a tubercular infection is a powerful tool of preventing complicated and progressive forms of tuberculosis in children.  

Ovarian Cancer Stage II

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... peritoneal cancer; the first panel (stage IIA) shows cancer inside both ovaries that has spread to the uterus and fallopian tube. The second panel (stage IIB) shows cancer inside both ovaries that has spread to the colon. The third ...

Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades.

Science.gov (United States)

Fischer, Joern; Joern, Fischer; Hellmich, Gunter; Gunter, Hellmich; Jackisch, Thomas; Thomas, Jackisch; Puffer, Erik; Erik, Puffer; Zimmer, Jörg; Jörg, Zimmer; Bleyl, Dorothea; Dorothea, Bleyl; Kittner, Thomas; Thomas, Kittner; Witzigmann, Helmut; Helmut, Witzigmann; Stelzner, Sigmar; Sigmar, Stelzner

2015-06-01

This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time. This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis. Five-year CSS rates improved for colonic cancer from 65.0% for patients treated between 1981 and 1986 to 88.1% for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4% in the first observation period to 89.8% in the second one. The local recurrence rate for rectal cancer dropped from 34.2% in the years 1981-1986 to 2.1% in the years 2007-2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7%, p = 0.409). Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.

Ages and Stages Questionnaire used to measure cognitive deficit in children born extremely preterm

DEFF Research Database (Denmark)

Klamer, Anja; Lando, Ane; Pinborg, Anja

2005-01-01

AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence...

Use of a combination of CEA and tumor budding to identify high-risk patients with stage II colon cancer.

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Du, Changzheng; Xue, Weicheng; Dou, Fangyuan; Peng, Yifan; Yao, Yunfeng; Zhao, Jun; Gu, Jin

2017-07-24

High-risk patients with stage II colon cancer may benefit from adjuvant chemotherapy, but identifying this patient population can be difficult. We assessed the prognosis value for predicting tumor progression in patients with stage II colon cancer, of a panel of 2 biomarkers for colon cancer: tumor budding and preoperative carcinoembryonic antigen (CEA). Consecutive patients (N = 134) with stage II colon cancer who underwent curative surgery from 2000 to 2007 were included. Multivariate analysis was used to evaluate the association of CEA and tumor budding grade with 5-year disease-free survival (DFS). The prognostic accuracy of CEA, tumor budding grade and the combination of both (CEA-budding panel) was determined. The study found that both CEA and tumor budding grade were associated with 5-year DFS. The prognostic accuracy for disease progression was higher for the CEA-budding panel (82.1%) than either CEA (70.9%) or tumor budding grade (72.4%) alone. The findings indicate that the combination of CEA levels and tumor budding grade has greater prognostic value for identifying patients with stage II colon cancer who are at high-risk for disease progression, than either marker alone.

The prognostic value of microRNA-126 and microvessel density in patients with stage II colon cancer

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Hansen, Torben Frøstrup; Kjær-Frifeldt, Sanne; Morgenthaler, Søren

2014-01-01

BACKGROUND: Angiogenesis plays a pivotal role in malignant tumour growth and the metastatic process. We analysed the prognostic value of two angiogenesis parameters, microRNA-126 (miRNA-126) and microvessel density (MVD), in a population based cohort of patients operated for stage II colon cancer...... estimate was not associated with either RF-CSS, p = 0.49, or OS, p = 0.94.CONCLUSION: The current population based study of patients operated for stage II colon cancer demonstrated correlations between several prognostic unfavourable characteristics and miRNA-126 and argues for a possible prognostic impact...

Changes of serum cortisol and plasma angiotensin-II (AT-II) levels in patients with open chest surgery during peri-operative stage

International Nuclear Information System (INIS)

Yu Yunyun; Tian Runhua; Zhao Huiyuan; Li Xiaoqin; Wang Ling

2005-01-01

Objective: To assess the systemic stress reaction in patients with open chest surgery through measurement of the changes of serum cortisol and plasma AT-II levels during peri-operative stage. Methods: Serum cortisol and plasma AT-II levels were measured with RIA in 35 patients underwent open chest surgery both before and after the operative procedure. Results: The serum level of cortisol and plasma levels of AT-II were significantly higher after operation than those before operation ( P < 0.05 ). Also, the systolic pressure and heart rate were increased significantly (P<0.05). The post-operative heart rate was significantly positively correlated with both cortisol and AT-II levels (P<0.05). Conclusion: Stress reaction is evident in patients after open chest surgery with increase of serum cortisol and plasma AT-II levels. The stress reaction, if excessive, should be properly dealt with. (authors)

Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

DEFF Research Database (Denmark)

Specht, L.; Horwich, A.; Ashley, S.

1994-01-01

patients in the International Database on Hodgkin's Disease who were initially in clinical Stages I or II, who were staged with laparotomy, and who relapsed after initial treatment with irradiation alone. Factors analyzed for outcome after first relapse included initial stage, age, sex, histology......PURPOSE: To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing after initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy. METHODS AND MATERIALS: Data were analyzed on 681...

Dose-Escalated Robotic SBRT for Stage I-II Prostate Cancer

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Robert eMeier

2015-04-01

Full Text Available Abstract: Stereotactic body radiotherapy (SBRT is the precise external delivery of very high-dose radiotherapy to targets in the body, with treatment completed in one to five fractions. SBRT should be an ideal approach for organ-confined prostate cancer because (I dose escalation should yield improved rates of cancer control; (II the unique radiobiology of prostate cancer favors hypofractionation and (III the conformal nature of SBRT minimizes high-dose radiation delivery to immediately adjacent organs, potentially reducing complications. This approach is also more convenient for patients, and is cheaper than intensity modulated radiotherapy (IMRT. Several external beam platforms are capable of delivering SBRT for early-stage prostate cancer, although most of the mature reported series have employed a robotic non-coplanar platform (i.e., CyberKnife. Several large studies report 5-year biochemical relapse rates which compare favorably to IMRT. Rates of late GU toxicity are similar to those seen with IMRT, and rates of late rectal toxicity may be less than with IMRT and low dose rate (LDR brachytherapy. Patient-reported quality of life (QOL outcomes appear similar to IMRT in the urinary domain. Bowel QOL may be less adversely affected by SBRT than with other radiation modalities. After five years of follow-up, SBRT delivered on a robotic platform is yielding outcomes at least as favorable as IMRT, and may be considered appropriate therapy for stage I-II prostate cancer.

Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, Urologic and Lung Cancers

Science.gov (United States)

2018-02-12

Healthy Subject; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC

Hodgkin's disease: correlation of clinical characteristics with probabilities for negative lymphangiogram vs. negative laparotomy findings in patients with stage I supradiaphragmatic presentations vs. those in patients with stage II

International Nuclear Information System (INIS)

Fuller, Lillian M.; Mirza, Nadeem Q.; Palmer, J. Lynn; Davis, Barry R.; Ha, Chul S.; Rodriguez, M. Alma; Hagemeister, Fredrick B.; Cabanillas, Fernando; McLaughlin, Peter; Butler, James J.; North, Luceil B.; Martin, Richard G.

1998-01-01

Purpose: At a time both when late complications and second malignancies have become a growing concern and when staging laparotomy has been largely abandoned and comparative studies for staging Hodgkin's disease by state of the art computed tomography (CT) vs. lymphangiography have revealed minimal differences in results for these procedures, our purpose for undertaking this study was twofold. Our initial reason was to determine and compare probabilities for negative abdominal findings for patients with Stage I presentations with those for patients with Stage II as determined by lymphangiography and subsequently by laparotomy for those patients who had negative lymphangiograms. Our second reason, being an extension of the first, was to create a resource that can be used in conjunction with other information for arriving at appropriate treatment decisions including giving either more or particularly less than standard institutional therapy and especially with respect to the abdomen. Methods and Materials: Data on 714 patients with prelymphangiogram Stage I-II upper torso presentations of Hodgkin's disease were entered prospectively in our database between 1968 and 1987. Twenty-eight with lymphocyte predominant disease, who had both negative lymphangiogram and negative laparotomy findings and 17 with questionable diagnoses of lymphocyte-depleted or unclassified disease were excluded from subsequent analyses of 669 patients with nodular sclerosis (NS) and mixed cellularity (MC) diagnoses. Results: Stage I: in final logistic models, negative lymphangiogram findings were associated strongly with a combination of no constitutional symptoms and nodular sclerosis histology, whereas negative laparotomy findings correlated strongly with a combination of no constitutional symptoms and female sex. Predicted probabilities depended on the ratios of favorable to unfavorable characteristics. Stage II: in final logistic models, negative lymphangiogram findings were associated

Overexpression of the S100A2 protein as a prognostic marker for patients with stage II and III colorectal cancer

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MASUDA, TAIKI; ISHIKAWA, TOSHIAKI; MOGUSHI, KAORU; OKAZAKI, SATOSHI; ISHIGURO, MEGUMI; IIDA, SATORU; MIZUSHIMA, HIROSHI; TANAKA, HIROSHI; UETAKE, HIROYUKI; SUGIHARA, KENICHI

2016-01-01

We aimed to identify a novel prognostic biomarker related to recurrence in stage II and III colorectal cancer (CRC) patients. Stage II and III CRC tissue mRNA expression was profiled using an Affymetrix Gene Chip, and copy number profiles of 125 patients were generated using an Affymetrix 250K Sty array. Genes showing both upregulated expression and copy number gains in cases involving recurrence were extracted as candidate biomarkers. The protein expression of the candidate gene was assessed using immunohistochemical staining of tissue from 161 patients. The relationship between protein expression and clinicopathological features was also examined. We identified 9 candidate genes related to recurrence of stage II and III CRC, whose mRNA expression was significantly higher in CRC than in normal tissue. Of these proteins, the S100 calcium-binding protein A2 (S100A2) has been observed in several human cancers. S100A2 protein overexpression in CRC cells was associated with significantly worse overall survival and relapse-free survival, indicating that S100A2 is an independent risk factor for stage II and III CRC recurrence. S100A2 overexpression in cancer cells could be a biomarker of poor prognosis in stage II and III CRC recurrence and a target for treatment of this disease. PMID:26783118

Estimating the adjuvant chemotherapy effect in elderly stage II and III colon cancer patients in an observational study.

Science.gov (United States)

Kim, Ki-Yeol; Cha, In-Ho; Ahn, Joong Bae; Kim, Nam Kyu; Rha, Sun Young; Chung, Hyun Cheol; Roh, Jae Kyung; Shin, Sang Joon

2013-05-01

Adjuvant chemotherapy has been known as a standard treatment for patients with resected colon cancer. However, in elderly colon cancer patients, the characteristics of patients are heterogeneous with regard to life expectancy and comorbidities. Thus, with regard to the effectiveness of adjuvant chemotherapy for colon cancer, it is difficult to extrapolate data of clinical trials from the younger into the older general population. Data for 382 elderly colon cancer patients were analyzed: 217 in Stage II and 165 in Stage III. The efficacy of adjuvant chemotherapy was evaluated in elderly colon cancer patients after a match by the propensity score method. For matched patients with Stage II colon cancer, there was no significant efficacy of adjuvant chemotherapy in the risk of death during all follow-up periods (P-value, 0.06-0.37). Though there was a tendency that the adjuvant chemotherapy reduces the death rate during the follow-up periods, it was not statistically significant. In the case of Stage III, the adjuvant chemotherapy was significantly effective in matched patients for 5-year (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.30-0.90) and overall survival (HR, 0.56; 95% CI, 0.34-0.94). Adjuvant chemotherapy for elderly patients with Stage II colon cancer is not effective, whereas elderly patients with Stage III with adjuvant chemotherapy appear to have a better survival rate in the general population. Copyright © 2012 Wiley Periodicals, Inc.

Early positron emission tomography response-adapted treatment in stage I and II hodgkin lymphoma

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André, Marc P.E.; Girinsky, Théodore; Federico, Massimo

2017-01-01

Purpose Patients who receive combined modality treatment for stage I and II Hodgkin lymphoma (HL) have an excellent outcome. Early response evaluation with positron emission tomography (PET) scan may improve selection of patients who need reduced or more intensive treatments. Methods We performed...

Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study

Directory of Open Access Journals (Sweden)

Maria Grazia Cagetti

2016-12-01

Full Text Available Abstract Background Actual caries figures emphasize the need to identify the risk indicators involved in the disease’s development. The hypothesis that certain risk indicators might affect the dynamic evolution of the caries process was assessed; to clarify this premise, a cross-sectional survey was performed in school children. Methods A total of 390 subjects aged 6–8 years old were randomly selected. Caries was assessed, and the subjects were stratified as follows: i highest caries score; ii most prevalent caries score; and iii number of affected teeth. Parents/guardians completed a questionnaire regarding vital statistics, socio-economic indicators, dietary habits, oral hygiene habits and oral health behaviours. Results Caries was detected in 42.31% of the subjects. Maternal nationality, parental education level, use of a sweetened pacifier at night, intake of lactose-free milk and toothbrushing frequency were statistically significant associated (p < 0.05 with subjects stratified according to the highest caries score. Parental educational level, maternal occupational status and use of a sweetened pacifier at night were associated (p < 0.05 with affected children stratified according to the most prevalent caries score. Maternal educational level and intake of lactose-free milk were associated with subjects with moderate caries stages compared to being caries-free (p = 0.01 and p = 0.02, respectively. Maternal nationality (p < 0.01 and toothbrushing frequency (p = 0.01 were associated with subjects affected by extensive lesions compared to caries-free children. In subjects affected by initial lesions as the most prevalent figure, gender (male and paternal occupation status (unemployed were statistically significant associated (p = 0.03 and p = 0.04, respectively compared to those affected by highest prevalence of extensive caries lesions. In children with the highest prevalence of moderate caries lesions

Analyzing proteasomal subunit expression reveals Rpt4 as a prognostic marker in stage II colorectal cancer.

LENUS (Irish Health Repository)

2012-02-01

Colorectal cancer is a leading cause of cancer-related deaths worldwide. Early diagnosis and treatment of colorectal cancer is the key to improving survival rates and as such a need exists to identify patients who may benefit from adjuvant chemotherapy. The dysregulation of the ubiquitin-proteasome system (UPS) has been implicated in oncogenesis and cancer cell survival, and proteasome inhibitors are in clinical use for a number of malignancies including multiple myeloma. In our study, we examined the protein expression of several key components of the UPS in colorectal cancer using immunohistochemistry to determine expression levels of ubiquitinylated proteins and the proteasomal subunits, 20S core and Rpt4 in a cohort of 228 patients with colon cancer. Multivariate Cox analysis revealed that neither the intensity of either ubiquitinylated proteins or the 20S core was predictive in either Stage II or III colon cancer for disease free survival or overall survival. In contrast, in Stage II patients increased Rpt4 staining was significantly associated with disease free survival (Cox proportional hazard ratio 0.605; p = 0.0217). Our data suggest that Rpt4 is an independent prognostic variable for Stage II colorectal cancer and may aid in the decision of which patients undergo adjuvant chemotherapy.

Correlation between hindfoot joint three-dimensional kinematics and the changes of the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot.

Science.gov (United States)

Zhang, Yi-Jun; Xu, Jian; Wang, Yue; Lin, Xiang-Jin; Ma, Xin

2015-02-01

The aim of this study was to explore the correlation between the kinematics of the hindfoot joint and the medial arch angle change in stage II posterior tibial tendon dysfunction flatfoot three-dimensionally under loading. Computed tomography (CT) scans of 12 healthy feet and 12 feet with stage II posterior tibial tendon dysfunction flatfoot were taken both in non- and full-body-weight-bearing condition. The CT images of the hindfoot bones were reconstructed into three-dimensional models with Mimics and Geomagic reverse engineering software. The three-dimensional changes of the hindfoot joint were calculated to determine their correlation to the medial longitudinal arch angle. The medial arch angle change was larger in stage II posterior tibial tendon dysfunction flatfoot compared to that in healthy foot under loading. The rotation and translation of the talocalcaneal joint, the talonavicular joint and the calcanocuboid joint had little influence on the change of the medial arch angle in healthy foot. However, the eversion of the talocalcaneal joint, the proximal translation of the calcaneus relative to the talus and the dorsiflexion of talonavicular joint could increase the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot under loading. Joint instability occurred in patients with stage II posterior tibial tendon dysfunction flatfoot under loading. Limitation of over movement of the talocalcaneal joint and the talonavicular joint may help correct the medial longitudinal arch in stage II posterior tibial tendon dysfunction flatfoot. Copyright © 2014 Elsevier Ltd. All rights reserved.

Differences in adjustment by child developmental stage among caregivers of children with disorders of sex development

Science.gov (United States)

2011-01-01

Background The current study sought to compare levels of overprotection and parenting stress reported by caregivers of children with disorders of sex development at four different developmental stages. Methods Caregivers (N = 59) of children with disorders of sex development were recruited from specialty clinics and were asked to complete the Parent Protection Scale and Parenting Stress Index/Short Form as measures of overprotective behaviors and parenting stress, respectively. Results Analyses of covariance (ANCOVAs) were conducted to examine differences between caregiver report of overprotection and parenting stress. Results revealed that caregivers of infants and toddlers exhibited more overprotective behaviors than caregivers of children in the other age groups. Further, caregivers of adolescents experienced significantly more parenting stress than caregivers of school-age children, and this effect was driven by personal distress and problematic parent-child interactions, rather than having a difficult child. Conclusions These results suggest that caregivers of children with disorders of sex development may have different psychosocial needs based upon their child's developmental stage and based upon the disorder-related challenges that are most salient at that developmental stage. PMID:22074416

WISC-IV and WIAT-II Profiles in Children with High-Functioning Autism

Science.gov (United States)

Mayes, Susan Dickerson; Calhoun, Susan L.

2008-01-01

Children with high-functioning autism earned above normal scores on the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) Perceptual Reasoning and Verbal Comprehension Indexes and below normal scores on the Working Memory and Processing Speed Indexes and Wechsler Individual Achievement Test-Second Edition (WIAT-II) Written…

Does adjuvant systemic therapy with interferon-alpha for stage II-III melanoma prolong survival?

NARCIS (Netherlands)

Eggermont, Alexander M. M.; Punt, Cornelis J. A.

2003-01-01

The experience with interferon-alpha in malignant melanoma resembles, to some degree, the experience with various kinds of adjuvant immunotherapeutic agents where 25 years of phase III trials of adjuvant therapy in stage II-IIII melanoma have not defined a standard therapy. Most trials failed to

Adjuvant chemotherapy for stage II colon cancer: influence of care structures' characteristics on a controversial clinical practice.

Science.gov (United States)

Alter, Eléonore; Phelip, Jean-Marc; Guilhot, Jean-Noel; Matysiak, Michel; Vermorel, Michel; Roblin, Xavier

2007-11-01

Adjuvant chemotherapy for stage II colon cancer is a controversial practice and is not recommended by the French Consensus Conference outside of therapeutic trial. To assess, within a well-defined population, the influence of hospital characteristics in this practice. In the Rhône-Alpes region (10% of the French population), 534 patients presenting with colon cancer stage II were operated on in 81 hospitals in the year 2000. The influence of hospital characteristics on the use of adjuvant chemotherapy was assessed using a multivariate logistic regression. Overall, 19.5% of patients received adjuvant chemotherapy. Younger age, T4 tumour, hospital volume lower than 20 colon cancer surgeries [odds ratio (OR) 2.96; Pclinical complications at diagnosis were independently associated with higher rates of chemotherapy. On the other hand, a number of examined lymph nodes lower than recommendations did not have any influence on chemotherapy use. Hospital characteristics had independently influenced the practice of adjuvant chemotherapy in stage II colon cancer. The more important institutional factor was the hospital procedure volume. The decisions of the multidisciplinary committees appeared at times paradoxical; a more comprehensive evaluation of this practice is needed.

Improvements in 5-year outcomes of stage II/III rectal cancer relative to colon cancer.

Science.gov (United States)

Renouf, Daniel J; Woods, Ryan; Speers, Caroline; Hay, John; Phang, P Terry; Fitzgerald, Catherine; Kennecke, Hagen

2013-12-01

Stage for stage, rectal cancer has historically been associated with inferior survival compared with colon cancer. Randomized trials of rectal cancer have generally demonstrated improvements in locoregional relapse but not survival. We compared therapy and outcomes of colon versus rectal cancer in 2 time cohorts to determine if relative improvements have occurred. Patients with resected stage II/III colorectal cancer referred to the British Columbia Cancer Agency in 1989/1990 and 2001/2002 were identified. The higher of clinical or pathologic stage was used for patients receiving preoperative chemoradiation. Disease-specific survival (DSS) and overall survival (OS) were compared for rectal and colon cancer between the 2 cohorts. Kaplan-Meier method was used for survival analysis. A total of 1427 patients were included, with 375 from 1989/1990 and 1052 from 2001/2002. Between 1989/1990 and 2001/2002 there were significant increases in the use of perioperative chemotherapy for both rectal and colon cancer (Prectal cancer. DSS significantly improved for rectal (Pcolon cancer (P=0.069). Five-year OS was significantly inferior for rectal versus colon cancer in 1989/1990 (46.1% vs. 57.2%, P=0.023) and was similar to that of colon cancer in 2001/2002 (63.7% vs. 66.2%, P=0.454). Advances in locoregional and systemic therapy significantly improved survival among patients with rectal cancer. DSS and OS are now similar between colon and rectal cancer for both stage II and III disease.

Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and Meta-analysis

International Nuclear Information System (INIS)

Lim, Yu Jin; Kim, Eunji; Kim, Hak Jae; Wu, Hong-Gyun; Yan, Jinchun; Liu, Qin; Patel, Shilpen

2016-01-01

Purpose: To evaluate the survival impact of postoperative radiation therapy (PORT) in stage II to IV thymomas, using systematic review and meta-analysis. Methods and Materials: A database search was conducted with EMBASE, PubMed, Web of Science, Cochrane Library, and Ovid from inception to August 2015. Thymic carcinomas were excluded, and studies comparing overall survival (OS) with and without PORT in thymomas were included. The hazard ratios (HRs) of OS were extracted, and a random-effects model was used in the pooled analysis. Results: Seven retrospective series with a total of 1724 patients were included and analyzed. Almost all of the patients underwent macroscopically complete resection, and thymoma histology was confirmed by the World Health Organization criteria. In the overall analysis of stage II to IV thymomas, OS was not altered with the receipt of PORT (HR 0.79, 95% confidence interval [CI] 0.58-1.08). Although PORT was not associated with survival difference in Masaoka stage II disease (HR 1.45, 95% CI 0.83-2.55), improved OS was observed with the addition of PORT in the discrete pooled analysis of stage III to IV (HR 0.63, 95% CI 0.40-0.99). Significant heterogeneity and publication bias were not found in the analyses. Conclusions: From the present meta-analysis of sole primary thymomas, we suggest the potential OS benefit of PORT in locally advanced tumors with macroscopically complete resection, but not in stage II disease. Further investigations with sufficient survival data are needed to establish detailed treatment indications.

Survival Impact of Adjuvant Radiation Therapy in Masaoka Stage II to IV Thymomas: A Systematic Review and Meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Lim, Yu Jin; Kim, Eunji [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Hak Jae, E-mail: khjae@snu.ac.kr [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Wu, Hong-Gyun [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cancer Research Institute, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul (Korea, Republic of); Yan, Jinchun [Department of Radiation Oncology, Dalian Medical University, Liaoning (China); Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Liu, Qin [The Wistar Institute, Philadelphia, Pennsylvania (United States); Patel, Shilpen [Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington (United States)

2016-04-01

Purpose: To evaluate the survival impact of postoperative radiation therapy (PORT) in stage II to IV thymomas, using systematic review and meta-analysis. Methods and Materials: A database search was conducted with EMBASE, PubMed, Web of Science, Cochrane Library, and Ovid from inception to August 2015. Thymic carcinomas were excluded, and studies comparing overall survival (OS) with and without PORT in thymomas were included. The hazard ratios (HRs) of OS were extracted, and a random-effects model was used in the pooled analysis. Results: Seven retrospective series with a total of 1724 patients were included and analyzed. Almost all of the patients underwent macroscopically complete resection, and thymoma histology was confirmed by the World Health Organization criteria. In the overall analysis of stage II to IV thymomas, OS was not altered with the receipt of PORT (HR 0.79, 95% confidence interval [CI] 0.58-1.08). Although PORT was not associated with survival difference in Masaoka stage II disease (HR 1.45, 95% CI 0.83-2.55), improved OS was observed with the addition of PORT in the discrete pooled analysis of stage III to IV (HR 0.63, 95% CI 0.40-0.99). Significant heterogeneity and publication bias were not found in the analyses. Conclusions: From the present meta-analysis of sole primary thymomas, we suggest the potential OS benefit of PORT in locally advanced tumors with macroscopically complete resection, but not in stage II disease. Further investigations with sufficient survival data are needed to establish detailed treatment indications.

Every Picture Tells A Story: Stages of Art Development in Children

African Journals Online (AJOL)

user

2013-07-07

Jul 7, 2013 ... The crux in this work is an analysis of the stages of art development among children .... emotional and cognitive competences in the child. In the same ... a basic property of the nervous system) as well as a psychological need.

Case study Early psychomotor development of children from triple pregnancy – case study

Directory of Open Access Journals (Sweden)

Łucja Bieleninik

2014-08-01

Full Text Available The aim of this study was to analyze the specificity and dynamics of psychomotor development in children from triplet pregnancy. The studied group was composed of siblings from triple pregnancy (T1, T2, T3, including two girls and one boy. This longitudinal study comprised three stages: stage I – children aged 25 months, stage II – children aged 29 months, and stage III – children aged 38 months. At each stage, the psychomotor development of children was examined with the Third Edition of Bayley Scales of Infant and Toddler Development (BSID-III and subjectively by their mother. Additionally, medical and nursing documentation was analyzed. Individual psychomotor development of children from triple pregnancy is different with regards to various spheres, and has different rates and dynamics throughout consecutive years. Psychomotor development of children from triple pregnancies is determined by gender and postnatal clinical parameters, i.e. birth weight, head circumference, postnatal morbidity, and prematurity-related conditions.

Differences in adjustment by child developmental stage among caregivers of children with disorders of sex development

Directory of Open Access Journals (Sweden)

Hullmann Stephanie E

2011-11-01

Full Text Available Abstract Background The current study sought to compare levels of overprotection and parenting stress reported by caregivers of children with disorders of sex development at four different developmental stages. Methods Caregivers (N = 59 of children with disorders of sex development were recruited from specialty clinics and were asked to complete the Parent Protection Scale and Parenting Stress Index/Short Form as measures of overprotective behaviors and parenting stress, respectively. Results Analyses of covariance (ANCOVAs were conducted to examine differences between caregiver report of overprotection and parenting stress. Results revealed that caregivers of infants and toddlers exhibited more overprotective behaviors than caregivers of children in the other age groups. Further, caregivers of adolescents experienced significantly more parenting stress than caregivers of school-age children, and this effect was driven by personal distress and problematic parent-child interactions, rather than having a difficult child. Conclusions These results suggest that caregivers of children with disorders of sex development may have different psychosocial needs based upon their child's developmental stage and based upon the disorder-related challenges that are most salient at that developmental stage.

Knowledge Is Power: Teaching Children about Type II Diabetes

Science.gov (United States)

Feild-Berner, Natalie; Balgopal, Meena

2011-01-01

World Diabetes Day (November 14) offers a wonderful opportunity to educate elementary children about the power they have to control their health. First lady Michelle Obama has urged Americans to educate themselves about childhood obesity, which is often associated with the onset of type II diabetes (Rabin 2010). The authors developed activities to…

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

DEFF Research Database (Denmark)

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

2011-01-01

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

The representation of time course events in visual arts and the development of the concept of time in children: a preliminary study.

Science.gov (United States)

Actis-Grosso, Rossana; Zavagno, Daniele

2008-01-01

By means of a careful search we found several representations of dynamic contents of events that show how the depiction of the passage of time in the visual arts has evolved gradually through a series of modifications and adaptations. The general hypothesis we started to investigate is that the evolution of the representation of the time course in visual arts is mirrored in the evolution of the concept of time in children, who, according to Piaget (1946), undergo three stages in their ability to conceptualize time. Crucial for our hypothesis is Stage II, in which children become progressively able to link the different phases of an event, but vacillate between what Piaget termed 'intuitive regulations', not being able to understand all the different aspects of a given situation. We found several pictorial representations - mainly dated back to the 14th to 15th century - that seem to fit within a Stage II of children's comprehension of time. According to our hypothesis, this type of pictorial representations should be immediately understood only by those children who are at Piaget's Stage II of time conceptualization. This implies that children at Stages I and III should not be able to understand the representation of time courses in the aforementioned paintings. An experiment was run to verify the agreement between children's collocation within Piaget's three stages - as indicated by an adaptation of Piaget's original experiment - and their understanding of pictorial representations that should be considered as Stage II type of representations of time courses. Despite the small sample of children examined so far, results seem to support our hypothesis. A follow-up (Experiment 2) on the same children was also run one year later in order to verify other possible explanations. Results from the two experiments suggest that the study of the visual arts can aid our understanding of the development of the concept of time, and it can also help to distinguish between the

A network-based predictive gene-expression signature for adjuvant chemotherapy benefit in stage II colorectal cancer.

Science.gov (United States)

Cao, Bangrong; Luo, Liping; Feng, Lin; Ma, Shiqi; Chen, Tingqing; Ren, Yuan; Zha, Xiao; Cheng, Shujun; Zhang, Kaitai; Chen, Changmin

2017-12-13

The clinical benefit of adjuvant chemotherapy for stage II colorectal cancer (CRC) is controversial. This study aimed to explore novel gene signature to predict outcome benefit of postoperative 5-Fu-based therapy in stage II CRC. Gene-expression profiles of stage II CRCs from two datasets with 5-Fu-based adjuvant chemotherapy (training dataset, n = 212; validation dataset, n = 85) were analyzed to identify the indicator. A systemic approach by integrating gene-expression and protein-protein interaction (PPI) network was implemented to develop the predictive signature. Kaplan-Meier curves and Cox proportional hazards model were used to determine the survival benefit of adjuvant chemotherapy. Experiments with shRNA knock-down were carried out to confirm the signature identified in this study. In the training dataset, we identified 44 PPI sub-modules, by which we separate patients into two clusters (1 and 2) having different chemotherapeutic benefit. A predictor of 11 PPI sub-modules (11-PPI-Mod) was established to discriminate the two sub-groups, with an overall accuracy of 90.1%. This signature was independently validated in an external validation dataset. Kaplan-Meier curves showed an improved outcome for patients who received adjuvant chemotherapy in Cluster 1 sub-group, but even worse survival for those in Cluster 2 sub-group. Similar results were found in both the training and the validation dataset. Multivariate Cox regression revealed an interaction effect between 11-PPI-Mod signature and adjuvant therapy treatment in the training dataset (RFS, p = 0.007; OS, p = 0.006) and the validation dataset (RFS, p = 0.002). From the signature, we found that PTGES gene was up-regulated in CRC cells which were more resistant to 5-Fu. Knock-down of PTGES indicated a growth inhibition and up-regulation of apoptotic markers induced by 5-Fu in CRC cells. Only a small proportion of stage II CRC patients could benefit from adjuvant therapy. The 11-PPI-Mod as

Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

Science.gov (United States)

García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

2016-01-01

Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Survival analysis of patients with clinical stages I or II Hodgkin's disease who have relapsed after initial treatment with radiotherapy alone

DEFF Research Database (Denmark)

Horwich, A.; Specht, L.; Ashley, S.

1997-01-01

relapse included initial stage, age, sex, histology, number of involved areas, mediastinal involvement, E-lesions, B-symptoms, erythrocyte sedimentation rate, alkaline phosphatase, serum albumin and haemoglobin. As well as presentation variables, we analysed the disease-free interval after initial......To aid treatment choice in early stage of Hodgkin's disease, we analysed patients registered in the IDHD Database with clinical stages I or II Hodgkin's disease who were not staged with laparotomy and whose initial treatment was with radiotherapy alone. The factors analysed for outcome after first...... radiotherapy and the extent of disease at relapse. A total of 1364 patients with clinical stage I or II Hodgkin's disease were treated with initial radiotherapy, of whom 473 relapsed. The probability of survival 10 years after relapse was 63%. For cause-specific survival (CSS), both multivariate and univariate...

Adherence to treatment guidelines and survival for older patients with stage II or III colon cancer in Texas from 2001 through 2011.

Science.gov (United States)

Zhao, Hui; Zhang, Ning; Ho, Vivian; Ding, Minming; He, Weiguo; Niu, Jiangong; Yang, Ming; Du, Xianglin L; Zorzi, Daria; Chavez-MacGregor, Mariana; Giordano, Sharon H

2018-02-15

Treatment guidelines for colon cancer recommend colectomy with lymphadenectomy of at least 12 lymph nodes for patients with stage I to stage III disease as surgery adherence (SA) and adjuvant chemotherapy for individuals with stage III disease. Herein, the authors evaluated adherence to these guidelines among older patients in Texas with colon cancer and the associated survival outcomes. Using Texas Cancer Registry data linked with Medicare data, the authors included patients with AJCC stage II and III colon cancer who were aged ≥66 years and diagnosed between 2001 and 2011. SA and adjuvant chemotherapy adherence rates to treatment guidelines were estimated. The chi-square test, general linear regression, survival probability, and Cox regression were used to identify factors associated with adherence and survival. The rate of SA increased from 47.2% to 84% among 6029 patients with stage II or stage III disease from 2001 to 2011, and the rate of adjuvant chemotherapy increased from 48.9% to 53.1% for patients with stage III disease during the same time period. SA was associated with marital status, tumor size, surgeon specialty, and year of diagnosis. Patient age, sex, marital status, Medicare state buy-in status, comorbidity status, and year of diagnosis were found to be associated with adjuvant chemotherapy. The 5-year survival probability for patients receiving guideline-concordant treatment was the highest at 87% for patients with stage II disease and was 73% for those with stage III disease. After adjusting for demographic and tumor characteristics, improved cancer cause-specific survival was associated with the receipt of stage-specific, guideline-concordant treatment for patients with stage II or stage III disease. The adherence to guideline-concordant treatment among older patients with colon cancer residing in Texas improved over time, and was associated with better survival outcomes. Future studies should be focused on identifying interventions to

Predictive value of pretreatment lymphocyte count in stage II colorectal cancer and in high-risk patients treated with adjuvant chemotherapy.

Science.gov (United States)

Liang, Lei; Zhu, Ji; Jia, Huixun; Huang, Liyong; Li, Dawei; Li, Qingguo; Li, Xinxiang

2016-01-05

Pretreatment lymphocyte count (LC) has been associated with prognosis and chemotherapy response in several cancers. The predictive value of LC for stage II colorectal cancer (CRC) and for high-risk patients treated with adjuvant chemotherapy (AC) has not been determined. A retrospective review of prospectively collected data from 1332 consecutive stage II CRC patients who underwent curative tumor resection was conducted. A pretreatment LC value risk, 459 (62.2%) of whom received AC. Patients with low LCs had significantly worse 5-year OS (74.6% vs. 90.2%, p risk patients with low LCs had the poorest DFS (p value or combined with high-risk status were both independent prognostic factors(p risk, AC-treated patients with high LCs had significantly longer DFS than untreated patients (HR, 0.594; 95% CI, 0.364-0.970; p = 0.035). There was no difference or trend for DFS or OS in patients with low LCs, regardless of the use of AC (DFS, p = 0.692; OS, p = 0.522). Low LC was also independently associated with poorer DFS in high-risk, AC-treated patients (HR, 1.885; 95% CI, 1.112-3.196; p = 0.019). Pretreatment LC is an independent prognostic factor for survival in stage II CRC. Furthermore, pretreatment LC reliably predicts chemotherapeutic efficacy in high-risk patients with stage II CRC.

[Relationships of the stages of behavior change in dietary habits of the mothers of school-age children with the breakfast intake of the children and the health-associated behavior of the family].

Science.gov (United States)

Imamura, Kayoko; Senoue, Aya; Wada, Miyuki; Sakoda, Makiko; Seto, Kozue; Haraguchi, Miho; Matsukida, Emi; Maruyama, Chizuko

2012-04-01

We aimed to clarify the relationships of the different stages of behavior change in dietary habits followed by the mothers of school-age children with the actual breakfast intake of these children and the health-associated behavior of the family. We carried out a questionnaire-based survey of 1949 children at 18 elementary schools and of 881 families with children attending seven elementary schools in Kagoshima prefecture. We were supplied with information about children's breakfast intake and content on the day they took the survey and information about mothers' breakfast intake and the stage of behavior change in dietary habits to which they belonged, for which five stages were defined using the stage-of-change model. The collection rates were 83.3% and 83.1% among children and mothers respectively. Of the children, 83.1% ate breakfast every day, while 15.1% were not in the habit of having breakfast. Furthermore, 98.6% children had eaten breakfast on the day of the survey, but 15.1% had eaten only staple foods such as rice or bread; only 34.0% children combined staple foods, a main dish, and vegetables/fruits in their breakfast. Regarding dietary stage, 28.1% of the mothers belonged to the "maintenance" stage; 24.0%, the "action" stage; 6.9%, the "preparation" stage; 9.8%, the "contemplation" stage; and 5.7%, the "precontemplation" stage. Mothers belonging to the first two stages constituted the "action group," because they were already taking care of their dietary habits, and mothers belonging to the latter three stages constituted the "no-action group", because they were not taking care of their dietary habits. The mothers who could provide no answers to the question constituted the "no-answer group" (25.5%). A comparison of the three groups revealed that mothers belonging to the no-answer group had more children who went without breakfast than the action group (P = 0.000). The children of mothers belonging to the no-action group (P = 0.003) and the no

Recovery in stages I and II of thermal and fission neutron irradiated molybdenum

International Nuclear Information System (INIS)

Coltman, R.R. Jr.; Klabunde, C.E.; Redman, J.K.

1975-01-01

The influence of initial dose and irradiation doping upon the recovery of Mo was studied for the markedly different types of damage produced by thermal and fission neutrons. The features of the Stage I recovery commonly seen for several fcc metals can be identified, including a I/sub D/ peak at 40 0 K. The typical dose-dependent behavior of a I/sub E/ subpeak was observed at approximately 47 0 K, and evidence for free interstitial migration is further supported by irradiation doping results. Stage II shows a first-order peak at 120 0 K in which the population percentage increases with increasing initial dose in opposite fashion to fcc impurity detrapping peaks. (auth)

Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials

International Nuclear Information System (INIS)

Young, R.C.; Walton, L.A.; Ellenberg, S.S.; Homesley, H.D.; Wilbanks, G.D.; Decker, D.G.; Miller, A.; Park, R.; Major, F. Jr.

1990-01-01

About a third of patients with ovarian cancer present with localized disease; despite surgical resection, up to half the tumors recur. Since it has not been established whether adjuvant treatment can benefit such patients, we conducted two prospective, randomized national cooperative trials of adjuvant therapy in patients with localized ovarian carcinoma. All patients underwent surgical resection plus comprehensive staging and, 18 months later, surgical re-exploration. In the first trial, 81 patients with well-differentiated or moderately well differentiated cancers confined to the ovaries (Stages Iai and Ibi) were assigned to receive either no chemotherapy or melphalan (0.2 mg per kilogram of body weight per day for five days, repeated every four to six weeks for up to 12 cycles). After a median follow-up of more than six years, there were no significant differences between the patients given no chemotherapy and those treated with melphalan with respect to either five-year disease-free survival or overall survival. In the second trial, 141 patients with poorly differentiated Stage I tumors or with cancer outside the ovaries but limited to the pelvis (Stage II) were randomly assigned to treatment with either melphalan (in the same regimen as above) or a single intraperitoneal dose of 32P (15 mCi) at the time of surgery. In this trial (median follow-up, greater than 6 years) the outcomes for the two treatment groups were similar with respect to five-year disease-free survival (80 percent in both groups) and overall survival (81 percent with melphalan vs. 78 percent with 32P; P = 0.48). We conclude that in patients with localized ovarian cancer, comprehensive staging at the time of surgical resection can serve to identify those patients (as defined by the first trial) who can be followed without adjuvant chemotherapy

PARTIAL SPLENECTOMY IN CHILDREN - AN ALTERNATIVE FOR SPLENECTOMY IN THE PATHOLOGICAL STAGING OF HODGKINS-DISEASE

NARCIS (Netherlands)

HOEKSTRA, HJ; TAMMINGA, RYJ; TIMENS, W

1994-01-01

Background: The more accurate staging of Hodgkin's disease in children is achieved with a staging laparotomy and splenectomy. A disadvantage of the splenectomy is the high risk for an overwhelming postsplenectomy sepsis (OPSI). Therefore, the partial splenectomy was introduced as an alternative to

Roosevelt's World War II Army of Community Service Workers. Children and Their Teachers.

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Field, Sherry L.

1996-01-01

Profiles the extraordinary World War II public support efforts conducted by school children and teachers across the United States. Encouraged by the Roosevelt administration, teachers and pupils mobilized support for war bond sales and salvage collection drives. Many children raised "Victory Gardens" producing food to help the war…

The prognostic importance of miR-21 in stage II colon cancer: a population-based study

DEFF Research Database (Denmark)

Kjaer-Frifeldt, S.; Hansen, T. F.; Nielsen, B. S.

2012-01-01

that increasing miR-21 expression levels were significantly correlated to decreasing RF-CSS. Further investigations of the clinical importance of miR-21 in the selection of high-risk stage II colon cancer patients are merited. British Journal of Cancer (2012) 107, 1169-1174. doi:10.1038/bjc.2012.365 www......BACKGROUND: Despite several years of research and attempts to develop prognostic models a considerable fraction of stage II colon cancer patients will experience relapse within few years from their operation. The aim of the present study was to investigate the prognostic importance of miRNA-21 (mi......-free cancer-specific survival (RF-CSS): HR = 1.26; 95% CI: 1.15-1.60; P importance and was found to be significantly related to poor RF-CSS: HR 1.41; 95% CI: 1.19-1.67; P

Definitive radiation therapy for medically inoperable patients with stage I and II non-small cell lung cancer

International Nuclear Information System (INIS)

Hayakawa, K.; Mitsuhashi, N.; Saito, Y.; Nakayama, Y.; Katano, S.; Furuta, M.; Sakurai, H.; Takahashi, T.; Niibe, H.

1995-01-01

Purpose: To evaluate the role of definitive radiation therapy (RT) in the treatment for medically inoperable patients with stage I-II non-small cell lung cancer (NSCLC). Materials and Methods: From 1976 through 1989, 84 patients with clinical stage I and II NSCLC were treated with definitive RT alone at Gunma University hospital. All patients were treated with 10 MV X-rays using antero-posterior parallel opposed fields. The total dose ranged from 60 Gy to 90 Gy (35 pts; 60-69 Gy, 39 pts; 70-74 Gy, 10 pts; ≥ 80 Gy) with once-daily standard fractionation. Results: The two and five-year survival rates were 74% and 31% for 28 patients with stage I disease, as compared with 40% and 19% for 56 patients with stage II respectively (p<0.05). Although there was no significant difference of survival rates by the histologic subtypes, in the patients with squamous cell carcinoma there were more long-term survivors. Fifty-three patients with tumors less than 5 cm in diameter had an infield progression rate of 14% at two years, in comparison with 38% of 31 patients with tumors greater than 5 cm (p<0.05). Overall distant failure occurred in 57% of the patients with smaller tumors and in 80% of the patients with larger tumors (p<0.05). The difference of survival rates for these two groups was statistically significant (p<0.005). Ten patients given a total dose of 80Gy or over had only 17% local progression at the time of last follow-up, however they had not been alive beyond three years because they developed pulmonary insufficiency due to severe stenosis of the proximal bronchus. For age and sex, there were no significant differences in survival, however, patients with performance status of 0-1 lived longer than those with a status of 2 or more (MST 24 versus 13 months; p=0.06). Conclusion: The tumor size was the most important factor not only for local control but also for distant failure. It was also suggested that the optimal radiation dose for medically inoperable stage I-II

Validation of the 12-gene colon cancer recurrence score as a predictor of recurrence risk in stage II and III rectal cancer patients.

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Reimers, Marlies S; Kuppen, Peter J K; Lee, Mark; Lopatin, Margarita; Tezcan, Haluk; Putter, Hein; Clark-Langone, Kim; Liefers, Gerrit Jan; Shak, Steve; van de Velde, Cornelis J H

2014-11-01

The 12-gene Recurrence Score assay is a validated predictor of recurrence risk in stage II and III colon cancer patients. We conducted a prospectively designed study to validate this assay for prediction of recurrence risk in stage II and III rectal cancer patients from the Dutch Total Mesorectal Excision (TME) trial. RNA was extracted from fixed paraffin-embedded primary rectal tumor tissue from stage II and III patients randomized to TME surgery alone, without (neo)adjuvant treatment. Recurrence Score was assessed by quantitative real time-polymerase chain reaction using previously validated colon cancer genes and algorithm. Data were analysed by Cox proportional hazards regression, adjusting for stage and resection margin status. All statistical tests were two-sided. Recurrence Score predicted risk of recurrence (hazard ratio [HR] = 1.57, 95% confidence interval [CI] = 1.11 to 2.21, P = .01), risk of distant recurrence (HR = 1.50, 95% CI = 1.04 to 2.17, P = .03), and rectal cancer-specific survival (HR = 1.64, 95% CI = 1.15 to 2.34, P = .007). The effect of Recurrence Score was most prominent in stage II patients and attenuated with more advanced stage (P(interaction) ≤ .007 for each endpoint). In stage II, five-year cumulative incidence of recurrence ranged from 11.1% in the predefined low Recurrence Score group (48.5% of patients) to 43.3% in the high Recurrence Score group (23.1% of patients). The 12-gene Recurrence Score is a predictor of recurrence risk and cancer-specific survival in rectal cancer patients treated with surgery alone, suggesting a similar underlying biology in colon and rectal cancers. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children

NARCIS (Netherlands)

Kerstjens, Jorien M.; Nijhuis, Ard; Hulzebos, Christian V.; van Imhoff, Deirdre E.; van Wassenaer-Leemhuis, Aleid G.; van Haastert, Ingrid C.; Lopriore, Enrico; Katgert, Titia; Swarte, Renate M.; van Lingen, Richard A.; Mulder, Twan L.; Laarman, Celeste R.; Steiner, Katerina; Dijk, Peter H.

2015-01-01

Objective To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. Methods We studied the test results of 224 children, born at <32 postmenstrual weeks,

Granisetron, Aprepitant, and Dexamethasone in Preventing Nausea and Vomiting in Patients Receiving Chemotherapy for Stage II, III, or IV Ovarian Cancer

Science.gov (United States)

2018-04-24

Nausea and Vomiting; Ovarian Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Cystadenocarcinoma; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma [v2; ref status: indexed, http://f1000r.es/4k6

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Tianhua Guo

2014-10-01

Full Text Available Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 × 103/μl in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our Institution between 2004 and 2013. The patients (48.7% male and 51.3% female had a mean age of 69.9 years (+/- 12.7 years at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients. Although the mean platelet count increased with the depth of tumor invasion (pT, its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57 had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4% with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery. The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis may be considered for adjuvant chemotherapy.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children

NARCIS (Netherlands)

Kerstjens, Jorien M.; Nijhuis, Ard; Hulzebos, Christian V.; van Imhoff, Deirdre E.; van Wassenaer-Leemhuis, Aleid G.; van Haastert, Ingrid C.; Lopriore, Enrico; Katgert, Titia; Swarte, Renate M.; van Lingen, Richard A.; Mulder, Twan L.; Laarman, Céleste R.; Steiner, Katerina; Dijk, Peter H.

2015-01-01

To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on

Breast-conserving therapy (BCT) in stage I-II synchronous bilateral breast cancer (SBBC)

Energy Technology Data Exchange (ETDEWEB)

Gollamudi, Smitha V; Gelman, Rebecca S; Peiro, Gloria; Schneider, Lindsey; Connolly, James L; Schnitt, Stuart; Silver, Barbara; Harris, Jay R

1995-07-01

PURPOSE: To determine whether patients with early-stage SBBC can be safely and effectively treated with bilateral BCT. MATERIALS and METHODS: We retrospectively reviewed records of 26 patients with clinical Stage I-II SBBC treated between 1968-1989 with bilateral BCT. SBBC was defined as tumors diagnosed no more than one month apart, with both sides demonstrating invasive cancer. Maximum (max) clinical stage was based on the more advanced breast tumor. Median age at diagnosis was 56 years (range, 32-85 years); menopausal status was 6 pre-, 16 post-, 3 peri-, and 1 unknown at diagnosis. Median follow-up for surviving pts is 95 months (range, 68-157). Outcome was compared to 1325 pts with unilateral Stage I or II breast cancer, within the same age range, treated during the same time period. There were no significant differences in median age, median total dose, tumor size, estrogen receptor (ER) status, pathologic nodal status, and use of systemic therapy between the study population and the comparison group. Local recurrence (LR) was evaluated as true recurrence (TR, i.e., in the original tumor bed), marginal miss (MM, at the edge of the boost field), or elsewhere (E). Median total dose to the primary was 6100 cGy (range, 5000-7000). Pathology was available for review in 19 cases. Cytology (nuclear and cytoplasmic features) was similar in (7(19)) evaluable cases, and architecture (growth pattern, ie, papillary, solid) was similar in (5(19)) cases. The presence of either cytologic or architectural similarity was noted in(9(19)) cases. 7 of 19 pts who had axillary lymph node evaluation on at least one side had pathological confirmation of lymph node metastasis. Stage was the same in both breasts in 13 cases (10 Stage I, 3 Stage II); ER status data was complete in 11 pts, and the same in both primaries in 9 cases. Cosmetic results and complications after BCT were scored. Statistical significance was evaluated by use of the Fisher exact test. RESULTS: The 5-yr actuarial

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study.

Science.gov (United States)

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong; Yang, Yunfeng

2017-01-01

Purpose . To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods . Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results . Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs ( p stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages.

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Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-06-01

To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . When compared with controls, there was a significant reduction in ANB angle (p cervical stages (p cervical stages (p cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage.

Phase II trial of a syllable-timed speech treatment for school-age children who stutter.

Science.gov (United States)

Andrews, Cheryl; O'Brian, Sue; Onslow, Mark; Packman, Ann; Menzies, Ross; Lowe, Robyn

2016-06-01

A recent clinical trial (Andrews et al., 2012) showed Syllable Timed Speech (STS) to be a potentially useful treatment agent for the reduction of stuttering for school-age children. The present trial investigated a modified version of this program that incorporated parent verbal contingencies. Participants were 22 stuttering children aged 6-11 years. Treatment involved training the children and their parents to use STS in conversation. Parents were also taught to use verbal contingencies in response to their child's stuttered and stutter-free speech and to praise their child's use of STS. Outcome assessments were conducted pre-treatment, at the completion of Stage 1 of the program and 6 months and 12 months after Stage 1 completion. Outcomes are reported for the 19 children who completed Stage 1 of the program. The group mean percent stuttering reduction was 77% from pre-treatment to 12 months post-treatment, and 82% with the two least responsive participants removed. There was considerable variation in response to the treatment. Eleven of the children showed reduced avoidance of speaking situations and 18 were more satisfied with their fluency post-treatment. However, there was some suggestion that stuttering control was not sufficient to fully eliminate situation avoidance for the children. The results of this trial are sufficiently encouraging to warrant further clinical trials of the method. Copyright © 2016 Elsevier Inc. All rights reserved.

The expression of chemokine receptors CXCR3 and CXCR4 in predicting postoperative tumour progression in stages I-II colon cancer: a retrospective study.

Science.gov (United States)

Du, Changzheng; Yao, Yunfeng; Xue, Weicheng; Zhu, Wei-Guo; Peng, Yifan; Gu, Jin

2014-01-01

The prognostic significance of chemokine receptors in stage I/II colon cancer is unclear. We assessed the prognostic value of chemokine receptor CXCR3 and CXCR4 in stage I/II colon cancer. 145 patients with stage I/II colon cancer who underwent curative surgery alone from 2000 to 2007 were investigated. Chemokine receptor expression was assessed by immunohistochemistry. The associations between CXCR3, CXCR4 and clinicopathological variables were analysed using the χ2 test, and the relationships between chemokine receptors and a 5-year disease-free survival were analysed by univariate and multivariate analyses. The high-expression rates of CXCR3 and CXCR4 were 17.9% (26/145) and 38.6% (56/145), respectively. There were no significant associations between the expressions of CXCR3, CXCR4 and clinicopathological factors including gender, age, tumour location, histological differentiation, pathological stage, lymphovascular invasion and pretreatment serum carcinoembryonic antigen (CEA). The 5-year disease-free survival was not significantly different between low-expression groups and high-expression groups of CXCR3 and CXCR4. Multivariate analysis revealed that serum CEA and a number of retrieved lymph nodes, rather than chemokine receptors, were independent prognosticators. CXCR3 and CXCR4 are not independent prognosticators for stage I/II colon cancer after curative surgery.

Survival and Complication Rate of Radiation Therapy in Stage I and II Carcinoma of uterine Cervix

International Nuclear Information System (INIS)

Ma, Sun Young; Cho, Heung Lea; Sohn, Seung Chang

1995-01-01

Purpose : To analyze survival rate and late rectal and bladder complication for patients with stage with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy. Materials and Methods : Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patients was 56 years (range 31-76). 26 patients were stage IB by FIGO classification. 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions. And we evaluated the external radiation dose and midline shield. Results : Acturial survival rate at 5 years was 92% for stage IB, 75% for stage IIA, 53% for stage IIB and 69% in all patients. Grade 1 rectal complications were developed in 20 cases(22%), grade 2 were in 22 cases (24%), 22 cases (24%) of grade 1 urinary complications and 17 cases (19%) of grade 2 urinary complications were observed But no patients had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications(7608cGy v 6960cGy, p<0.01). Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without urinary complications (7041cGy v 6269cGy, p<0.01). While there was no significant

Stages of Penile Cancer

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... under a microscope . Stage II In stage II , cancer has spread: to connective tissue just under the skin of the penis . Also, ... spread to one lymph node in the groin . Cancer has also spread: to connective tissue just under the skin of the penis . Also, ...

The effect of regular hemodialysis on the nutritional status of children with end-stage renal disease

Directory of Open Access Journals (Sweden)

Hala M Lotfy

2015-01-01

Full Text Available Growth failure is one of the most common and profound clinical manifestation of chronic kidney disease (CKD in infants, children and adolescents. The aim of this study was to assess the nutritional status of Egyptian children with end-stage renal disease (ESRD on regular hemodialysis (HD. The study included 50 Egyptian children with ESRD on regular HD, following-up at the Pediatric Nephrology unit, Cairo University. History, including dietary history, was taken for all patients and clinical examination was performed on all of them. Body weight, standing height, height or length SD score, the skin fold thickness, mid-arm circumference, mid-arm muscle circumference and mid-arm muscle circumference area were also assessed. The height of the patients was the most affected anthropometric parameter, as 78% of the patients were shorter (height SDS below -3. Body weight is less affected than height, as body weight SDS of 34% of patients was less than -3 SDS. In addition, the body mass index of 16% of the patients was 97 th percentile. Although most ESRD patients received adequate protein and caloric intake, their growth was markedly affected, especially with longer period on HD. We suggest that assessment of growth parameters should be performed at a minimum period of every six months in children with CKD stages 2-3. For children with more advanced CKD (stages 4-5 and 5D, more frequent evaluation may be warranted due to the greater risk of abnormalities.

Upper Gastrointestinal Disorders in Children with End -Stage Renal Disease

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Esfahani S.T

2009-04-01

Full Text Available This study was undertaken to define the prevalence of the upper Gastrointestinal (GI lesions, dyspeptic symptoms, H.pylori infection, and the impact of duration of dialysis on upper GI symptoms and lesions of children with End-stage renal disease. We studied 69 children with ESRD who were under regular hemodialysis therapy in our department. The age of the patients were between 4-18 years (mean: 11.3. 57(82.6% of 69 patients had GI symptoms and 12(17.4% were symptom free, the prevalence of each symptom in 57 symptomatic children was as follows: anorexia 48(84.2%, nausea/vomiting 39 (68.4%, belching/heartburn 20(35%, abdominal distention 15(26.3%, and epigastric pain 8(14%. 65(92.4% of 69 patients with ESRD had pathologic lesions and the most common lesion was gastritis .There was no case of gastric angiodysplasia in our patients. 15(21.7% of 69 patients had H. pylori infection. The prevalence of H.pylori infection in non-uremic children with upper GI symptoms is about 27% in our pediatric gastroenterology department, so there was no significant difference in prevalence of H.pylori infection between uremic and non-uremic children in our study (p value = 0.4735. There was no significant relationship between duration of dialysis and dyspeptic symptoms or upper GI lesions (p values were 0.8775 and 0.7435, respectively. Conclusions: Upper GI disorders are very common in children with ESRD, even when they have no upper GI symptoms, the most common lesion is gastritis. The prevalence of H.pylori infection is not different between children with ESRD and non-uremic children with upper GI symptoms, and duration of hemodialysis therapy has no significant effect on prevalence of GI symptoms and lesions.

Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder

DEFF Research Database (Denmark)

Vinberg, Maj; Mikkelsen, Rie Lambaek; Kirkegaard, Thomas

2017-01-01

Aim In a naturalistic clinical study of patients in the early stages of bipolar disorders the aim was to assess differences between patients with bipolar I (BD I) and bipolar II (BD II) disorders on clinical characteristics including affective symptoms, subjective cognitive complaints, functional...... level, the presence of comorbid personality disorders and coping strategies. Methods Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status using...... Inventory for Stressful Situations. Results In total, 344 patients were included (BD I (n=163) and BD II (n=181). Patients with BD II presented with significantly more depressive symptoms, more cognitive complaints, lower overall functioning, and a higher prevalence of comorbid personality disorders...

The Evolution of a Children's Domestic Violence Counseling Group: Stages and Processes

Science.gov (United States)

Thompson, E. Heather

2011-01-01

The purpose of this qualitative case study is to illuminate the lived experiences of 4 young children between 6 and 7 years old who witnessed domestic violence while revealing the complex relationship between group process and stage development in their 18-week counseling group. Data revealed that processes occurring between and among group…

[Premorbid stage in the development of anxiety in children].

Science.gov (United States)

Savost'ianova, O L

2002-01-01

The peculiarities of premorbid stage in children, aged 5-15 years, with ICD-10 diagnosis of anxiety-phobic disorders have been studied. The patient's mental state has been described earlier (Savostyanova, 2001). Retrospective evaluation of the patient's state in premorbid allowed to detect the disturbances in personality formation, anxiety phobic reactions and autochthon phases, represented by continuum of subclinical disorders, from floating anxiety to the signs of vital anxiety. These traits are distinguished by instability and inconsistency as well as by mild expression, which did not reach a level of manifest disorders. Personality of the children, who develop anxiety phobic disorders, may be emotionally labile as well as rigid one inclining to negative effectiveness. Hereditable and environment factors influencing anxiety phobic disorders development were detected. The premorbid traits are concluded to reflect inherited anxiety diathesis, which determines the peculiarities of reaction to negative environment and results not only in personality development but also in the large spectrum of future anxiety phobic symptoms.

Profiling MHC II immunopeptidome of blood-stage malaria reveals that cDC1 control the functionality of parasite-specific CD4 T cells.

Science.gov (United States)

Draheim, Marion; Wlodarczyk, Myriam F; Crozat, Karine; Saliou, Jean-Michel; Alayi, Tchilabalo Dilezitoko; Tomavo, Stanislas; Hassan, Ali; Salvioni, Anna; Demarta-Gatsi, Claudia; Sidney, John; Sette, Alessandro; Dalod, Marc; Berry, Antoine; Silvie, Olivier; Blanchard, Nicolas

2017-11-01

In malaria, CD4 Th1 and T follicular helper (T FH ) cells are important for controlling parasite growth, but Th1 cells also contribute to immunopathology. Moreover, various regulatory CD4 T-cell subsets are critical to hamper pathology. Yet the antigen-presenting cells controlling Th functionality, as well as the antigens recognized by CD4 T cells, are largely unknown. Here, we characterize the MHC II immunopeptidome presented by DC during blood-stage malaria in mice. We establish the immunodominance hierarchy of 14 MHC II ligands derived from conserved parasite proteins. Immunodominance is shaped differently whether blood stage is preceded or not by liver stage, but the same ETRAMP-specific dominant response develops in both contexts. In naïve mice and at the onset of cerebral malaria, CD8α + dendritic cells (cDC1) are superior to other DC subsets for MHC II presentation of the ETRAMP epitope. Using in vivo depletion of cDC1, we show that cDC1 promote parasite-specific Th1 cells and inhibit the development of IL-10 + CD4 T cells. This work profiles the P. berghei blood-stage MHC II immunopeptidome, highlights the potency of cDC1 to present malaria antigens on MHC II, and reveals a major role for cDC1 in regulating malaria-specific CD4 T-cell responses. © 2017 The Authors. Published under the terms of the CC BY 4.0 license.

5-YEAR SURVIVAL OF PATIENTS WITH STAGE II UTERINE CANCER DEPENDING ON MORPHOLOGIC FEATURES OF TUMOR

Directory of Open Access Journals (Sweden)

Ye. A. Mustafina

2008-01-01

Full Text Available Retrospective data of treatment results of 109 patients with rarely observed stage II uterine cancer, admitted to N.N. Blokhin Russian Cancer Research Center from 1980 to 2000 is analyzed. Correlation of overall 5-year survival rates of stage IIA and IIB uterine can- cer patients with a number of tumor morphologic features is studied. The influence of some non-elucidated morphologic features of stage IIA and IIB uterine cancer such as the degree of cellular anaplasia, the depth of tumor invasion into the uterine neck, lymho- vascular invasion into the myometrium and uterine neck, microscopic vessels density in the area of the most extensive invasion, the presence of necrotic areas in the tumor tissue on long-term treatment results are analyzed.

Tiotropium bromide in the routine care of GOLD stage II COPD patients: a pharmaeconomic evaluation

Directory of Open Access Journals (Sweden)

Orietta Zaniolo

2011-06-01

Full Text Available Background: a secondary pre-specified analysis of the UPLIFT cohort demonstrated that the inclusion of tiotropium bromide in the routine care of GOLD stage II (moderate chronic obstructive pulmonary disease (COPD patients is associated with stronger improvements of survival, quality of life, and exacerbation rate than those shown in the total cohort; in this subgroup, tiotropium furthermore induces a significant reduction in the rate of FEV1 decline.Objective: to adapt the Spiriva® model, originally built to evaluate cost-effectiveness of tiotropium inclusion in the general COPD population, to GOLD II patients.Methods: the Spiriva® model is a probabilistic Markov patient-level simulation developed over a lifetime horizon to compare outcomes associated with the inclusion of tiotropium in routine care (RC for COPD treatment with those obtained with RC alone. Patients are characterised by gender, age, height, smoking status and FEV1. Model structure and sources have been maintained unvaried, except for demographic characteristics, specific for GOLD II patients, as extrapolated from an Italian observational study, and tiotropium efficacy, based on the secondary analysis of GOLD II UPLIFT patients. As in the original model, only direct health care costs are considered.Results: patients treated with tiotropium on average (95% CI gain 0.70 (0.00/7.23 LYs or 0.77 (0.02/4.67 QALYs compared to RC. The incremental lifetime cost is € 3,520 (-6,391/26,686, meaning that the incremental cost required to gain a QALY (incremental cost-effectiveness ratio – ICER is equal to € 4,548. Sensitivity analysis shows that tiotropium has a 50% probability of being cost-effective for a willingness-to-pay (WTP around 4,600 €/QALY; 100% probability is achieved with a WTP of € 9,300.Conclusions: the adoption of a strategy based on the inclusion of tiotropium from the early COPD stages represents good value for money in Italy, as the ICER estimated for GOLD II

Efficacy of biofeedback on quality of life in stages I and II pelvic organ prolapse: A Pilot study.

Science.gov (United States)

Ahadi, Tannaz; Taghvadoost, Neda; Aminimoghaddam, Soheila; Forogh, Bijan; Bazazbehbahani, Roxana; Raissi, Gholam Reza

2017-08-01

Pelvic organ prolapse (POP) is a prevalent disorder which seriously affects the sufferer's quality of life. The main goal of this study was to evaluate biofeedback impact on quality of life in women with mild to moderate POP. 40 females in stages I and II POP were allocated into 2 groups. One group received pelvic floor muscle exercise and lifestyle advice in addition to biofeedback twice a week for 4 weeks, while the other received a lifestyle advice sheet and pelvic floor muscle exercise without biofeedback. A valid Persian version of P-QOL questionnaire was applied to assess the patients̕ quality of life at baseline, 4 weeks and 12 weeks follow up. Pressure biofeedback and Physical examination were also performed in order to determine pelvic floor muscle strength and staging of the prolapse, respectively. Collected data were analyzed by mixed ANOVA test using SPSS 22. Biofeedback improved the quality of life in seven of nine P-QOL domains. However, it had no significant impact either on pelvic floor muscle strength or on the stage of the prolapse. Biofeedback could be considered as a non-invasive treatment leading to quality of life promotion in women with stages I and II POP. Copyright © 2017 Elsevier B.V. All rights reserved.

[A retrospective study on nutritional status and growth and development of 37 children with chronic kidney disease stage 3 to 5].

Science.gov (United States)

Bao, R; Chen, C Y

2016-09-01

To retrospectively analyze the nutritional status and growth and development situation of the children with chronic kidney disease stage 3 to 5 when they were diagnosed at the first visit. After searching for the data of all the hospitalized cases during January 2007 to September 2015 in the Department of Nephrology of Children's Hospital Affiliated to the Capital Institute of Pediatrics from the medical record system, data of 37 cases with complete clinical data were collected; all these cases were diagnosed as chronic kidney disease stage 3 to 5 according to the diagnostic criteria.We recorded these children's age, height, weight, body mass index, albumin, blood lipids and acidosis situation when they were first diagnosed, and then, analyzed and summarized their nutritional status and growth and development situation. In these 37 cases, 24 cases were boys and 13 cases were girls; 23 cases (62%) were shorter than the third percentile of age-sex-specific height; 18 cases (49%) exhibited lower weight than the third percentile of age-sex-specific weight; 5 cases (13.5%) showed lower BMI than the third percentile of height-age BMI, and 5 cases (13.5%) had obesity. The level of albumin was (37.0±8.7) g/L, and no statistically significant difference was observed within each stage. In all of these cases, 10 cases were hypoalbuminemia (27%), and the difference of its frequency between stage 3-4 and stage 5 was not statistically significant. Triglyceride was (2.2±1.1) mmol/L. The mean level was higher than the normal range, but with no statistically significant difference within each stage; 21 cases (62%) were diagnosed as hypertriglyceridemia, which were more frequent compared with the occurrence of the hypercholesterolemia (32%), the high low density lipoprotein (26%) and the low high density lipoprotein(12%). And the occurrence of decompensated metabolic acidosis in stage 5 (69%) was significantly higher than that in stage 3-4 (38%) (P=0.036 6, children with chronic

Routine educational outcome measures in health studies: Key Stage 1 in the ORACLE Children Study follow-up of randomised trial cohorts.

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Jones, David R; Pike, Katie; Kenyon, Sara; Pike, Laura; Henderson, Brian; Brocklehurst, Peter; Marlow, Neil; Salt, Alison; Taylor, David J

2011-01-01

Statutory educational attainment measures are rarely used as health study outcomes, but Key Stage 1 (KS1) data formed secondary outcomes in the long-term follow-up to age 7 years of the ORACLE II trial of antibiotic use in preterm babies. This paper describes the approach, compares different approaches to analysis of the KS1 data and compares use of summary KS1 (level) data with use of individual question scores. 3394 children born to women in the ORACLE Children Study and resident in England at age 7. Analysis of educational achievement measured by national end of KS1 data (KS1) using Poisson regression modelling and anchoring of the KS1 data using external standards. KS1 summary level data were obtained for 3239 (95%) eligible children; raw individual question scores were obtained for 1899 (54%). Use of individual question scores where available did not change the conclusion of no evidence of treatment effects based on summary KS1 outcome data. When accessible for medical research purposes, routinely collected educational outcome data may have advantages of low cost and standardised definition. Here, summary scores lead to similar conclusions to raw (individual question) scores and so are attractive and cost-effective alternatives.

Subdiaphragmatic stage I and II Hodgkin's disease - long-term follow-up and prognostic factors

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Liao Zhongxing; Ha, Chul S.; Fuller, Lillian M.; Hagemeister, Fredrick B.; Cabanillas, Fernando; Tucker, Susan L.; Hess, Mark A.; Cox, James D.

1997-01-01

Purpose: To report long term follow-up results and analyze prognostic factors for overall and disease-free survival in patients with subdiaphragmatic stage I and II Hodgkin's disease. Methods and Materials: From September 1962 to April 1995, 109 patients presented to the M. D. Anderson Cancer Center with subdiaphragmatic Hodgkin's disease. The medical records of these patients were retrospectively reviewed. Twenty-two patients who received no treatment at M. D. Anderson Cancer Center or who had radiation therapy at other institutions were excluded. The remaining 87 patients formed the basis of this study. The median age of our group was 33 years with a male:female ratio of 3.3:1. The histological subtypes were nodular sclerosis in 21 (24.1%) patients, mixed cellularity in 31 (35.6%), lymphocyte predominence in 33 (37.9%), lymphocyte depletion in 1 (1.1%) and unclassified histology in 1 (1.1%). Thirty three (37%) patients underwent laparotomy, 74 (85.1%) had lymphangiography, and 35 (40.2%) had computerized tomography of the abdomen. Twenty two (25%) patients had more than three sites of nodal involvement at presentation, 56 (64.4%) had pelvic or abdominal disease, and 14 (18.4%) had bulky disease which was defined as disease with largest dimension ≥ 7 cm. Stage distribution was IA in 33.3%, IIA in 39.1%, and IIB in 27.6%. Sixty (69%) patients were treated with radiotherapy alone, 23 (26.4%) with chemotherapy and radiation, and 4 (4.6%) with chemotherapy alone. Results: The 10 and 20 year actuarial overall survival rates for all the patients were 74.6% and 55.3%, and the corresponding disease free survival rates were 72.4% and 67.5%, respectively. On univariate analysis, age, B symptoms, nodular sclerosis or mixed cellularity histology, and decreased albumin and hemoglobin level were statistically significant adverse pretreatment factors for overall survival. B symptoms, decreased albumin level, more than 3 sites of disease at presentation, and stage were

Outcome of one-stage treatment of developmental dysplasia of hip in older children

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Basant Kumar Bhuyan

2012-01-01

Conclusions: Young children having DDH can safely be treated with an extensive one-stage triple procedure of open reduction, femoral shortening derotation, and Salter′s osteotomy, without increasing the risk of AVN. Early diagnosis and intervention is the successful treatment of patients suffering from DDH.

Cluster II quartet take the stage together

Science.gov (United States)

1999-11-01

This is the only occasion on which all four of ESA's Cluster II spacecraft will be on display together in Europe. Four Spacecraft, One Mission The unique event takes place near the end of the lengthy assembly and test programme, during which each individual spacecraft is being assembled in sequence, one after the other. Two have already completed their assembly and systems testing and are about to be stored in special containers at IABG prior to shipment to the Baikonur launch site in Kazakhstan next spring. In the case of the other two, flight models 5 and 8, installation of the science payloads has finished, but their exhaustive series of environmental tests at IABG have yet to begin. Following delivery to the launch site next April, the satellites will be launched in pairs in June and July 2000. Two Soyuz rockets, each with a newly designed Fregat upper stage, are being provided by the Russian-French Starsem company. This will be the first time ESA satellites have been launched from the former Soviet Union. Cluster II is a replacement for the original Cluster mission, which was lost during the maiden launch of Ariane 5 in June 1996. ESA, given the mission's importance in its overall strategy in the area of the Sun-Earth connection, decided to rebuild this unique project. ESA member states supported that proposal. On 3 April 1997, the Agency's Science Programme Committee agreed. Cluster II was born. European Teamwork Scientific institutions and industrial enterprises in almost all the 14 ESA member states and the United States are taking part in the Cluster II project. Construction of the eight Cluster / Cluster II spacecraft has been a major undertaking for European industry. Built into each 1200 kg satellite are six propellant tanks, two pressure tanks, eight thrusters, 80 metres of pipework, about 5 km of wiring, 380 connectors and more than 14 000 electrical contacts. All the spacecraft were assembled in the giant clean room at the Friedrichshafen plant of

Accuracy of episodic autobiographical memory in children with early thyroid hormone deficiency using a staged event

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Karen A. Willoughby

2014-07-01

Full Text Available Autobiographical memory (AM is a highly constructive cognitive process that often contains memory errors. No study has specifically examined AM accuracy in children with abnormal development of the hippocampus, a crucial brain region for AM retrieval. Thus, the present study investigated AM accuracy in 68 typically and atypically developing children using a staged autobiographical event, the Children's Autobiographical Interview, and structural magnetic resonance imaging. The atypically developing group consisted of 17 children (HYPO exposed during gestation to insufficient maternal thyroid hormone (TH, a critical substrate for hippocampal development, and 25 children with congenital hypothyroidism (CH, who were compared to 26 controls. Groups differed significantly in the number of accurate episodic details recalled and proportion accuracy scores, with controls having more accurate recollections of the staged event than both TH-deficient groups. Total hippocampal volumes and anterior hippocampal volumes were positively correlated with proportion accuracy scores, but not total accurate episodic details, in HYPO and CH. In addition, greater severity of TH deficiency predicted lower proportion accuracy scores in both HYPO and CH. Overall, these results indicate that children with early TH deficiency have deficits in AM accuracy and that the anterior hippocampus may play a particularly important role in accurate AM retrieval.

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease)

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Kim, Sang Won; Chun, Misun; Kim, Myung Wook; Kim, Wook Hwan; Kang, Seok Yun; Kang, Seung Hee; Oh, Young Taek; Lee, Sunyoung; Yang, Juno [Ajou University School of Medicine, Suwon (Korea, Republic of)

2007-12-15

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

The Outcome of Postoperative Radiation Therapy for Patients with Stage II Pancreatic Cancer (T3 or N1 Disease)

International Nuclear Information System (INIS)

Kim, Sang Won; Chun, Misun; Kim, Myung Wook; Kim, Wook Hwan; Kang, Seok Yun; Kang, Seung Hee; Oh, Young Taek; Lee, Sunyoung; Yang, Juno

2007-01-01

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1- and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2- and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer

The drama of the continuous increase in end-stage renal failure in patients with type II diabetes mellitus.

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Rychlík, I; Miltenberger-Miltenyi, G; Ritz, E

1998-01-01

Type II diabetes mellitus has become the leading cause of end-stage renal failure in many countries of Western Europe. In all European countries, even in those with a relatively low prevalence of diabetic nephropathy, the number of patients with type II diabetes mellitus admitted for renal replacement therapy has recently increased continuously. Survival and medical rehabilitation of patients with type II diabetes on renal replacement therapy is significantly worse than in non-diabetic patients. It is obvious that in order to stem the tide, intense efforts are necessary (i) to inform the medical community about the renal risk of type II diabetes and the striking effectiveness of preventive measures, (ii) to provide better care for diabetic patients, and (iii) to reduce the high prevalence of diabetes in the population by modification of the Western life style.

Treatment of type II and type III open tibia fractures in children.

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Bartlett, C S; Weiner, L S; Yang, E C

1997-07-01

To determine whether severe open tibial fractures in children behave like similar fractures in adults. A combined retrospective and prospective review evaluated treatment protocol for type II and type III open tibial fractures in children over a ten-year period from 1984 to 1993. Twenty-three fractures were studied in children aged 3.5 to 14.5 (18 boys and 5 girls). There were six type II, eight type IIIA, and nine type IIIB fractures. Type I fractures were not included. Seven fractures were comminuted with significant butterfly fragments or segmental patterns. Treatment consisted of adequate debridement of soft tissues, closure of dead space, and stabilization with external fixation. Bone debridement only included contaminated devitalized bone or devitalized bone without soft tissue coverage. Bone that could be covered despite periosteal stripping was preserved. Clinical and roentgenographic examinations were used to determine time to union. All fractures in this series healed between eight and twenty-six weeks. Wound coverage included two flaps, three skin grafts, and two delayed primary closures. No bone grafts were required. There were no deep infections, growth arrests, or malunions. Follow-up has ranged from six months to four years. Open tibia fractures in children differ from similar fractures in adults in the following ways: soft tissues have excellent healing capacity, devitalized bone that is not contaminated or exposed can be saved and will become incorporated, and external fixation can be maintained until the fracture has healed. Periosteum in young children can form bone even in the face of bone loss.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children.

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Jorien M Kerstjens

Full Text Available To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3 to help identify or exclude neurodevelopmental impairment (NDI in very preterm-born children at the corrected age of two.We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII and neurological examination at 22-26 months' corrected age. We defined NDI as a score of <70 on the cognitive--or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening. We compared NDI with abnormal ASQ3 scores, i.e., < -2SDs on any domain, and with ASQ3 total scores. To correct for possible overestimation of BSIDIII, we also analyzed the adjusted BSIDIII thresholds for NDI, i.e., scores <80 and <85.We found 61 (27% children with abnormal ASQ3 scores, and 10 (4.5% children who had NDI with original BSIDIII thresholds (<70. Twelve children had NDI at BSIDIII thresholds at <80, and 15 had <85. None of the 163 (73% children who passed ASQ3 had NDI. The sensitivity of ASQ3 to detect NDI was excellent (100%, its specificity was acceptable (76%, and its negative predictive value (NPV was 100%. Sensitivity and NPV remained high with the adjusted BSIDIII thresholds.The Ages and Stages Questionnaire is a simple, valid and cost-effective screening tool to help identify and exclude NDI in very preterm-born children at the corrected age of two years.

Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS.

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Pavão, Silvia Leticia; Ledebt, Annick; Savelsbergh, Geert J P; Rocha, Nelci Adriana C F

2017-08-01

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn't affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn't result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparative Analysis between preoperative Radiotherapy and postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma

International Nuclear Information System (INIS)

Keum, Ki Chang; Lee, Chang Geol; Chung, Eun Ji; Lee, Sang Wook; Kim, Woo Cheol; Chang, Sei Kyung; Oh, Young Taek; Suh, Chang Ok; Kim, Gwi Eon

1995-01-01

Purpose : To obtain the optical treatment method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy(pre-op R) and postoperative radiotherapy(post-op RT). Materials and Methods : A retrospective review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stage I; 12 patients, Stage II; 7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO(Bilateral Salphingoophorectomy) (Group 1) and 43 patients( Stage 1; 32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT was administered on 4-5 weeks following surgery. All patients exept 1 patient(Group2; ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55Gy(median 45Gy) in 5-6 week through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180cGy per fraction. ICR doses were prescribed to point A(20-39.6 Gy, median 39Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy, median 21Gy) in Group2. Results : The overall 5 year survival rate was 95%. No survival difference between pre-op and post-op RT group.(89.3% vs 97.7%, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1(p>0.1), but affected by presence of lymph node metastasis in post-op RT group(p<0.5). The complication rate of pre-op RT group was higher than post-op RT.(16% vs 5%) Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate

Carcinoma microsatellite instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for stage II rectal cancer.

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Yang, Liu; Sun, Yan; Huang, Xin-En; Yu, Dong-Sheng; Zhou, Jian-Nong; Zhou, Xin; Li, Dong-Zheng; Guan, Xin

2015-01-01

Rectal cancers with high microsatellite-instable have clinical and pathological features that differentiate them from microsatellite-stable or low- frequency carcinomas, which was studied rarely in stage II rectal cancer, promoting the present investigation of the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II rectal cancer. Data of 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2008 to 2012 were retrospectively collected. All patients experienced a total mesorectal excision (TME) operation. Survival analysis were analyzed using the Cox regression method. Five-year rate of disease-free survival (DFS) was noted in 390 (84.8%) of 460 patients with stage II rectal cancer. Of 460 tissue specimens, 97 (21.1%) exhibited high-frequency microsatellite instability. Median age of the patients was 65 (50-71) and 185 (40.2%) were male. After univariate and multivariate analysis, microsatellite instability (p= 0.001), female sex (pchemotherapy (pchemotherapy, those cancers displaying high-frequency microsatellite instability had a better 5-year rate of DFS than tumors exhibiting microsatellite stability or low-frequency instability (HR, 13.61 [95% CI, 1.88 to 99.28]; p= 0.010), while in 259 patients who received adjuvant chemotherapy, there was no DFS difference between the two groups (p= 0.145). Furthermore, patients exhibiting microsatellite stability or low-frequency instability who received adjuvant chemotherapy had a better 5-year rate of DFS than patients did not (HR, 5.16 [95% CI, 2.90 to 9.18]; pchemotherapy and gender. Fluorouracil-based adjuvant chemotherapy benefits patients of stage II rectal cancer with microsatellite-stable or low microsatellite-instable, but not those with high microsatellite- instable. Additionally, free of adjuvant chemotherapy, carcinomas with high microsatellite

Are stage IV vestibular schwannomas preoperatively different from other stages?

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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

Treatment outcome, body image, and sexual functioning after orchiectomy and radiotherapy for Stage I-II testicular seminoma

International Nuclear Information System (INIS)

Incrocci, Luca; Hop, Wim C.J.; Wijnmaalen, Arendjan; Slob, A. Koos

2002-01-01

Purpose: Orchiectomy followed by infradiaphragmatic irradiation is the standard treatment for Stage I-II testicular seminoma in The Netherlands. Because body image and sexual functioning can be affected by treatment, a retrospective study was carried out to assess treatment outcome, body image, and changes in sexuality after orchiectomy and radiotherapy. Methods and Materials: The medical charts of 166 patients with Stage I-II testicular seminoma were reviewed. A questionnaire on body image and current sexual functioning regarding the frequency and quality of erections, sexual activity, significance of sex, and changes in sexuality was sent to 157 patients (at a mean of 51 months after treatment). Results: Seventy-eight percent (n=123, mean age 42 years) completed the questionnaire. During irradiation, almost half of patients experienced nausea and 19% nausea and vomiting. Only 3 patients had disease relapse. After treatment, about 20% reported less interest and pleasure in sex and less sexual activity. Interest in sex, erectile difficulties, and satisfaction with sexual life did not differ from age-matched healthy controls. At the time of the survey, 17% of patients had erectile difficulties, a figure that was significantly higher than before treatment, but which correlated also with age. Twenty percent expressed concerns about fertility, and 52% found their body had changed after treatment. Cancer treatment had negatively influenced sexual life in 32% of the patients. Conclusions: Orchiectomy with radiotherapy is an effective and well-tolerated treatment for Stage I-II testicular seminoma. Treatment-induced changes in body image and concerns about fertility were detected, but the sexual problems encountered did not seem to differ from those of healthy controls, although baseline data are lacking

ColoLipidGene: signature of lipid metabolism-related genes to predict prognosis in stage-II colon cancer patients

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Vargas, Teodoro; Moreno-Rubio, Juan; Herranz, Jesús; Cejas, Paloma; Molina, Susana; González-Vallinas, Margarita; Mendiola, Marta; Burgos, Emilio; Aguayo, Cristina; Custodio, Ana B.; Machado, Isidro; Ramos, David; Gironella, Meritxell; Espinosa-Salinas, Isabel; Ramos, Ricardo; Martín-Hernández, Roberto; Risueño, Alberto; De Las Rivas, Javier; Reglero, Guillermo; Yaya, Ricardo; Fernández-Martos, Carlos; Aparicio, Jorge; Maurel, Joan; Feliu, Jaime; de Molina, Ana Ramírez

2015-01-01

Lipid metabolism plays an essential role in carcinogenesis due to the requirements of tumoral cells to sustain increased structural, energetic and biosynthetic precursor demands for cell proliferation. We investigated the association between expression of lipid metabolism-related genes and clinical outcome in intermediate-stage colon cancer patients with the aim of identifying a metabolic profile associated with greater malignancy and increased risk of relapse. Expression profile of 70 lipid metabolism-related genes was determined in 77 patients with stage II colon cancer. Cox regression analyses using c-index methodology was applied to identify a metabolic-related signature associated to prognosis. The metabolic signature was further confirmed in two independent validation sets of 120 patients and additionally, in a group of 264 patients from a public database. The combined analysis of these 4 genes, ABCA1, ACSL1, AGPAT1 and SCD, constitutes a metabolic-signature (ColoLipidGene) able to accurately stratify stage II colon cancer patients with 5-fold higher risk of relapse with strong statistical power in the four independent groups of patients. The identification of a group of 4 genes that predict survival in intermediate-stage colon cancer patients allows delineation of a high-risk group that may benefit from adjuvant therapy, and avoids the toxic and unnecessary chemotherapy in patients classified as low-risk group. PMID:25749516

Closure of patent ductus arteriosus in children, small infants, and premature babies with Amplatzer duct occluder II additional sizes: multicenter study.

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Sungur, Metin; Karakurt, Cemsit; Ozbarlas, Nazan; Baspinar, Osman

2013-08-01

To evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. Retrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. The median patient age and weight were 6.5 (0.5-168) months and 6.8 (1.19-57) kg, respectively. In the study, 26 children had a body weight of ≤ 6 kg. Of these 26 children, 9 had a body weight of ≤ 3 kg. The median narrowest diameter of PDA was 2 (1.2-4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1-18) months. Neither death nor any major complications occurred. Our study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants. © 2013 Wiley Periodicals, Inc.

Evaluation of insulin like growth factor-1 (If-1) in children with different stages of chronicle renal failure

International Nuclear Information System (INIS)

Derakshan, A.; Karamifar, H.; Razavi, N.S.M.; Fallahzadeh, M.H.; Hashemi, G.H.

2007-01-01

Growth retardation in children with chronic kidney disease (CKD) is multifactorial that include inadequate protein and calorie intake, persistent metabolic acidosis, calcitriol deficiency, renal osteodystrophy, drug toxicity, uremic toxins and growth factor abnormalities such as insulin- like growth factor (IGF) and IGF binding proteins. In this study, we compare the IGF-1 levels in normal and growth retarded CKD children. Serum IGF-1 levels were determined in 22 children with end-stage renal disease, 26 children, with CKD at different stages, 23 children with normal height and weight for age, and 23 children with constitutionally short stature. Mean serum levels of IGF-1 were 209+- ng/m1 in the ESRD group (group1), 159+-163 ng/m1 in the CKD group (group2), 420+-182 ng/ml in normal children (group3), and 360+-183 ng/ml in children with constitutional short stature (group4). The differences in the levels of IGF-1 in groups 1 and 2 were statistically significant when compared to groups 3 and 4(p<0.0001 and p< 0.02, respectively), while the levels of IGF-1 were not statistically different between groups 1 and 2. No correlation was found between IGF-1levels and glomerular filtrations are height or weight in groups 1 and 2. In conclusion, serum levels of IGF-1 in children with CKD are significantly lower than healthy children. (author)

MENTAL ACTIVITY RESTORATION PECULIARITIES IN CHILDREN WITH SEVERE TRAUMATIC BRAIN INJURY AT THE EARLY STAGE OF REHABILITATION

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A. V. Zakrepina

2013-01-01

Full Text Available The article is concerned with rehabilitation issues of children with severe traumatic brain injury (STBI. It gives the results of the study which was aimed at analyzing the psychophysical health restoration dynamics in children with STBI and determining the pedagogic typology of deviant development at traumatic brain injury in order to devise a training-organizational work plan for children being on the stages of complex rehabilitation.

Vineland-II adaptive behavior profile of children with attention-deficit/hyperactivity disorder or specific learning disorders.

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Balboni, Giulia; Incognito, Oriana; Belacchi, Carmen; Bonichini, Sabrina; Cubelli, Roberto

2017-02-01

The evaluation of adaptive behavior is informative in children with attention-deficit/hyperactivity disorder (ADHD) or specific learning disorders (SLD). However, the few investigations available have focused only on the gross level of domains of adaptive behavior. To investigate which item subsets of the Vineland-II can discriminate children with ADHD or SLD from peers with typical development. Student's t-tests, ROC analysis, logistic regression, and linear discriminant function analysis were used to compare 24 children with ADHD, 61 elementary students with SLD, and controls matched on age, sex, school level attended, and both parents' education level. Several item subsets that address not only ADHD core symptoms, but also understanding in social context and development of interpersonal relationships, allowed discrimination of children with ADHD from controls. The combination of four item subsets (Listening and attending, Expressing complex ideas, Social communication, and Following instructions) classified children with ADHD with both sensitivity and specificity of 87.5%. Only Reading skills, Writing skills, and Time and dates discriminated children with SLD from controls. Evaluation of Vineland-II scores at the level of item content categories is a useful procedure for an efficient clinical description. Copyright © 2016 Elsevier Ltd. All rights reserved.

Combined chemo-radiation therapy to adult patients with B-cell lymphoma in stage I and II

International Nuclear Information System (INIS)

Shimoyama, Masanori

1988-01-01

155 adult patients with B-lymphoma in stage I and II who were treated in National Cancer Center Hospital between 1975 and 1986 were analyzed for treatment outcome. 5-year survival rates were about 66 % in these patients and almost equal in the patients treated with radiation alone, doxorubicin-containing combination chemotherapy alone, or combined chemoradiation therapy. However, when analysis was limited to patients in stage I, patients treated with chemotherapy alone seemed to have better survival rate than those treated with radiation alone. In the patients who were in stage III or more and had bulky mass more than 10 cm in diameter, small residual tumor was sometimes detected by restaging procedure after achieving apparent remission by multi-drug chemotherapy. In these patients, additional radiation therapy was quite usefull to eradicate residual tumor cell to cure. (author)

Mantle irradiation alone for pathologic stage I and II Hodgkin's disease: long-term follow-up and patterns of failure

International Nuclear Information System (INIS)

Liao Zhongxing; Ha, Chul S.; Vlachaki, Maria T.; Hagemeister, Frederick; Cabanillas, Fernando; Hess, Mark; Tucker, Susan; Cox, James D.

2001-01-01

Purpose: We performed a retrospective study to determine the long-term outcome, patterns of failure, and prognostic factors for patients with pathologic Stage I or II Hodgkin's disease (HD) who were treated with mantle irradiation alone. Methods and Materials: The medical records of 145 patients with pathologic Stage I or II supradiaphragmatic Hodgkin's disease treated with mantle irradiation alone between June 1967 and June 1991 were reviewed. Patterns of failure, overall survival (OS) rate, and progression-free survival (PFS) rate were determined. Univariate and multivariate analyses were performed to identify adverse prognostic factors for OS and PFS. The number of adverse prognostic factors per patient was counted, and a prognostic score was assigned to each patient. The log-rank test was used to compare the OS or PFS rates among patients with prognostic scores 0, 1, and 2. Results: The median patient age was 27 years (range 10-66), with almost even male to female distribution. Every patient had splenectomy and negative laparotomy (LAP). Fifty-one patients had Stage I disease (IA-49, IB-2) and 94 Stage II (IIA-89, IIB-5). The histologic subtypes were nodular sclerosing in 110, mixed cellularity in 28, lymphocyte predominance in 5, lymphocyte depleted in 1, and unclassified in 1. Twelve patients with Stage II disease had ≥ 3 sites of nodal involvement. Fifty-four patients had a prognostic score of 0, 70 of 1, and 21 of 2. The median follow-up time for the 109 surviving patients was 146 months (range 25-381). The 10- and 20-year actuarial OS rates for the whole group were 87.6% and 65.3%, respectively. The corresponding actuarial PFS rates were 75.3% and 74.2%, respectively. Thirty-six patients (9 Stage I, 27 Stage II) had relapses in a total of 41 sites. Failures by histology were 29 patients with nodular sclerosing, 6 with mixed cellularity, and 1 with lymphocyte predominance. Failures by sites were: trans-diaphragmatic, 22 (para-aortic nodes, 15; as the only

The benefit of microsatellite instability is attenuated by chemotherapy in stage II and stage III gastric cancer: Results from a large cohort with subgroup analyses.

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Kim, Soo Young; Choi, Yoon Young; An, Ji Yeong; Shin, Hyun Beak; Jo, Ara; Choi, Hyeji; Seo, Sang Hyuk; Bang, Hui-Jae; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon

2015-08-15

We previously reported that the prognosis of microsatellite instability high (MSI-H) gastric cancer is similar to that of MSI-low/microsatellite stable (MSI-L/MSS) gastric cancer. The reason for this seemed to be related to the effects of chemotherapy. To verify this hypothesis, we expanded the study population and reanalyzed the prognosis of MSI-H gastric cancer. Data from 1,276 patients with Stage II and III gastric cancer who underwent gastrectomy with curative intent between January 2005 and June 2010 were reviewed. The prognosis of MSI-H tumors in comparison with MSI-L/MSS tumors was analyzed, according to the administration of chemotherapy and other clinicopathologic features. A total of 361 (28.3%) patients did not receive chemotherapy (MSI-H = 47 and MSI-L/MSS = 314), whereas 915 (71.7%) patients did receive chemotherapy (MSI-H = 58 and MSI-L/MSS = 857). The hazard ratio of MSI-H versus MSI-L/MSS was 0.49 (95% confidence interval: 0.26-0.94, p = 0.031) when chemotherapy was not received and 1.16 (95% confidence interval: 0.78-1.71, p = 0.466) when chemotherapy was received. In subgroup analyses, the prognosis of MSI-H was better in Stage III, women, with lymph node metastasis, and undifferentiated histology subgroups when chemotherapy was not received. However, in patients treated with chemotherapy, prognosis was worse for MSI-H tumors in Stage III, undifferentiated histology, and diffuse type subgroups of gastric cancer. In conclusion, MSI-H tumors were associated with a good prognosis in Stage II and III gastric cancer when patients were treated by surgery alone, and the benefits of MSI-H status were attenuated by chemotherapy. © 2015 UICC.

Surgical resection of locally advanced primary transverse colon cancer--not a worse outcome in stage II tumor.

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Hung, Hsin-Yuan; Yeh, Chien-Yuh; Changchien, Chung-Rong; Chen, Jinn-Shiun; Fan, Chung-Wei; Tang, Reiping; Hsieh, Pao-Shiu; Tasi, Wen-Sy; You, Yau-Tong; You, Jeng-Fu; Wang, Jeng-Yi; Chiang, Jy-Ming

2011-07-01

In locally advanced primary transverse colon cancer, a tumor may cause perforation or invade adjacent organs. Extensive resection is the best choice of treatment, but such procedures must be weighed against the potential survival benefits. This study was performed to identify the clinicopathological features and treatment outcomes of such tumors. We retrospectively reviewed the database of the Colorectal Cancer Registry of Chang Gung Memorial Hospital between February 1995 and December 2005. Patients with colon cancer sited between the hepatic and splenic flexure that involved an adjacent organ without distant metastasis were defined as having locally advanced transverse colon cancer. A total of 827 patients who underwent surgery for transverse primary colon cancer were enrolled in the study. Stage II and stage III colon cancer were diagnosed in 548 patients. Thirty-two (5.8%) patients were diagnosed with locally advanced tumors. Multivariate analysis revealed that stage III, preoperative carcinoembryonic antigen ≥5 ng/mL, a tumor with perforation or obstruction, and the presence of a locally advanced tumor were significant prognostic factors for both overall and cancer-specific survival. Postoperative morbidity rates differed significantly between the locally advanced and non-locally advanced tumor groups (22.7% vs. 12.3%, P transverse colon tumors (P = 0.21). Surgical resection of locally advanced transverse colon tumors resulted in a higher morbidity and mortality than that of non-locally advanced tumors, but the benefit of extensive surgery in the case of locally advanced tumors cannot be underestimated. Furthermore, this benefit is more pronounced in the case of stage II tumors.

Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience.

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Ali, Amany M; Sayd, Heba A; Hamza, Hesham M; Salem, Mohamed A

2011-03-29

Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL.

Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience

Directory of Open Access Journals (Sweden)

Mohamed A. Salem

2011-03-01

Full Text Available Abdominal Non-Hodgkin lymphomas (NHL are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI, Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15. Thirty patients (86% presented with abdominal pain, 23 patients (66% presented with abdominal mass and distention, 13 patients (34% presented with weight loss, and intestinal obstruction occurred in six patients (17%. The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively. Burkitt's lymphoma was the most common histological type in 29 patients (83%. Ten (28.5% stage II (group A and 25 (71.5% stage III (group B. Complete resections were performed in 10 (28.5%, debulking in 6 (17% and imaging guided biopsy in 19 (54%. A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months. The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL.

Development and independent validation of a prognostic assay for stage II colon cancer using formalin-fixed paraffin-embedded tissue.

LENUS (Irish Health Repository)

Kennedy, Richard D

2011-12-10

Current prognostic factors are poor at identifying patients at risk of disease recurrence after surgery for stage II colon cancer. Here we describe a DNA microarray-based prognostic assay using clinically relevant formalin-fixed paraffin-embedded (FFPE) samples.

Long-Term Outcome of Steroid-Resistant Nephrotic Syndrome in Children.

Science.gov (United States)

Trautmann, Agnes; Schnaidt, Sven; Lipska-Ziętkiewicz, Beata S; Bodria, Monica; Ozaltin, Fatih; Emma, Francesco; Anarat, Ali; Melk, Anette; Azocar, Marta; Oh, Jun; Saeed, Bassam; Gheisari, Alaleh; Caliskan, Salim; Gellermann, Jutta; Higuita, Lina Maria Serna; Jankauskiene, Augustina; Drozdz, Dorota; Mir, Sevgi; Balat, Ayse; Szczepanska, Maria; Paripovic, Dusan; Zurowska, Alexandra; Bogdanovic, Radovan; Yilmaz, Alev; Ranchin, Bruno; Baskin, Esra; Erdogan, Ozlem; Remuzzi, Giuseppe; Firszt-Adamczyk, Agnieszka; Kuzma-Mroczkowska, Elzbieta; Litwin, Mieczyslaw; Murer, Luisa; Tkaczyk, Marcin; Jardim, Helena; Wasilewska, Anna; Printza, Nikoleta; Fidan, Kibriya; Simkova, Eva; Borzecka, Halina; Staude, Hagen; Hees, Katharina; Schaefer, Franz

2017-10-01

We investigated the value of genetic, histopathologic, and early treatment response information in prognosing long-term renal outcome in children with primary steroid-resistant nephrotic syndrome. From the PodoNet Registry, we obtained longitudinal clinical information for 1354 patients (disease onset at >3 months and children, respectively, with the highest remission rates achieved with calcineurin inhibitor-based protocols. Ten-year ESRD-free survival rates were 43%, 94%, and 72% in children with IIS resistance, complete remission, and partial remission, respectively; 27% in children with a genetic diagnosis; and 79% and 52% in children with histopathologic findings of minimal change glomerulopathy and FSGS, respectively. Five-year ESRD-free survival rate was 21% for diffuse mesangial sclerosis. IIS responsiveness, presence of a genetic diagnosis, and FSGS or diffuse mesangial sclerosis on initial biopsy as well as age, serum albumin concentration, and CKD stage at onset affected ESRD risk. Our findings suggest that responsiveness to initial IIS and detection of a hereditary podocytopathy are prognostic indicators of favorable and poor long-term outcome, respectively, in children with steroid-resistant nephrotic syndrome. Children with multidrug-resistant sporadic disease show better renal survival than those with genetic disease. Furthermore, histopathologic findings may retain prognostic relevance when a genetic diagnosis is established. Copyright © 2017 by the American Society of Nephrology.

Speeding up PET/MR for cancer staging of children and young adults

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Aghighi, Maryam; Pisani, Laura Jean; Sun, Ziyan; Klenk, Christopher; Madnawat, Himani; Owen, Daniel; Quon, Andrew; Moseley, Michael; Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Molecular Imaging Program at Stanford, Stanford, CA (United States); Fineman, Sandra Luna [Stanford University, Department of Pediatrics, Lucile Packard Children' s Hospital, Stanford, CA (United States); Advani, Ranjana [Stanford University, Department of Medicine, Stanford Hospital, Stanford, CA (United States); Von Eyben, Rie [Stanford University, Department of Radiation and Oncology, Stanford, CA (United States)

2016-12-15

Combining {sup 18}F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared {sup 18}F-FDG PET/STIR with accelerated {sup 18}F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a {sup 18}F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. {sup 18}F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. Comparing {sup 18}F-FDG PET/FSPGR to {sup 18}F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to {sup 18}F-FDG PET/STIR, but could be acquired with shorter acquisition time. (orig.)

Thymidine phosphorylase and hypoxia-inducible factor 1-α expression in clinical stage II/III rectal cancer: association with response to neoadjuvant chemoradiation therapy and prognosis.

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Lin, Shuhan; Lai, Hao; Qin, Yuzhou; Chen, Jiansi; Lin, Yuan

2015-01-01

The aim of this study was to determine whether pretreatment status of thymidine phosphorylase (TP), and hypoxia-inducible factor alpha (HIF-1α) could predict pathologic response to neoadjuvant chemoradiation therapy with oxaliplatin and capecitabine (XELOXART) and outcomes for clinical stage II/III rectal cancer patients. A total of 180 patients diagnosed with clinical stage II/III rectal cancer received XELOXART. The status of TP, and HIF-1α were determined in pretreatment biopsies by immunohistochemistry (IHC). Tumor response was assessed in resected regimens using the tumor regression grade system and TNM staging system. 5-year disease free survival (DFS) and 5-year overall survival (OS) were evaluated with the Kaplan-Meier method and were compared by the log-rank test. Over expression of TP and low expression of HIF-1α were associated with pathologic response to XELOXART and better outcomes (DFS and OS) in clinical stage II/III rectal cancer patients (P rectal cancer received XELOXART. Additional well-designed, large sample, multicenter, prospective studies are needed to confirm the result of this study.

Association between sleep stages and hunger scores in 36 children.

Science.gov (United States)

Arun, R; Pina, P; Rubin, D; Erichsen, D

2016-10-01

Childhood obesity is a growing health challenge. Recent studies show that children with late bedtime and late awakening are more obese independent of total sleep time. In adolescents and adults, a delayed sleep phase has been associated with higher caloric intake. Furthermore, an adult study showed a positive correlation between REM sleep and energy balance. This relationship has not been demonstrated in children. However, it may be important as a delayed sleep phase would increase the proportion of REM sleep. This study investigated the relationship between hunger score and sleep physiology in a paediatric population. Thirty-six patients referred for a polysomnogram for suspected obstructive sleep apnoea were enrolled in the study. Sleep stages were recorded as part of the polysomnogram. Hunger scores were obtained using a visual analogue scale. Mean age was 9.6 ± 3.5 years. Mean hunger scores were 2.07 ± 2.78. Hunger scores were positively correlated with percentage of total rapid eye movement (REM) sleep (r = 0.438, P hunger score (r = -0.360, P hunger scores. These findings suggest that delayed bedtime, which increases the proportion of REM sleep and decreases the proportion of SWS, results in higher hunger levels in children. © 2015 World Obesity.

Long term results of mantle irradiation(MRT) alone in 261 patients with clinical stage I-II supradiaphragmatic Hodgkin's disease

International Nuclear Information System (INIS)

Wirth, A.; Byram, D.; Chao, M.; Corry, J.; Davis, S.; Kiffer, J.; Laidlaw, C.; Quong, G.; Ryan, G.; Liew, K.

1997-01-01

Purpose: We report our results using MRT for clinical stage I-II HD and assess the value of published prognostic criteria in our study population. Pts and Methods: Between 1969 and 1994, 261 pts were treated with MRT alone for clinical stage I-II supradiaphragmatic HD. Pt characteristics: median age-30; M-54%/F-46%; stage IA-52%, IB-2%, IIA-37%, IIB-8%; histology LP-21%, NS-51%, MC-23%, other 5%; median ESR 18. CT abdomen and LAG were performed in 61% and 60% respectively. No pt had prior staging laparotomy. No pt received infradiaphragmatic RT. Central axis dose was 32 Gy-36 Gy. Univariate analysis was performed for prognostic factors for progression-free (PFS) and overall survival(OS). Outcome was assessed in favourable subsets as defined by: EORTC (v. favourable: CSIA, LP or NS histology, age < 40, female, no bulk, ESR < 50; favourable: CSI-II, age < 50, < 4 sites, no bulky mediastinal mass, ESR < 50 with no B symptoms or ESR < 30 with B symptoms); Princess Margaret Hospital (PMH) (IA-IIA, LP or NS histology, ESR < 40, age < 50, no large mediastinal mass, no E lesion). Results: 261 pts completed RT, with 5% requiring treatment interruption for toxicity. Significant factors (P<0.05) for PFS were stage, performance status, histology, B symptoms, number of sites, ESR and bulk. Significant factors (P<0.05) for OS were age, performance status, histology and B symptoms. (The results of a multivariate analysis will be presented.) Results in our study population using published prognostic criteria (in %): Thirty-six percent progressed following RT: 8% in-field; 24% out of field only (including 10% in the paraaortic/splenic region alone); 4% marginal; Fifty-seven percent of relapsed pts remain progression free after subsequent salvage treatment. Two cases of acute leukaemia, 8 cases of non-Hodgkin's lymphoma and 14 (non-skin) carcinomas occurred, of which 11 were in-field. Seventy pts have died. The cause was: HD 41%; other malignancy 20%; cardiovascular 17%; other 15

Feasibility of sequential adjuvant chemotherapy with a 3-month oxaliplatin-based regimen followed by 3 months of capecitabine in patients with stage III and high-risk stage II colorectal cancer: JSWOG-C2 study.

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Tsuruta, Atsushi; Yamashita, Kazuki; Tanioka, Hiroaki; Tsuji, Akihito; Inukai, Michio; Yamakawa, Toshiki; Yamatsuji, Tomoki; Yoshimitsu, Masanori; Toyota, Kazuhiro; Yamano, Taketoshi; Nagasaka, Takeshi; Okajima, Masazumi

2016-01-01

Six months of oxaliplatin-based chemotherapy is the standard adjuvant chemotherapy for completely resected stage III colorectal cancer (CRC). Also, patients with stage II CRC who are considered to be at high risk of disease recurrence often receive the same adjuvant chemotherapy treatment. We prospectively investigated the extent and degree of neuropathy suffered by stage III and high-risk stage II resectable CRC patients who underwent sequential approach involving 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine. Patients with completely resected stage III and high-risk stage II CRC aged ≥20 years were eligible. Patients were treated with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CAPOX) for 3 months followed by capecitabine (2,500 mg/m 2 on days 1-14 every 3 weeks) for 3 months. Primary end points were frequency and the grade of oxaliplatin-induced neurotoxicity as evaluated using the physician-based Common Terminology Criteria for Adverse Events version 4.0 (CTCAE) grading and the patient-based scale, self-reported Patient Neurotoxicity Questionnaire. Ninety-one patients were enrolled and 86 patients assessed. Eighty-four percent of patients completed the planned oxaliplatin-based therapy for 3 months, and 63% of patients completed all treatments for the full 6 months. Overall incidences of grade 3 or 4 peripheral sensory or motor neuropathy according to the CTCAE were 3.5% and 1.2%, respectively. Regarding the peripheral sensory neuropathy, the proportion of Patient Neurotoxicity Questionnaire (grade C-E) and CTCAE (grade 2-4) at months 1.5/3/6 were 11.3/22.1/29.4% and 5.3/4.4/11.3%, respectively (Spearman correlation coefficient: 0.47). A sequential approach to adjuvant chemotherapy with 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine was tolerated by patients and associated with a low incidence of neuropathy.

Staging of Lung Cancer

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... LUNG CANCER MINI-SERIES #2 Staging of Lung Cancer Once your lung cancer is diagnosed, staging tells you and your health care provider about ... at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV ...

Prognostic implication of serum hepatocyte growth factor in stage II/III breast cancer patients who received neoadjuvant chemotherapy.

Science.gov (United States)

Kim, Hyori; Youk, Jeonghwan; Yang, Yaewon; Kim, Tae-Yong; Min, Ahrum; Ham, Hye-Seon; Cho, Seongcheol; Lee, Kyung-Hun; Keam, Bhumsuk; Han, Sae-Won; Oh, Do-Youn; Ryu, Han Suk; Han, Wonshik; Park, In Ae; Kim, Tae-You; Noh, Dong-Young; Im, Seock-Ah

2016-03-01

In stage II/III breast cancer, neoadjuvant chemotherapy (NAC) is a standard treatment. Although several biomarkers are used to predict prognosis in breast cancer, there is no reliable predictive biomarker for NAC success. Recently, the hepatocyte growth factor (HGF) and cMet signaling pathway demonstrated to be involved in breast cancer tumor progression, and its potential as a biomarker is under active investigation. In this study, we assessed the potential of serum HGF as a prognostic biomarker for NAC efficacy. Venous blood samples were drawn from patients diagnosed with stage II/III breast cancer and treated with NAC in Seoul National University Hospital from August 2004 to November 2009. Serum HGF level was determined using an ELISA system. We reviewed the medical records of the patients and investigated the association of HGF level with patients' clinicopathologic characteristics. A total of 121 female patients (median age = 45 years old) were included. Median level of HGF was 934 pg/ml (lower quartile: 772, upper quartile: 1145 pg/ml). Patients with higher HGF level than median value were significantly more likely to have clinically detectable regional node metastasis (p = 0.017, Fisher's exact test). Patients with complete and partial response according to the American Joint Committee on Cancer 7th Edition criteria tended to have higher HGF level (p = 0.105 by t test). Patients with an HGF level higher than the upper quartile value had longer relapse-free survival than the other patients (106 vs. 85 months, p = 0.008). High serum HGF levels in breast cancer patients are associated with clinically detectable regional node metastasis and, paradoxically, with longer relapse-free survival in stage II/III breast cancer.

Prediction of basal metabolic rate in obese children and adolescents considering pubertal stages and anthropometric characteristics or body composition.

Science.gov (United States)

Lazzer, S; Patrizi, A; De Col, A; Saezza, A; Sartorio, A

2014-06-01

To develop and crossvalidate new equations for predicting basal metabolic rate (BMR) in obese children and adolescents in relation to pubertal stages, anthropometric characteristics or body composition. A total of 1696 obese Caucasian children and adolescents (mean body mass index z-score: 3.5±0.8) participated in this study. BMR was determined by indirect calorimetry and fat-free mass (FFM) and fat mass (FM) by bioelectrical impedance analysis. Equations were derived by stepwise multiple regression analysis using a calibration cohort of 848 subjects, and the equations were crossvalidated with a Bland and Altman method in the remaining 848 subjects. Two new specific equations based on gender (1: males; 0: females), pubertal stages (from 1 to 5, assessed according Marshall & Tanner methods) and body weight (BW, kg), stature (m) or body composition (kg) were generated as follows: (1) BMR=(BW × 0.044)+(stature × 2.836)-(pubertal stage × 0.148)+(gender × 0.781)-0.551 (adjusted coefficient of determination (R(2)adj)= 0.69 and root mean squared error (RMSE)=0.954 MJ); (2) BMR=(FFM × 0.082)+(FM × 0.037)-(pubertal stage × 0.125)+(gender × 0.706)+2.528 (R(2)adj= 0.70 and RMSE=0.943 MJ). In the crossvalidation group, mean-predicted BMR was not significantly different from the mean-measured BMR (MBMR) for all children and adolescents, as well as for boys and girls (differenceBMR was predicted accurately (90-110% of MBMR) in 67% of subjects. The new prediction equations considering the pubertal stages allow an accurate and more appropriate (vs equations using chronological age) estimation of BMR in obese children and adolescents.

Clinical significance of determination of changes of serum IGF-II, IL-6, IL-8, TNF-α levels after treatment in children with bronchopneumonia

International Nuclear Information System (INIS)

Feng Yue

2011-01-01

Objective: To explore the clinical significance of changes of serum IGF-II, IL-6, IL-8 and TNF-α levels after treatment in children with bronchopneumonia. Methods: Serum IGF-II, IL-6, IL-8 and TNF-α levels with RIA were detected both before and after treatment in 33 patients with children bronchopneumonia as well as in 35 controls. Results: Before treatment, serum IGF-II, IL-6, IL-8 and TNF-α levels were significantly higher in the patients than those in the controls (P 0.05). Conclusions: Serum IGF-II, IL-6, IL-8 and TNF-α could take part in the pathogenesis of children bronchopneumonia in various ways and determination of these levels was clinically important. (authors)

Mapping the extent of disease by multislice computed tomography, magnetic resonance imaging and sentinel node evaluation in stage I and II cervical carcinoma

Directory of Open Access Journals (Sweden)

Rajaram S

2010-01-01

Full Text Available Aims: (1 To map the extent of disease in women with stage I and II carcinoma cervix by multislice spiral computed tomography (CT, magnetic resonance imaging (MRI and sentinel nodes. (2 To assess accuracy of each modality individually and in conjunction with FIGO clinical staging. Design and Setting: Prospective, single-blind study. Departments of Obstetrics and Gynaecology, Radiodiagnosis, and Pathology, UCMS and GTBH and Division of Radiological Imaging and Bioinformatics, INMAS, Delhi. Material and Method: The study was conducted on 25 women with cervical cancer FIGO stage I and II. Each woman underwent clinical staging, multislice spiral CT and MRI which was compared to the gold-standard histopathology/cytology. The overall accuracy of each modality and improvement of clinical staging by CT/MRI were noted. Sentinel nodes were evaluated by intracervical Patent Blue V dye injection. Statistical Analysis: Sensitivity, specificity, positive and negative predictive values were calculated by 2Χ2 contingency tables. Results: The accuracy of staging by FIGO, CT and MRI was 68%, 52% and 80%, respectively. MRI and CT improved the overall accuracy of FIGO staging to 96% and 80%, respectively. Sentinel nodes were identified in 89% of patients with 91% accuracy. Conclusion: MRI emerges as the most valuable stand-alone modality improving accuracy of FIGO staging to 96%. Sentinel lymph-node evaluation appears promising in evaluating spread beyond cervix.

Organ preservation in stage II and III head and neck cancer utilizing alternate week concomitant chemoradiotherapy

International Nuclear Information System (INIS)

Mansur, David B.; Vokes, Everett; Mittal, Bharat B.; Stenson, Kerstin; Kies, M.; Pelzer, H.; Nautiyal, Jaishanker; Kozloff, Mark; Weichselbaum, Ralph R.; Haraf, Daniel J.

1996-01-01

Purpose: A prospective phase II trial was conducted to determine the efficacy and rate of organ preservation of alternate week concomitant chemoradiotherapy in stage II and III head and neck cancer. Methods: Forty-nine patients (10 stage II and 39 stage III) with squamous cell carcinoma of the head and neck region have been entered into a prospective phase II trial. Pretreatment evaluation included history and physical examination, computed tomography of the neck, bone scan, chest x-ray, panendoscopy and biopsy confirmation of malignancy. Therapy is given in 2 week cycles consisting of 5 days of concomitant chemoradiotherapy followed by a nine day break during which no treatment is given. Each cycle of treatment consists of 1.0 gm hydroxyurea P.O. every 12 hours for 6 days (11 doses per cycle) and 800mg/m 2 /d continuous infusion 5-fluorouracil along with concomitant radiation therapy (RT) administered in 1.8-2.0 Gy daily fractions for five days. This alternate week (week on/week off) schedule is continued for a total of 7 cycles resulting in an overall treatment time of 13 weeks and a total RT dose of 70 Gy. Extent of initial surgery included biopsy only (59.2%), minimal laser debulking (12.2%), and resection with or without neck dissection (28.6%). Results: The majority of patients are male (71.4%), with a median age of 61.3 years. Primary sites included oral cavity (16.3%), oropharynx (12.2%), larynx (57.1%), hypopharynx (8.1%), and nasopharynx (4.1%). T stage included T3 (32 patients, 65.3%), T2 (16 patients, 32.7%), and T1 (1 patient). N stage included N1 (17 patients, 34.7%), and N0 (32 patients, 65.3%). With a median follow-up of 27 months, the overall response rate is 100% (91.7 complete response, and 8.3% partial response). The 5 year actuarial local control, disease free survival, and overall survival is 90.1%, 88.3%, and 65.0%, respectively. One patient has failed with distant disease alone. Four patients had isolated local failures and (3(4)) were

Prognostic significance of the PC10 index for patients with stage II and III oesophageal cancer treated with radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Sugahara, Shinji; Irie, Toshiyuki; Nozawa, Kumiko; Nakajima, Kotaro [Hitachi General Hospital, Ibaraki (Japan). Dept. of Radiology; Ohara, Kiyoshi; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Dept. of Radiology; Takahashi, Atsushi [Hitachi General Hospital, Ibaraki (Japan). Dept. of Pathology; Watanabe, Teruo [Tsukuba Univ., Ibaraki (Japan). Dept. of Pathology; Tanaka, Naomi [Tsukuba Univ., Ibaraki (Japan). Dept. of Internal Medicine

1999-07-01

The monoclonal antibody PC10 is used for immunohistochemical staining of the proliferating cell nuclear antigen (PCNA). The percentage of PC10-positive cancer cells is defined as the PC10 index. We evaluated the relationship between the PC10 index in pretreatment endoscopic biopsies and the prognoses of 47 patients with Stage II-III oesophageal squamous cell carcinoma treated with radiotherapy. The patients with a PC10 index >40% had significantly poorer prognoses than the other patients (p=0.0007). Proportional hazards model analysis indicated that only the PC10 index was a prognostic factor (p=0.0009). The patient group of complete responders showed significantly lower PC10 indices compared to patients with a partial response or no change (p=0.049). The PC10 index can be a good predictive indicator of the prognosis in patients with Stage II-III oesophageal cancer treated with radiotherapy. (orig.)

Neurological and cardiac complications in a cohort of children with end-stage renal disease

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Jumana H Albaramki

2016-01-01

Full Text Available Adult patients with chronic kidney disease are at risk of major neurologic and cardiac complications. The purpose of this study is to review the neurological and cardiac complications in children with end-stage renal disease (ESRD. A retrospective review of medical records of children with ESRD at Jordan University Hospital was performed. All neurological and cardiac events were recorded and analyzed. Data of a total of 68 children with ESRD presenting between 2002 and 2013 were reviewed. Neurological complications occurred in 32.4%; seizures were the most common event. Uncontrolled hypertension was the leading cause of neurological events. Cardiac complications occurred in 39.7%, the most common being pericardial effusion. Mortality from neurological complications was 45%. Neurological and cardiac complications occurred in around a third of children with ESRD with a high mortality rate. More effective control of hypertension, anemia, and intensive and gentle dialysis are needed.

Relationship Between Parenting Style and Children Academic Achievement Among Elementary Students Grade II and III

OpenAIRE

Defia Rizki, Sari; Susilawati; Mariam, Iyam

2017-01-01

HUBUNGAN POLA ASUH ORANG TUA DENGAN PRESTASI BELAJARANAK USIA SEKOLAH DASAR KELAS II DAN IIIRelationship between Parenting Style and Children Academic Achievementamong Elementary Students Grade II and IIISari Defia Rizki1, Susilawati2, Iyam Mariam3123Sekolah Tinggi Ilmu Kesehatan SukabumiJalan Karamat Nomor 36, Karamat, Kec. Sukabumi, Kota Sukabumi,Jawa Barat 431221e-mail: Pola asuh merupakan cara yang digunakan orang tua dalam mencoba berbagai strategi untukmendoron...

Phase I (or phase II) dose-ranging clinical trials: proposal of a two-stage Bayesian design.

Science.gov (United States)

Zohar, Sarah; Chevret, Sylvie

2003-02-01

We propose a new design for phase I (or phase II) dose-ranging clinical trials aiming at determining a dose of an experimental treatment to satisfy safety (respectively efficacy) requirements, at treating a sufficiently large number of patients to estimate the toxicity (respectively failure) probability of the dose level with a given reliability, and at stopping the trial early if it is likely that no dose is safe (respectively efficacious). A two-stage design was derived from the Continual Reassessment Method (CRM), with implementation of Bayesian criteria to generate stopping rules. A simulation study was conducted to compare the operating characteristics of the proposed two-stage design to those reached by the traditional CRM. Finally, two applications to real data sets are provided.

Children of non-Western origin with end-stage renal disease in the Netherlands, Belgium and a part of Germany have impaired health-related quality of life compared with Western children

NARCIS (Netherlands)

Schoenmaker, Nikki J.; Haverman, Lotte; Tromp, Wilma F.; van der Lee, Johanna H.; Offringa, Martin; Adams, Brigitte; Bouts, Antonia H. M.; Collard, Laure; Cransberg, Karlien; van Dyck, Maria; Godefroid, Nathalie; van Hoeck, Koenraad; Koster-Kamphuis, Linda; Lilien, Marc R.; Raes, Ann; Taylan, Christina; Grootenhuis, Martha A.; Groothoff, Jaap W.

2014-01-01

Many children with end-stage renal disease (ESRD) living in Western Europe are of non-Western European origin. They have unfavourable somatic outcomes compared with ESRD children of Western origin. In this study, we compared the Health-related Quality of Life (HRQoL) of both groups. All children

Rehabilitation of children at the inpatient stage after surgical treatment of unstable fractures of the thoracolumbar and lumbar spine

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Alla V. Ovechkina

2017-12-01

Full Text Available Introduction. The modern approach to the treatment of unstable fractures of the thoracolumbar and lumbar spine in children is surgical stabilization at the early stages after trauma by using metal structures that quickly restore vertical functionality to the patient and shorten the period of inpatient treatment. However, the issues related to restorative treatment have not been sufficiently addressed. Aim. To develop an algorithm for restorative treatment of children at the inpatient stage after surgical treatment of unstable uncomplicated fractures of the thoracolumbar and lumbar spine. Material and methods. Based on the results of treatment of 73 patients aged 9 to 17 years with unstable uncomplicated vertebral fractures, an algorithm of stage-by-stage rehabilitation by means of therapeutic gymnastics depending on the severity of the injury, method of surgical stabilization of the spine, physical condition of the child, and time passed after the operation was developed. Results and discussion. The use of differentiated groups of respiratory gymnastics and isometric and dynamic exercises for muscle groups restored vertical functionality to patients in 1–3 days after surgery, restored spine and motor functions, and shortened the duration of inpatient treatment to a range of 10–14 days. Conclusion. The developed algorithm for physical rehabilitation of children after surgical treatment of unstable injuries of the thoracic and lumbar spine by using metal structures at the inpatient stage contributed to the selection of the most rational and effective program of restorative treatment.

A systematic review and meta-analysis of the safety, feasibility and effect of exercise in women with stage II+ breast cancer.

Science.gov (United States)

Singh, Ben; Spence, Rosalind R; Steele, Megan L; Sandler, Carolina X; Peake, Jonathan M; Hayes, Sandra C

2018-05-03

To systematically evaluate the safety, feasibility and effect of exercise among women with stage II+ breast cancer. CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published prior to March 1, 2017. Randomised, controlled, exercise trials involving at least 50% of women diagnosed with stage II+ breast cancer were included. Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also explored. There were no differences in adverse events between exercise and usual care (risk difference: feasibility outcomes were similar, irrespective of exercise mode, supervision, duration, or timing. Effects of exercise for quality of life, fitness, fatigue, strength, anxiety, depression, body mass index and waist circumference compared with usual care were significant (standardised mean difference range: 0.17-0.77, pfeasibility and effects of exercise for those with stage II+ breast cancer, suggesting that national and international exercise guidelines appear generalizable to women with local, regional and distant breast cancer. Copyright © 2018. Published by Elsevier Inc.

Social Development Training Project. Stage I and Stage II. [The Granville Project].

Science.gov (United States)

Riches, Vivienne C., Ed.

The book presents a training program developed at the Granville Work Preparation Centre in Australia, to teach mildly retarded adolescents basic social skills and competencies. The program is divided into two stages, with a total of 17 different skill areas. Stage 1 covers self-awareness, social/interpersonal skills, relaxation and behavioral self…

Age estimation by dental developmental stages in children and adolescents in Iceland.

Science.gov (United States)

Vidisdottir, Sigridur Rosa; Richter, Svend

2015-12-01

Studies have shown that it is necessary to create a database for dental maturity for every population and compare it to others. The present study is the first one for dental development in the Icelandic population the age range being 4-24 years. It will help in forensic dental age estimation and will also help dentists, physicians, anthropologists, archaeologists and other professionals who rely on developmental age assessment in children and adolescents. In this present retrospective cross-sectional study, dental maturity was determined in 1100 Icelandic children and adolescents from orthopantomograms (OPGs). The first 100 were used for a pilot study and the remaining 1000 for the main study. A total of 23 subjects were excluded. The sample consisted of 508 girls and 469 boys from the age of 4-24 years and a dental developmental scoring system was used as a standard for determination of dental maturity stages. A total of 200 OPGs were studied both on the left and right side and the remaining on the right side. Dental maturity was established for all teeth and both genders, when the sample permitted, from the beginning of crown formation to the root apex closure. The Cronbach's Alpha reliability test showed high reliability, R=0.982. Girls in Iceland reach dental maturity root completed (stage 10, Rc) at 17.81 years of age for the maxillary and at 18.47 years for the mandibular teeth. Boys reach dental maturity root completed (stage 10, Rc) at 18.00 years of age in the maxilla and 17.63 in the mandible. There was no significant difference between left and right side (r=0.95-1.00) and there was no gender difference, except in root formation in maxillary and mandibular canines where girls reached root completed earlier than boys. A reliable database has been established in Iceland for tooth development in the age range of 4-24 years, which is compatible with international studies. These results will help forensic odontologists and other professionals to estimate with

Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis.

Science.gov (United States)

Haeseker, Guus A; Mureau, Marc A; Faber, Frank W M

2010-01-01

In this study, clinical and radiological results after lateral column lengthening by calcaneocuboid distraction arthrodesis and calcaneus osteotomy were compared. Thirty-three patients (35 feet) treated with lateral column lengthening by distraction arthrodesis (14 patients, 16 feet; group I) or by calcaneus osteotomy (19 patients, 19 feet; group II) for adult-acquired flatfoot deformity caused by stage II posterior tibial tendon dysfunction were compared retrospectively. Mean follow-up was 42.4 months (range, 6-78 months) for group I and 15.8 months (range, 6-32 months) for group II (P lengthening by means of calcaneus osteotomy rather than distraction arthrodesis of the calcaneocuboid joint, for correction of stage II posterior tibial tendon dysfunction. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Cephalometric aspects of thalassemic children in the Indian subcontinent: A cross-sectional study

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Amit Anand Samba

2018-01-01

Full Text Available Objectives: To compare the cephalometric characteristics of thalassemic children in the Indian subcontinent with the controls, matched for sex and dental age. Methodology: A total of 31 thalassemic children were a part of the study. Cephalometric readings were recorded for the study and the control group. Results: Within the Group I stage, the anterior cranial base length was 68.40±2.93 mm, shorter when compared to the control group. In the Group II stage, the maxillary/mandibular angle was 31.58° for the case group and the mandibular length was shorter in comparison to the controls. In the Group III stage, the SNB angle was 76.42°, lesser than the control group. A relative maxillary prognathism of 9.88 mm and 12.85 mm was observed in thalassemic males and females respectively through the Wiley's analysis. Conclusion: The overall picture depicted a retruded position of the maxilla and a retrognathic mandible within the study group. A class II profile has also been observed among the study subjects.

Could semiquantitative FDG analysis add information to the prognosis in patients with stage II/III breast cancer undergoing neoadjuvant treatment?

Energy Technology Data Exchange (ETDEWEB)

Evangelista, Laura; Cervino, Anna Rita [Veneto Institute of Oncology IOV - IRCCS, Radiotherapy and Nuclear Medicine Unit, Padua (Italy); Ghiotto, Cristina; Guarneri, Valentina; Conte, Pierfranco [Veneto Institute of Oncology IOV - IRCCS, Medical Oncology 2 Unit, Padua (Italy); Saibene, Tania; Michieletto, Silvia; Fernando, Bozza [Veneto Institute of Oncology IOV - IRCCS, Breast Unit, Padua (Italy); Orvieto, Enrico [University Hospital of Padua, Department of Pathology, Padua (Italy)

2015-10-15

We investigated whether maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), total lesion glycolysis (TLG) and whole-body (WB) SUVmax, WB MTV and WB TLG measured by {sup 18}F-FDG PET/CT could improve prognostic stratification in patients with stage II/III breast cancer (BC). We prospectively enrolled 99 consecutive women (median age 50 years, range 27 - 77 years) with pathologically proven stage II/III BC who underwent pretreatment FDG PET/CT. WB SUVmax, WB MTV and WB TLG were measured in all malignant lesions. Survival was analysed using the Kaplan-Meier method. Cox proportional hazards models were constructed to test for relationships among WB SUVmax, WB MTV, WB TLG, and overall survival (OS) and disease-free survival (DFS), after adjustment for age, and histopathological and immunohistochemical features (oestrogen/progesterone and HER2 expression, proliferation index and grade). The median values of WB SUVmax, WB MTV and WB TLG were 16.2 (range 1.5 - 33.1), 14 cm{sup 3} (range 0.03 - 708.6 cm{sup 3}) and 62.5 (0.06 - 3869.4), respectively. All WB semiquantitative values were higher in patients with higher TNM stage, although not significantly (all p > 0.05). The median follow-up for surviving patients was 30 months, with a range of 13 - 45 months. Both PFS and OS of patients with low WB SUVmax, WB MTV and WB TLG were longer than that of patients with high WB values for progression, although not statistically significant. However, stratifying the patients in accordance with the stage of disease, both PFS and OS were significantly lower in patients with high WB TLG and stage III than in patients with stage II (p < 0.05). In multivariate analyses, WB MTV and WB TLG were independent prognostic factors for PFS (hazard ratio 1.004, 95 % confidence interval 1.002 - 1.006, p < 0.001, and hazard ratio 1.001, 95 % confidence interval 1.000 - 1.001, p = 0.011, respectively). The addition of WB TLG to clinical data may provide a more detailed

Gene Expression Profile in the Early Stage of Angiotensin II-induced Cardiac Remodeling: a Time Series Microarray Study in a Mouse Model

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Meng-Qiu Dang

2015-01-01

Full Text Available Background/Aims: Angiotensin II (Ang II plays a critical role in the cardiac remodeling contributing to heart failure. However, the gene expression profiles induced by Ang II in the early stage of cardiac remodeling remain unknown. Methods: Wild-type male mice (C57BL/6 background, 10-weeek-old were infused with Ang II (1500 ng/kg/min for 7 days. Blood pressure was measured. Cardiac function and remodeling were examined by echocardiography, H&E and Masson staining. The time series microarrays were then conducted to detected gene expression profiles. Results: Microarray results identified that 1,489 genes were differentially expressed in the hearts at day 1, 3 and 7 of Ang II injection. These genes were further classified into 26 profiles by hierarchical cluster analysis. Of them, 4 profiles were significant (No. 19, 8, 21 and 22 and contained 904 genes. Gene Ontology showed that these genes mainly participate in metabolic process, oxidation-reduction process, extracellular matrix organization, apoptotic process, immune response, and others. Significant pathways included focal adhesion, ECM-receptor interaction, cytokine-cytokine receptor interaction, MAPK and insulin signaling pathways, which were known to play important roles in Ang II-induced cardiac remodeling. Moreover, gene co-expression networks analysis suggested that serine/cysteine peptidase inhibitor, member 1 (Serpine1, also known as PAI-1 localized in the core of the network. Conclusions: Our results indicate that many genes are mainly involved in metabolism, inflammation, cardiac fibrosis and hypertrophy. Serpine1 may play a central role in the development of Ang II-induced cardiac remodeling at the early stage.

Features of tennis methods of teaching 5-6 years old children in the initial stages

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E.V. Kurmaeva

2014-06-01

Full Text Available Purpose : theoretical and methodological justification for the existing teaching methods tennis of 5-6 years old children. Material : 17 special analysis and scientific and methodological sources. Results : the features of the existing methods of teaching children at an early stage of training. The main theses of the existing methods: 1 the training process is carried out in the form of games; 2 the level of general physical preparedness level exceeds special; 3 The first two years of the children do not participate in official competitions; 4 education of children begins with " School Ball ", with a gradual transition to employment with racket and ball; 5 training is built on two levels: theoretical - each " part" in the form of pre- formation of a mental model of rational behavior, and practical - the formation of the ability to perform motor actions. Conclusions : it was found that the existing methods of constructing the training process for children 5-6 years do not account for their physiological characteristics, therefore proposed to use computer technology and animation, that will shorten the formation of motor skills of children.

Cervical vertebral column morphology related to craniofacial morphology and head posture in preorthodontic children with Class II malocclusion and horizontal maxillary overjet

DEFF Research Database (Denmark)

Arntsen, Torill; Sonnesen, Ane Liselotte

2011-01-01

In preorthodontic children with Class II malocclusion and horizontal maxillary overjet, cervical column morphology was examined and related to craniofacial morphology and head posture for the first time.......In preorthodontic children with Class II malocclusion and horizontal maxillary overjet, cervical column morphology was examined and related to craniofacial morphology and head posture for the first time....

Blood transfusion and survival after surgery for Stage I and II breast cancer

International Nuclear Information System (INIS)

Herman, K.; Kolodziejski, L.

1993-01-01

The records of 690 Stage I and II breast cancer patients (31% of them with transfusions), who underwent mastectomy with axillary dissection were examined whether perioperative blood transfusion might be detrimental to survival. The overall 5- and 1-year survival rates for 477 patients who had not received transfusions were 75% and 63% respectively, compared with 66% and 49% for those who had transfusions (p=0.005). There was no significant difference between the group in any other of the most important prognostic factors. An analysis of the subpopulation of patients with favorable prognostic factors yielded similar results. A multivariate analysis indicated that blood transfusion was one of the four variables significantly related to survival. (author)

An evaluation on time status of functional orthopedic treatment in class II skeletal patients with cervical vertebrae maturation stage (CVMS index

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Dalili Z.

2004-08-01

Full Text Available Statement of Problem: Considerable response to functional orthopedic appliances treatment in class II skeletal patients occurs during pubertal growth spurt. Therefore, it seems necessary to investigate indices indicating mandibular growth pattern. It has been proved that analyzing cervical vertebral maturation stage is a more valid index than that of hand wrist. Purpose: The aim of this study was to evaluate the time status of functional orthopedic treatment in class II skeletal patients using CVMS index. Materials and Methods: In this descriptive-inferential study, lateral cephalometric radiographs of 153 class II skeletal patients with mandibular deficiency, before treatment, were studied by an oral and maxillofacial radiologist using the index of cervical vertebral maturation stage (CVMS and were categorized in three phases: CVMS I (desirable phase of treatment, CVMS II (ideal phase, and CVMS III (undesirable phase of treatment. Results: Statistical analysis ranked the prevalence of treatment phases as: 41.8% in desirable phase (CVMS I, 28.1% in ideal phase (CVMA II and 30% in undesirable phase (CVMS III. No significant differences were found between the three phases using Chi-square analysis. Time status of functional orthopedic treatment was also evaluated based on age and sex. The results showed significant differences between two sexes (P=0.032. Conclusion: The present study suggests the analysis of CVMS index, along with clinical criteria, in the determination of an ideal time for functional orthopedic treatment to prevent patients’ exhaustion during treatment Period.

KRAS as a predictor of poor prognosis and benefit from postoperative FOLFOX chemotherapy in patients with stage II and III colorectal cancer.

Science.gov (United States)

Deng, Yanhong; Wang, Li; Tan, Shuyun; Kim, George P; Dou, Ruoxu; Chen, Dianke; Cai, Yue; Fu, Xinhui; Wang, Lei; Zhu, Jun; Wang, Jianping

2015-08-01

The KRAS gene frequently mutates in colorectal cancer (CRC). Here we investigated the prognostic and predictive role of KRAS mutation in patients with stage II or III CRC. A consecutive cohort of patients with stage II or III CRC from a single center database was studied. The association between KRAS status, adjuvant FOLFOX therapy, and 3-year disease-free survival (3-y DFS) was analyzed. Of our 433 patients, 166 (38.3%) exhibited the KRAS mutation. Among the 190 patients who did not receive adjuvant therapy, those with KRAS mutation tumors had a worse 3-y DFS (hazard ratio [HR], 1.924; 95% confidence interval [CI], 1.078-3.435; P = 0.027). Among patients who received adjuvant chemotherapy, KRAS mutation was not correlated with worse 3-y DFS (HR, 1.083; 95% CI, 0.618-1.899; P = 0.781). Adjuvant chemotherapy improved 3-y DFS only among patients with KRAS mutant tumors (78.0% vs 69.2%) on multivariate analysis adjusted for age, stage, grade, site, vessel invasion, and carcinoembryonic antigen level (HR, 0.454; 95% CI, 0.229-0.901; P = 0.024). In contrast, there was no benefit of adjuvant chemotherapy in the KRAS wild-type group (84.3% vs 82.0%). KRAS mutation indicates poor prognosis. FOLFOX adjuvant chemotherapy benefits patients with stage II or III colorectal cancer with KRAS mutant tumors and is worth further investigation. Copyright © 2015 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

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Carmona, Ruben; Gulaya, Sachin; Murphy, James D. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Rose, Brent S. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts (United States); Wu, John; Noticewala, Sonal [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T. [Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California San Diego, La Jolla, California (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Vaida, Florin [Department of Family and Preventive Medicine, Biostatistics and Bioinformatics, University of California San Diego Medical Center, San Diego, California (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

2014-07-15

Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification.

Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

International Nuclear Information System (INIS)

Carmona, Ruben; Gulaya, Sachin; Murphy, James D.; Rose, Brent S.; Wu, John; Noticewala, Sonal; McHale, Michael T.; Yashar, Catheryn M.; Vaida, Florin; Mell, Loren K.

2014-01-01

Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification

Profile and outcome of neuroblastoma with convertional chemotherapy in children older than one year: a 15-years experience.

Science.gov (United States)

Bansal, Deepak; Marwaha, R K; Trehan, Amita; Rao, K L N; Gupta, Vishal

2008-02-01

The clinical profile and outcome of neuroblastoma in 103 children, older than one-year is presented. 74 had Stage IV, 27 Stage III and one patient each had Stage I or II disease. Treatment included chemotherapy followed by surgical resection/debulking. Radiotherapy was administered to those with residual tumor. Chemotherapy consisted of OPEC (vincristine, cyclophosphamide, cisplatin and etoposide). The caretakers of 54 (52.4%) children either did not opt for or defaulted therapy, whilst 3 patients died before chemotherapy could be initiated. Of the remaining 46 patients, the tumor progressed during therapy in 19 (41.3%). Relapse of disease was documented in 22 (47.8%) cases. Merely 4 (8.7%) children are disease free for a period of 16.5+/-6.7 months. Majority of children presented with advanced disease and the outcome was dismal with conventional non-myloablative chemotherapy.

Expression of PAT and NPT II proteins during the developmental stages of a genetically modified pepper developed in Korea.

Science.gov (United States)

Kim, Hyo Jin; Lee, Si Myung; Kim, Jae Kwang; Ryu, Tae Hun; Suh, Seok Cheol; Cho, Hyun Suk

2010-10-27

Estimation of the protein levels introduced in a biotechnology-derived product is conducted as part of an overall safety assessment. An enzyme-linked immunosorbent assay (ELISA) was used to analyze phosphinothricin acetyltransferase (PAT) and neomycin phosphotransferase II (NPT II) protein expression in a genetically modified (GM) pepper plant developed in Korea. PAT and NPT II expression levels, based on both dry weight and fresh weight, were variable among different plant generations and plant sections from isolated genetically modified organism (GMO) fields at four developmental stages. PAT expression was highest in leaves at anthesis (11.44 μg/gdw and 2.17 μg/gfw) and lowest in roots (0.12 μg/gdw and 0.01 μg/gfw). NPT II expression was also highest in leaves at anthesis (17.31 μg/gdw and 3.41 μg/gfw) and lowest in red pepper (0.65 μg/gdw and 0.12 μg/gfw). In pollen, PAT expression was 0.59-0.62 μg/gdw, while NPT II was not detected. Both PAT and NPT II showed a general pattern of decreased expression with progression of the growing season. As expected, PAT and NPT II protein expression was not detectable in control pepper plants.

Serum levels of insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) in healthy infants, children, and adolescents

DEFF Research Database (Denmark)

Juul, A; Dalgaard, P; Blum, W F

1995-01-01

index (BMI), and pubertal stage. Therefore, we measured IGFBP-3, IGF-I, IGF-II, IGFBP-1, and IGFBP-2 levels by RIA in 907 healthy children to establish well characterized normative data on IGFBP-3 according to age, sex, and pubertal stage and to study the complex relationship between IGFs and their BPs...

Tumors with unmethylated MLH1 and the CpG island methylator phenotype are associated with a poor prognosis in stage II colorectal cancer patients.

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Fu, Tao; Liu, Yanliang; Li, Kai; Wan, Weiwei; Pappou, Emmanouil P; Iacobuzio-Donahue, Christine A; Kerner, Zachary; Baylin, Stephen B; Wolfgang, Christopher L; Ahuja, Nita

2016-12-27

We previously developed a novel tumor subtype classification model for duodenal adenocarcinomas based on a combination of the CpG island methylator phenotype (CIMP) and MLH1 methylation status. Here, we tested the prognostic value of this model in stage II colorectal cancer (CRC) patients. Tumors were assigned to CIMP+/MLH1-unmethylated (MLH1-U), CIMP+/MLH1-methylated (MLH1-M), CIMP-/MLH1-U, or CIMP-/MLH1-M groups. Age, tumor location, lymphovascular invasion, and mucin production differed among the four patient subgroups, and CIMP+/MLH1-U tumors were more likely to have lymphovascular invasion and mucin production. Kaplan-Meier analyses revealed differences in both disease-free survival (DFS) and overall survival (OS) among the four groups. In a multivariate analysis, CIMP/MLH1 methylation status was predictive of both DFS and OS, and DFS and OS were shortest in CIMP+/MLH1-U stage II CRC patients. These results suggest that tumor subtype classification based on the combination of CIMP and MLH1 methylation status is informative in stage II CRC patients, and that CIMP+/MLH1-U tumors exhibit aggressive features and are associated with poor clinical outcomes.

A high force of plasmodium vivax blood-stage infection drives the rapid acquisition of immunity in papua new guinean children.

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Cristian Koepfli

Full Text Available When both parasite species are co-endemic, Plasmodium vivax incidence peaks in younger children compared to P. falciparum. To identify differences in the number of blood stage infections of these species and its potential link to acquisition of immunity, we have estimated the molecular force of blood-stage infection of P. vivax ((molFOB, i.e. the number of genetically distinct blood-stage infections over time, and compared it to previously reported values for P. falciparum.P. vivax (molFOB was estimated by high resolution genotyping parasites in samples collected over 16 months in a cohort of 264 Papua New Guinean children living in an area highly endemic for P. falciparum and P. vivax. In this cohort, P. vivax episodes decreased three-fold over the age range of 1-4.5 years.On average, children acquired 14.0 new P. vivax blood-stage clones/child/year-at-risk. While the incidence of clinical P. vivax illness was strongly associated with mol FOB (incidence rate ratio (IRR = 1.99, 95% confidence interval (CI95 [1.80, 2.19], (molFOB did not change with age. The incidence of P. vivax showed a faster decrease with age in children with high (IRR = 0.49, CI95 [0.38, 0.64] p<0.001 compared to those with low exposure (IRR = 0.63, CI95[0.43, 0.93] p = 0.02.P. vivax (molFOB is considerably higher than P. falciparum (molFOB (5.5 clones/child/year-at-risk. The high number of P. vivax clones that infect children in early childhood contribute to the rapid acquisition of immunity against clinical P. vivax malaria.

A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery

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Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De-Sen

2016-01-01

Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment. PMID:27008710

A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery.

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Peng, Jian-Hong; Fang, Yu-Jing; Li, Cai-Xia; Ou, Qing-Jian; Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De Sen

2016-04-19

Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment.

Management of stage I and II A/B avascular necrosis of femoral head with core decompression autologous cancellous bone grafting and platelet rich plasma factors

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Tushar Agarwal

2015-01-01

Full Text Available Background: Avascular necrosis (AVN of the femoral head is a progressive disease that generally affects patients in the third through fifth decades of life; if left untreated, it leads to complete deterioration of the hip joint. Treatments range from simple decompression of the femoral head, to bone grafting of the involved area, or by using a vascularized fibular graft with varying degree of success. In most instances, the disease progresses further causing secondary arthritis. We present a study of management of early stage AVN (stage I and II A/B of Ficat Arlet classification with core decompression autologous cancellous bone grafting along with platelet rich plasma. Aims: To evaluate the results of the above modality in the management of AVN of the hip. Settings and Design: This prospective study of 30 cases was done during the period of 2011-2013. Materials and Methods: Patients with stage I and II A/B were treated with the above modality and were followed up for 1-year. The results were evaluated on the basis of progression or remission of the disease by radiographic studies, preoperative and postoperative Harris hip score (HHS, age and sex distribution. Statistical Analysis Used: Primer software for calculating the statistical data was used and paired t-test was applied to all the data. Results: Show males were more affected than females and average age group of presentation in stage I and II was 29 years (22-55. The most common cause was idiopathic followed by steroid use. Average preoperative HHS was 56.80 and postoperative HHS was 79.73. 60% (18 showed remission of the disease (radiographically compared to preoperative stage at 1-year follow-up, in 30% (9 disease did not progress further and 10% (3 progressed and required arthroplasty. Conclusion: Management of stage I and II A/B AVN of femur showed good satisfactory results in terms of disease remission and prevention of the further progress of the disease by the above method at 1

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

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Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

One shot tract dilation for percutaneous nephrolithotomy: is it safe and effective in preschool children?

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Hosseini, Seyed Reza; Mohseni, Mohammad Ghasem; Alizadeh, Farshid

2014-01-01

To evaluate the safety and feasibility of percutaneous tract dilation by the one-stage method in preschool children. Between April 2009 and February 2013, all preschool (stage Amplatz according to Frattini et al. [J Endourol 2001;15:919-923] (group II, 31 patients). The primary endpoint of interest was fluoroscopy time. Secondary endpoints included tract creation and dilation time, success rate and complications. Stone-free status was defined as residuals ≤3 mm. Age, stone size, operation success and operation time were not significantly different between the studied groups. The most common stone composition was calcium oxalate in both groups. The mean ± standard deviation of access and fluoroscopy times in groups I and II were 7.3 ± 1.2 min vs. 5.9 ± 1.5 min (p > 0.05) and 70.0 ± 8.9 s vs. 22.0 ± 5.6 s (p stage method is safe and effective. Also, it is associated with considerably less radiation exposure in preschool children. © 2014 S. Karger AG, Basel.

Preliminary investigation of stereotactic body radiation therapy for medically inoperable stage I/II non-small cell lung cancer

International Nuclear Information System (INIS)

Guo Jindong; Lu Changxing; Wang Jiaming; Liu Jun; Li Hongxuan; Wang Changlu; Gao Lanting; Zhao Lei

2011-01-01

Objective: To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy (SBRT) in patients with medically inoperable stage I/II non-small cell lung cancer (NSCLC). Methods: SBRT was applied to 30 patients, including clinically staged T 1 , T 2 (≤5 cm) or T 3 (chest wall primary tumors only), N 0 , M 0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results: The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response (CR), partial response (PR) and stable disease (SD) rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months (range, 4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%) developed Grade 2 pneumonitis, no grade > 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions: It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage I / II NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up. (authors)

Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

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Ruella, Marco [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia (United States); Filippi, Andrea Riccardo [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Bruna, Riccardo [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Di Russo, Anna [Radiation Oncology, Istituto Nazionale Tumori, Milano (Italy); Magni, Michele [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Caracciolo, Daniele [Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Passera, Roberto [Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Matteucci, Paola; Di Nicola, Massimo [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Corradini, Paolo [Division of Haematology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy); Parvis, Guido [Division of Haematology, San Luigi Gonzaga Hospital, Orbassano, Torino (Italy); Gini, Guido; Olivieri, Attilio [Division of Haematology, Ospedali Riuniti, Ancona (Italy); Ladetto, Marco [Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino (Italy); Ricardi, Umberto [Department of Oncology, Radiation Oncology, University of Torino, Torino (Italy); Tarella, Corrado, E-mail: corrado.tarella@gmail.com [Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino (Italy); Hemato-Oncology Division, European Institute of Oncology, Milano (Italy); Devizzi, Liliana [Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano (Italy)

2016-03-15

Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab courses (375 mg/m{sup 2}, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.

Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

International Nuclear Information System (INIS)

Ruella, Marco; Filippi, Andrea Riccardo; Bruna, Riccardo; Di Russo, Anna; Magni, Michele; Caracciolo, Daniele; Passera, Roberto; Matteucci, Paola; Di Nicola, Massimo; Corradini, Paolo; Parvis, Guido; Gini, Guido; Olivieri, Attilio; Ladetto, Marco; Ricardi, Umberto; Tarella, Corrado; Devizzi, Liliana

2016-01-01

Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab courses (375 mg/m"2, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.

Validation study of a quantitative multigene reverse transcriptase-polymerase chain reaction assay for assessment of recurrence risk in patients with stage II colon cancer.

Science.gov (United States)

Gray, Richard G; Quirke, Philip; Handley, Kelly; Lopatin, Margarita; Magill, Laura; Baehner, Frederick L; Beaumont, Claire; Clark-Langone, Kim M; Yoshizawa, Carl N; Lee, Mark; Watson, Drew; Shak, Steven; Kerr, David J

2011-12-10

We developed quantitative gene expression assays to assess recurrence risk and benefits from chemotherapy in patients with stage II colon cancer. We sought validation by using RNA extracted from fixed paraffin-embedded primary colon tumor blocks from 1,436 patients with stage II colon cancer in the QUASAR (Quick and Simple and Reliable) study of adjuvant fluoropyrimidine chemotherapy versus surgery alone. A recurrence score (RS) and a treatment score (TS) were calculated from gene expression levels of 13 cancer-related genes (n = 7 recurrence genes and n = 6 treatment benefit genes) and from five reference genes with prespecified algorithms. Cox proportional hazards regression models and log-rank methods were used to analyze the relationship between the RS and risk of recurrence in patients treated with surgery alone and between TS and benefits of chemotherapy. Risk of recurrence was significantly associated with RS (hazard ratio [HR] per interquartile range, 1.38; 95% CI, 1.11 to 1.74; P = .004). Recurrence risks at 3 years were 12%, 18%, and 22% for predefined low, intermediate, and high recurrence risk groups, respectively. T stage (HR, 1.94; P < .001) and mismatch repair (MMR) status (HR, 0.31; P < .001) were the strongest histopathologic prognostic factors. The continuous RS was associated with risk of recurrence (P = .006) beyond these and other covariates. There was no trend for increased benefit from chemotherapy at higher TS (P = .95). The continuous 12-gene RS has been validated in a prospective study for assessment of recurrence risk in patients with stage II colon cancer after surgery and provides prognostic value that complements T stage and MMR. The TS was not predictive of chemotherapy benefit.

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)

Hospital-level Variation in Utilization of Surgery for Clinical Stage I-II Pancreatic Adenocarcinoma.

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Swords, Douglas S; Mulvihill, Sean J; Skarda, David E; Finlayson, Samuel R G; Stoddard, Gregory J; Ott, Mark J; Firpo, Matthew A; Scaife, Courtney L

2017-07-11

To (1) evaluate rates of surgery for clinical stage I-II pancreatic ductal adenocarcinoma (PDAC), (2) identify predictors of not undergoing surgery, (3) quantify the degree to which patient- and hospital-level factors explain differences in hospital surgery rates, and (4) evaluate the association between adjusted hospital-specific surgery rates and overall survival (OS) of patients treated at different hospitals. Curative-intent surgery for potentially resectable PDAC is underutilized in the United States. Retrospective cohort study of patients ≤85 years with clinical stage I-II PDAC in the 2004 to 2014 National Cancer Database. Mixed effects multivariable models were used to characterize hospital-level variation across quintiles of hospital surgery rates. Multivariable Cox proportional hazards models were used to estimate the effect of adjusted hospital surgery rates on OS. Of 58,553 patients without contraindications or refusal of surgery, 63.8% underwent surgery, and the rate decreased from 2299/3528 (65.2%) in 2004 to 4412/7092 (62.2%) in 2014 (P < 0.001). Adjusted hospital rates of surgery varied 6-fold (11.4%-70.9%). Patients treated at hospitals with higher rates of surgery had better unadjusted OS (median OS 10.2, 13.3, 14.2, 16.5, and 18.4 months in quintiles 1-5, respectively, P < 0.001, log-rank). Treatment at hospitals in lower surgery rate quintiles 1-3 was independently associated with mortality [Hazard ratio (HR) 1.10 (1.01, 1.21), HR 1.08 (1.02, 1.15), and HR 1.09 (1.04, 1.14) for quintiles 1-3, respectively, compared with quintile 5] after adjusting for patient factors, hospital type, and hospital volume. Quality improvement efforts are needed to help hospitals with low rates of surgery ensure that their patients have access to appropriate surgery.

Children of non-Western origin with end-stage renal disease in the Netherlands, Belgium and a part of Germany have impaired health-related quality of life compared with Western children

NARCIS (Netherlands)

Schoenmaker, N.J.; Haverman, L.; Tromp, W.F.; Lee, J.H. van der; Offringa, M.; Adams, B.; Bouts, A.H.M.; Collard, L.; Cransberg, K.; Dyck, M. van; Godefroid, N.; Hoeck, K. van; Koster-Kamphuis, L.; Lilien, M.R.; Raes, A.; Taylan, C.; Grootenhuis, M.A.; Groothoff, J.W.

2014-01-01

BACKGROUND: Many children with end-stage renal disease (ESRD) living in Western Europe are of non-Western European origin. They have unfavourable somatic outcomes compared with ESRD children of Western origin. In this study, we compared the Health-related Quality of Life (HRQoL) of both groups.

A PROSPECTIVE STUDY ON PREOPERATIVE CONCURRENT CHEMORADIATION WITH CAPECITABINE IN STAGE II/III CARCINOMA OF RECTUM

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Anish Kuttappan Soman

2017-09-01

Full Text Available BACKGROUND Fluorouracil (5-FU based chemoradiotherapy represents the standard treatment option for the preoperative treatment of advanced rectal cancer. Capecitabine is an oral precursor of 5-FU with the advantage of delivering the chemotherapy in an outpatient setup. NSABP R-04 & a German phase 3 trial by Hofheinz et al showed that Capecitabine was equivalent to 5-FU. The primary objective of this study was to evaluate pathological response (PR, clinical & surgical outcomes of stage II & III patients treated with chemoradiation with Capecitabine. The secondary objective was to evaluate toxicity and compliance to treatment. MATERIALS AND METHODS This single arm prospective study included 35 patients with stages II & III adenocarcinoma of rectum who after evaluation were treated with pelvic radiotherapy and concurrent Capecitabine. Toxicities were graded using RTOG scoring criteria. Clinical response was assessed after EBRT completion, and patients were referred for surgery after 4-6 weeks. Pathologic response and completeness of resection were assessed from the histopathology report. RESULTS Growth located within 5 cm from anal verge was seen in 24 (68.5% patients and 6 were inoperable upfront. All patients completed the intended preoperative treatment and 88.6% did not have any toxicity related break in RT. Clinical response was seen in 80% of patients after Chemoradiation. Out of 35 treated 80% of them underwent surgery. APR was performed in 64.2% and 35.7% had LAR. Out of 6 upfront inoperable patients, 3 were converted to operable. Out of 23 APR cases, 7 were converted to anterior resection (30.4%, p=0.046. 96% of operated patients had an R0 resection, including all the 3 upfront inoperable patients. Minimal pathologic response was seen in 89.2% of patients and 7.14% had complete pathologic response. There were no Grade 4 or 5 toxicities. Only 2.9% had a Grade 3 event. 45.7% had maximum of Grade 1 events and 48.6% had maximum of Grade 2

Prognostic implications of occult nodal tumour cells in stage I and II colon cancer: The correlation between micrometastasis and disease recurrence

NARCIS (Netherlands)

Sloothaak, D. A. M.; van der Linden, R. L. A.; van de Velde, C. J. H.; Bemelman, W. A.; Lips, D. J.; van der Linden, J. C.; Doornewaard, H.; Tanis, P. J.; Bosscha, K.; van der Zaag, E. S.; Buskens, C. J.

2017-01-01

Occult nodal tumour cells should be categorised as micrometastasis (MMs) and isolated tumour cells (ITCs). A recent meta-analysis demonstrated that MMs, but not ITCs, are prognostic for disease recurrence in patients with stage I/II colon cancer. The objective of this retrospective multicenter study

Radiation therapy for stage I-II non-small cell lung cancer in patients aged 75 years and older

International Nuclear Information System (INIS)

Furuta, Masaya; Hayakawa, Kazushige; Katano, Susumu

1996-01-01

Between 1976 and 1992, 32 patients aged 75 and older with stage I-II non-small cell lung cancer (NSCLC) were given definitive radiation therapy. These patients did not undergo surgery because of old age, poor cardiac/pulmonary condition, or refusal to give consent. The mean age was 79 years, and 11 patients were over 80 years old. The histologic type was squamous cell carcinoma in 25 patients and adenocarcinoma in 7. The clinical T and N stage was T1N0 in 4 patients, T2N0 in 9, and T2N0 in 19. The total dose of radiation therapy given to each patient exceeded 60 Gy using 10-MV X-rays. The treatment was completed in all 32 patients without treatment-related complications. The 2- and 5-year overall actuarial survival rates were 40% and 16%, respectively. Eleven intercurrent deaths occurred, including 7 patients who died of heart disease. The 2- and 5-year cause-specific survival rates were 57% and 36%, respectively. None of the patients developed severe pneumonitis requiring hospitalization. All but three patients received radiation therapy on an inpatient basis. The mean duration of the hospital stay for initial treatment was 56 days, and mean ratio to total survival period (mean 739 days) was 8%. Although many elderly patients have concurrent medical complications such as heart disease and chronic pulmonary disease, the present study showed that elderly patients with clinical stage I-II NSCLC can expert a realistic probability of long-term survival with definitive radiation therapy. (author)

EU Kids Online II Dataset: A Cross-National Study of Children's Use of the Internet and Its Associated Opportunities and Risks

Science.gov (United States)

Livingstone, Sonia; Cagiltay, Kursat; Ólafsson, Kjartan

2015-01-01

In the EU Kids Online II project, data were collected from children and parents via in-home face-to-face interviews in 25 European countries to examine children's Internet use, activities and skills, the risk of harm they encountered, parental awareness, and safety strategies regarding children's Internet use and risks. The project provides…

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

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Aisha Khoja

Full Text Available ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1 were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05 . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001, which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001, and in SNA (p < 0.001 and SNB (p = 0.016 angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007 and CS-4 (p = 0.024, and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05. There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05. There was significant retraction of the upper lip in CS-3 (p = 0.001, protrusion of the lower lip in CS-2 (p = 0.005, increase in nasolabial angle in CS-4 (p = 0.006 and Z-angle in CS-3 (p = 0.016, reduction in H-angle in CS-2 (p = 0.013 and CS-3 (p = 0.002 groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and

Clinical experience with radiation enhancement by hyperbaric oxygen in children with recurrent neuroblastoma stage IV

International Nuclear Information System (INIS)

Voute, P.A.; Kleij, A.J. van der; De Kraker, J.; Hoefnagel, C.A.; Tiel-van Buul, M.M.C.; Gennip, H. van

1995-01-01

The high risk group of patients with neuroblastoma are children over 1 year with stage IV disease. Most series report a maximum of 20% survival at 5 years. For recurrent neuroblastoma stage IV, cure rates are not reported in the literature, but they are nil. Any treatment for recurrent neuroblastoma stage IV remains a therapeutic dilemma. The outcome of radiation therapy is variable. A very important factor in tumour treatment remains tumour hypoxia, and others, such as metabolic factors, also play a role. Combined application of radiation modifiers may influence the final survival rate. In an attempt to improve the survival of recurrent neuroblastoma stage IV, hyperbaric oxygen and radioionated meta-Iodobenzylguanidine (MIBG) was used in a clinical setting. Although survival may not be used as a determinant of the usefulness of a treatment for stage IV neuroblastoma disease, a better one is not available. In this study, at 28 months, a cumulative probability of survival of 32% was recorded for patients treated with [ 131 I]MIBG and hyperbaric oxygen compared to 12% for [ 131 I]MIBG treatment alone. These preliminary results are promising but further studies are needed to reveal substantial therapeutic gain. (Author)

Acculturation is Not Related to Physical Activity Stage of Change for Children in Hawai'i.

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Rotter, Markus; Nigg, Claudio R; Renda, Gloria A; Novotny, Rachel

2016-02-01

The relationship between acculturation and physical activity stages of change is unexplored. Stages of change conceptualize behavior change as a progression through a series of five stages indicating the readiness to change behavior. The level of acculturation can be assessed using the Ethnocultural Identity Behavioral Index (EIBI) which is based on three factors: Cultural Activities, Social Interaction and Language Opportunities. The purpose of this project was to explore the relationship between parental acculturation and physical activity stages of change in Hawai'i children. Participants (N = 85; 62% female; aged 5-8 years; 22% Native Hawaiian or Other Pacific Islanders, 42% Asian, 25% White, and 11% Other) completed the EIBI and a physical activity stages of change measure. Acculturation factor means were: Cultural Activities = 4 (SD = 1.26), Social Interaction = 3 (SD = 1.04), and Language Opportunities = 4 (SD = 1.29). The physical activity stages of change distribution was Precontemplation = 11 (13%), Contemplation/Preparation = 15 (18%), and Action/Maintenance = 59 (69%). Analysis of covariance (ANCOVA) for Cultural Activities F(3, 81) = 0.77, P = .47, Social Interaction F(3, 81) = 0.93, P = .40; and Language Opportunities F(3, 81) = 1.34, P = .27 showed no significant differences between physical activity stages of change. The results of our study do not show an association between acculturation and readiness to change for physical activity. The lack of differences may be due to participants being moderately acculturated, possibly lessening the differentiation of acculturation by physical activity stages of change.

Methylation of WNT target genes AXIN2 and DKK1 as robust biomarkers for recurrence prediction in stage II colon cancer

NARCIS (Netherlands)

Kandimalla, R.; Linnekamp, J. F.; van Hooff, S.; Castells, A.; Llor, X.; Andreu, M.; Jover, R.; Goel, A.; Medema, J. P.

2017-01-01

Stage II colon cancer (CC) still remains a clinical challenge with patient stratification for adjuvant therapy (AT) largely relying on clinical parameters. Prognostic biomarkers are urgently needed for better stratification. Previously, we have shown that WNT target genes AXIN2, DKK1, APCDD1, ASCL2

CHANGES IN MOTOR SKILLS OF CHILDREN WHO TRAIN SPORTS SWIMMING AT THE INITIAL STAGE OF SCHOOL EDUCATION (IN ANNUAL TRAINING CYCLE

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Paul Eider

2015-12-01

Full Text Available Introduction: This is an empirical article aiming at defining the changes of motor fitness in children practicing swimming at early stage of training in year-long training cycle. Proper selection of candidates to practice certain sports is a very complex process. One needs to select from the very large population of children, girls and boys, characterized by certain features, including somatic and motor features, which developed in a longstanding process of training, will lead them to become champions. The purpose of the research: The purpose of the research was to define the changes of motor fitness in girls’ practicing swimming at early stage of training in year-long training cycle. Material and Methods: The subjects to the research were 85 girls aged 7 (1st year of primary school, including 36 girls in swimming group and 49 girls in control group. 36 of them belonged to swimmers’ group- all girls were members of the Municipal Swimming Club in Szczecin. Control group consisted of 49 girls, who attended the same elementary schools. The examinations were carried out twice in the 2009-2010 academic year. The most reliable and accurate indirect test- EUROFIT Test Battery-was used. Results : The research revealed changes in both groups (Sw, C in terms of all eight tests. Examination II proved statistically significant improvement of results in both groups (Sw, C in comparison to Examination I. The dynamics of changes in general balance, flexibility, static force, functional force, running agility, was bigger in the girls who practiced swimming. As the speed of movement of upper limb, explosive force and thorax force are concerned; the differences of results in both examinations were similar in both groups (swimming group and control group. Progressive changes in motor fitness of the examined groups are a positive phenomenon in the development of child’s young organism. Conclusions: Swimming training significantly affected the dynamics of

The effect of laparoscopic surgery in stage II and III right-sided colon cancer: a retrospective study

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Kye Bong-Hyeon

2012-05-01

Full Text Available Abstract Background This retrospective study compared the clinicopathological results among three groups divided by time sequence to evaluate the impact of introducing laparoscopic surgery on long-term oncological outcomes for right-sided colon cancer. Methods From April 1986 to December 2006, 200 patients who underwent elective surgery with stage II and III right-sided colon cancer were analyzed. The period for group I referred back to the time when laparoscopic approach had not yet been introduced. The period for group II was designated as the time when first laparoscopic approach for right colectomy was carried out until we overcame its learning curve. The period for group III was the period after overcoming this learning curve. Results When groups I and II, and groups II and III were compared, overall survival (OS did not differ significantly whereas disease-free survival (DFS in groups I and III were statistically higher than in group II (P = 0.042 and P = 0.050. In group III, laparoscopic surgery had a tendency to provide better long-term OS ( P = 0.2036 and DFS ( P = 0.2356 than open surgery. Also, the incidence of local recurrence in group III (2.6% was significantly lower than that in groups II (7.4% and I (12.1% ( P = 0.013. Conclusions Institutions should standardize their techniques and then provide fellowship training for newcomers of laparoscopic colon cancer surgery. This technique once mastered will become the gold standard approach to colon surgery as it is both safe and feasible considering the oncological and technical aspects.

Justification of a dose of diuretics in antihypertensive treatment of patients with essential hypertension stage II-III

OpenAIRE

Plesh, I. A.; Boreyko, L. D.; Slyvka, N. O.; Kshanovska, G. I.

2017-01-01

"Pressor natriuresis" coefficient in  ratio of daily urinary sodium excretion (ENadob) by means of  electrometric method using ionselective electrodes (SINO - 005) to average of median arterial pressure (MAPdob) a day  and character of circadian rhytm, by the method of daily monitoring of blood pressure (hardware «Solvaig») to optimize the dose of a diuretic in combined antihypertensive treatment was determened іn 65 patients with essential  hypertension (EH II-III stage and 26 control (normo...

Transoral Robotic Surgery in Treating Patients With Benign or Stage I-IV Head and Neck Cancer

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2014-11-07

Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Nasopharynx; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the Oral Cavity; Stage II Lymphoepithelioma of the Nasopharynx; Stage II Lymphoepithelioma of the Oropharynx; Stage II Mucoepidermoid Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Hypopharynx; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Adenoid Cystic Carcinoma of the Oral Cavity; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Lymphoepithelioma of the Oropharynx; Stage III Mucoepidermoid Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage

FEATURES OF MEMORY IN CHILDREN OF PRESCHOOL AGE WITH CONSEQUENCES OF PERINATAL LESIONS OF THE CENTRAL NERVOUS SYSTEM

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T. S. Krivonogova

2014-01-01

Full Text Available The ability of memory was investigated in 524 children, aged 4 to 7; with remote consequences of perinatal damage of the central nervous system (CNS. A weak memory ability was detected in 42% of children with dysfunctions of the general and fine motility and in 59% of children with impaired speech. Severe gestosis, anemia in pregnancy (stage II and a delayed intrauterine fetal development were found to have a negative influence on memory shaping process.

Desempenho de crianças pré-termo com muito baixo peso e extremo baixo peso segundo o teste Denver-II The performance of pre-term children with very and extreme low weight according to the Denver-II test

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Lívia de Castro Magalhães

2011-12-01

Full Text Available OBJETIVOS: analisar o desempenho de crianças da região metropolitana Belo Horizonte/MG nascidas pré-termo com muito e extremo baixo peso nos itens do teste Denver II. MÉTODOS: as crianças foram selecionadas em um programa de acompanhamento do desenvolvimento de crianças de risco. A amostra incluiu 177 crianças, nas quais o Teste de Denver II foi aplicado nas idades corrigidas de 4, 8, 12, 18 e 24 meses. As respostas foram comparadas (χ2 aos dados da amostra normativa do instrumento. RESULTADOS: crianças pré-termo de muito e extremo baixo peso apresentaram desempenho superior no primeiro ano de vida com desvantagem a partir dos 12 meses em relação à amostra normativa do Denver II. O grupo de extremo baixo peso foi o que apresentou pior desempenho. CONCLUSÕES: houve diferenças no padrão de respostas das crianças examinadas em relação à amostra normativa do Denver II, sendo importante fazer mais estudos acerca da validade do teste para a população brasileira.OBJECTIVES: to evaluate the performance on the Denver II test of preterm children with very and extreme low weight from the Belo Horizonte/MG metropolitan region. METHODS: the children were selected as part of a program to monitor the development of children at risk. The sample included 177 children, to whom the Denver II Test was applied at corrected ages of 4, 8, 12, 18 and 24 months. The responses were compared (χ2 to data from a normative sample. RESULTS: preterm children with very or extremely low weight showed improved performance in the first year of life, although disadvantages began to emerge after twelve months in relation to the normative Denver II sample. The extremely low weight group performed the worst. CONCLUSIONS: there were differences in the pattern of children's responses compared to those of the normative Denver II sample, and it is important to carry out further studies of the validity of this test for the Brazilian population.

Narrative Skills, Gender, Culture, and Children's Long-Term Memory Accuracy of a Staged Event

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Klemfuss, J. Zoe; Wang, Qi

2017-01-01

This study examined the extent to which school-aged children's general narrative skills provide cognitive benefits for accurate remembering or enable good storytelling that undermines memory accuracy. European American and Chinese American 6-year-old boys and girls (N = 114) experienced a staged event in the laboratory and were asked to tell a…

Lengthening Temporalis Myoplasty for Single-Stage Smile Reconstruction in Children with Facial Paralysis.

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Panossian, Andre

2016-04-01

Free muscle transfer for dynamic smile reanimation in facial paralysis is not always predictable with regard to cosmesis. Hospital stays range from 5 to 7 days. Prolonged operative times, longer hospital stays, and excessive cheek bulk are associated with free flap options. Lengthening temporalis myoplasty offers single-stage smile reanimation with theoretical advantages over free tissue transfer. From 2012 to 2014, 18 lengthening temporalis myoplasties were performed in 14 children for smile reconstruction. A retrospective chart review was completed for demographics, operative times, length of hospital stay, and perioperative complications. Fourteen consecutive patients with complete facial paralysis were included. Four patients underwent single-stage bilateral reconstruction, and 10 underwent unilateral procedures. Diagnoses included Möbius syndrome (n = 5), posterior cranial fossa tumors (n = 4), posttraumatic (n = 2), hemifacial microsomia (n = 1), and idiopathic (n = 2). Average patient age was 10.1 years. Average operative time was 410 minutes (499 minutes for bilateral lengthening temporalis myoplasty and 373 for unilateral lengthening temporalis myoplasty). Average length of stay was 3.3 days (4.75 days for bilateral lengthening temporalis myoplasty and 2.8 for unilateral lengthening temporalis myoplasty). Nine patients required minor revisions. Lengthening temporalis myoplasty is a safe alternative to free tissue transfer for dynamic smile reconstruction in children with facial paralysis. Limited donor-site morbidity, shorter operative times, and shorter hospital stays are some benefits over free flap options. However, revisions are required frequently secondary to tendon avulsions and adhesions. Therapeutic, IV.

Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm

International Nuclear Information System (INIS)

Gill, Beant S.; Vargo, John A.; Pai, Sarah S.; Balasubramani, Goundappa K.; Beriwal, Sushil

2015-01-01

Purpose: Mantle cell lymphoma (MCL) is a rare, albeit aggressive subset of non-Hodgkin lymphoma, resulting in varied treatment approaches. Given the paucity of data defining the optimal management for early-stage MCL, we conducted an analysis using the National Cancer Data Base (NCDB) to identify practice patterns and outcomes. Methods and Materials: The NCDB was queried for patients with stage I to II MCL diagnosed from 1998 to 2012 receiving chemotherapy (CT) or radiation therapy (RT), or both (CT+RT). Univariate and multivariable analyses for factors associated with treatment selection were completed using logistic regression. Propensity scores with inverse probability treatment weighting (IPTW) were calculated based on the conditional probability of receiving CT+RT. The log-rank test and Cox proportional hazards modeling with IPTW adjustment were conducted for the survival analyses. Results: In total, 2539 patients were identified. The key characteristics were as follows: 69% were male, 71% were aged ≥60 years, 28% had extranodal involvement, and 51% had stage I disease. Of the 2539 patients, 70% underwent CT, 11% underwent RT, and 19% underwent CT+RT. The use of CT+RT decreased from 23.1% to 14.1% in 1998 to 2002 and 2010 to 2012 (P<.001). CT+RT usage was lower for patients with the following characteristics: age ≥60 years, female sex, stage II disease, and the presence of B symptoms. With a median follow-up period of 42.8 months, the unadjusted 3-year overall survival estimates for patients receiving CT, RT, or CT+RT were 67.8%, 72.4%, and 79.8%, respectively (P<.001). After correcting for indication bias through IPTW-adjusted modeling, CT+RT reduced the risk of overall mortality compared with monotherapy (hazard ratio 0.65, P=.029). Conclusions: Although uncommon, patients with stage I-II MCL can have favorable outcomes. Despite a continued decline in the usage of consolidative RT, combined modality therapy improves survival in this cohort compared

Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm

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Gill, Beant S.; Vargo, John A. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Pai, Sarah S. [Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Balasubramani, Goundappa K. [Department of Epidemiology, Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States)

2015-11-01

Purpose: Mantle cell lymphoma (MCL) is a rare, albeit aggressive subset of non-Hodgkin lymphoma, resulting in varied treatment approaches. Given the paucity of data defining the optimal management for early-stage MCL, we conducted an analysis using the National Cancer Data Base (NCDB) to identify practice patterns and outcomes. Methods and Materials: The NCDB was queried for patients with stage I to II MCL diagnosed from 1998 to 2012 receiving chemotherapy (CT) or radiation therapy (RT), or both (CT+RT). Univariate and multivariable analyses for factors associated with treatment selection were completed using logistic regression. Propensity scores with inverse probability treatment weighting (IPTW) were calculated based on the conditional probability of receiving CT+RT. The log-rank test and Cox proportional hazards modeling with IPTW adjustment were conducted for the survival analyses. Results: In total, 2539 patients were identified. The key characteristics were as follows: 69% were male, 71% were aged ≥60 years, 28% had extranodal involvement, and 51% had stage I disease. Of the 2539 patients, 70% underwent CT, 11% underwent RT, and 19% underwent CT+RT. The use of CT+RT decreased from 23.1% to 14.1% in 1998 to 2002 and 2010 to 2012 (P<.001). CT+RT usage was lower for patients with the following characteristics: age ≥60 years, female sex, stage II disease, and the presence of B symptoms. With a median follow-up period of 42.8 months, the unadjusted 3-year overall survival estimates for patients receiving CT, RT, or CT+RT were 67.8%, 72.4%, and 79.8%, respectively (P<.001). After correcting for indication bias through IPTW-adjusted modeling, CT+RT reduced the risk of overall mortality compared with monotherapy (hazard ratio 0.65, P=.029). Conclusions: Although uncommon, patients with stage I-II MCL can have favorable outcomes. Despite a continued decline in the usage of consolidative RT, combined modality therapy improves survival in this cohort compared

Risk Factors for Complications Differ Between Stages of Tissue-Expander Breast Reconstruction.

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Lovecchio, Francis; Jordan, Sumanas W; Lim, Seokchun; Fine, Neil A; Kim, John Y S

2015-09-01

Tissue-expander (TE) placement followed by implant exchange is currently the most popular method of breast reconstruction. There is a relative paucity of data demonstrating patient factors that predict complications specifically by stage of surgery. The present study attempts to determine what complications are most likely to occur at each stage and how the risk factors for complications vary by stage of reconstruction. A retrospective chart review was performed on all 1275 patients who had TEs placed by the 2 senior authors between 2004 and 2013. Complication rates were determined at each stage of reconstruction, and these rates were further compared between patients who had pre-stage I radiation, post-stage I radiation, and no radiation exposure. Multivariate logistic regression was used to identify independent predictors of complications at each stage of reconstruction. A total of 1639 consecutive TEs were placed by the senior authors during the study period. The overall rate for experiencing a complication at any stage of surgery was 17%. Complications occurred at uniformly higher rates during stage I for all complications (92% stage I vs 7% stage II vs 1% stage III, P higher intraoperative percent fill (OR, 3.3; 95% CI, 1.7-6.3). Post-stage I radiation was the only independent risk factor for a stage II complication (OR, 4.5; 95% CI, 1.4-15.2). Complications occur at higher rates after stage I than after stage II, and as expected, stage III complications are exceedingly rare. Risk factors for stage I complications are different from risk factors for stage II complications. Body mass index and smoking are associated with complications at stage I, but do not predict complications at stage II surgery. The stratification of risk factors by stage of surgery will help surgeons and patients better manage both risk and expectations.

Harvesting policy for a delayed stage-structured Holling II predator-prey model with impulsive stocking prey

International Nuclear Information System (INIS)

Jiao Jianjun; Meng Xinzhu; Chen Lansun

2009-01-01

A predator-prey model with a stage structure for the predator, which improves the assumption that each individual predator has the same ability to capture prey, is proposed by Wang et al. [Wang W, Mulone G, Salemi F, Salone V. Permanence and stability of a stage-structured predator-prey model. J Math Anal Appl 2001;262:499-528]. It is assumed that immature individuals and mature individuals of the predator are divided by a fixed age and that immature predators do not have the ability to attack prey. We do economic management behavior for Wang model [Wang et al., 2001] by continuous harvesting on predator and impulsive stocking on prey. Then, a delayed stage-structured Holling type II predator-prey model with impulsive stocking prey and continuous harvesting predator is established. It is also assumed that the predating products of the predator is only to increase its bearing ability. We obtain the sufficient conditions of the global attractivity of predator-extinction boundary periodic solution and the permanence of the system. Our results show that the behavior of impulsive stocking prey plays an important role for the permanence of the system, and provide tactical basis for the biological resource management. Further, the numerical analysis is also inserted to illuminate the dynamics of the system.

Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base.

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Singh, Babu; Qureshi, Muhammad M; Truong, Minh Tam; Sahni, Debjani

2018-02-03

The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined. To compare survival outcomes in patients with early stage MCC treated with MOHS versus WLE. A retrospective review of all cases in the National Cancer Data Base (NCDB) of MCC of clinical Stage I-II MCC treated with WLE or MOHS was performed. 1,795 cases of Stage I-II MCC were identified who underwent WLE (N=1,685) or MOHS (N=110). There was no difference in residual tumor on surgical margins between the two treatment groups (p=0.588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted HR 1.02; 95% CI 0.72-1.45, p=0.897). There was no difference in overall survival between the two groups on propensity score matched analysis. Disease specific survival was not reported as this data in not available in the NCDB. MOHS appears to be as effective as WLE in treating early stage MCC. Copyright © 2018. Published by Elsevier Inc.

Single stage reduction and stabilization of basilar invagination after failed prior fusion surgery in children with Down's syndrome.

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Hedequist, Daniel; Bekelis, Kimon; Emans, John; Proctor, Mark R

2010-02-15

We describe an innovative single-stage reduction and stabilization technique using modern cervical instrumentation. We hypothesis modern instrumentation has made more aggressive surgical corrections possible and has reduced the need for transoral resection of the odontoid and traction reduction in children with basilar invagination. Craniocervical junction abnormalities, including atlantoaxial instability and progressive basilar invagination, are relatively common phenomenon in Down's syndrome patients, and can lead to chronic progressive neurologic deficits, catastrophic injury, and death. This patient population also can be a difficult one in which to perform successful stabilization and fusion. We reviewed the records and films on 2 children with Down's syndrome and atlantoaxial instability who had undergone prior occipital-cervical fusion and then presented with symptomatic progressive basilar invagination due to atlantoaxial displacement. In both cases, the children had progressive symptoms of spinal cord and brain stem compression. Multiple approaches for surgical correction, including preoperative traction and transoral odontoid resection, were considered, but ultimately it was elected to perform a single stage posterior operation. In both patients, we performed fusion takedown, intraoperative realignment with reduction of the basilar invagination, and stabilization using modern occipito-cervical instrumentation. In both children, excellent cranio-cervical realignment was achieved; along with successful fusion and improvement in clinical symptoms. In this article we will discuss the clinical cases and review the background of craniocervical junction abnormalities in Down's syndrome patients. We hypothesis modern instrumentation has made more aggressive surgical corrections possible and has reduced the need for transoral resection of the odontoid and traction reduction in children with basilar invagination.

Non-surgical breast-conservation treatment (KORTUC-BCT) using a new image-guided, enzyme-targeted, and breast cancer stem cell targeted radiosensitization treatment (KORTUC II) for patients with stage I or II breast cancer

International Nuclear Information System (INIS)

Ogawa, Yasuhiro; Kubota, Kei; Tadokoro, Michiko

2012-01-01

Tumor tissue can be re-oxygenated by inactivating peroxidase/catalase in the tumor tissue through application of hydrogen peroxide. The hydrogen peroxide in turn is then degraded to produce oxygen. In this way, low-LET (linear energy transfer) radioresistant tumors can be transformed into radiosensitive ones (Ogawa Y, et al: Int J Mol Med 12: 453-458, 845-850, 2003, Ogawa Y, et al: Int J Mol Med 14: 397-403, 2004, Kariya S, et al: Int J Radiat Oncol Biol Phys 75: 449-454, 2009). The purpose of the present study was to establish a non-surgical breast-conservation treatment (KORTUC-BCT) by utilizing a novel Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II) radiosensitization treatment. KORTUC I was shown to remarkably enhance radiotherapeutic effects in various types of superficially exposed and locally advanced neoplasms (Ogawa Y, et al: Oncol Rep 19: 1389-1394, 2008). Based on clinical experiences using KORTUC I, a new radiosensitizing agent containing hydrogen peroxide and sodium hyaluronate has been developed for intra-tumoral injection in various tumors which are not superficially exposed. The agent is composed of 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (CD44 molecule). Sodium hyaluronate mixed with hydrogen peroxide attaches to CD44-positive tumor cells, which are generally reported to be breast cancer stem cells. This new method, named KORTUC II, was approved by our local ethics committee for treatment of advanced skin cancer (including malignant melanoma), bone/soft tissue malignant neoplasm, breast cancer and metastatic lymph node. A total of 39 early stage breast cancer patients (stage I: 12 patients and stage II: 27) were enrolled in the KORTUC II trial upon fully informed consent. Mean age of the patients was 61.1 years old. All 39 patients were unable or unwilling to undergo surgery and therefore undertook non-surgical breast-conservation treatment (KORTUC-BCT) by KORTUC II. A maximum of 6 ml of the agent was

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

Science.gov (United States)

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

2014-01-01

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

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

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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

Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Rades, Dirk; Setter, Cornelia; Dahl, Olav; Schild, Steven E.; Noack, Frank

2011-01-01

Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobin levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p 70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of ≥12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of ≥12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of tumor cells was an independent prognostic factor for locoregional control and survival in patients irradiated for NSCLC. EPO-R expression showed a trend

Stage I-II squamous cell carcinoma of the oral cavity treated by iridium-192

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Piedbois, P.; Mazeron, J.J.; Haddad, E.; Coste, A.; Martin, M.; Levy, C.; Raynal, M.; Pavlovitch, J.M.; Peynegre, R.; Perquin, B.; Bourgeois, J.P. le

1991-01-01

This is a retrospective analysis of 233 evaluable patients with stage I-II squamous cell carcinoma of the oral cavity treated by definitive brachytherapy. Minimum follow-up is 3 years. Treatment of the neck was chosen by a multidisciplinary team, according to age, medical status and availability for follow-up. One hundred and ten patients (47 percent) underwent elective neck dissection (END), 28 (25 percent) had positive nodes and received neck irradiation post-operatively. One hundred and twenty-three patients (53 percent) were regularly followed up only, with therapeutic neck dissection (TND) reserved for cases of node relapses. In the END group, there were 19 neck relapses (17 percent): 12/60 (20 percent) in patients with mobile tongue carcinoma and 7/50 (14 percent) in patients with floor of the mouth carcinoma. Salvage treatment was successful in 13-21 (62 percent) cases. Ten-year survival is 37 percent for the END-group and 31 percent for the TND group. Tumour stage and infiltration into underlying tissues increased the probability of neck relapse and death. Furthermore, a multivariate analysis showed that patients treated in the TND group had a higher probability of death than patients treated in the END group (p<0.04). (author). 30 refs.; 2 figs.; 7 tabs

Statistical inference for extended or shortened phase II studies based on Simon's two-stage designs.

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Zhao, Junjun; Yu, Menggang; Feng, Xi-Ping

2015-06-07

Simon's two-stage designs are popular choices for conducting phase II clinical trials, especially in the oncology trials to reduce the number of patients placed on ineffective experimental therapies. Recently Koyama and Chen (2008) discussed how to conduct proper inference for such studies because they found that inference procedures used with Simon's designs almost always ignore the actual sampling plan used. In particular, they proposed an inference method for studies when the actual second stage sample sizes differ from planned ones. We consider an alternative inference method based on likelihood ratio. In particular, we order permissible sample paths under Simon's two-stage designs using their corresponding conditional likelihood. In this way, we can calculate p-values using the common definition: the probability of obtaining a test statistic value at least as extreme as that observed under the null hypothesis. In addition to providing inference for a couple of scenarios where Koyama and Chen's method can be difficult to apply, the resulting estimate based on our method appears to have certain advantage in terms of inference properties in many numerical simulations. It generally led to smaller biases and narrower confidence intervals while maintaining similar coverages. We also illustrated the two methods in a real data setting. Inference procedures used with Simon's designs almost always ignore the actual sampling plan. Reported P-values, point estimates and confidence intervals for the response rate are not usually adjusted for the design's adaptiveness. Proper statistical inference procedures should be used.

Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study.

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Vinberg, Maj; Mikkelsen, Rie Lambaek; Kirkegaard, Thomas; Christensen, Ellen Margrethe; Kessing, Lars Vedel

2017-01-15

In a naturalistic clinical study of patients in the early stages of bipolar disorders the aim was to assess differences between patients with bipolar I (BD I) and bipolar II (BD II) disorders on clinical characteristics including affective symptoms, subjective cognitive complaints, functional level, the presence of comorbid personality disorders and coping strategies. Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status using the Functional Assessment Short Test. Cognitive complaints were assessed using the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire, the presence of comorbid personality disorders using the Standardized Assessment of Personality - Abbreviated Scale and coping style using the Coping Inventory for Stressful Situations. In total, 344 patients were included (BD I (n=163) and BD II (n=181). Patients with BD II presented with significantly more depressive symptoms, more cognitive complaints, lower overall functioning, and a higher prevalence of comorbid personality disorders. Finally, they exhibited a trend towards using less adaptive coping styles. It cannot be omitted that some patients may have progressed from BD II to BD I. Most measures were based on patient self report. Overall, BD II was associated with a higher disease burden. Clinically, it is important to differentiate BD II from BD I and research wise, there is a need for tailoring and testing specific interventions towards BD II. Copyright © 2016 Elsevier B.V. All rights reserved.

The second stage of a Titan II rocket is lifted for mating at the launch tower, Vandenberg AFB

Science.gov (United States)

2000-01-01

At the launch tower, Vandenberg Air Force Base, Calif., the second stage of a Titan II rocket is lifted to vertical. The Titan will power the launch of a National Oceanic and Atmospheric Administration (NOAA-L) satellite scheduled no earlier than Sept. 12. NOAA-L is part of the Polar-Orbiting Operational Environmental Satellite (POES) program that provides atmospheric measurements of temperature, humidity, ozone and cloud images, tracking weather patterns that affect the global weather and climate. Can we eliminate neoadjuvant chemoradiotherapy in favor of neoadjuvant multiagent chemotherapy for select stage II/III rectal adenocarcinomas: Analysis of the National Cancer Data base.

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Cassidy, Richard J; Liu, Yuan; Patel, Kirtesh; Zhong, Jim; Steuer, Conor E; Kooby, David A; Russell, Maria C; Gillespie, Theresa W; Landry, Jerome C

2017-03-01

Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers. In the NCDB, 21,707 patients from 2004 through 2012 with clinical T2N1 (cT2N1), cT3N0, or cT3N1 rectal cancers were identified who had received NCRT or NMAC followed by low anterior resection. Kaplan-Meier analyses, log-rank tests, and Cox-proportional hazards regression analyses were conducted along with propensity score matching analysis to reduce treatment selection bias. The 5-year actuarial overall survival (OS) rate was 75% for patients who received NCRT versus 67.2% for those who received NMAC (P elimination of neoadjuvant RT for select patients with stage II and III rectal adenocarcinoma was associated with worse OS and should not be recommended outside of a clinical trial. Cancer 2017;123:783-93. © 2016 American Cancer Society. © 2016 American Cancer Society.

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

OpenAIRE

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong; Yang, Yunfeng

2017-01-01

Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350?N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5?mm). Results. Compared with the flatfoot model, the LCLs showed significant...

Minimally invasive transcanal myringotomy for pediatric early stage congenital cholesteatoma.

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Jang, Chul Ho; Jung, Eun Kyung; Sung, Chung Man; Kim, Seung Beom; Kim, Young Yoon; Seong, Jong Yuap; Kang, Sung Hoon; Cho, Yong Beom

2016-11-01

Recently, minimally invasive transcanal myringotomy (MITM), which is a useful surgical technique for early stage congenital cholesteatoma (CC) in children, was introduced. The purpose of this study is to evaluate the short-term surgical results of MITM in pediatric early stage CC. We retrospectively reviewed the charts of 24 patients who underwent MITM between January 2013 and October 2015. The patients' ages ranged from 1 to 16 years (mean, 2.6 years). There were 17 male and 7 female patients. The right side (n = 13) was affected twice as often as the left side (n = 11). The most common site was the anterosuperior quadrant (15 cases). The diameter of the CC on axial computed tomography images ranged from 2.8 to 5.7 mm (mean, 3.9 mm). CCs were graded according to Potsic's system: 18 cases were classified as stage I, 3 case as stage II, and 3 cases as stage III. AllCCs except 1 were closed type. In21 patients, the tympanic membrane closed naturally without recurrence. Three patients showed small persistent dry perforation. Natural closure occurred in these patients, who were treated with paper patches. MITM is a simple, effective technique for removing an early stage CC from the middle ear, and it can minimize operative time, length of hospitalization, and postoperative morbidity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?

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Grave, Keith; Townsend, Grant

2003-11-01

Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians. Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt. Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.

A comparison of 12-gene colon cancer assay gene expression in African American and Caucasian patients with stage II colon cancer.

Science.gov (United States)

Govindarajan, Rangaswamy; Posey, James; Chao, Calvin Y; Lu, Ruixiao; Jadhav, Trafina; Javed, Ahmed Y; Javed, Awais; Mahmoud, Fade A; Osarogiagbon, Raymond U; Manne, Upender

2016-06-18

African American (AA) colon cancer patients have a worse prognosis than Caucasian (CA) colon cancer patients, however, reasons for this disparity are not well understood. To determine if tumor biology might contribute to differential prognosis, we measured recurrence risk and gene expression using the Oncotype DX® Colon Cancer Assay (12-gene assay) and compared the Recurrence Score results and gene expression profiles between AA patients and CA patients with stage II colon cancer. We retrieved demographic, clinical, and archived tumor tissues from stage II colon cancer patients at four institutions. The 12-gene assay and mismatch repair (MMR) status were performed by Genomic Health (Redwood City, California). Student's t-test and the Wilcoxon rank sum test were used to compare Recurrence Score data and gene expression data from AA and CA patients (SAS Enterprise Guide 5.1). Samples from 122 AA and 122 CA patients were analyzed. There were 118 women (63 AA, 55 CA) and 126 men (59 AA, 67 CA). Median age was 66 years for AA patients and 68 for CA patients. Age, gender, year of surgery, pathologic T-stage, tumor location, the number of lymph nodes examined, lymphovascular invasion, and MMR status were not significantly different between groups (p = 0.93). The mean Recurrence Score result for AA patients (27.9 ± 12.8) and CA patients (28.1 ± 11.8) was not significantly different and the proportions of patients with high Recurrence Score values (≥41) were similar between the groups (17/122 AA; 15/122 CA). None of the gene expression variables, either single genes or gene groups (cell cycle group, stromal group, BGN1, FAP, INHBA1, Ki67, MYBL2, cMYC and GADD45B), was significantly different between the racial groups. After controlling for clinical and pathologic covariates, the means and distributions of Recurrence Score results and gene expression profiles showed no statistically significant difference between patient groups. The distribution of

A comparison of 12-gene colon cancer assay gene expression in African American and Caucasian patients with stage II colon cancer

International Nuclear Information System (INIS)

Govindarajan, Rangaswamy; Posey, James; Chao, Calvin Y.; Lu, Ruixiao; Jadhav, Trafina; Javed, Ahmed Y.; Javed, Awais; Mahmoud, Fade A.; Osarogiagbon, Raymond University; Manne, Upender

2016-01-01

African American (AA) colon cancer patients have a worse prognosis than Caucasian (CA) colon cancer patients, however, reasons for this disparity are not well understood. To determine if tumor biology might contribute to differential prognosis, we measured recurrence risk and gene expression using the Oncotype DX® Colon Cancer Assay (12-gene assay) and compared the Recurrence Score results and gene expression profiles between AA patients and CA patients with stage II colon cancer. We retrieved demographic, clinical, and archived tumor tissues from stage II colon cancer patients at four institutions. The 12-gene assay and mismatch repair (MMR) status were performed by Genomic Health (Redwood City, California). Student’s t-test and the Wilcoxon rank sum test were used to compare Recurrence Score data and gene expression data from AA and CA patients (SAS Enterprise Guide 5.1). Samples from 122 AA and 122 CA patients were analyzed. There were 118 women (63 AA, 55 CA) and 126 men (59 AA, 67 CA). Median age was 66 years for AA patients and 68 for CA patients. Age, gender, year of surgery, pathologic T-stage, tumor location, the number of lymph nodes examined, lymphovascular invasion, and MMR status were not significantly different between groups (p = 0.93). The mean Recurrence Score result for AA patients (27.9 ± 12.8) and CA patients (28.1 ± 11.8) was not significantly different and the proportions of patients with high Recurrence Score values (≥41) were similar between the groups (17/122 AA; 15/122 CA). None of the gene expression variables, either single genes or gene groups (cell cycle group, stromal group, BGN1, FAP, INHBA1, Ki67, MYBL2, cMYC and GADD45B), was significantly different between the racial groups. After controlling for clinical and pathologic covariates, the means and distributions of Recurrence Score results and gene expression profiles showed no statistically significant difference between patient groups. The distribution of Recurrence Score

Ultrasound assessment of the meniscus complex formation in health children and with the 1st stage of longitudinal platypodia ones

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Alexei Ivantsov

2013-04-01

Full Text Available Objectives: Foot arch reduces the exposure of weight and buf load due to its bufer function. in longitudinal platypodia foot looses this function and articular menisci have to take the role of the bufers (shock absorbers. Materials and Methods: Ultrasound assessment of meniscus thickness was performed on the joint space level. Results: varus type (43.4% of the meniscus complex adaptation was dominant in 5-7 years old patients with the 1st stage longitudinal platypodia; symmetric type (51.9% – in 8-12 years old patients; valgus type (56% – in 13-17 years old ones. Healthy children showed the valgus type in all age periods. Conclusions: in our opinion the dominance of the varus type of the meniscus complex in 5-7 aged children and its further conversion into the valgus type in case of the 1st stage longitudinal platypodia refects the reduction of the lower extremities transformation processes from the varus into the most functional convenient valgus position at the age of 13-17. Keywords: meniscus, children, ultrasound investigation.

Primary Definitive Procedure versus Conventional Three-staged Procedure for the Management of Low-type Anorectal Malformation in Females: A Randomized Controlled Trial.

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Gupta, Alisha; Agarwala, Sandeep; Sreenivas, Vishnubhatla; Srinivas, Madhur; Bhatnagar, Veereshwar

2017-01-01

Females with Krickenbeck low-type anorectal malformations - vestibular fistula (VF) and perineal fistula (PF) - are managed either by a primary definitive or conventional three-staged approach. Ultimate outcome in these children may be affected by wound dehiscence leading to healing by fibrosis. Most of the literature favors one approach over other based on retrospective analysis of their outcomes. Whether a statistically significant difference in wound dehiscence rates between these approaches exists needed to be seen. A randomized controlled trial for girls <14 years with VF or PF was done. Random tables were used to randomize 33 children to Group I (primary procedure) and 31 to Group II (three-staged procedure). Statistical analysis was done for significance of difference ( P < 0.05) in the primary outcome (wound dehiscence) and secondary outcomes (immediate and early postoperative complications). Of the 64 children randomized, 54 (84%) had VF. Both groups were comparable in demography, clinical profile and age at surgery. The incidence of wound dehiscence (39.4% vs. 18.2%; P = 0.04), immediate postoperative complications (51.5% vs. 12.9%; P = 0.001), and early postoperative complications (42.4% vs. 12.9%; P = 0.01) was significantly higher in Group I as compared to Group II. Six of 13 children (46.2%) with dehiscence in Group I required a diverting colostomy to be made. Females with VF or PF undergoing primary definitive procedure have a significantly higher incidence of wound dehiscence ( P = 0.04), immediate ( P = 0.001) and early postoperative complications ( P = 0.01).

Avascular necrosis of the femoral head; Staging by MR imaging

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Kokubo, Takashi; Takatori, Yoshio; Ninomiya, Setsuo; Sasaki, Yasuhito [Tokyo Univ. (Japan). Faculty of Medicine

1993-03-01

Magnetic resonance (MR) images and conventional radiographs were compared in 142 hips with avascular necrosis, and a staging system for the disease based on MR imaging was developed. MR images were classified into three patterns: a band of low signal intensity (class I); an area of low signal intensity with internal spot(s) of high signal (class II); and an area of low signal intensity without internal spots of high signal (class III). Most MR class I lesions were in radiographic stage I (normal) or II (sclerotic or cystic changes without collapse). Most MR class II lesions were in radiographic stage III (segmental collapse), and most MR class III lesions were in stage III or IV (secondary degenerative changes). The MR image classification was closely correlated with radiographic staging (p<0.01, using [chi] square test). We considered that this classification closely reflected the different stages of the disease according to the histopathology of the bone marrow. (author).

A prospective randomized study of postoperative adjuvant chemo-radiotherapy (CT+RT) vs. radiotherapy(RT) alone in resected stage II and IIIA non-small cell lung cancer (NSCLC)

International Nuclear Information System (INIS)

Chang, Geol Lee; Joo, Hang Kim; Kyung, Young Chung; Doo, Yun Lee; Kil, Dong Kim; Won, Young Lee; Sung, Kyu Kim; Sei, Kyu Kim; Gwi, Eon Kim

1995-01-01

Objective: A prospective randomized study has been conducted to compare the results of treatment between CT+RT and RT alone as an adjuvant setting in completely resected stage II and IIIA NSCLC. Materials and Methods: Patients who had completely resected stage II and IIIA NSCLC were randomized into a CT+RT arm(arm A) and a RT alone arm(arm B) as an adjuvant setting after stratification according to cell type(squamous vs. non-squamous) and stage(II vs. IIIA). CT(Etoposide 100mg/m2 I.V. infusion d1-3, Cisplatin 20mg/m2 I.V. infusion d1-5, total 6cycles) was started in postop. 3 weeks with a 4 weeks interval. RT(5040cGy/5-6wks, 180cGy/fr) was started in postoperative 5 weeks after the first cycle of CT for group A and in postoperative 4 weeks for group B. A total of 69 patients were registered from Sep. 1990 to Jun. 1993. Sixty five of these patients were evaluable because 4 patients were ineligible due to distant metastasis before adjuvant treatment. Two patients who refused adjuvant treatment were included in this study to avoid selection bias. Results: Sixteen patients (48%) have received CT of more than 3 cycles and 51 patients(78%) have received RT of more than 50Gy. Four patients died due to treatment-related complications [broncho-pleural fistula 3(arm A:B=2:1), pneumonia 1(arm A)]. Survival and the patterns of failure are as follows: Conclusion: There is no statistical significance in either the overall survival or the patterns of failure between the CT+RT arm and RT alone arm as an adjuvant setting in resected stage II and IIIA NSCLC

THE APPRAISAL OF ELECTROBIOLOGICAL ACTIVITY OF THE GASTROINTESTINAL TRACT AMONG CHILDREN AND THE SELECTION OF THE DRUG THERAPY

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A.P. Ponomareva

2006-01-01

Full Text Available The method of the peripheral electrogastroenteromyography has been used for appraisal of the motor function among 85 children (44 girls, 41 boys aged between 6 and 15 years old with chronic gastroduodenitis at the stage of recrudescence (I group — 45 children, chronic gastroduodenitis without recrudescence (II group — 20 children, peptic ulcer disease at the stage of recrudescence (III group — 10 children and chronic duodenal obstruction related in most cases to arteriomesen teric compression (iv group — 10 children. Palpable changes in electrogastroentrerography indices were noted only among children with chronic duodenal obstruction and manifested as the increase of electrobiological activity after taking the medication along with the reduction of the indices, which showed the contractive activity itself. Taking of the medications differentially affects the electrogastroentrerography indices: domperidone increases both electro biological activity itself and myo electrical activity, whereas mebeverine decreases them, acting as not only a spasmolysant but also a motility modulator.Key words: electrobiological activity, chronic gastroduo denitis, peptic ulcer disease, children.

Carotid intima-media thickness in children with end-stage renal disease on dialysis.

Science.gov (United States)

Gheissari, A; Sirous, M; Hajzargarbashi, T; Kelishadi, R; Merrikhi, A; Azhir, A

2010-01-01

Cardiovascular morbidity and mortality are common in end stage renal disease (ESRD) patients. There is scarce data on carotid and bulb intima-media thickness (IMT-C and IMT-B) as an early marker of atherosclerosis and related factors in children on hemodialysis (HD) and peritoneal dialysis (PD). Since we did not have enough information about our patients, this study was carried on all ESRD children (hemodialysis and peritoneal dialysis) in a referral center. Data was collected from 16 ESRD children under 18 years with seven patients on PD and nine on HD. Lab tests and biochemical parameters including serum von Willebrand factor (vWF), homocystein, apo lipoprotein A, apo lipoprotein B and quantitative CRP were measured in fasting patients just before initiating dialysis. IMT-C and IMT-B were measured by gray scale ultrasound using 7.5 MHZ probe. The mean of age was 12.76+/-4.5 years. The mean duration of dialysis in HD and PD patients were not significantly different; 11.88+/-3.25 months and 10.14+/-2.4 months respectively. Mean of systolic blood pressure in HD group was significantly higher than PD group, 135.55+/-25.54 mmHg versus 121.42+/-12.14 mmHg, Phomocystein and IMT-C. However, we could not demonstrate any difference between IMT-B in case and control group. After adjusting for age, partial correlation showed significant correlation between IMT-C and following factors: N-PTH and serum alkaline phosphatase. Longitudinal studies with large size samples are needed to clarify the contributing factors with intima-media thickness in ESRD children.

Improved Survival With Radiation Therapy in Stage I-II Primary Mediastinal B Cell Lymphoma: A Surveillance, Epidemiology, and End Results Database Analysis

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Jackson, Matthew W., E-mail: matthew.jackson@ucdenver.edu [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, Colorado (United States); Rusthoven, Chad G.; Jones, Bernard L. [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, Colorado (United States); Kamdar, Manali [Department of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado (United States); Rabinovitch, Rachel [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, Colorado (United States)

2016-01-01

Background: Primary mediastinal B cell lymphoma (PMBCL) is an uncommon lymphoma for which trials are few with small patient numbers. The role of radiation therapy (RT) after standard immunochemotherapy for early-stage disease has never been studied prospectively. We used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate PMBCL and the impact of RT on outcomes. Methods and Materials: We queried the SEER database for patients with stage I-II PMBCL diagnosed from 2001 to 2011. Retrievable data included age, gender, race (white/nonwhite), stage, extranodal disease, year of diagnosis, and use of RT as a component of definitive therapy. Kaplan-Meier overall survival (OS) estimates, univariate (UVA) log-rank and multivariate (MVA) Cox proportional hazards regression analyses were performed. Results: Two hundred fifty patients with stage I-II disease were identified, with a median follow-up time of 39 months (range, 3-125 months). The median age was 36 years (range, 18-89 years); 61% were female; 76% were white; 45% had stage I disease, 60% had extranodal disease, and 55% were given RT. The 5-year OS for the entire cohort was 86%. On UVA, OS was improved with RT (hazard ratio [HR] 0.446, P=.029) and decreased in association with nonwhite race (HR 2.70, P=.006). The 5-year OS was 79% (no RT) and 90% (RT). On MVA, white race and RT remained significantly associated with improved OS (P=.007 and .018, respectively). The use of RT decreased over time: 61% for the 67 patients whose disease was diagnosed from 2001 to 2005 and 53% in the 138 patients treated from 2006 to 2010. Conclusion: This retrospective population-based analysis is the largest PMBCL dataset to date and demonstrates a significant survival benefit associated with RT. Nearly half of patients treated in the United States do not receive RT, and its use appears to be declining. In the absence of phase 3 data, the use of RT should be strongly considered for its survival benefit in early-stage

ColoFinder: a prognostic 9-gene signature improves prognosis for 871 stage II and III colorectal cancer patients

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Mingguang Shi

2016-03-01

Full Text Available Colorectal cancer (CRC is a heterogeneous disease with a high mortality rate and is still lacking an effective treatment. Our goal is to develop a robust prognosis model for predicting the prognosis in CRC patients. In this study, 871 stage II and III CRC samples were collected from six gene expression profilings. ColoFinder was developed using a 9-gene signature based Random Survival Forest (RSF prognosis model. The 9-gene signature recurrence score was derived with a 5-fold cross validation to test the association with relapse-free survival, and the value of AUC was gained with 0.87 in GSE39582(95% CI [0.83–0.91]. The low-risk group had a significantly better relapse-free survival (HR, 14.8; 95% CI [8.17–26.8]; P < 0.001 than the high-risk group. We also found that the 9-gene signature recurrence score contributed more information about recurrence than standard clinical and pathological variables in univariate and multivariate Cox analyses when applied to GSE17536(p = 0.03 and p = 0.01 respectively. Furthermore, ColoFinder improved the predictive ability and better stratified the risk subgroups when applied to CRC gene expression datasets GSE14333, GSE17537, GSE12945and GSE24551. In summary, ColoFinder significantly improves the risk assessment in stage II and III CRC patients. The 9-gene prognostic classifier informs patient prognosis and treatment response.

Predictive value of PET-CT for pathological response in stages II and III breast cancer patients following neoadjuvant chemotherapy with docetaxel.

Science.gov (United States)

García García-Esquinas, Marta A; Arrazola García, Juan; García-Sáenz, José A; Furió-Bacete, V; Fuentes Ferrer, Manuel E; Ortega Candil, Aída; Cabrera Martín, María N; Carreras Delgado, José L

2014-01-01

To prospectively study the value of PET-CT with fluorine-18 fluorodeoxyglucose (FDG) to predict neoadjuvant chemotherapy (NAC) response of locoregional disease of stages II and III breast cancer patients. A written informed consent and approval were obtained from the Ethics Committee. PET-CT accuracy in the prediction of pathologic complete response (pCR) after NAC was studied in primary tumors and lymph node metastasis in 43 women (mean age: 50 years: range: 27-71 years) with histologically proven breast cancer between December 2009 and January 2011. PET-CT was performed at baseline and after NAC. SUV(max) percentage changes (ΔSUV(max)) were compared with pathology findings at surgery. Receiver-operator characteristic (ROC) analysis was used to discriminate between locoregional pCR and non-pCR. In patients not achieving pCR, it was investigated if ΔSUV(max) could accurately identify the residual cancer burden (RCB) classes: RCB-I (minimal residual disease (MRD)), RCB-II (moderate RD), and RCB-III (extensive RD). pCR was obtained in 11 patients (25.6%). Residual disease was found in 32 patients (74.4%): 16 (37.2%) RCB-I, 15 (35.6%) RCB-II and 2 (4.7%) RCB-III. Sensitivity, specificity, and accuracy to predict pCR were 90.9%, 90.6%, and 90.7%, respectively. Specificity was 94.1% in the identification of a subset of patients who had either pCR or MRD. Accuracy of ΔSUV(max) in the locoregional disease of stages II and III breast cancer patients after NAC is high for the identification of pCR cases. Its specificity is potentially sufficient to identify a subgroup of patients who could be managed with conservative surgery. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Factors Associated with Neurodevelopment for Children with Single Ventricle Lesions

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Goldberg, Caren S.; Lu, Minmin; Sleeper, Lynn A.; Mahle, William T.; Gaynor, J. William; Williams, Ismee A.; Mussatto, Kathleen A.; Ohye, Richard G.; Graham, Eric M.; Frank, Deborah U.; Jacobs, Jeffrey P.; Krawczeski, Catherine; Lambert, Linda; Lewis, Alan; Pemberton, Victoria L.; Sananes, Renee; Sood, Erica; Wechsler, Stephanie B.; Bellinger, David C.; Newburger, Jane W.

2014-01-01

Objective To measure neurodevelopment at 3 years in children with single right ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months, and patient and medical factors. Study design All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n=203) and other measures of behavior, and quality of life (QOL) were completed at age 3 years. Medical history, including measures of growth, feeding, and complications, was assessed through annual record review and phone interview. The Bayley Scales of Infant Development-II (BSID-II) scores from age 14 months were also evaluated as predictors. Results Scores on each ASQ domain were significantly lower than normal (p<0.001). ASQ domain scores at 3 years varied nonlinearly with 14-month BSID-II. More complications, abnormal growth, and evidence of feeding, vision, or hearing problems, were independently associated with lower ASQ scores, although models explained < 30% of variation. Shunt type was not associated with any ASQ domain score, or with behavior or QOL measures. Conclusion Children with SV have impaired neurodevelopment at 3 years. Lower ASQ scores are associated with medical morbidity, and lower BSID-II scores, but not with shunt type. However, because only a modest percentage of variation in 3-year neurodevelopmental outcome could be predicted from early measures, all children with SV should be followed longitudinally to improve recognition of delays. PMID:24952712

Validation of the 12-gene colon cancer recurrence score in NSABP C-07 as a predictor of recurrence in patients with stage II and III colon cancer treated with fluorouracil and leucovorin (FU/LV) and FU/LV plus oxaliplatin.

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Yothers, Greg; O'Connell, Michael J; Lee, Mark; Lopatin, Margarita; Clark-Langone, Kim M; Millward, Carl; Paik, Soonmyung; Sharif, Saima; Shak, Steven; Wolmark, Norman

2013-12-20

Accurate assessments of recurrence risk and absolute treatment benefit are needed to inform colon cancer adjuvant therapy. The 12-gene Recurrence Score assay has been validated in patients with stage II colon cancer from the Cancer and Leukemia Group B 9581 and Quick and Simple and Reliable (QUASAR) trials. We conducted an independent, prospectively designed clinical validation study of Recurrence Score, with prespecified end points and analysis plan, in archival specimens from patients with stage II and III colon cancer randomly assigned to fluorouracil (FU) or FU plus oxaliplatin in National Surgical Adjuvant Breast and Bowel Project C-07. Recurrence Score was assessed in 892 fixed, paraffin-embedded tumor specimens (randomly selected 50% of patients with tissue). Data were analyzed by Cox regression adjusting for stage and treatment. Continuous Recurrence Score predicted recurrence (hazard ratio for a 25-unit increase in score, 1.96; 95% CI, 1.50 to 2.55; P < .001), as well as disease-free and overall survival (both P < .001). Recurrence Score predicted recurrence risk (P = .001) after adjustment for stage, mismatch repair, nodes examined, grade, and treatment. Recurrence Score did not have significant interaction with stage (P = .90) or age (P = .76). Relative benefit of oxaliplatin was similar across the range of Recurrence Score (interaction P = .48); accordingly, absolute benefit of oxaliplatin increased with higher scores, most notably in patients with stage II and IIIA/B disease. The 12-gene Recurrence Score predicts recurrence risk in stage II and stage III colon cancer and provides additional information beyond conventional clinical and pathologic factors. Incorporating Recurrence Score into the clinical context may better inform adjuvant therapy decisions in stage III as well as stage II colon cancer.

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

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Haichao Zhou

2017-01-01

Full Text Available Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1 intact foot, (2 flatfoot, and (3 cuboid osteotomy LCL (2, 3, 4, and 5 mm. Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p<.05. Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p=.044 and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p<.05, but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

The influence of pelvic lymph node disease on survival for stage I and II carcinoma of the cervix

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Alcock, C.J.; Toplis, P.J.

1987-01-01

Two hundred and eighteen patients were referred to the Oxford Radiotherapy Department in the 5 years 1973-77 with stages I and II tumours of the uterine cervix. One hundred and eighty-one underwent pre-operative intracavitary radiotherapy followed by Wertheim hysterectomy and pelvic lymphadenectomy. Twenty-three per cent of these patients had metastatic disease in pelvic lymph nodes. Fifty-five per cent of patients with positive pelvic nodes died of carcinoma of the cervix compared with 9% of negative node cases. Prognostic factors are discussed and management of carcinoma of the cervix reviewed. (author)

Survival prognostic value of morphological and metabolic variables in patients with stage I and II non-small cell lung cancer

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Domachevsky, L. [Rabin Medical Center, Department of Nuclear Medicine, Petah Tikva (Israel); Beilinson Hospital, Petah Tikva (Israel); Groshar, D.; Bernstine, H. [Rabin Medical Center, Department of Nuclear Medicine, Petah Tikva (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Galili, R. [Lady Davis-Carmel Medical Center, Department of Cardiothoracic Surgery, Haifa (Israel); Saute, M. [Rabin Medical Center, Department of Cardiothoracic Surgery, Petah Tiqva (Israel)

2015-11-15

The prognosis of patients with non-small cell lung cancer (NSCLC) is important, as patients with resectable disease and poor prognostic variables might benefit from neoadjuvant therapy. The goal of this study is to evaluate SUVmax, SUVmax ratio, CT volume (CTvol), metabolic tumour volume (MTV) and total lesion glycolisis (TLG) as survival prognostic markers. In addition, we defined two variables; MTV x SUVmax (MTVmax) and CTvol x SUVmax (CTvolmax) and assessed whether they can be used as prognostic markers. Patients with stage I-II NSCLC who underwent 18 F FDG PET/CT and surgery were evaluated. Cox proportional-hazard model was used to determine the association between variables and survival. Similar analysis was performed in cases with no lymph node (LN) involvement. One hundred and eighty-one patients were included (at the end of the study, 140 patients were alive). SUVmax with a cut-off value of 8.2 was significant survival prognostic factor regardless of LN involvement (P = 0.012). In cases with no LN involvement, SUVmax and CTvol (≥7.1 ml) were significant survival prognostic factors with P = 0.004 and 0.03, respectively. SUVmax may be a useful prognostic variable in stage I-II NSCLC while morphologic tumour volume might be useful in cases with no lymph node involvement. (orig.)

Developmental steps of the human cervical spine: parameters for evaluation of skeletal maturation stages.

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dos Santos, Marcos Fabio Henriques; de Lima, Rodrigo Lopes; De-Ary-Pires, Bernardo; Pires-Neto, Mário Ary; de Ary-Pires, Ricardo

2010-06-01

The central objective of this investigation was to focus on the development of the cervical spine observed by lateral cephalometric radiological images of children and adolescents (6-16 years old). A sample of 26 individuals (12 girls and 14 boys) was classified according to stages of cervical spine maturation in two subcategories: group I (initiation phase) and group II (acceleration phase). The morphology of the cervical spine was assessed by lateral cephalometric radiographs obtained in accordance with an innovative method for establishing a standardized head posture. A total of 29 linear variables and 5 angular variables were used to clarify the dimensions of the cervical vertebrae. The results suggest that a few measurements can be used as parameters of vertebral maturation both for males and females. The aforementioned measurements include the inferior depth of C2-C4, the inferior depth of C5, the anterior height of C4-C5, and the posterior height of C5. We propose original morphological parameters that may prove remarkably useful in the determination of bone maturational stages of the cervical spine in children and adolescents.

Tissue expander-stimulated lengthening of arteries for the treatment of midaortic syndrome in children.

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Kim, Heung Bae; Vakili, Khashayar; Ramos-Gonzalez, Gabriel J; Stein, Deborah R; Ferguson, Michael A; Porras, Diego; Lock, James E; Chaudry, Gulraiz; Alomari, Ahmad; Fishman, Steven J

2018-01-17

Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experience with a novel approach using a tissue expander (TE) to lengthen the normal native arteries in children with MAS, allowing primary aortic repair without the need for prosthetic graft material. We conducted a retrospective review of patients with MAS undergoing the TE-stimulated lengthening of arteries (TESLA) procedure at our institution from 2010 to 2014. Data are presented as mean (range). Five patients aged 4.8 years (3-8 years) underwent the TESLA procedure. Stages of this procedure include the following: stage I, insertion of retroaortic TE; stage II, serial TE injections; and stage III, final repair with excision of aortic stenosis and primary end-to-end aortic anastomosis. Stage II was completed in 4 months (1-9 months) with 12 (7-20) TE injections. Goal lengthening was achieved in all patients. Stage III could not be completed in one patient because of extreme aortic inflammation, which precluded safe excision of the aortic stenosis and required use of a prosthetic bypass graft. The other four patients completed stage III with two (one to three) additional vessels also requiring reconstruction (renal or mesenteric arteries). At 3.2 years (1-6 years) of follow-up, all patients are doing well. The TESLA procedure allows surgical correction of MAS without the need for prosthetic grafts in young children who are still growing. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Site of relapse after chemotherapy alone for stage I and II Hodgkin's disease

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Shahidi, Mehdi; Kamangari, Nahid; Ashley, Sue; Cunningham, David; Horwich, Alan

2006-01-01

Background: Short course chemotherapy followed by radiotherapy is a standard treatment for early Hodgkin's disease. There is yet no consensus regarding the appropriate radiotherapy portal following chemotherapy. A good guide to the adjuvant radiotherapy field is the site of relapse in patients treated with chemotherapy alone. Patients and methods: From 1980 to 1996, 61 patients with stage I and II supradiaphragmatic Hodgkin's disease were treated with chemotherapy alone at the Royal Marsden Hospital. We undertook a retrospective review and failure analysis to define the pattern of recurrence. Results: After a median follow-up of 6.5 years, 24 patients had relapsed giving a 5-year relapse rate of 40%. The 5 and 10-year actuarial survival rates were 94 and 89%, respectively with cause-sepecific survival being 94% at 5 and 10 years. Two-thirds of the relapses were nodal and supradiaphragmatic. Twenty patients (83%) relapsed in the initially involved sites of disease and this was the sole site of recurrence in 11 (45%) of patients. In retrospect, it appeared that at least 12 recurrences could have been prevented by involved field radiotherapy. Review of detailed imaging data (available in 9 out of 11 patients with recurrences in initial sites of disease) showed that the relapses were always in the initially involved nodes. Conclusion: After chemotherapy alone in early stage HD most initial recurrences are nodal. Loco-regional recurrences are in the originally involved nodes. Based on limited data it appears that involved nodal RT is equivalent to involved field radiotherapy and may halve the risk of recurrence

Glycogen storage disease type II (Pompe disease in children

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A. N. Semyachkina

2014-01-01

Full Text Available The paper gives the data available in the literature, which reflect the manifestations, diagnosis, and current treatments of the rare (orphan inherited disease glycogen storage disease type II or Pomp disease in children, as well as its classification. The infant form is shown to be most severe, resulting in death from cardiovascular or pulmonary failure generally within the first year of a child’s life. Emphasis is laid on major difficulties in the differential and true diagnosis of this severe disease. Much attention is given to the new pathogenetic treatment — genetically engineered enzyme replacement drug Myozyme®. The authors describe their clinical case of a child with the juvenile form of glycogen storage disease type II (late-onset Pompe disease. Particular emphasis is laid on the clinical symptoms of the disease and its diagnostic methods, among which the morphological analysis of a muscle biopsy specimen by light and electron microscopies, and enzyme and DNA diagnoses are of most importance. The proband was found to have significant lysosomal glycogen accumulation in the muscle biopsy specimen, reduced lymphocyte acid α-1,4-glucosidase activity to 4,2 nM/mg/h (normal value, 13,0—53,6 nM/mg/h, described in the HGMD missense mutation database from 1000 G>A p.Gly334er of the GAA in homozygous state, which verified the diagnosis of Pompe disease. 

An open-label, two-stage, phase II study of bevacizumab and lapatinib in children with recurrent or refractory ependymoma: a collaborative ependymoma research network study (CERN).

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DeWire, Mariko; Fouladi, Maryam; Turner, David C; Wetmore, Cynthia; Hawkins, Cynthia; Jacobs, Carmen; Yuan, Ying; Liu, Diane; Goldman, Stewart; Fisher, Paul; Rytting, Michael; Bouffet, Eric; Khakoo, Yasmin; Hwang, Eugene I; Foreman, Nicholas; Stewart, Clinton F; Gilbert, Mark R; Gilbertson, Richard; Gajjar, Amar

2015-05-01

Co-expression of ERBB2 and ERBB4, reported in 75% of pediatric ependymomas, correlates with worse overall survival. Lapatinib, a selective ERBB1 and ERBB2 inhibitor has produced prolonged disease stabilization in patients with ependymoma in a phase I study. Bevacizumab exposure in ependymoma xenografts leads to ablation of tumor self-renewing cells, arresting growth. Thus, we conducted an open-label, phase II study of bevacizumab and lapatinib in children with recurrent ependymomas. Patients ≤ 21 years of age with recurrent ependymoma received lapatinib orally twice daily (900 mg/m(2)/dose to the first 10 patients, and then 700 mg/m(2)/dose) and bevacizumab 10 mg/kg intravenously on days 1 and 15 of a 28-day course. Lapatinib serum trough levels were analyzed prior to each course. Total and phosphorylated VEGFR2 expression was measured in peripheral blood mononuclear cells (PBMCs) before doses 1 and 2 of bevacizumab and 24-48 h following dose 2 of bevacizumab. Twenty-four patients with a median age of 10 years (range 2-21 years) were enrolled; 22 were eligible and 20 evaluable for response. Thirteen had anaplastic ependymoma. There were no objective responses; 4 patients had stable disease for ≥ 4 courses (range 4-14). Grade 3 toxicities included rash, elevated ALT, and diarrhea. Grade 4 toxicities included peri-tracheostomy hemorrhage (n = 1) and elevated creatinine phosphokinase (n = 1). The median lapatinib pre-dose trough concentration was 3.72 µM. Although the combination of bevacizumab and lapatinib was well tolerated in children with recurrent ependymoma, it proved ineffective.

Causes and outcome of late referral of children who develop end-stage kidney disease.

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Kennedy, Sean E; Bailey, Rohan; Kainer, Gad

2012-03-01

This study aims to characterise the timing of referral to a paediatric nephrology unit of children who develop end-stage kidney disease (ESKD). This study also aims to determine whether late referral (LR) influences outcomes and to explore factors that may lead to LR. A retrospective case review of all incident patients with ESKD who received renal replacement therapy (RRT) at a single paediatric centre. Time between referral to a paediatric nephrologist and commencement of RRT, demographic and clinical data were collated. Estimated glomerular filtration rate (eGFR) at referral was calculated using height and creatinine. LR was defined as having an eGFR ≤ 30 mL/min/1.73 m(2) when first seen by a paediatric nephrologist. RRT was initiated for 74 patients Children referred before age 1 year (41%) had a more prolonged course before ESKD. Median (interquartile range) eGFR at referral of children > 1 year was 27.2 (9.0-52.0) mL/min/1.73 m(2) . Twenty-two (55%) of these children were referred late (LR) with an eGFR ≤ 30 mL/min/1.73 m(2) . LR patients were more likely to have glomerulonephritis or haemolytic uraemic syndrome and to live in a remote or outer regional area. LR patients had higher urea, lower haemoglobin and were more likely to receive haemodialysis via a vascular catheter. A significant proportion of children who develop ESKD are referred late to nephrology units with potentially preventable complications. Aetiology of renal disease and geographic isolation contribute to LR. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study.

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Taylor, Fiona G M; Quirke, Philip; Heald, Richard J; Moran, Brendan; Blomqvist, Lennart; Swift, Ian; Sebag-Montefiore, David J; Tekkis, Paris; Brown, Gina

2011-04-01

To assess local recurrence, disease-free survival, and overall survival in magnetic resonance imaging (MRI)-predicted good prognosis tumors treated by surgery alone. The MERCURY study reported that high-resolution MRI can accurately stage rectal cancer. The routine policy in most centers involved in the MERCURY study was primary surgery alone in MRI-predicted stage II or less and in MRI "good prognosis" stage III with selective avoidance of neoadjuvant therapy. Data were collected prospectively on all patients included in the MERCURY study who were staged as MRI-defined "good" prognosis tumors. "Good" prognosis included MRI-predicted safe circumferential resection margins, with MRI-predicted T2/T3a/T3b (less than 5 mm spread from muscularis propria), regardless of MRI N stage. None received preoperative or postoperative radiotherapy. Overall survival, disease-free survival, and local recurrence were calculated. Of 374 patients followed up in the MERCURY study, 122 (33%) were defined as "good prognosis" stage III or less on MRI. Overall and disease-free survival for all patients with MRI "good prognosis" stage I, II and III disease at 5 years was 68% and 85%, respectively. The local recurrence rate for this series of patients predicted to have a good prognosis tumor on MRI was 3%. The preoperative identification of good prognosis tumors using MRI will allow stratification of patients and better targeting of preoperative therapy. This study confirms the ability of MRI to select patients who are likely to have a good outcome with primary surgery alone.

Quality of life in children and adolescents with chronic kidney disease: a comparative study between different disease stages and treatment modalities.

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Kul, Müslüm; Cengel Kültür, Ebru; Senses Dinç, Gülser; Bilginer, Yelda; Uluç, Sait; Baykan, Hayriye

2013-01-01

This study aimed to compare the quality of life of children and adolescents in various stages of their chronic kidney disease (CKD) who were managed with different treatment modalities to that of children and adolescents without any chronic disease. The study included 18 renal transplant and 21 dialysis patients (8 on hemodialysis, 13 on peritoneal dialysis) and 16 patients who did not yet require renal replacement therapy. The control group consisted of 37 children without any chronic disease. Psychosocial Health Summary scores, Physical Health Summary scores, and Total Scale scores of Pediatric Quality of Life Inventory scores were estimated for the groups. CKD patients had lower scores in all scales of Pediatric Quality of Life Inventory than the control group. There were no differences in self-reported scores on the Pediatric Quality of Life scale scores between treatment groups; however, parents of the transplant patients had reported higher (more favorable) Physical Health Summary scores than those of the dialysis patients. Reports of parents and their children differed only in Physical Health Summary scores in the dialysis group; self-reports of the children were more favorable. These findings show that children and adolescents with CKD experience impaired quality of life on the physical and psychosocial functioning domains in comparison with healthy controls. The study findings implicate the need for further studies to investigate the quality of life in CKD patients at different stages as well as the perceptional differences between pediatric and adolescent CKD patients and caregiver proxy-reports about their quality of life.

Bone radioisotope scanning: usefulness in the evaluation and observation of patients with breast cancer in clinical stage II, III, IV

International Nuclear Information System (INIS)

Cano P, R.A.

1995-01-01

The clinical records of 420 patients with diagnosis of breast cancer well documented by the pathological anatomy in clinical stage II, III and IV were reviewed. In each one of them has been done at least a bone scanning during the diagnosis. In 52 cases carried out sericeous dosages of CA 15-3 and in some cases it was necessary to administer Samarium-153 EDTMP as palliative therapy of bone pain. The presence of secondary gamma-graphic focuses was 0/84 cases (0%) in clinical stage II, 54/265 cases (20%) in III and 41/91 cases (45%) in IV. The one focus appeared in 6.7% of the cases. In 7 of the 52 cases that received sericeous dosages of CA 15-3 were detected secondary osseous lesions, and 5 of them presented a marker elevation. The bone scanning has shown in many cases the presence of getters focuses in singular places of skeleton, urinary excretory system or mammary tissue. The gamma rays from Sm-153 allowed us to get some appropriate basal views post-therapy of the secondary lesions. The results show that the great incidence of secondary lesions in the skeleton occurred in cases of stages III and IV unlike other countries. The serial repetition of the radioisotope scanning. The presence of one focus in the skeleton of a patient with a well-known neoplasia makes us to do a careful evaluation of the focus nature. The presence of tracer accumulation in the kidney, ureter and bladder allows us to infer the pathology of excretory system that is the first evidence of its presence in many cases. (author). 71 refs., 7 figs., 6 tabs

Streets and stages: urban renewal and the arts after World War II.

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Foulkes, Julia L

2010-01-01

Lincoln Center for the Performing Arts in Manhattan and the revitalization of the Brooklyn Academy of Music in Brooklyn offer insights into the intersection of arts and urbanization after World War II. This intra-city comparison shows the aggrandizing pull of the international arena in the shaping of Lincoln Center and the arts it featured in contrast to the local focus and debate that transformed how BAM fit into its Brooklyn neighborhood. The performing arts, bound as they are to a moment fused in space and time, reveal the making of place within grandiose formal buildings as well as outside on the streets that surround them—and it is, perhaps, that tensile connection between stages and streets that informs the relevancy of both the institution and the arts it features. At a time when the suburbs pulled more and more people, the arts provided a counterforce in cities, as magnet and stimulus. The arts were used as compensation for the demolition and re-building of a neighborhood in urban renewal, but they also exposed the more complex social dynamics that underpinned the transformation of the mid-20th century American city from a segregated to a multi-faceted place.

Endoscope-Assisted and Controlled Argus II Epiretinal Prosthesis Implantation in Late-Stage Retinitis Pigmentosa: A Report of 2 Cases.

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Özmert, Emin; Demirel, Sibel

2016-01-01

Several different approaches for restoring sight in subjects who are blind due to outer retinal degeneration are currently under investigation, including stem cell therapy, gene therapy, and visual prostheses. Although many different types of visual prostheses have shown promise, to date, the Argus II Epiretinal Prosthesis System, developed in a clinical setting over the course of 10 years, is the world's first and only retinal prosthesis that has been approved by the United States Food and Drug Administration (FDA) and has been given the CE-Mark for sale within the European Economic Area (EEA). The incidence of serious adverse events from Argus II implantation decreased over time after minor changes in the implant design and improvements in the surgical steps used for the procedure had been made. In order to further decrease the scleral incision-related complications and enhance the assessment of the tack position and the contact between the array and the inner macular surface, we used an ophthalmic endoscope during the regular course of Argus II implantation surgery in 2 patients with late-stage retinitis pigmentosa in an attempt to improve the anatomical and functional outcomes.

Endoscope-Assisted and Controlled Argus II Epiretinal Prosthesis Implantation in Late-Stage Retinitis Pigmentosa: A Report of 2 Cases

Directory of Open Access Journals (Sweden)

Emin Özmert

2016-12-01

Full Text Available Several different approaches for restoring sight in subjects who are blind due to outer retinal degeneration are currently under investigation, including stem cell therapy, gene therapy, and visual prostheses. Although many different types of visual prostheses have shown promise, to date, the Argus II Epiretinal Prosthesis System, developed in a clinical setting over the course of 10 years, is the world’s first and only retinal prosthesis that has been approved by the United States Food and Drug Administration (FDA and has been given the CE-Mark for sale within the European Economic Area (EEA. The incidence of serious adverse events from Argus II implantation decreased over time after minor changes in the implant design and improvements in the surgical steps used for the procedure had been made. In order to further decrease the scleral incision-related complications and enhance the assessment of the tack position and the contact between the array and the inner macular surface, we used an ophthalmic endoscope during the regular course of Argus II implantation surgery in 2 patients with late-stage retinitis pigmentosa in an attempt to improve the anatomical and functional outcomes.

Outcome of patients with stage III or inoperable WT treated on the second United Kingdom WT protocol (UKWT2); a United Kingdom Children's Cancer Study Group (UKCCSG) study.

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Grundy, R G; Hutton, C; Middleton, H; Imeson, J; Pritchard, J; Kelsey, A; Marsden, H B; Vujanic, G M; Taylor, R E

2004-04-01

The aims of UKWT2 included consolidating the results for stage III patients obtained in UKWT1 and improving the outcome for patients with inoperable tumours by giving vincristine, actinomycin-D and doxorubicin in an intensive schedule (Intensive AVA). The second UK WT trial (UKWT2) ran between July 1986 and September 1991 accruing 448 patients. One hundred and six patients were diagnosed and treated for stage III disease. Six had clear cell sarcoma of the kidney (CCSK) and seven had rhabdoid tumours of the kidney (RTK) and are analysed separately. One other patient was excluded from overall analysis. Ninety-two patients were followed for a median of 115 months. Seventy-five received standard chemotherapy and abdominal radiotherapy according to protocol. Seventeen had stage III disease at immediate nephrectomy, but radiotherapy was omitted by physician choice. Thirty-three patients had inoperable disease at diagnosis and received pre-nephrectomy chemotherapy. Overall survival (OS) at 4 years for stage III favourable histology (FH) patients receiving abdominal RT was 83% (CI: 73-89). For children with stage III disease in whom RT was omitted the OS was 82% (CI: 59-97) and for inoperable disease 94% (CI: 78-98). The overall and event-free survival (EFS) of children with stage III CCSK was 100% and was achieved with the majority of patients not receiving radiotherapy (CI: 48-100). Three of seven children with RTK are alive EFS and OS 43% (CI: 10-73). For patients treated by abdominal radiotherapy the overall local control rate was 94.4% (CI: 86.4-98.5*%), 96.7% (CI: 88.5-99.6%) for flank RT and 83.3% (51.6-98.0%) for whole abdominal radiotherapy (WRT). The outcome for stage III FH disease was similar to that reported for UKWT1 and NWTS-3. The combination of abdominal RT together with 3-drug chemotherapy achieves a high abdominal tumour control rate. Flank RT is probably sufficient for localised tumour rupture. The high cure rates for children in this trial with

Intensity-modulated radiation therapy followed by GDP chemotherapy for newly diagnosed stage I/II extranodal natural killer/T cell lymphoma, nasal type.

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Huang, Yu; Yang, Jianliang; Liu, Peng; Zhou, Shengyu; Gui, Lin; He, Xiaohui; Qin, Yan; Zhang, Changgong; Yang, Sheng; Xing, Puyuan; Sun, Yan; Shi, Yuankai

2017-09-01

Extranodal natural killer (NK)/T cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and the majority of ENKTL cases are diagnosed at the localized stage. Radiotherapy in combination with chemotherapy has been used for localized ENKTL, but the optimal combination treatment modality and the best first-line chemotherapy regimen have not been defined. In this retrospective study, 44 patients with newly diagnosed, stages I/II ENKTL were enrolled and received intensity-modulated radiation therapy (IMRT, 50-56 Gy) followed by GDP (gemcitabine, dexamethasone, and cisplatin) chemotherapy. The median number of chemotherapy cycles per patient was 4 (range, 2-6 cycles). At the end of treatment, the overall response rate was 95% (42/44), including 39 patients (89%) who attained complete response. Two patients developed systemic progression after IMRT. With a median follow-up of 37.5 months, the 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 85% (95% CI, 74 to 96%) and 77% (95% CI, 64 to 91%), respectively. Locoregional and systemic failure rates for this treatment were 9% (4/44) and 14% (6/44), respectively. The most common grades 3 to 4 adverse events included leukopenia (37%), neutropenia (34%), and mucositis (25%). No treatment-related deaths were observed. This study suggested high efficacy and low toxicity of IMRT followed by GDP regimen chemotherapy for newly diagnosed stage I/II ENKTL patients. These results require further investigation in prospective trials.

[Application of lateral malleolus hook-plate in treatment of stage II supination-adduction type medial malleolus fracture].

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Chen, Yu; Zhang, Hui; Huang, Fuguo; Xiang, Zhuo; Fang, Yue; Liu, Lei; Cen, Shiqiang

2014-09-01

To investigate the application of lateral malleolus hook-plate for the treatment of stage II supination-adduction type medial malleolus fractures. Between January 2011 and June 2013, 21 patients with stage II supination-adduction type ankle fractures were treated with lateral malleolus hook-plate, including 12 males and 9 females with an average age of 55.5 years (range, 27-65 years). The injury causes were sprain in 17 cases and traffic accident in 4 cases. The mean time between injury and admission was 12.4 hours (range, 2-72 hours). The tibial distal medial articular surface collapse was found in 7 cases by CT examination and in 3 cases by X-ray film. Of 21 cases, there were 12 cases of low transverse fractures of lateral malleolus, 7 cases of short oblique fractures of lateral malleolus, and 2 cases of ankle joint lateral collateral ligament injury without fractures of lateral malleolus. After operation, the clinical outcome was evaluated according to the talus-leg angle, the recovery of Coin-sign continuity, inside-outside and top ankle gap, talus slope, American Orthopedic Foot and Ankle Society (AOFAS) score, Olerud-Molander score, Kofoed evaluation standards, and patient satisfaction. Seventeen cases were followed up 18.7 months on average (range, 12-25 months). Primary healing was obtained in 16 cases except 1 case of delayed healing. Fracture healed at an average of 14.6 weeks (range, 12-16 weeks). All cases achieved anatomical reduction, the continuity of Coin-sign, and consistency of inside and outside joint gap; no talus tilt occurred. There was no complication of reduction loss, loosening or breakage of internal fixation, or osteoarthritis during follow-up. The talus-leg angle of the affected side was significantly improved to (83.4 ± 1.8)° at 1 week after operation from preoperative (74.8 ± 7.1)° (t = 5.370, P = 0.000), but no significant difference was found when compared with normal side (83.8 ± 2.3)° (t = 0.676, P = 0.509). The AOFAS score

MR staging accuracy for endometrial cancer based on the new FIGO stage

International Nuclear Information System (INIS)

Shin, Kyung Eun; Park, Byung Kwan; Kim, Chan Kyo; Bae, Duk Soo; Song, Sang Yong; Kim, Bohyun

2011-01-01

Background: Magnetic resonance imaging (MRI) has been frequently used to determine a preoperative treatment plan for gynecologic cancers. However, the MR accuracy for staging an endometrial cancer is not satisfactory based on the old FIGO staging system. Purpose: To evaluate MR accuracy for staging endometrial cancer using the new FIGO staging system. Material and Methods: Between January 2005 and May 2009, 199 women underwent surgery due to endometrial cancer. In each patient, an endometrial cancer was staged using MR findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparison. Histopathologic findings were used as a standard of reference. Results: The accuracy of MRI in the staging of endometrial carcinoma stage I, II, III, and IV using the old FIGO staging system were 80% (159/199), 89% (178/199), 90% (179/199), and 99% (198/199), respectively, compared to 87% (174/199), 97% (193/199), 90% (179/199), and 99% (198/199), respectively, when using the new FIGO staging criteria. The overall MR accuracy of the old and new staging systems were 51% (101/199) and 81% (161/199), respectively. Conclusion: MRI has become a more useful tool in the preoperative staging of endometrial cancers using the new FIGO staging system compared to the old one with increased accuracy

A multigene prognostic assay for selection of adjuvant chemotherapy in patients with T3, stage II colon cancer: impact on quality-adjusted life expectancy and costs.

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Hornberger, John; Lyman, Gary H; Chien, Rebecca; Meropol, Neal J

2012-12-01

Uncertainty exists regarding appropriate and affordable use of adjuvant chemotherapy in stage II colon cancer (T3, proficient DNA mismatch repair). This study aimed to estimate the effectiveness and costs from a US societal perspective of a multigene recurrence score (RS) assay for patients recently diagnosed with stage II colon cancer (T3, proficient DNA mismatch repair) eligible for adjuvant chemotherapy. RS was compared with guideline-recommended clinicopathological factors (tumor stage, lymph nodes examined, tumor grade, and lymphovascular invasion) by using a state-transition (Markov) lifetime model. Data were obtained from published literature, a randomized controlled trial (QUick And Simple And Reliable) of adjuvant chemotherapy, and rates of chemotherapy use from the National Cooperative Cancer Network Colon/Rectum Cancer Outcomes study. Life-years, quality-adjusted life expectancy, and lifetime costs were examined. The RS is projected to reduce adjuvant chemotherapy use by 17% compared with current treatment patterns and to increase quality-adjusted life expectancy by an average of 0.035 years. Direct medical costs are expected to decrease by an average of $2971 per patient. The assay was cost saving for all subgroups of patients stratified by clinicopathologic factors. The most influential variables affecting treatment decisions were projected years of life remaining, recurrence score, and patients' disutilities associated with adjuvant chemotherapy. Use of the multigene RS to assess recurrence risk after surgery in stage II colon cancer (T3, proficient DNA mismatch repair) may reduce the use of adjuvant chemotherapy without decreasing quality-adjusted life expectancy and be cost saving from a societal perspective. These findings need to be validated in additional cohorts, including studies of clinical practice as assay use diffuses into nonacademic settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR

Duration of the peak of adolescent growth spurt in class i and ii malocclusion subjects using a cervical vertebrae maturation analysis.

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Salazar-Lazo, Rodrigo; Arriola-Guillén, Luis E; Flores-Mir, Carlos

2014-01-01

The aim of the present work was to determine the duration of the adolescent peak growth spurt using cervical vertebral maturation analysis in class I and II malocclusion subjects. The study was conducted on a sample which consisted of 154 lateral cephalograms of children and adolescents aged 9-15 years (84 females and 70 males). The evaluation of skeletal maturation stage was performed using a visual morphological analysis of CS3 and CS4 cervical vertebrae. The sagittal skeletal relation was evaluated according to Steiner analysis. Descriptive statistics were used to summarize chronological age in each malocclusion group and for each CS3 and CS4 skeletal maturation stage. Due to a lack of normal distribution, comparisons of CS3 and CS4 age intervals on class I and II subjects were compared using the Mann-Whitney U test for independent samples. The results show that the mean duration of the adolescent peak growth spurt was 10 months between CS3 and CS4 stages in class I malocclusion subjects, whereas in class II malocclusion patients the duration was 6 months. This difference of 4 months was statistically significant (p<0.001). Finally, a clinically significant difference of 4 months in the duration of the adolescent peak growth spurt for class I and II malocclusion subjects was identified.

Role of Postmastectomy Radiation After Neoadjuvant Chemotherapy in Stage II-III Breast Cancer

International Nuclear Information System (INIS)

Fowble, Barbara L.; Einck, John P.; Kim, Danny N.; McCloskey, Susan; Mayadev, Jyoti; Yashar, Catheryn; Chen, Steven L.; Hwang, E. Shelley

2012-01-01

Purpose: To identify a cohort of women treated with neoadjuvant chemotherapy and mastectomy for whom postmastectomy radiation therapy (PMRT) may be omitted according to the projected risk of local-regional failure (LRF). Methods and Materials: Seven breast cancer physicians from University of California cancer centers created 14 hypothetical clinical case scenarios, identified, reviewed, and abstracted the available literature (MEDLINE and Cochrane databases), and formulated evidence tables with endpoints of LRF, disease-free survival, and overall survival. Using the American College of Radiology appropriateness criteria methodology, appropriateness ratings for postmastectomy radiation were assigned for each scenario. Finally, an overall summary risk assessment table was developed. Results: Of 24 sources identified, 23 were retrospective studies from single institutions. Consensus on the appropriateness rating, defined as 80% agreement in a category, was achieved for 86% of the cases. Distinct LRF risk categories emerged. Clinical stage II (T1-2N0-1) patients, aged >40 years, estrogen receptor-positive subtype, with pathologic complete response or 0-3 positive nodes without lymphovascular invasion or extracapsular extension, were identified as having ≤10% risk of LRF without radiation. Limited data support stage IIIA patients with pathologic complete response as being low risk. Conclusions: In the absence of randomized trial results, existing data can be used to guide the use of PMRT in the neoadjuvant chemotherapy setting. Using available studies to inform appropriateness ratings for clinical scenarios, we found a high concordance of treatment recommendations for PMRT and were able to identify a cohort of women with a low risk of LRF without radiation. These low-risk patients will form the basis for future planned studies within University of California Athena Breast Health Network.

Values of some topographic parameters of optic nerve head obtained by Heidelberg retina tomograph II in volunteers and different stage primary open-angle glaucoma patients

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B. Anguelov

2013-01-01

Full Text Available Purpose: То assess the values of the top five topographic parameters of optic nerve head (ONH obtained by Heidelberg retina tomograph (HRT II in volunteers and primary open angle glaucoma (POAG patients with different stage of perimetric changes.Methods: 73 eyes (38 volunteers at the age of 56 years ±13, 11 men and 27 women and 170 eyes (90 patients at the age of 66 years ±12, 33 men and 57 women were examined. We performed the comprehensive ophthalmic examination, standard automated perimetry and measurement of the top five topographic parameters of ONH — rim area, rim volume, cup shape measure, height variation contour и mean RNFL thickness. For the purpose of this study we used HRT II.Results: We determine the values of the investigated topographic parameters of the ONH for healthy volunteers (rim area = 1.68±0.22 mm2, rim volume = 0.44±0.07 mm3, cup shape measure = –0.2±0.06, height variation contour = 0.38±0.08 mm and mean RNFL thickness = 0.24±0.03 mm and for the patients in different perimetric glaucoma stages (early stage: rim area = 1.52±0.47 mm2, rim volume = 0.38±0.17 mm3, cup shape measure = –0.14±0.1, height variation contour = 0.36±0.09 mm and mean RNFL thickness = 0.22±0.11 mm; moderate stage: rim area = 1.21±0.46 mm2, rim volume = 0.27±0.17 mm3, cup shape measure = –0.09±0.1, height variation contour = 0.36±0.17 mm and mean RNFL thickness = 0.16±0.12 mm; severe stage: rim area = 0.97±0.01 mm2, rim volume = 0.18±0.17 mm3, cup shape measure = –0.06±0.1, height variation contour = 0.28±0.11 mm and mean RNFL thickness = 0.17±0.11 mm. Hodapp-Parrish-Anderson (H-P-A ’s staging system includes three separate levels (early, moderate and severe of glaucoma according to visual field defects. Each stage is additionally characterized by the values of the top five topographic parameters of the ONH.Conclusion: Early diagnosis, staging and follow-up of POAG are based on both function and

Detection of Serum Protein Biomarkers for the Diagnosis and Staging of Hepatoblastoma

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Wei Zhao

2015-06-01

Full Text Available The present study aimed to identify serum biomarkers for the detection of hepatoblastoma (HB. Serum samples were collected from 71 HB patients (stage I, n = 19; stage II, n = 19, stage III, n = 19; and stage IV, n = 14 and 23 age- and sex-matched healthy children. Differential expression of serum protein markers were screened using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS, and the target proteins were isolated and purified using HPLC and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS, SEQUEST, and bioinformatics analysis. Differential protein expression was confirmed by enzyme-linked immunosorbent analysis (ELISA. SELDI-TOF-MS screening identified a differentially expressed protein with an m/z of 9348 Da, which was subsequently identified as Apo A–I; its expression was significantly lower in the HB group as compared to the normal control group (1546.67 ± 757.81 vs. 3359.21 ± 999.36, respectively; p < 0.01. Although the expression level decreased with increasing disease stage, pair-wise comparison revealed significant differences in Apo A–I expression between the normal group and the HB subgroups (p < 0.01. ELISA verified the reduced expression of Apo A–I in the HB group. Taken together, these results suggest that Apo A–I may represent a serum protein biomarker of HB. Further studies will assess the value of using Apo A–I expression for HB diagnosis and staging.

Cognitive impairment is associated with Hoehn and Yahr stages in early, de novo Parkinson disease patients.

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Siciliano, Mattia; De Micco, Rosa; Trojano, Luigi; De Stefano, Manuela; Baiano, Chiara; Passaniti, Carla; De Mase, Antonio; Russo, Antonio; Tedeschi, Gioacchino; Tessitore, Alessandro

2017-08-01

The relationship between motor impairment and cognitive deterioration has long been described in Parkinson's disease (PD). The aim of the study was to compare cognitive performance of de novo PD patients in relation to the motor impairment severity according to Hoehn and Yahr (HY) stages. Forty de novo PD patients at HY stage I and 40 patients at HY stage II completed a standardized neuropsychological battery. A multivariate analysis of covariance was used to compare cognitive performance between HY groups. Odds ratios (ORs) were employed to explore the risk of cognitive impairment between HY stages. Finally, the prevalence of mild cognitive impairment (MCI) was estimated for patients in HY stage I and II. Patients at HY stage I obtained better scores on neuropsychological tests than patients at HY stage II (p = 0.001). Univariate analysis of covariance revealed significant differences between HY stages on Rey's auditory verbal learning test -immediate recall (p cognitive impairment were greater for HY stage II than stage I group. MCI occurred in 7.5% of patients in HY stage I, and in 42.5% of patients in HY stage II. In de novo PD patients, the severity of motor impairment at the diagnosis is associated to cognitive deficits and higher risk of MCI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interpretation of electrocardiographic, echocardiographic and biochemical findings during different stages of Canine Visceral Leishmaniasis

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Ural K

2017-09-01

Full Text Available Objective. The purpose of the present study was to test the hypothesis that cardiac alterations participate within different stages of CVL. Materials and methods. Twenty-eight dogs were diagnosed with CVL, were classified [based on clinical signs, rapid ELISA/IFAT, hematological and serum biochemical tests, urinary protein/creatinine ratio, ECG and ECHO]. as follows; group I (mild disease, group II (moderate disease, group III (severe disease, group IV (very severe disease and group V included healthy controls. Results. Ig G antibodies against leishmaniasis as tested by IFAT, were deemed 1/64 to 1/16000 among infected groups. There were statistical significance regarding mean values for WBC [among healthy control group (V. and other groups (p=0.049], RBC [among stage III-stage IV and other groups (p=0.001], Hb [between stage I and stage III-stage IV (p=0.008, HCT [between stage I and other groups (p = 0.001] MCHC [between stage I and stage II- stage IV (p=0.046], serum creatinine [(p=0.008 stage IV and stage I-II within group V], serum protein [(p=0.002 among stage IV and stage I-III- healthy control groups] and serum albumine [(p=0.004 among stage IV and stage I-II]. There was no alteration in CTnI concentrations,among groups. UPC analysis revealed statistical difference among control group and stage II to IV dogs (p=0.000. Moderate or severe ECG abnormalities were detected in 6/28 of diseased dogs. Regarding ECHO examination LA/ Ao value presented significant difference (p=0.003 among stage IV and other groups. Conclusions. It may be suggested that establishing Leishvet Working Group to those of dogs classified into stage I to IV, ECG [left atrial/ventricular enlargement, myocardial hypoxia] and ECHO [left atrial dilation, decrased/increased LVIDs, decrased/increased LVIDd, shortened FS and EF (systolic dysfunction] alterations must be taken into account along with hematological and serum biochemical analysis.

Staging of third molar development in relation to chronological age of 5-16 year old Indian children.

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Hegde, Sapna; Patodia, Akash; Dixit, Uma

2016-12-01

The usefulness of the developmental status of the third molar has been studied in assessment of the chronological age of adolescents in whom the development of the other permanent teeth is nearly complete. However, little is known about the timing and pattern of third-molar development in the Indian population. This study aimed to stage the third molar development in relation to chronological age of 5-16year old Indian children. In this cross-sectional observational study, the status of third molar development in relation to chronological age of 1139 Indian children aged 5-16 years was evaluated radiographically, using Orhan's modification of Demirjian's method. The frequency of occurrence of the third molars varied from 47% to 70%. Crypt formation, crown completion and root completion occurred as early as 5.4, 8.7 and 15.0 years, respectively. No significant differences based on gender or side were observed in third-molar development (p>0.05). For most stages, maxillary third molars were slightly more advanced than their mandibular counterparts (p>0.05). Considering the high degree of variability observed in third molar genesis and development, the usefulness of this tooth in age determination studies may be very limited in the age group studied. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stage I and II malt lymphoma: results of treatment with radiotherapy

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Tsang, Richard W.; Gospodarowicz, Mary K.; Pintilie, Melania; Bezjak, Andrea; Wells, Woodrow; Hodgson, David C.; Crump, Michael

2001-01-01

Purpose: Mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct disease with specific clinical and pathologic features that may affect diverse organs. We analyzed our recent experience with Stage I/II MALT lymphoma presenting in the stomach and other organs to assess the outcome following involved field radiation therapy (RT). Patients and Methods: Seventy patients with Stage IE (62) and IIE (8) disease were treated between 1989 and 1998. Patients with transformed MALT were excluded. The median age was 62 years (range, 24-83 years), M:F ratio 1:2.2. Presenting sites included stomach, 15; orbital adnexa, 19; salivary glands, 15; thyroid, 8; lung, 5; upper airways, 3 (nasopharynx, 2; larynx, 1); urinary bladder, 3; breast, 1; and rectum, 1. Staging included site-specific imaging, CT abdomen in 66 patients (94%) and bone marrow biopsy in 54 (77%). Sixty-two patients received radiation therapy: 52 received RT alone, 7 received chemotherapy and RT, and 3 received antibiotics followed by RT. Median RT dose was 30 Gy (range, 17.5-35 Gy). Most frequently used RT prescriptions were 25 Gy (26 patients--18 orbit, 6 stomach, and 2 salivary glands), 30 Gy (23 patients), and 35 Gy (8 patients). Five patients had complete surgical excision of lymphoma and no other treatment (stomach 1, salivary 2, lung 2), whereas 2 patients with gastric lymphoma received antibiotics only. One patient refused treatment and was excluded from the analysis of treatment outcome, leaving 69 patients with a median follow-up of 4.2 years (range, 0.3-11.4 years). Results: A complete response was achieved in 66/69 patients, and 3 patients had partial response (2 lung, 1 orbit). The 5-year disease-free survival (DFS) was 76%, and the overall survival was 96%. No relapses were observed in patients with stomach and thyroid lymphoma. The 5-year DFS for these patients was 93%, in contrast to 69% for patients presenting in other sites (p 0.006). Among the 5 patients treated with surgery only, 2

Mental additions and verbal-domain interference in children with developmental dyscalculia.

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Mammarella, Irene C; Caviola, Sara; Cornoldi, Cesare; Lucangeli, Daniela

2013-09-01

This study examined the involvement of verbal and visuo-spatial domains in solving addition problems with carrying in a sample of children diagnosed with developmental dyscalculia (DD) divided into two groups: (i) those with DD alone and (ii) those with DD and dyslexia. Age and stage matched typically developing (TD) children were also studied. The addition problems were presented horizontally or vertically and associated with verbal or visuo-spatial information. Study results showed that DD children's performance on mental calculation tasks was more impaired when they tackled horizontally presented addition problems compared to vertically presented ones that are associated to verbal domain involvement. The performance pattern in the two DD groups was found to be similar. The theoretical, clinical and educational implications of these findings are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Therapy for stage I aggressive non-Hodgkin's lymphoma

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Kluin-Nelemans, Hanneke

2002-01-01

Although radiotherapy was considered sufficient for stage I and limited stage II aggressive non-Hodgkin's lymphoma in the past, new data from randomized studies have shown that intensified chemotherapy or combined modality therapy (multiagent chemotherapy followed by involved field radiotherapy) can

Phase II trial of the regulatory T cell-depleting agent, denileukin diftitox, in patients with unresectable stage IV melanoma

International Nuclear Information System (INIS)

Telang, Sucheta; Gragg, Hana; Clem, Brian F; McMasters, Kelly M; Miller, Donald M; Chesney, Jason; Rasku, Mary Ann; Clem, Amy L; Carter, Karen; Klarer, Alden C; Badger, Wesley R; Milam, Rebecca A; Rai, Shesh N; Pan, Jianmin

2011-01-01

We previously found that administration of an interleukin 2/diphtheria toxin conjugate (DAB/IL2; Denileukin Diftitox; ONTAK) to stage IV melanoma patients depleted CD4 + CD25 HI Foxp3 + regulatory T cells and expanded melanoma-specific CD8 + T cells. The goal of this study was to assess the clinical efficacy of DAB/IL2 in an expanded cohort of stage IV melanoma patients. In a single-center, phase II trial, DAB/IL2 (12 μg/kg; 4 daily doses; 21 day cycles) was administered to 60 unresectable stage IV melanoma patients and response rates were assessed using a combination of 2-[ 18 F]-fluoro-2-deoxy-glucose (FDG)-positron emission tomography (PET) and computed tomography (CT) imaging. After DAB/IL2 administration, 16.7% of the 60 patients had partial responses, 5% stable disease and 15% mixed responses. Importantly, 45.5% of the chemo/immuno-naïve sub-population (11/60 patients) experienced partial responses. One year survival was markedly higher in partial responders (80 ± 11.9%) relative to patients with progressive disease (23.7 ± 6.5%; p value < 0.001) and 40 ± 6.2% of the total DAB/IL2-treated population were alive at 1 year. These data support the development of multi-center, randomized trials of DAB/IL2 as a monotherapy and in combination with other immunotherapeutic agents for the treatment of stage IV melanoma. http://www.clinicaltrials.gov/ct2/show/NCT00299689

Dental arch relationship in children with complete unilateral cleft lip and palate following warsaw (one-stage repair) and oslo protocols.

NARCIS (Netherlands)

Fudalej, P.S.; Hortis-Dzierzbicka, M.; Dudkiewicz, Z.; Semb, G.

2009-01-01

OBJECTIVE: To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. MATERIAL: Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP

The Second Stage of a Saturn V Ready For Test

Science.gov (United States)

1970-01-01

This Saturn V S-II (second) stage is being lifted into position for a test at the Vehicle Assembly Building at the Kennedy Space Center. When the Saturn V booster stage (S-IC) burned out and dropped away, power for the Saturn was provided by the 82-foot-long and 33-foot-diameter S-II stage. Developed by the Space Division of North American Aviation under the direction of the Marshall Space Flight Center, the stage utilized five J-2 engines, each producing 200,000 pounds of thrust. The engines used liquid oxygen and liquid hydrogen as propellants. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

The Effectiveness Test of Oil Phase Ointment Containing Snakehead Fish (Channa striata Extract on Open Stage II Acute Wounded Wistar Strain Male Rats

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Fransisca Daisa

2017-08-01

Full Text Available The snakehead (Channa striata contained fatty acids omega-3 and omega-6 are useful as nutrients in accelerating the wound healing process. This study aims to determine the effectiveness of the oil phase extract ointment snakehead in the healing of acute wounds open stage II. Testing the effectiveness of wound healing using 6 groups: normal, gel bioplacenton (positive control, ointment base (negative control, ointments snakehead extract oil phase concentration of 10; 20 and 40% of the 4 rats with acute wounds open stage II and observation until day 16 injury. The area of the wound was measured with the image J program Macbiophotonic, calculated% healing power, and AUC values. A statistical test to the total AUC values per rat with SPSS for Windows 22.0 program using One Way ANOVA and Post-hoc LSD test. The results showed a significant difference in the negative group with ointment concentration of 20% (p <0.05. The treatment group phase ointment fish oil extract is effective for wound healing is best to have a concentration of 20% for percentage of wound healing power of 97.157% and the average AUC value of 865.683% of the day.

Dose-response relationship in locoregional control for patients with stage II-III esophageal cancer treated with concurrent chemotherapy and radiotherapy

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Zhang Zhen; Liao Zhongxing; Jin Jing; Ajani, Jaffer; Chang, Joe Y.; Jeter, Melenda; Guerrero, Thomas; Stevens, Craig W.; Swisher, Stephen; Ho, Linus; Yao, James; Allen, Pamela; Cox, James D.; Komaki, Ritsuko

2005-01-01

Purpose: To evaluate the correlation between radiation dose and locoregional control (LRC) for patients with Stage II-III unresectable esophageal cancer treated with concurrent chemotherapy and radiotherapy. Methods and materials: The medical records of 69 consecutive patients with clinical Stage II or III esophageal cancer treated with definitive chemoradiotherapy at the University of Texas M. D. Anderson Cancer Center between 1990 and 1998 were retrospectively reviewed. Of the 69 patients, 43 had received ≤51 Gy (lower dose group) and 26 >51 Gy (higher dose group). The median dose in the lower and higher dose groups was 30 Gy (range, 30-51 Gy) and 59.4 Gy (range, 54-64.8 Gy), respectively. Two fractionation schedules were used: rapid fractionation, delivering 30 Gy at 3 Gy/fraction within 2 weeks, and standard fractionation, delivering ≥45 Gy at 1.8-2 Gy/fraction daily. Total doses of 5% (46.2% vs. 23.3%). The lower dose group had more N1 tumors, but the tumor classification and stage grouping were similar in the two groups. The median follow-up time for all patients was 22 months (range, 2-56 months). Patients in the higher dose group had a statistically significant better 3-year local control rate (36% vs. 19%, p = 0.011), disease-free survival rate (25% vs. 10%, p = 0.004), and overall survival rate (13% vs. 3%, p = 0.054). A trend toward a better distant-metastasis-free survival rate was noted in the higher dose group (72% vs. 59%, p = 0.12). The complete clinical response rate was significantly greater in the higher dose group (46% vs. 23%, p = 0.048). In both groups, the most common type of first failure was persistence of the primary tumor. Significantly fewer patients in the higher dose group had tumor persistence after treatment (p = 0.02). No statistically significant difference was found between the two groups in the pattern of locoregional or distant failure. The long-term side effects of chemoradiotherapy were similar in the two groups, although

Treatment outcomes regarding the addition of targeted agents in the therapeutic portfolio for stage II-III rectal cancer undergoing neoadjuvant chemoradiation.

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Liang, Jin-Tung; Chen, Tzu-Chun; Huang, John; Jeng, Yung-Ming; Cheng, Jason Chia-Hsien

2017-11-24

To evaluate the impact of targeted agents in stage II-III rectal cancer undergoing neoadjuvant concurrent chemoradiation therapy (CCRT). A retrospective study was performed in 124 consecutive patients with clinically T 3 N 0-2 M 0 -staged rectal cancer incorporating targeted agents in CCRT. Pathologic complete response was detected in 34.2% (n=26) of bevacizumab+FOLFOX-treated patients (n=76), which was significantly higher (p=0.019, post-hoc statistical power =35.87%) than that (n=10, 20.8%) of the cetuximab+FOLFOX-treated patients (n=48). Patients receiving cetuximab+FOLFOX therapy tended to develop severe liver toxicity (91.7%, n=44 versus 17.1%, n=13, panalysis within bevacizumab+FOLFOX-treated patients with either wild-type (n=36) or mutant (n=40) K-ras status indicated K-ras status did not significantly influence the treatment outcomes. The addition of bevacizumab instead of cetuximab to FOLFOX in the neoadjuvant settings for T 3 N 0-2 M 0 -staged rectal cancer could induce a promising rate of pathologic complete response and lesser hepatotoxicity.

Ovarian chocolate cysts. Staging with relaxation time in MR imaging

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Sugimura, Kazuro; Ishida, Tetsuya; Takemori, Masayuki; Kitagaki, Hajime; Tanaka, Yutaka; Yamasaki, Katsuhito; Shimizu, Tadafumi; Kono, Michio

1988-10-01

Accurate preoperative staging of ovarian chocolate cysts is very important because recent hormonal therapy has been effective in low stage patients. However, it has been difficult to assess the preoperative stage of ovarian chocolate cysts. We evaluated the diagnostic potential of MRI in preoperative staging of 15 overian chocolate cysts. It was well known that the older the ovarian chocolate cyst was the more iron content it had. We examined the iron contents effect on T1 and T2 relaxation times in surgically confirmed chocolate cysts (stage II: 3 cases, stage III: 3 cases and stage IV: 9 cases by AFS classification, 1985) employing the 0.15-T MR system and 200 MHz spectrometer. There was a positive linear relation between T1 of the lesion using the MR system (T1) and T1 of the resected contents using the spectrometer (sp-T1); r = 0.93. The same relation was revealed between T2 and sp-T2; r = 0.87. It was indicated that T1 and T2 using the MR system was accurate. There was a negative linear relation between T1 and the iron contents ( r = -0.81) but no relation between T2 and the iron contents. T1 was 412 +- 91 msec for stage II, 356 +- 126 msec for stage III and 208 +- 30 msec for stage IV. T1 for stage IV was shorter than that for stage II and III, statistically significant differences were noted (p < 0.05). Thus, T1 was useful in differentiating a fresh from an old ovarian chocolate cyst. We concluded that T1 relaxation time using the MR system was useful for the staging of an ovarian chocolate cyst without surgery.

Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmec Type II in Children with Impetigo in Japan

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H. Kikuta

2011-01-01

Full Text Available Background. The ratio of CA-MRSA in children with impetigo has been increasing in Japan. Methods. Antimicrobial susceptibilities of 136 S. aureus isolates from children with impetigo were studied. Furthermore, molecular epidemiological analysis and virulence gene analysis were performed. Results. Of the 136 S. aureus isolates, 122 (89.7% were MSSA and 14 (10.3% were MRSA. Of the 14 MRSA strains, 11 belonged to CC89 (ST89, ST91, and ST2117 and carried diverse types of SCCmec: type II (IIb: 3 strains; unknown subtype: 4 strains, type IVa (2 strains, and unknown type (2 strains. The remaining three strains exhibited CC8 (ST-8-SCCmec type VIa, CC121 (ST121-SCCmec type V, and CC5 (ST5-nontypeable SCCmec element, respectively. None were lukS-PV-lukF-PV gene positive. Gentamicin- and clarithromycin-resistant strains were frequently found in both MRSA and MSSA. Conclusions. PVL-negative CC89-SCCmec type II strains are the most predominant strains among the CA-MRSA strains circulating in the community in Japan.

New clinical staging for pharyngeal surgery in obstructive sleep apnea patients.

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Vidigal, Tatiana Aguiar; Haddad, Fernanda Louise Martinho; Cabral, Rafael Ferreira Pacheco; Oliveira, Maria Claudia Soares; Cavalcante, Ricardo Rodrigues; Bittencourt, Lia Rita Azeredo; Tufik, Sergio; Gregório, Luis Carlos

2014-01-01

The success of pharyngeal surgery in the treatment of obstructive sleep apnea syndrome depends on the appropriate selection of patients. To propose a new staging for indication of pharyngeal surgery in obstructive sleep apnea syndrome. A total of 54 patients undergoing extended tonsillectomy were retrospectively included, divided into six stages. Stage I: patients with palatine tonsils grade 3/4 and modified Mallampati index 1/2; stage II: palatine tonsils 3/4 and modified Mallampati index 3/4; stage III: palatine tonsils 1/2 and modified Mallampati index 1/2; stage IV: palatine tonsils 1/2 and modified Mallampati index 3/4; stage V: body mass index ≥40 kg/m(2) with palatine tonsils 3/4 and modified Mallampati index 1, 2, 3, or 4. Stage VI: body mass index ≥40 with palatine tonsils 1/2 and modified Mallampati index 1, 2, 3, or 4. The surgical success rates were 88.9%, 75.0%, 35.7%, 38.5%, and 100.0% in stages I-V. The presence of hypertrophic palatine tonsils was the anatomical factor in common in the most successful stages (I, II, and V), regardless of body mass index. Although the modified Mallampati index classes 3 and 4 reduced the success rate of surgery in patients with hypertrophic tonsils (stage II), the presence of modified Mallampati index classes 1 and 2 did not favor surgical success in patients with normal tonsils (stage III). Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Macrophage Inhibitory Cytokine-1 (MIC-1 as A Biomarker for Diagnosis 
and Prognosis of Stage I-II Non-small Cell Lung Cancer

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Yuning LIU

2016-04-01

Full Text Available Background and objective Increased macrophage inhibitory cytokine-1 (MIC-1, member of transforming growth factor-β (TGF-β superfamily, was found in patients serum with epithelial tumors. Therefore, our aim was to delineate the diagnostic and prognostic value of serum MIC-1 in patients with stage I-II non-small cell lung cancer (NSCLC. Methods A total of 152 consecutive patients with stage I–II NSCLC were prospectively enrolled and underwent follow up after total resection of tumor. Serum MIC-1 level was detected in lung cancer patients by ELISA, 48 benign pulmonary disease patients and 105 healthy controls, and was correlated with clinical features and prognosis of patients. Results The level of MIC-1 of NSCLC patients was significantly higher than that of controls (P<0.001 and benign pulmonary disease patients (P<0.001. A threshold of 1,000 pg/mL could be used to diagnose early-stage NSCLC with 70.4% sensitivity and 99.0% specificity. The level of MIC-1 was associated with elder age (P=0.001, female (P=0.03 and T2 (P=0.022. A threshold of 1,465 pg/mL could identify patients with early poor outcome with 72.2% sensitivity and 66.1% specificity. The overall 3-year survival rate in patients with high level of MIC-1 (≥1,465 pg/mL was significantly lower than that of patients with low MIC-1 level (77.6% vs 94.8%. Multivariable Cox regression revealed that a high level of MIC-1 was an independent risk factor for compromised overall survival (HR=3.37, 95%CI: 1.09-10.42, P=0.035. Conclusion High level of serum MIC-1 could be served as a potential biomarker for diagnosis and poorer outcome in patients with early-stage NSCLC.

Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial.

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Karoui, Mehdi; Rullier, Anne; Luciani, Alain; Bonnetain, Franck; Auriault, Marie-Luce; Sarran, Antony; Monges, Geneviève; Trillaud, Hervé; Le Malicot, Karine; Leroy, Karen; Sobhani, Iradj; Bardier, Armelle; Moreau, Marie; Brindel, Isabelle; Seitz, Jean François; Taieb, Julien

2015-07-10

In patients with high risk stage II and stage III colon cancer (CC), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 20 to 30% of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for these CCs and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery. PRODIGE 22--ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy and feasibility of two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4 + Cetuximab) in a peri-operative strategy in patients with bulky CCs. Patients with CC deemed as high risk T3, T4 and/or N2 on initial abdominopelvic CT scan are randomized to either colectomy and adjuvant chemotherapy (control arm), or 4 cycles of neoadjuvant chemotherapy with FOLFOX-4 (for RAS mutated patients). In RAS wild-type patients a third arm testing FOLFOX+ cetuximab has been added prior to colectomy. Patients in the neoadjuvant chemotherapy arms will receive postoperative treatment for 4 months (8 cycles) to complete their therapeutic schedule. The primary endpoint of the study is the histological Tumor Regression Grade (TRG) as defined by Ryan. The secondary endpoints are: treatment strategy safety (toxicity, primary tumor related complications under chemotherapy, peri-operative morbidity), disease-free and recurrence free survivals at 3 years, quality of life, carcinologic quality and

Effect of a Shortened Duration of FOLFOX Chemotherapy on the Survival Rate of Patients with Stage II and III Colon Cancer.

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Ji, Woong Bae; Hong, Kwang Dae; Kim, Jung-Sik; Joung, Sung-Yup; Um, Jun Won; Min, Byung-Wook

2018-01-01

FOLFOX chemotherapy is widely used as an adjuvant treatment for advanced colon cancer. The duration of adjuvant chemotherapy is usually set to 6 months, which is based on a former study of 5-fluorouracil/leucovorin chemotherapy. However, the FOLFOX regimen is known to have complications, such as peripheral neuropathy. The aim of this study was to compare the survival rates and complications experienced by patients receiving either 4 or 6 months of FOLFOX chemotherapy. Retrospective data analysis was performed for stage II and III patients who underwent radical resection of colon cancer. We compared the 5-year survival rates and the occurrence of complications in patients who completed only 8 cycles of FOLFOX chemotherapy with patients who completed 12 cycles of chemotherapy. Among 188 patients who underwent adjuvant FOLFOX chemotherapy for stage II or III colon cancer, 83 (44.1%) completed 6 months of FOLFOX chemotherapy and 64 (34.0%) patients discontinued after 4 months of chemotherapy. The 5-year overall survival and disease-free survival rates did not show a significant difference. Patients in the 6-month group had peripheral neuropathy more frequently (p = 0.028). Five-year overall and disease-free survival were not significantly different between the 2 groups. Large-scale prospective studies are necessary for the analysis of complications and survival rates. © 2017 S. Karger AG, Basel.

Evaluation of the Turkish Version of the "Ages and Stages Questionnaires: Social-Emotional" in Identifying Children with Social-Emotional Problems

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Kucuker, Sevgi; Kapci, Emine Gul; Uslu, Runa Idil

2011-01-01

The applicability of the Age and Stages Questionnaires: Social Emotional (ASQ-SE; J. Squires, D. Bricker & E. Twombly, 2003) for Turkish children was examined. A total of 608 mothers completed the ASQ-SE's. Overall sensitivity and overall specificity were 83.7% and 89.9%, respectively. Test-retest reliability, assessed by classifying children…

Ontogenetic view on PIVKA-II in the development of prothrombin synthesis in infants

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O. G. Ivanko

2017-12-01

Full Text Available The aim of the research was to study the content of PIVKA-II in the blood serum as an integrative measure of latent vitamin K deficiency in breastfed infants aged from the birth to 6 months of life. Materials and methods. 178 children aged from the birth to 6 months of life who were born without birth injuries in the term of 38–41 of weeks gestation with a weight 2800–4200 g were examined. The immunoenzyme assay for PIVKA-II study was performed with ANTIBODY RESEARCH kit PIVKA-II ELISA Kit (USA Results. Children who had not received postnatal prophylactic injection of vitamin K1 in dose of 1 mg intramuscularly in their majority (62 % had abnormally elevated serum PIVKA-II (>40 Au/ml at the first week of life. In 92 % of children who had received a prophylactic dose of vitamin K1 immediately after birth, PIVKA-II was in a normal limit. The normal concentrations of PIVKA-II were observed in children aged 2–6 months regardless of vitamin K prophylactics. The situation worsened dramatically in children who were treated with antibiotics because more than 50 % of these children have experienced high PIVKA-II values. Conclusions. Almost all the children in their first week of life whom for any reasons vitamin K1 was not prescribed have exhibited an elevation of PIVKA-II in blood serum. This indicates an inborn deficiency of vitamin K experienced by fetuses and newborns. Prophylactic injection of vitamin K1 to newborns normalizes the processes of prothrombin carboxylation and PIVKA-II concentrations are getting normal. Children, who did not receive vitamin K1 after the birth, during the first month of life spontaneously normalize the PIVKA-II concentrations. The improvement of prothrombin carboxylation is obviously connected with the colon microbiota development which can provide children with well absorbed vitamin K2 (menaquinone. In 55.5 % of breastfed children aged up to 6 months who had received antibiotics the PIVKA-II appeared elevated again

Effects of Botulinum Toxin-A and Goal-Directed Physiotherapy in Children with Cerebral Palsy GMFCS Levels I & II.

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Löwing, Kristina; Thews, Karin; Haglund-Åkerlind, Yvonne; Gutierrez-Farewik, Elena M

2017-08-01

To evaluate short and long-term effects of botulinum toxin-A combined with goal-directed physiotherapy in children with cerebral palsy (CP). A consecutive selection of 40 children, ages 4-12 years, diagnosed with unilateral or bilateral CP, and classified in GMFCS levels I-II. During the 24 months, 9 children received one BoNT-A injection, 10 children two injections, 11 children three injections, and 10 children received four injections. 3D gait analysis, goal-attainment scaling, and body function assessments were performed before and at 3, 12, and 24 months after initial injections. A significant but clinically small long-term improvement in gait was observed. Plantarflexor spasticity was reduced after three months and remained stable, while passive ankle dorsiflexion increased after 3 months but decreased slightly after 12 months. Goal-attainment gradually increased, reached the highest levels at 12 months, and levels were maintained at 24 months. The treatments' positive effect on spasticity reduction was identified, but did not relate to improvement in gait or goal-attainment. No long-term positive change in passive ankle dorsiflexion was observed. Goal attainment was achieved in all except four children. The clinical significance of the improved gait is unclear. Further studies are recommended to identify predictors for positive treatment outcome.

Radiotherapy for primary localized (stage I and II) non-Hodgkin's lymphoma of the oral cavity

International Nuclear Information System (INIS)

Sunaba, Kohji; Shibuya, Hitoshi; Okada, Norihiko; Amagasa, Teruo; Enomoto, Shoji; Kishimoto, Seiji

2000-01-01

Purpose: To assess the role of radiation therapy in the treatment of primary localized (Stage I: 24 cases and Stage II: 13 cases) non-Hodgkin's Lymphoma (NHL) of the oral cavity. Methods and Materials: In total, 37 patients (27 male, 10 female) with primary localized NHL of the oral cavity have been treated with radiotherapy alone (23 cases) or radiation with chemotherapy (14 cases). The age range was 29 to 86 years (median: 65). Clinical and treatment variables with potential prognostic significance for survival were evaluated by univariate and multivariate analysis. Of the 37 patients, 31 (84%) had intermediate-grade lymphomas and six (14%) had high-grade lymphomas. Four patients showed necrotic ulcer in the central portion of the hard palate. Results: The 5-year actuarial survival rate for all cases was 73%. The 5-year survival rates for intermediate-grade and high-grade lymphoma were 85% and 14%, respectively. Significant prognostic factors identified by the multivariate analysis were histologic grade of malignancy (p = 0.02) and central necrotic ulcer in the tumor (p = 0.02). Chemotherapy did not improve survival (p = 0.41). Conclusions: Our analysis suggests that radiotherapy alone may be approved as the treatment for localized oral NHL with no ulceration and intermediate histology. However, patients with high-grade lymphoma and/or necrotic ulcer are difficult to cure with radiation alone and aggressive treatment should be advocated to improve survival

Early stage cervical cancer of the uterine

International Nuclear Information System (INIS)

Kaneyasu, Yuuko; Fujiwara, Hisaya

2011-01-01

This paper describes the present state of radiotherapy (RT) of early stage cervical cancer involving the history, outcomes of clinical trials, procedure for each stage, irradiation methods, concurrent chemo-RT (CCRT), late adverse events, and QOL after RT. It has a history of >100 years from the brachytherapy with radium, but is not yet completely established even now. There are many RT trials hitherto. Retrospectively, no significant difference is seen in outcomes of radical RT and surgery: 80-90% efficacy for stage I and 60-80% for II in the former, respectively, and 80-96% and 65-80%, in the latter. Between RT and surgery, there is a report of randomized comparative study in Italy. In Japan, reported are comparative outcomes based on patients' choice for therapy, retrospective studies including authors' one, prospective multi-institutional cooperative trials by Japanese Radiation Oncology Study Group, and Treatment Guidelines for Cervical Cancer (2007). RT procedure depends on the stage defined by FIGO (International Federation of Gynecology and Obstetrics) and at stages I-II, intracavitary RT is major with optimal dose 29 Gy/5 fractions for I, and 23/4 Gy with external total pelvic radiation 50 Gy for II. In external radiation, the planning target volume includes the whole pelvic field with 1.8-2 Gy/5 weeks and optionally, the extended field when metastasis suspicious. Intracavitary RT with application device in the uterine is of significance for the cancer as 50% complete cure even in stage III is reported. CCRT brings about good prognosis, which is shown in a Japanese trial to compare postoperative RT alone and CCRT with CDDP and 5-FU. The late adverse events are seen mainly in the large bowel and studies of QOL, an important factor for choice of treatment, are now in progress. (T.T.)

The Effects of Music and Group Stage on Group Leader and Member Behavior in Psychoeducational Groups for Children of Divorce

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Cercone, Kristin; DeLucia-Waack, Janice

2012-01-01

This study examined the effects of music and group stage on group process and group leader and member behavior within 8-week psychoeducational groups for children of divorce. Audiotapes of group sessions were rated using the Interactional Process Analysis and the Group Sessions Ratings Scale. Both treatment groups were very similar in terms of…

Social-Emotional Correlates of Early Stage Social Information Processing Skills in Children With and Without Autism Spectrum Disorder.

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Russo-Ponsaran, Nicole M; McKown, Clark; Johnson, Jason K; Allen, Adelaide W; Evans-Smith, Bernadette; Fogg, Louis

2015-10-01

Difficulty processing social information is a defining feature of autism spectrum disorder (ASD). Yet the failure of children with ASD to process social information effectively is poorly understood. Using Crick and Dodge's model of social information processing (SIP), this study examined the relationship between social-emotional (SE) skills of pragmatic language, theory of mind, and emotion recognition on the one hand, and early stage SIP skills of problem identification and goal generation on the other. The study included a sample of school-aged children with and without ASD. SIP was assessed using hypothetical social situations in the context of a semistructured scenario-based interview. Pragmatic language, theory of mind, and emotion recognition were measured using direct assessments. Social thinking differences between children with and without ASD are largely differences of quantity (overall lower performance in ASD), not discrepancies in cognitive processing patterns. These data support theoretical models of the relationship between SE skills and SIP. Findings have implications for understanding the mechanisms giving rise to SIP deficits in ASD and may ultimately inform treatment development for children with ASD. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Negative effect of cyclin D1 overexpression on recurrence-free survival in stage II-IIIA lung adenocarcinoma and its expression modulation by vorinostat in vitro.

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Lee, Eunju; Jin, DongHao; Lee, Bo Bin; Kim, Yujin; Han, Joungho; Shim, Young Mog; Kim, Duk-Hwan

2015-12-17

This study was aimed at identifying prognostic biomarkers for stage II-IIIA non-small cell lung cancer (NSCLC) according to histology and at investigating the effect of vorinostat on the expression of these biomarkers. Expression levels of cyclin D1, cyclin A2, cyclin E, and p16 proteins that are involved in the G1-to-S phase progression of cell cycle were analyzed using immunohistochemistry in formalin-fixed paraffin-embedded tissues from 372 samples of stage II-IIIA NSCLC. The effect of vorinostat on the expression of these proteins, impacts on cell cycle, and histone modification was explored in lung cancer cells. Abnormal expression of cyclin A2, cyclin D1, cyclin E, and p16 was found in 66, 47, 34, and 51 % of 372 cases, respectively. Amongst the four proteins, only cyclin D1 overexpression was significantly associated with poor recurrence-free survival (adjusted hazard ratio = 1.87; 95 % confidence interval = 1.12 - 2.69, P = 0.02) in adenocarcinoma but not in squamous cell carcinoma (P = 0.44). Vorinostat inhibited cell cycle progression to the S-phase and induced down-regulation of cyclin D1 in vitro. The down-regulation of cyclin D1 by vorinostat was comparable to a siRNA-mediated knockdown of cyclin D1 in A549 cells, but vorinostat in the presence of benzo[a]pyrene showed a differential effect in different lung cancer cell lines. Cyclin D1 down-regulation by vorinostat was associated with the accumulation of dimethyl-H3K9 at the promoter of the gene. The present study suggests that cyclin D1 may be an independent prognostic factor for recurrence-free survival in stage II-IIIA adenocarcinoma of lung and its expression may be modulated by vorinostat.

The influence of micrometastases on prognosis and survival in stage I-II colon cancer patients: the Enroute⊕ Study

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Pruijt Hans FM

2011-05-01

Full Text Available Abstract Background The presence of lymph node metastases remains the most reliable prognostic predictor and the gold indicator for adjuvant treatment in colon cancer (CC. In spite of a potentially curative resection, 20 to 30% of CC patients testing negative for lymph node metastases (i.e. pN0 will subsequently develop locoregional and/or systemic metastases within 5 years. The presence of occult nodal isolated tumor cells (ITCs and/or micrometastases (MMs at the time of resection predisposes CC patients to high risk for disease recurrence. These pN0micro+ patients harbouring occult micrometastases may benefit from adjuvant treatment. The purpose of the present study is to delineate the subset of pN0 patients with micrometastases (pN0micro+ and evaluate the benefits from adjuvant chemotherapy in pN0micro+ CC patients. Methods/design EnRoute+ is an open label, multicenter, randomized controlled clinical trial. All CC patients (age above 18 years without synchronous locoregional lymph node and/or systemic metastases (clinical stage I-II disease and operated upon with curative intent are eligible for inclusion. All resected specimens of patients are subject to an ex vivo sentinel lymph node mapping procedure (SLNM following curative resection. The investigation for micrometastases in pN0 patients is done by extended serial sectioning and immunohistochemistry for pan-cytokeratin in sentinel lymph nodes which are tumour negative upon standard pathological examination. Patients with ITC/MM-positive sentinel lymph nodes (pN0micro+ are randomized for adjuvant chemotherapy following the CAPOX treatment scheme or observation. The primary endpoint is 3-year disease free survival (DFS. Discussion The EnRoute+ study is designed to improve prognosis in high-risk stage I/II pN0 micro+ CC patients by reducing disease recurrence by adjuvant chemotherapy. Trial Registration ClinicalTrials.gov: NCT01097265

A comparison of volumetric modulated arc therapy and sliding-window intensity-modulated radiotherapy in the treatment of Stage I-II nasal natural killer/T-cell lymphoma

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Liu, Xianfeng [Department of Radiation Oncology, Chongqing Cancer Institute, Chongqing (China); Yang, Yong [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Jin, Fu; He, Yanan; Zhong, Mingsong; Luo, Huanli; Qiu, Da; Li, Chao; Yang, Han; He, Guanglei [Department of Radiation Oncology, Chongqing Cancer Institute, Chongqing (China); Wang, Ying, E-mail: zjajf@126.com [Department of Radiation Oncology, Chongqing Cancer Institute, Chongqing (China)

2016-04-01

This article is aimed to compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for Stage I-II nasal natural killer/T-cell lymphoma (NNKTL). Ten patients with Stage I-II NNKTL treated with IMRT were replanned with VMAT (2 arcs). The prescribed dose of the planning target volume (PTV) was 50 Gy in 25 fractions. The VMAT plans with the Anisotropic Analytical Algorithm (Version 8.6.15) were based on an Eclipse treatment planning system; the monitor units (MUs) and treatment time (T) were scored to measure the expected treatment efficiency. All the 10 patients under the study were subject to comparisons regarding the quality of target coverage, the efficiency of delivery, and the exposure of normal adjacent organs at risk (OARs). The study shows that VMAT was associated with a better conformal index (CI) and homogeneity index (HI) (both p < 0.05) but slightly higher dose to OARs than IMRT. The MUs with VMAT (650.80 ± 24.59) were fewer than with IMRT (1300.10 ± 57.12) (relative reduction of 49.94%, p = 0.00) when using 2-Gy dose fractions. The treatment time with VMAT (3.20 ± 0.02 minutes) was shorter than with IMRT (7.38 ± 0.18 minutes) (relative reduction of 56.64%, p = 0.00). We found that VMAT and IMRT both provide satisfactory target dosimetric coverage and OARs sparing clinically. Likely to deliver a bit higher dose to OARs, VMAT in comparison with IMRT, is still a better choice for treatment of patients with Stage I-II NNKTL, thanks to better dose distribution, fewer MUs, and shorter delivery time.

Feasibility of sequential adjuvant chemotherapy with a 3-month oxaliplatin-based regimen followed by 3 months of capecitabine in patients with stage III and high-risk stage II colorectal cancer: JSWOG-C2 study

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Tsuruta A

2016-11-01

Full Text Available Atsushi Tsuruta,1,* Kazuki Yamashita,2,* Hiroaki Tanioka,3 Akihito Tsuji,4,5 Michio Inukai,6 Toshiki Yamakawa,7 Tomoki Yamatsuji,8 Masanori Yoshimitsu,9 Kazuhiro Toyota,10 Taketoshi Yamano,11 Takeshi Nagasaka,12 Masazumi Okajima13 On behalf of the Japan Southwest Oncology Group (JSWOG 1Department of Digestive Surgery, Kawasaki Medical School Hospital, 2Department of Surgery, 3Department of Medical Oncology, Okayama Rosai Hospital, Okayama, 4Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, 5Department of Clinical Oncology, Faculty of Medicine, Kagawa University Hospital, Kagawa, 6Department of Medicine, Okayama Saiseikai General Hospital, Okayama, 7Department of Surgery, Kagawa Prefectural Central Hospital, Takamatsu, 8Department of General Surgery, Kawasaki Medical School, Okayama, 9Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, 10Department of Surgery, National Hospital Organization Higashihirosima Medical Center, Higashihiroshima, 11Department of Surgery, Kurashiki Medical Center, 12Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 13Department of Surgery, Hiroshima City Hospital, Hiroshima, Japan *These authors contributed equally to this work Background: Six months of oxaliplatin-based chemotherapy is the standard adjuvant chemotherapy for completely resected stage III colorectal cancer (CRC. Also, patients with stage II CRC who are considered to be at high risk of disease recurrence often receive the same adjuvant chemotherapy treatment. We prospectively investigated the extent and degree of neuropathy suffered by stage III and high-risk stage II resectable CRC patients who underwent sequential approach involving 3 months of an oxaliplatin-based regimen followed by 3 months of capecitabine. Patients and methods: Patients with completely resected stage III and high-risk stage II CRC aged ≥20 years were

Characteristics of mentalization patterns in parents of children with difficulties in realizing developmental objectives of the latency stage - qualitative analysis results.

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Dejko, Karolina; Janusz, Bernadetta; Treger, Bartosz

2016-01-01

The aim of the study was to answer the question about the ability to mentalize emotional states in parents of children with difficulties in realizing developmental objectives of the latency stage. The research was exploratory in nature; the aim was formulated on the basis of notions from the field literature indicating a correlation between the attachment style and the ability to mentalize in the parents and psychosocial functioning of their children. The structured Adult Attachment Interview (AAI) was used as the main tool for the research. The analysis was performed with the Reflective Functioning Scale. Total of 9 narrations obtained through AAI were subjected to qualitative analysis. The conducted analysis showed that parents of children with difficulties in realizing developmental objectives of the latency stage are characterized by reduced mentalization skills. The mentalization pattern isolated in the analysis, characteristic for the studied group encompasses the tendency towards idealization, generalization, describing the relation at the behavioural level and avoidance of reflecting upon mental states experienced in the context of early attachment relations, and the lack of coherence. Difficulties in mentalization of relationships mainly concern the relation with the mother. Relations established later in life are better mentalized than the early relations with parents. Observed disturbance in mentalization may suggest possible disturbances in the process of reflecting and containing in the early developmental stages of the examined persons. Mentalization skills were developed later in life of the examined persons. Idealization turned out to be the process that is most impacting and interfering with free reflections upon one's own emotions and emotions of the others (including those of one's own child).

Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial – the PRODIGE 22 - ECKINOXE trial

International Nuclear Information System (INIS)

Karoui, Mehdi; Rullier, Anne; Luciani, Alain; Bonnetain, Franck; Auriault, Marie-Luce; Sarran, Antony; Monges, Geneviève; Trillaud, Hervé; Le Malicot, Karine; Leroy, Karen; Sobhani, Iradj; Bardier, Armelle; Moreau, Marie; Brindel, Isabelle; Seitz, Jean François; Taieb, Julien

2015-01-01

In patients with high risk stage II and stage III colon cancer (CC), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 20 to 30 % of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for these CCs and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery. PRODIGE 22 - ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy and feasibility of two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4 + Cetuximab) in a peri-operative strategy in patients with bulky CCs. Patients with CC deemed as high risk T3, T4 and/or N2 on initial abdominopelvic CT scan are randomized to either colectomy and adjuvant chemotherapy (control arm), or 4 cycles of neoadjuvant chemotherapy with FOLFOX-4 (for RAS mutated patients). In RAS wild-type patients a third arm testing FOLFOX+ cetuximab has been added prior to colectomy. Patients in the neoadjuvant chemotherapy arms will receive postoperative treatment for 4 months (8 cycles) to complete their therapeutic schedule. The primary endpoint of the study is the histological Tumor Regression Grade (TRG) as defined by Ryan. The secondary endpoints are: treatment strategy safety (toxicity, primary tumor related complications under chemotherapy, peri-operative morbidity), disease-free and recurrence free survivals at 3 years, quality of life, carcinologic quality and

Head injury in children

International Nuclear Information System (INIS)

Sugiura, Makoto; Mori, Nobuhiko; Yokosuka, Reiko; Yamamoto, Masaaki; Imanaga, Hirohisa

1981-01-01

Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I and II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented. (author)

A comparison of non-contrast and contrast-enhanced MRI in the initial stage of Legg-Calve-Perthes disease

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Kim, Harry K.W. [Texas Scottish Rite Hospital for Children, Center of Excellence in Hip Disorders, Dallas, TX (United States); University of Texas Southwestern, Department of Orthopedic Surgery, Dallas, TX (United States); Kaste, Sue [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee School of Health Sciences, Department of Radiology, Memphis, TN (United States); Dempsey, Molly; Wilkes, David [Texas Scottish Rite Hospital for Children, Department of Radiology, Dallas, TX (United States)

2013-09-15

A prognostic indicator of outcome for Legg-Calve-Perthes disease (LCP) is needed to guide treatment decisions during the initial stage of the disease (stage 1), before deformity occurs. Radiographic prognosticators are applicable only after fragmentation (stage II). We investigated pre- and postcontrast MRI in depicting stage I femoral head involvement. Thirty children with stage I LCP underwent non-contrast coronal T1 fast spin-echo (FSE) and corresponding postcontrast fat-suppressed T1-weighted fast spin-echo (FSE) sequences to quantify the extent of femoral head involvement. Three pediatric radiologists and one pediatric orthopedic surgeon independently measured central head involvement. Interobserver reliability of percent head involvement using non-contrasted MR images had intraclass correlation coefficient (ICC) of 0.72. Postcontrast MRI improved interobserver reliability (ICC 0.82). Qualitatively, the area of involvement was more clearly visible on contrast-enhanced MRI. A comparison of results obtained by each observer using the two MRI techniques showed no correlation. ICC ranged from -0.08 to 0.03 for each observer. Generally, greater head involvement was depicted by contrast compared with non-contrast MRI (Pearson r = -0.37, P = 0.04). Pre- and postcontrast MRI assess two different components of stage I LCP. However, contrast-enhanced MRI more clearly depicts the area of involvement. (orig.)

Genetic modification of risk assessment based on staging of preclinical type 1 diabetes in siblings of affected children.

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Mrena, S; Savola, K; Kulmala, P; Reijonen, H; Ilonen, J; Akerblom, H K; Knip, M

2003-06-01

We set out to study the association between human leukocyte antigen-defined genetic disease susceptibility and the stage of preclinical type 1 diabetes and whether genetic predisposition affects the natural course of preclinical diabetes in initially nondiabetic siblings of affected children. A total of 701 initially unaffected siblings were graded into four stages of preclinical type 1 diabetes based on the initial number of disease-associated autoantibodies detectable close to the time of diagnosis of the index case: no prediabetes (no antibodies), early (one antibody specificity), advanced (two antibodies), and late prediabetes (three or more antibodies). Another classification system covering 659 siblings was based on a combination of the initial number of antibodies and the first-phase insulin response (FPIR) to iv glucose: no prediabetes (no antibodies), early (one antibody specificity, normal FPIR), advanced (two or more antibodies, normal FPIR), and late prediabetes (at least one antibody, reduced FPIR). Genetic susceptibility to type 1 diabetes was defined by human leukocyte antigen identity and DR and DQ genotypes. There was a higher proportion of siblings with late prediabetes initially among those with strong genetic disease susceptibility than among those with decreased genetic predisposition (16.7% vs. 0.5%; P siblings with no signs of prediabetes among those with genotypes conferring decreased risk (91.2% vs. 70.4% among those with high-risk DQB1 genotypes; P siblings than when combined with genetic susceptibility. Genetic susceptibility played a role in whether the initial prediabetic stage progressed (progression in 29.6% of the high-risk siblings compared with 6.6% of the siblings with DQB1 genotypes conferring decreased risk; P siblings of affected children.

Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

International Nuclear Information System (INIS)

Reinertsen, Kristin Valborg; Cvancarova, Milada; Wist, Erik; Bjoro, Trine; Dahl, Alv A.; Danielsen, Turi; Fossa, Sophie D.

2009-01-01

Purpose: A possible association between thyroid diseases (TD) and breast cancer (BC) has been debated. We examined prevalence and development of TD in women after multimodal treatment for Stage II/III BC compared with women from a general population. Secondarily, we explored the impact of two different radiotherapy (RT) techniques (standardized field arrangements vs. computed tomography [CT]-based dose planning) on TD in BC patients examined 35-120 months after primary BC treatment. Methods and Materials: A total of 403 BC patients completed a questionnaire about TD and had blood samples taken for analyses of thyroid function. All had undergone postoperative RT with or without (2%) adjuvant systemic treatment. The results in the BC patients were compared with a cancer-free, age-matched control group from a general population (CGr). Results: There was higher prevalence of self-reported hypothyroidism in the BC patients as compared with the CGr (18% vs. 6%, p < 0.001). The raised prevalence was predominantly due to a substantial increase in the development of hypothyroidism after BC diagnosis, whereas the prevalence of hypothyroidism before BC diagnosis was similar to that observed in the CGr. Patients treated with CT-based RT showed a trend for increased post-BC development of hypothyroidism as compared with those treated with standardized field arrangements (p = 0.08). Conclusions: Hypothyroidism is significantly increased in women after multimodal treatment for Stage II/III BC. Radiation to the thyroid gland may be a contributing factor. BC patients should be routinely screened for hypothyroidism.

New therapeutical strategies in adjuvant treatment of stage I B and II A cervical cancer after Wertheim-Mergs radical hysterectomy

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Ivanov, S.

2003-01-01

Patients after Wertheim-Mergs radical hysterectomy of stage I B and II A cervical cancer with positive lymph nodes and unfavourable prognostic factors are usually given adjuvant radiotherapy. The aim of our study was to research retrospectively and to analyse the survival of patients after radical hysterectomy and postoperative radiotherapy. Prognostic factors, survival rate failures of treatment and the way of recurrence were evaluated for 420 patients in I B and II A stage for the period of 1990-2003. All patients were radically operated and underwent an adjuvant radiotherapy, 25 of them received adjuvant chemotherapy. Positive lymph nodes were found in 24.52%. All patients having positive for metastases lymph nodes and those with negative lymph nodes but unfavorable prognostic factors received adjuvant radiotherapy (RT). The 5 years survival rate was 63% for the patients with positive lymph nodes and 89% for those with negative lymph nodes. The level of recurrence was 14% for patients with negative and 35% for those with positive lymph nodes. There were 39 pelvic and 41 distant recurrences, but the behavior was different between patients with negative lymph nodes (32 pelvic and 12 distant recurrences) and with positive ones (7 pelvic and 29 distant recurrences). The updated 5 years survival was 24% for patients with pelvic recurrences and 6% for the patients with distant ones. Our therapy strategy for patients with negative lymph nodes who have distant recurrences involves an adjuvant chemotherapy. All patients with negative lymph nodes but positive parametric and positive surgical margins receive postsurgical radiotherapy or an intensive follow up. (author)

Peculiarities of the course of ulcerative colitis in children at the present stage

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M.F. Denisova

2017-03-01

Full Text Available Background. As to severity of the course, the incidence of complications and mortality rate, ulcerative colitis hold a position within the top of the gastrointestinal system diseases in children. Goal of research — to study peculiarities of the course of ulcerative colitis at the present stage. Materials and methods. The retrospective analysis was conducted of 184 clinical records of the children, who were on examination and treatment at the Department of the diseases of gastrointestinal system of the State Institution “Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine” between 2004 and 2014. Results and discussion. Ulcerative colitis is common in the children of all ages, among which the preschool children and teenagers are at greater risk than others. The risk factors include both the antenatal and the postnatal ones: gestational toxicosis and miscarriage threat, weight deficit at birth, artificial feeding, intestinal infections. Ulcerative colitis is characterized by chronic relapse, slow progression of the disease, and the typical clinical symptoms are: diarrhea, hemorrhagic colitis, abdominal pain syndrome, toxic syndrome, late physical development. In terms of localization, the inflammation process most often affects the entire large bowel (59.6 %, left-sided colitis (28.5 %, and proctosigmoiditis (accounts for 11.9 % are less common. The informative criteria of ulcerative colitis activity are the Pediatric Ulcerative Colitis Activity Index (PUCAI, fecal calprotectin level, a number of complete blood count values (hemoglobin, leucocytes, platelets, erythrocyte sedimentation rate and biochemical studies (C-reactive protein, alpha-2 globulins. The modern combined baseline therapy is efficient in 22 % of patients suffering from total colitis, in 42–58 % — from left-sided colitis according to the follow-up study results. Monotherapy with 5-aminosalicylic acid medications was

Impact of lymph node micrometastasis for the UICC stage in non-small cell lung carcinoma

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Ouyang Weiwei; Lu Bing; He Chang; Long Yiguo; Wang Ping

2007-01-01

Objective: To detect cytokeratin in routine pathology negative regional lymph nodes postoperatively in non-small cell lung carcinoma (NSCLC). To investigate the relationship of lymph node micrometastasis in P-TNM stages NSCLC and survival rates. Methods: From Jan. 1996 to Dec. 2003, 107 paraffin-embedded specimens of T1-T4N0-N1M0 NSCLC patients were collected. Anti-cytokeratin(CK) antibody AE1/AE3 was applied to detect cytokeratin with Envision TM method in routine pathological negative region lymph nodes in NSCLC, and selected negative control, positive control and blank control. The pulmo- nary hilar lymph node micrometastasis was upward regulated with stage pCK-N1, mediastinal lymph node mi- crometastatsis was upward regulated with stage pCK-N2. The result applied to SPSS11.0 software to process. Results: The CK positive rate was 29.9% in all the patients. The CK positive rate was 27% (21/78), 30% (7/23), 67%(4/6)in stage p- I, p-II and p-III, respectively. All these data showed the tendency by which detectable rate increased and was accompanied by disease progress. Comparing the annual survival rate and median survival time of the non-micrometastasis group with the micrometastasis group in two groups, the survival rate difference was statistically significant. Comparing the armnal survival rate and median sur- vival time in pCK-III A stage with p- I -II stage, pCK-III A stage annual survival rate and median survival time was significantly different(P=0.020). Similarly, comparing the survival rate in pCK-II B stage with p- I B stage, pCK- II B stage survival rate was significantly different( P = 0. 059). Comparing the survival time of pCK-IIIA stage with p-III stage, pCK-II B stage, with p-II B stage, euther survival time difference was statistically significant (P=0.838, 0.518). Conclusions: The rate of positive cytokeratin increase is accompanied by the disease progress in NSCLC. Positive cytokeratin has disadvantageous prognosis. It is showed that pCK-N1 may

Micro satellite instability in colorectal cancer stage II. Hospital Central de las fuerzas armadas

International Nuclear Information System (INIS)

Della Valle, A; Santander G; Camejo, N; Spera, G.

2010-01-01

Introduction: micro satellite instability (MSI) is a good prognostic factor in colorectal cancer (CRC) located. Its value as a predictive marker against adjuvant treatment of chemotherapy (CT) has been shown fluoropyrimidine in various publications. The MSI occurs in 15% of colorectal tumors and sporadic in 90% of tumors in the context of colorectal cancer syndrome hereditary nonpolyposis. In Uruguay there are no studies about this phenomenon. Objective: To determine the incidence of micro satellite instability in a sample of patients using the Hospital Central de las fuerzas armadas oncology service, association with a compatible family history and the histological features of the tumors associated therewith. Methods: The medical records of patients were analyzed with CRC diagnosed stage II between 01/2001 and 12/2009. Data of the patients were analyzed which had complete histology and evolution. Results: 30/52 patients (57.6%) were analyzed. 40% had a detected MSI by kits for Pcr (polymerase chain reaction) to D2S123, D5S250, D17S346, BAT25 and BAT26 according to the Bethesda criteria. In those patients they filed a MSI: the median age was 70 years; 58.3% male. No patient had a family history consistent with HNPCC. 5.6% (3) they received Adjuvant chemotherapy treatment. Regarding tumor characteristics: 75% (9) were T3, and T4 were 25% (3); 8.3% histologic grade I (1) II 58.3% (7) 8.3% III (1) without Data 33% (6). This tumor lymphocyte infiltration was reported in 25% (3), absent 33.3% (4), not reported in 41.6% (5). Conclusions: This is the first analysis of these characteristics carried out in Uruguay. The same has been detected MSI percentage higher than reported in the literature International. In either case a compatible family history met HNPCC

Clinical significance of determination of changes of serum IGF-II, GM-CSF and TNF-α levels after treatment in children with acute nephritis

International Nuclear Information System (INIS)

Xu Xiaoyan; Zhou Hong; Xu Weiqin; Li Xinghua

2008-01-01

Objective: To explore the clinical significance of determination of changes of serum IGF-II, GM-CSF and TNF- α levels after treatment in children with acute nephritis. Methods: Serum IGF-II, GM-CSF and TNF-α levels (with RIA) were measured in 31 pediatric patients with acute nephritis and 35 controls. Results: Before treatment, the serum IGF-II, GM-CSF and TNF-α levels in the patients were significantly higher than those in controls (P< O.01). After treatment for 3 months, the serum IGF-II, GM-CSF and TNF-α levels, though markedly corrected, remained significantly higher than those in controls (P<0.05). Conclusion: Determination of changes of serum IGF-II, GM-CSF and TNF-α contents after treatment might be of prognostic importance in pediatric patients with acute nephritis. (authors)

Patterns of Sociodemographic and Clinicopathologic Characteristics of Stages II and III Colorectal Cancer Patients by Age: Examining Potential Mechanisms of Young-Onset Disease

OpenAIRE

Murphy, Caitlin C.; Sanoff, Hanna K.; Stitzenberg, Karyn B.; Baron, John A.; Lund, Jennifer L.; Sandler, Robert S.

2017-01-01

Background and Aims. As a first step toward understanding the increasing incidence of colorectal cancer (CRC) in younger (age < 50) populations, we examined demographic, clinicopathologic, and socioeconomic characteristics and treatment receipt in a population-based sample of patients newly diagnosed with stages II and III CRC. Methods. Patients were sampled from the National Cancer Institute's Patterns of Care studies in 1990/91, 1995, 2000, 2005, and 2010 (n = 6, 862). Tumor characteristics...

Stage-to-stage progression of chronic kidney disease in renal transplantation with chronic allograft dysfunction

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Khalkhali H

2009-11-01

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:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; 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: Although the short-term results of kidney transplantation have improved greatly during the past decades, the long-term results have not improved according. Graft loss due to chronic allograft dysfunction (CAD is a major concern in renal transplant recipients (RTRs. There is little data about disease progression in this patient population. In this paper, we investigated history of kidney function as the pattern, waiting time and rate of pass from intermediate stages in RTR with CAD."n"nMethods: In a single-center retrospective study, 214 RTRs with CAD investigated at the Urmia University Hospital urmia, Iran from 1997 to 2005. Kidney function at each visit assessed with GFR. We apply NKF and K/DOQI classification of chronic kidney disease (CKD staging system to determine pattern of disease progression per stage in this group of patients. "n"nResults: The pure death-censored graft loss was 26% with mean waiting time 81.7 months. 100% of RTRs passed from stage I to II in mean waiting time 26.3 months. The probability of prognostic factors transition from stage II to III was 88.9% with mean waiting time 25.5 months, transition from III to IV was 55.7% with mean waiting time of 24.9 months and transition for

Screening and staging for non-small cell lung cancer by serum laser Raman spectroscopy.

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Wang, Hong; Zhang, Shaohong; Wan, Limei; Sun, Hong; Tan, Jie; Su, Qiucheng

2018-08-05

Lung cancer is the leading cause of cancer-related death worldwide. Current clinical screening methods to detect lung cancer are expensive and associated with many complications. Raman spectroscopy is a spectroscopic technique that offers a convenient method to gain molecular information about biological samples. In this study, we measured the serum Raman spectral intensity of healthy volunteers and patients with different stages of non-small cell lung cancer. The purpose of this study was to evaluate the application of serum laser Raman spectroscopy as a low cost alternative method in the screening and staging of non-small cell lung cancer (NSCLC). The Raman spectra of the sera of peripheral venous blood were measured with a LabRAM HR 800 confocal Micro Raman spectrometer for individuals from five groups including 14 healthy volunteers (control group), 23 patients with stage I NSCLC (stage I group), 24 patients with stage II NSCLC (stage II group), 19 patients with stage III NSCLC (stage III group), 11 patients with stage IV NSCLC (stage IV group). Each serum sample was measured 3 times at different spots and the average spectra represented the signal of Raman spectra in each case. The Raman spectrum signal data of the five groups were statistically analyzed by analysis of variance (ANOVA), principal component analysis (PCA), linear discriminant analysis (LDA), and cross-validation. Raman spectral intensity was sequentially reduced in serum samples from control group, stage I group, stage II group and stage III/IV group. The strongest peak intensity was observed in the control group, and the weakest one was found in the stage III/IV group at bands of 848 cm -1 , 999 cm -1 , 1152 cm -1 , 1446 cm -1 and 1658 cm -1 (P Raman spectroscopy can effectively identify patients with stage I, stage II or stage III/IV Non-Small Cell Lung cancer using patient serum samples. Copyright © 2018 Elsevier B.V. All rights reserved.

Association Between Use of Traditional Chinese Medicine Herbal Therapy and Survival Outcomes in Patients With Stage II and III Colorectal Cancer: A Multicenter Prospective Cohort Study.

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Xu, Yun; Mao, Jun J; Sun, Lingyun; Yang, Lin; Li, Jie; Hao, Yingxu; Li, Huashan; Hou, Wei; Chu, Yuping; Bai, Yu; Jia, Xiaoqiang; Wang, Jinwan; Shen, Lin; Zhang, Ying; Wang, Jianbin; Liu, Jianping; Yang, Yufei

2017-11-01

Chinese cancer patients often use Traditional Chinese Medicine (TCM) herbal medicine during or after active cancer treatments. However, little is known about how TCM herbal medicine impacts cancer outcomes. This study aimed to evaluate the association between TCM herbal therapy and survival outcomes in patients with stage II or III colorectal cancer. We conducted an eight-center prospective cohort study in China among patients who had undergone radical resection for stage II and III colorectal cancer. All patients received comprehensive conventional treatments according to National Comprehensive Cancer Network (NCCN) guidelines, and follow-up visits were conducted over five years. We defined high exposure as a patient's use of TCM individualized herbs for more than one year, ascertained via clinical interviews. The primary outcome was disease-free survival (DFS), with overall survival (OS) as a secondary outcome. Between April 2007 and February 2009, we enrolled 312 patients into the cohort; 166 (53.2%) met the definition of high exposure to TCM herbs. Adjusting for covariates, high exposure to TCM was associated with both better DFS (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.39 to 0.98) and OS (HR = 0.31, 95% CI = 0.14 to 0.68). In subgroup exploratory analysis, the effects demonstrated that the differences in outcomes were statistically significant in patients who had received chemotherapy. Longer duration of TCM herbal use is associated with improved survival outcomes in stage II and III colorectal cancer patients in China. More research is needed to evaluate the effects and underlying mechanisms of herbal medicine on colorectal cancer outcomes. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Regional nodal relapse in surgically staged Merkel cell carcinoma

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Hoeller, Ulrike; Mueller, Thomas; Schubert, Tina; Budach, Volker; Ghadjar, Pirus [Charite Universitaetsmedizin Berlin, Department of Radiation Oncology, Berlin (Germany); Brenner, Winfried [Charite Universitaetsmedizin Berlin, Department of Nuclear Medicine, Berlin (Germany); Kiecker, Felix [Charite Universitaetsmedizin Berlin, Department of Dermatology, Berlin (Germany); Schicke, Bernd [Tumor Center Berlin, Berlin (Germany); Haase, Oliver [Charite Universitaetsmedizin Berlin, Department of Surgery, Berlin (Germany)

2014-10-08

The nodal relapse pattern of surgically staged Merkel cell carcinoma (MCC) with/without elective nodal radiotherapy (RT) was studied in a single institution. A total of 51 patients with MCC, 33 % UICC stage I, 14 % II, 53 % III (4 lymph node metastases of unknown primary) were eligible. All patients had surgical staging: 23 patients sentinel node biopsy (SNB), 22 patients SNB followed by lymphadenectomy (LAD) and 6 patients LAD. In all, 94 % of the primary tumors (PT) were completely resected; 57 % of patients received RT, 51 % of known PT sites, 33 % (8/24 patients) regional RT to snN0 nodes and 68 % (17/27 patients) to pN+ nodes, mean reference dose 51.5 and 50 Gy, respectively. Mean follow-up was 6 years (range 2-14 years). A total of 22 % (11/51) patients developed regional relapses (RR); the 5-year RR rate was 27 %. In snN0 sites (stage I/II), relapse occurred in 5 of 14 nonirradiated vs. none of 8 irradiated sites (p = 0.054), resulting in a 5-year RR rate of 33 % versus 0 % (p = 0.16). The crude RR rate was lower in stage I (12 %, 2/17 patients) than for stage II (43 %, 3/7 patients). In stage III (pN+), RR appeared to be less frequent in irradiated sites (18 %, 3/14 patients) compared with nonirradiated sites (33 %, 3/10 patients, p = 0.45) with 5-year RR rates of 23 % vs. 34 %, respectively. Our data suggest that adjuvant nodal RT plays a major role even if the sentinel nodes were negative. Adjuvant RT of the lymph nodes in patients with stage IIa tumors and RT after LAD in stage III tumors is proposed and should be evaluated prospectively. (orig.) [German] Untersucht wurde das regionaere Rezidivmuster des Merkelzell-Karzinoms (MCC) nach chirurgischem Staging und stadienadaptierter Therapie. Eingeschlossen wurden 51 Patienten mit lokalisiertem MCC: 33 % hatten UICC-Stadium-I-, 14 % -II-, 53 % -III-Tumoren (davon 4 Lymphknotenmetastasen eines unbekannten Primaertumors). Alle Patienten erhielten ein chirurgisches Staging: 23 Waechterlymphknotenbiopsien (SNB

[The initial (I and II) and advanced (III and IV) stages of juvenile patellar chondromalacia. Its diagnosis by magnetic resonance using a 1.5-T magnet with FLASH sequences].

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Macarini, L; Rizzo, A; Martino, F; Zaccheo, N; Angelelli, G; Rotondo, A

1998-06-01

Juvenile patellar chondromalacia is a common orthopedic disorder which can mimic other conditions; early diagnosis is mandatory to prevent its evolution into osteoarthrosis. In the early stages of patellar chondromalacia (I and II), the lesions originate in the deep cartilage layer and the joint surface is not affected. Arthroscopy can demonstrate joint surface changes only and give indirect information about deeper lesions. We investigated the yield of 2D FLASH MRI with 30 degrees flip angle and a dedicated coil in the diagnosis of patellar chondromalacia, especially in its early stages. Eighteen patients (mean age: 21 years) with clinically suspected patellar chondromalacia were examined with MRI; 13 of them were also submitted to arthroscopy. A 1.5 T unit with a transmit-and-receive extremity coil was used. We acquired T1 SE sequences (TR/TE: 500-700/15/20) and 2D T2* FLASH sequence (TR/TE/FA: 500-800/18/30 degrees). The field of view was 160-180 mm and the matrix 192 x 256, with 2-3 NEX. The images were obtained on the axial plane. The lesions were classified in 4 stages according to Shahriaree classification. Agreement between MR and arthroscopic findings was good in both early and advanced lesions in 12/13 cases. Early lesions appeared as hyperintense focal thickening of the hyaline cartilage (stage I) or as small cystic lesions within the cartilage and no articular surface involvement (stage II). The medial patellar facet was the most frequent site. Advanced lesions appeared as articular surface ulcerations, thinning and cartilage hypointensity (stage III); stage IV lesions presented as complete erosions of the hyaline cartilage and hypointense underlying bone. 2D FLASH MRI with 30 degrees flip angle can show the differences in water content in the cartilage and thus permit to detect early chondromalacia lesions in the deep cartilage.

Computerized tomography for diagnosis and staging of renal pelvic tumor

International Nuclear Information System (INIS)

Fukuoka, Hiroshi; Goto, Akihiko; Kitamura, Hajime

1985-01-01

Although we have no definite criteria available yet for clinical staging of renal pelvic tumor, the preoperative staging of this disease is nevertheless important in view of the current tendency that the necessity for renal conservative operation is considered. CT is now a routine work also for diagnosing renal pelvic tumor. The present study was performed in order to validate its usefulness for diagnosing and staging the disease. Our series consisted of 8 patients with renal pelvic tumor, in 6 of whom a definite diagnosis was established after demonstrating filling defect on pyelogram, but in the remaining two with extensive infiltration, and squamous cell carcinoma associated with staghorn calculus respectively, CT failed to provide a definite diagnosis. CT findings of an extension of the mass in the renal pelvis or renal calyces into adipose tissue of the renal sinus or renal parenchyma were judged to indicate an invasive type (Stage III), while a non-invasive type (Stage I or II) was defined on the basis of otherwise CT findings. Consistency with pathological stages was noted in 7 of the 8 cases (87.5 %). It was difficult to differentiate Stage I and Stage II on CT findings. CT was considered to be extremely useful tool for preoperative staging of renal pelvic tumor. (author)

Role of Radio-Iodinated Meta-Iodo Benzyl Guanidine in Assessment of Children with Neuroblastoma NEMROCK

International Nuclear Information System (INIS)

Abd El-Aal, H.

2006-01-01

Background: For more than ten years. M] BG has been successfully used in diagnosis and staging of children with neuroblastoma [1]. Aim of the Study: Identify the role of 131 I MIBG in the assessment of neuroblastoma and correlate its findings with other non-invasive tests. Patients and Methods: Twenty eight patients with. neuroblastoma attending the Pediatric Oncology Unit, Kasr EI-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK), Cairo University, over a period of 5 years (2002-2006) were assessed by MlBG scanning. The age of patients ranged from 40 days to 12 years with a mean of 4.7years ± 1.1. They were 16 boys and 12 girls with a M:F ratio of J :3, none was stage I and II, 7 patients (25%) were stage III and 21 patients (75%) were stage IV (Evan's staging system). Clinically, 24 patients (85.7%) presented with an abdominal mass, and 3 patients (10.7%) with a mediastinal mass. Metastases were present in the bone marrow in II children (39.3%), lymph nodes in 5 (17.9%), CNS in 4 (14.3%), liver in 2 (7.1 %), soft tissues in 3 (10.7%), lungs and pleura in I (3.6%), brain in I (3.6%), and testis in I patient (3.8%). Results: 131 I M IBG could accurately diagnose local and distant neuroblastoma lesions in 23 patients with a sensitivity of 82.2%. High levels of VMA correlated with no cardiac uptake in the first 24 hours in 7/8 patients with a sensitivity of 87.5%. On the other hand, low VMA levels were associated with cardiac uptake of 131 I MIBG in 3/4 patients with a specificity of 75%, a PPV of 88% and NPV of 86.7%. 131 I MlBG scintigraphy and bone marrow aspiration agreed on detecting neuroblastoma lesions in 24/28 patients (85.7%) p 131 I MIBG scintigraphy, in a dose of 2 mci can be used with 87.5% accuracy in the diagnosis and follow-up of Children with neuroblastoma

Pretreatment hemoglobin in early stage glottic cancer: red flag or red herring?

International Nuclear Information System (INIS)

Tucker, J. Curtis; Hixson, William C.; Kim, Robert Y.; Smith, Judy W.; Mayo, Matthew S.

1996-01-01

Purpose: To evaluate the impact of pretreatment hemoglobin levels on the recurrence rate of patients with early stage glottic carcinoma treated with definitive radiotherapy. Materials and Methods: Between May 1972 and December 1992, one hundred three patients with stage I or II glottic carcinoma were treated with definitive radiotherapy. The records were reviewed and analyzed for the effects of pretreatment hemoglobin and hematocrit, stage, dose per fraction (180 vs 200 cGy), treatment interruptions, and differentiation of the tumor. The majority of stage I patients were treated to a total dose of 64 to 66 Gy, and stage II patients were treated to 68 to 70 Gy. Mean and median follow up were 85 and 75 months, respectively. Results: With mean follow up of 85 months, the recurrence rate for patients with hemoglobin ≤13 g/dL was 33.3%, and patients with hemoglobin >13 g/dL was 20% (p 0.19). For stage I (n = 84), the recurrence rate with hemoglobin ≤13 g/dL and >13 g/dL was 26% and 17%, respectively (p = 0.51). For stage II patients (n = 19) with hemoglobin ≤13 g/dL and >13 g/dL, the recurrence rate was 50% and 36%, respectively (p = 0.66). Using a Fisher's exact test, the only variables showing a statistically significant prognosis for recurrence were treatment interruption and stage. The recurrence rate with a treatment interruption was 40% compared with 15% if there was no interruption (p 0.0039). The recurrence rate for stage I was 19%, and for stage II was 42% (p = 0.067). Other factors showed no significant increase in recurrence; dose per fraction (p = 0.421), grade of differentiation (p = 0.740). Conclusion: While pretreatment hemoglobin levels below 13 g/dL do not significantly affect the recurrence rates for T1N0 and T2N0 glottic carcinomas, treatment interruptions are a significant factor in the failure of these patients

Association between serum uric acid and metabolic syndrome components in prepubertal obese children (Tanner Stage I) from Nuevo León, Mexico - a preliminary study.

Science.gov (United States)

Perez, Elizabeth Solis; Medina, Mario Alberto González; Lomeli, Manuel Lopez-Cabanillas; González, Verónica Tijerina; Pérez, Jesús Zacarías Villarreal; Lavalle González, Fernando J; Imrhan, Victorine; Juma, Shanil; Vijayagopal, Parakat; Boonme, Kittipong; Prasad, Chandan

2017-01-01

Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease and diabetes. Previous studies in obese children demonstrating a positive association between serum uric acid (sUA) and components of MetS are confounded by lack of uniformity in age and pubertal status of children. Therefore, we have examined the role of sUA in MetS and its components in pre-pubertal children (Tanner Stage I, age ≤ 9 years). Pre-pubertal obese children (32 boys, 27 girls, age 6-9 years) were recruited from Nuevo Leon, Mexico. For comparison, an equal number of children with normal body mass index (BMI) in the same age range (22 Boys, 39 girls, age 6-9 years) were also recruited from the same community. Presence of MetS and its components was defined according to the criteria of International Diabetes Federation. Fasting blood was analyzed for lipids, glucose, insulin, and uric acid. Among the obese children, sUA was positively associated with insulin resistance and hypertriglyceridemia and negatively associated with high density lipoprotein-cholesterol (HDLc). Subjects were three times more likely to have a MetS diagnosis per one unit (md/dL) difference in sUA. Of the 59 obese pre-pubertal children, 20 were classified as having MetS defined by the presence of abdominal obesity and two or more of other components described under methods. Of these, 57.1% (20/61) had sUA between 5.1 and 7.1 mg/dl. The findings of this study clearly indicate a positive relationship between uric acid and MetS and its components in pre-pubertal obese children with Tanner stage I and ≤9 years of age.

Primary chemotherapy and preoperative-dose irradiation for patients with stage II larger than 3 CM or locally advanced non inflammatory breast cancer

International Nuclear Information System (INIS)

Touboul, E.; Lefranc, J.P.; Blondon, J.; Deniaud, E.; Buffat, L.; Benmiloud, M.; Laugier, A.; Schlienger, M.

1995-01-01

Purpose: The aims of this prospective study were to evaluate the outcome and the possibility of breast conserving treatment for patients with stage II larger than 3 cm or locally advanced non inflammatory breast cancer, after primary chemotherapy followed by external preoperative-dose irradiation. Materials and methods: Between April 1982 and June 1990, 147 consecutive patients with large breast cancer (stage II > 3 cm [n=50], stage IIIA [n=58], stage IIIB [n=35] and stage IV with isolated clinical supraclavicular or sub-clavicular node involvement [n=4] were treated. The median age was 49 years. Mean tumor size was 6 cm (range 1 - 16 cm). Sixty percent (n=88) of the patients were postmenopausal. Histological classification was : 120 infiltrating ductal carcinomas, 21 infiltrating lobular carcinomas, 4 medullary carcinomas and 2 mucosecreting carcinomas. Grade distribution according to Scarff, Bloom and Richardson was : 14 grade 1, 72 grade 2, 30 grade 3 and 31 non classified. Median follow-up was 94 months from the beginning of the treatment. The induction treatment consisted of 4 courses of chemotherapy (doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil) every 4 weeks followed by preoperative irradiation (45 Gy to the breast and nodal areas) using 60Co in 141 patients and 6 MV photons in 6 patients. A fifth course of chemotherapy was given after radiation therapy and three different locoregional approaches were proposed depending on the tumoral response. In 52 patients (35%) with residual tumor larger than 3 cm in diameter or located behind the nipple or with bifocal tumors, mastectomy and axillary dissection were performed. Ninety-five other patients (65%) benefited from conservative treatment : 48 patients (33%) achieved complete remission and received a booster dose of 25 to 30 Gy to the initial tumor bed by external photon beam or by iridium 192 implant ; 47 patients (32%) who had a residual mass less than or equal to 3 cm in diameter were treated by

Appendectomy in the surgical staging of ovarian carcinoma.

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Beşe, T; Kösebay, D; Kaleli, S; Oz, A U; Demirkiran, F; Gezer, A

1996-06-01

Extensive debulking is accepted as the primary method of operative management for carcinoma of the ovary. However, there is no consensus regarding the role of appendectomy in primary surgical treatment. The aim of this study was to assess the role of appendectomy in the surgical staging and cytoreduction of ovarian carcinoma. The study was a retrospective review of 90 primary malignant ovarian carcinoma patients who had an appendectomy in addition to primary cytoreductive surgery. Out of 90 patients, 10 (11.1%) had metastasis to the appendix. The rate of metastasis to the appendix was 11.5% (9/78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non-epithelial ovarian tumors. Of the patients with metastasis in the appendix, malignant epithelial ovarian tumors were identified in 90% (serous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metastases to the appendix in the other histological types. Although metastasis to the appendix was not observed in early stage ovarian carcinomas, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all patients with metastasis to the appendix. Appendectomy for stage I and II patients was not beneficial and did not affect final staging. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytoreductive surgery in early stage (stage I and II) malignant epithelial ovarian tumors. Appendectomy would contribute to the cytoreduction of advanced stage disease if it is macroscopically involved.

Type I-II laryngeal cleft: clinical course and outcome.

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Slonimsky, Guy; Carmel, Eldar; Drendel, Michael; Lipschitz, Noga; Wolf, Michael

2015-04-01

Laryngeal cleft (LC) is a rare congenital anomaly manifesting in a variety of symptoms, including swallowing disorders and aspirations, dyspnea, stridor and hoarseness. The mild forms (types I-II) may be underdiagnosed, leading to protracted symptomatology and morbidity. To evaluate the diagnostic process, clinical course, management and outcome in children with type I-II laryngeal clefts. We conducted a retrospective case analysis for the years 2005-2012 in a tertiary referral center. Seven children were reviewed: five boys and two girls ranging in age from birth to 5 years. The most common presenting symptoms were cough, aspirations and pneumonia. Evaluation procedures included fiber-optic laryngoscopy (FOL), direct laryngoscopy (DL) and videofluoroscopy. Other pathologies were seen in three children. Six children underwent successful endoscopic surgery and one child was treated conservatively. The postoperative clinical course was uneventful in most of the cases. Types I-II LC should be considered in the differential diagnosis of children presenting with protracted cough and aspirations. DL is crucial for establishing the diagnosis. Endoscopic surgery is safe and should be applied promptly when conservative measures fail.

Decades of Recorded Music for Children: Norwegian Children’s Phonograms from World War II to the Present

Directory of Open Access Journals (Sweden)

Petter Dyndahl

2017-09-01

Full Text Available This article presents a study of Norwegian-recorded music for children from World War II to the present, combining a historical perspective with an ethnographic approach. The underlying research has employed both quantitative and qualitative approaches, producing various data sets. The results of the data analyses indicate that the evolution of children’s phonograms is characterized by some distinct genre- and style-related development features. This article describes and interprets such features in light of concepts and theories of children’s culture and music sociology. It also elaborates on the emergence of a music market aimed at children, with an emphasis on phonograms. The association with the popular music industry enables an apparent contradiction, addressed in this article, between pedagogical and commercial considerations and outcomes.

The histologic risk model is a useful and inexpensive tool to assess risk of recurrence and death in stage I or II squamous cell carcinoma of tongue and floor of mouth.

Science.gov (United States)

Sinha, Namita; Rigby, Matthew H; McNeil, Michael L; Taylor, S Mark; Trites, Jonathan Rb; Hart, Robert D; Bullock, Martin J

2018-02-02

Surgery is the mainstay of treatment for low-stage (stage I/II, ie, T1N0/T2N0) squamous cell carcinoma of oral cavity. However, a significant percentage of low-stage squamous cell carcinoma of oral cavity will develop local recurrence and disease-related mortality. In this study, we stratified 64 patients with low-stage of oral tongue and floor of mouth patients into high-, intermediate- and low-risk categories based on existing histologic risk model. The classification of these risk categories was based on presence or absence of perineural invasion and evaluation of tumor-host junction for worst pattern of invasion and lymphocytic host response. We correlated risk category and other variables with recurrence and death. In a univariate model, high-risk category tumors had a significantly higher rate of recurrence and death due to recurrence compared with low/intermediate-risk categories (P=0.000 and P=0.047, respectively). Controlling for margin status and T-stage, high-risk category had a 12.4 odds ratio of later recurrence when compared with low/intermediate-risk categories, with a P-value of 0.001. In conclusion, we found low-stage oral cavity squamous cell carcinoma patients with high-risk category have a significantly higher risk for recurrence when compared with patients in the low- or intermediate-risk category, even when controlling for margin status and T-stage. These patients may be suitable candidates for adjuvant treatment to decrease morbidity and mortality associated with a recurrence. Our results indicate that the histologic risk model is a useful and simple tool to assess risk of recurrence in stage I or II squamous cell carcinoma of oral cavity.Modern Pathology advance online publication, 2 February 2018; doi:10.1038/modpathol.2017.183.

Characterization of the coagulation profile in children with liver disease and extrahepatic portal vein obstruction or shunt.

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Beattie, William; Magnusson, Maria; Hardikar, Winita; Monagle, Paul; Ignjatovic, Vera

2017-03-01

Chronic liver disease causes a disruption of procoagulant and anticoagulant factors, resulting in a fragile state, prone to increased rates of both bleeding and thrombosis. Currently, there is limited literature describing the changes observed in pediatric liver disease and extrahepatic portal vein obstruction or shunt. This study aimed to describe the changes that occur in children with chronic liver disease and extrahepatic portal vein obstruction or shunt. We measured the concentration and activity of key procoagulant and anticoagulant factors in children with liver disease, children with extrahepatic portal vein obstruction or shunt, and healthy children. Children with severe liver disease had coagulopathic changes, including either decreased concentration or activity of factor II, factor V, and factor VII. Nineteen percent (8/42) of the cohort had significant bleeding. Thrombophilic changes were also observed, including decreased concentration or activity of protein C, protein S, and antithrombin and increased concentration and activity of factor VIII and Von Willebrand factor. Similar coagulation factor changes were observed in children with extrahepatic portal vein obstruction or shunt. There was a trend toward greater changes in coagulation factor activity compared to concentration. This study provides a detailed description of the changes in both the concentration and activity of coagulation factors in pediatric liver disease and extrahepatic portal vein obstruction or shunt. Interestingly, procoagulant and anticoagulant factors were deranged in portal vein obstruction or shunt to a similar degree as in liver disease. An improved understanding of the coagulation profile in the pediatric setting will contribute to the improved management of liver disease and extrahepatic portal obstruction or shunt. PELD: pediatric end-stage liver disease score; MELD: model for end-stage liver disease score; ELISA: enzyme-linked immunosorbent assay; MCRI: Murdoch Childrens

Analysis of cosmetic results and complications in patients with Stage I and II breast cancer treated by biopsy and irradiation

International Nuclear Information System (INIS)

Clarke, D.; Martinez, A.; Cox, R.S.

1983-01-01

Between May, 1973 and December, 1980, 78 Stage I and II breast carcinomas in 76 patients were treated by biopsy and radiotherapy with curative intent. With a maximum follow-up of 10 years, a minimum of 2 1/2 years and a median follow-up of 3 1/2 years, a loco-regional control rate of 97% was obtained. Cosmetic results and treatment complications were studied. Patient characteristics, tumor size, excisional biopsy technique, axillary staging procedure and radiotherapy techniques were analyzed and all found to be important factors affecting cosmesis and complications. The most common complications included transient breast edema observed in 51% of patients, breast fibrosis (usually mild) seen in 23% of the population, axillary hematoma or seroma formation in 15%, mild arm edema in 14% and basilic vein thrombosis in 10% of patients. The causes of these and other less frequent complications are discussed. The overall cosmetic result was excellent in 78%, satisfactory in 18% and unsatisfactory in 4% of patients. Recommendations for improving cosmetic results and minimizing complications are made

Heavy Metal Exposure in Predicting Peripheral Neuropathy in Patients With Stage I-III Breast Cancer Undergoing Chemotherapy

Science.gov (United States)

2017-06-14

Male Breast Cancer; Neurotoxicity; Peripheral Neuropathy; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

Minocycline Hydrochloride in Reducing Chemotherapy Induced Depression and Anxiety in Patients With Stage I-III Breast Cancer

Science.gov (United States)

2017-08-07

Anxiety Disorder; Depression; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

The effect of adjuvant radiation on survival in early stage clear cell ovarian carcinoma.

Science.gov (United States)

Hogen, Liat; Thomas, Gillian; Bernardini, Marcus; Bassiouny, Dina; Brar, Harinder; Gien, Lilian T; Rosen, Barry; Le, Lisa; Vicus, Danielle

2016-11-01

To assess the impact of adjuvant radiotherapy (RT) on survival in patients with stage I and II ovarian clear cell carcinoma (OCCC). Data collection and analysis of stage I and II OCCC patients treated at two tertiary centers in Toronto, between 1995 and 2014, was performed. Descriptive statistics and Kaplan-Meier survival probability estimates were completed. The log-rank test was used to compare survival curves. 163 patients were eligible. 44 (27%) patients were treated with adjuvant RT: 37 of them received adjuvant chemotherapy (CT), and 7 had RT only. In the no-RT group, there were 119 patients: 83 patients received adjuvant CT and 36 had no adjuvant treatment. The 10year progression free survival (PFS) was 65% for patients treated with RT, and 59% no-RT patients. There were a total of 41 (25%) recurrences in the cohort: 12 (27.2%) patients in RT group and 29 (24.3%) in the no-RT group. On multivariable analysis, adjuvant RT was not significantly associated with an increased PFS (0.85 (0.44-1.63) p=0.63) or overall survival (OS) (0.84 (0.39-1.82) p=0.66). In the subset of 59 patients defined as high-risk: stage IC with positive cytology and/or surface involvement and stage II: RT was not found to be associated with a better PFS (HR 1.18 (95% CI: 0.55-2.54) or O S(HR 1.04 (95% CI: 0.40-2.69)). Adjuvant RT was not found to be associated with a survival benefit in patients with stage I and II ovarian clear cell carcinoma or in a high risk subset of patients including stage IC cytology positive/surface involvement and stage II patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Spectral characteristics of caries-related autofluorescence spectra and their use for diagnosis of caries stage

Science.gov (United States)

Son, Sung-Ae; Jung, Kyeong-Hoon; Ko, Ching-Chang; Kwon, Yong Hoon

2016-01-01

The purpose of the present study was to identify factors useful for diagnosis of the caries stage from laser-induced autofluorescence (AF) spectra. Affected teeth were accurately staged and allocated to four groups: sound, stage II, stage III, or stage IV. A 405-nm laser was used to produce AF spectra. The spectrum factors analyzed were spectrum slope at 550 to 600 nm, spectral area from 500 and 590 nm, and intensity ratio of peaks 625 and 667 nm (625/667 nm). DIAGNOdent was used as control measurement. AF spectra of sound teeth had a peak near 500 nm followed by a smooth decline to 800 nm. As caries progressed, some specimens in stages II to IV showed one or two peak(s) near 625 and 667 nm. Slopes at 550 to 600 nm and areas under the curve at 500 to 590 nm were significantly different (p<0.001) for each stage. Two-peak ratios were also significantly different (p<0.001) except for stage III and stage IV. DIAGNOdent readings for sound and stage II and stage III and IV were not significantly different. Among the studied factors, the spectrum slope at 550 to 600 nm and area under curve at 500 to 590 nm could be useful treatment decision-making tools for carious lesions.

Systems Support Mapping in Guiding Self-Management in Stage I-III Colorectal Cancer Survivors

Science.gov (United States)

2018-04-26

Cancer Survivor; Stage I Colorectal Cancer AJCC v8; Stage II Colorectal Cancer AJCC v8; Stage IIA Colorectal Cancer AJCC v8; Stage IIB Colorectal Cancer AJCC v8; Stage IIC Colorectal Cancer AJCC v8; Stage III Colorectal Cancer AJCC v8; Stage IIIA Colorectal Cancer AJCC v8; Stage IIIB Colorectal Cancer AJCC v8; Stage IIIC Colorectal Cancer AJCC v8

A review of the stages of work hardening

Energy Technology Data Exchange (ETDEWEB)

Rollett, A.D.; Kocks, U.F.

1993-07-01

Stages of work hardening are reviewed with emphasis on links between each stage. Simple quantitative descriptions are given for each stage. Similarities between stage I, easy glide, and stage IV, large strain hardening, are pointed out both in terms of magnitude of the hardening rate and of the underlying mechanism of dislocation debris accumulation. Stage II is described as an athermal hardening stage that occurs when statistical variations in the dislocation ``forest`` lead to geometrical storage of dislocations. The steadily decreasing hardening rate observed in stage III is characterized by the increasing rate of loss of dislocation density due to dynamic recovery. Stage III appears to have an asymptote to a saturation stress which is determined by the characteristics of the dislocation tangles, or cell walls. The imperfect nature of the dynamic recovery process, however, leads to the accumulation of dislocation debris and this, by analogy with stage 1, causes the apparent saturation stress to rise, thus causing stage IV.

Etiology and management of dyslipidemia in children with chronic kidney disease and end-stage renal disease.

Science.gov (United States)

Khurana, Mona; Silverstein, Douglas M

2015-12-01

Lipids are essential components of cell membranes, contributing to cell fuel, myelin formation, subcellular organelle function, and steroid hormone synthesis. Children with chronic kidney disease (CKD) and end-stage renal disease (ESRD) exhibit various co-morbidities, including dyslipidemia. The prevalence of dyslipidemias in children with CKD and ESRD is high, being present in 39-65% of patients. Elevated lipid levels in children without renal disease are a risk factor for cardiovascular disease (CVD), while the risk for CVD in pediatric CKD/ESRD is unclear. The pathogenesis of dyslipidemia in CKD features various factors, including increased levels of triglycerides, triglyceride-rich lipoproteins, apolipoprotein C3 (ApoC-III), decreased levels of cholesterylester transfer protein and high-density lipoproteins, and aberrations in serum very low-density and intermediate-density lipoproteins. If initial risk assessment indicates that a child with advanced CKD has 2 or more co-morbidities for CVD, first-line treatment should consist of non-pharmacologic management such as therapeutic lifestyle changes and dietary counseling. Pharmacologic treatment of dyslipidemia may reduce the incidence of CVD in children with CKD/ESRD, but randomized trials are lacking. Statins are the only class of lipid-lowering drugs currently approved by the U.S. Food and Drug Administration (FDA) for use in the pediatric population. FDA-approved pediatric labeling for these drugs is based on results from placebo-controlled trial results, showing 30-50% reductions in baseline low-density lipoprotein cholesterol. Although statins are generally well tolerated in adults, a spectrum of adverse events has been reported with their use in both the clinical trial and post-marketing settings.

CT and MRI appearances and radiologic staging of pediatric renal cell carcinoma

Energy Technology Data Exchange (ETDEWEB)

Downey, Ryan T. [University of Michigan Health System, Department of Radiology, Ann Arbor, MI (United States); Dillman, Jonathan R.; Ladino-Torres, Maria F.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); McHugh, Jonathan B. [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States); Ehrlich, Peter F. [University of Michigan Health System, Department of Surgery, Section of Pediatric Surgery, Ann Arbor, MI (United States)

2012-04-15

Renal cell carcinoma (RCC) is an uncommon but noteworthy primary pediatric renal malignancy. There is a paucity of published data regarding the CT/MRI appearances and accuracy of pretreatment radiologic staging of this form of cancer in children. To review the various CT/MRI appearances of pediatric RCC and assess the accuracy of pretreatment radiologic staging using these imaging modalities. Institutional Departments of Pathology and Radiology records were searched from 1995 through 2010 for children (younger than 18 years of age) with RCC. Available pretreatment contrast-enhanced abdominopelvic CT and MRI examinations were reviewed by two radiologists. Pertinent imaging findings were documented by consensus, and correlation was made between radiologic and surgicopathological TNM staging. Pretreatment imaging studies from 10 RCCs in nine children (four girls and five boys; mean age 12.9 years) were reviewed. The mean size of the primary tumor was 6.2 cm (range, 1.5-12.6 cm). Ninety percent of RCCs demonstrated heterogeneous postcontrast enhancement. Fifty percent of masses had associated hemorrhage, while 40% contained internal calcification. Regarding TNM staging, N staging was correct for 10 of 10 tumors, while M staging was correct for 10 of 10 tumors. Imaging correctly staged only 4 of 10 tumors with respect to T stage. Radiologic and surgicopathological overall staging were concordant for 8 of 10 tumors. Pediatric RCCs typically present as large, heterogeneous masses, and they commonly hemorrhage and contain internal calcification. Radiologic and surgicopathological overall TNM staging are frequently concordant, although radiologic T staging is often incorrect. (orig.)

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

Science.gov (United States)

2018-06-04

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

Hypofractionated Radiation Therapy After Mastectomy in Preventing Recurrence in Patients With Stage IIa-IIIa Breast Cancer

Science.gov (United States)

2018-04-06

Ductal Breast Carcinoma; Invasive Breast Carcinoma; Lobular Breast Carcinoma; Medullary Breast Carcinoma; Stage II Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Tubular Breast Carcinoma

Hematological Manifestation in HIV Infected Children

International Nuclear Information System (INIS)

Bhowmik, A.; Banerjee, P.

2015-01-01

Objective: To determine the common hematological abnormalities in HIV infected children and any association of these abnormalities with HIV disease severity. Study Design: Cross-sectional study. Place and Duration of Study: Regional Pediatric ART centre, Medical College and Hospital, Kolkata, West Bengal, India, from November 2011 to November 2012. Methodology: Children up to 12 years with confirmed diagnosis of HIV infection were clinically examined and tested for complete hemogram and CD4 count. Bone marrow study was done in selected patient depending on hemogram report. Children were divided in different stages according to WHO clinical staging. Each of the hematological parameters was assessed for any association with progression of disease. Fisher's Exact Test was used for determining the association between WHO clinical staging and abnormal blood parameters. P-value < 0.05 was taken as significant. Results: Sixty nine percent of the study population was anemic; 47.37% (18/38), 66.67% (8/12), 71.43% (15/21) and 93.10% (27/29) of stage 1, 2, 3 and 4 respectively were anemic in the study population (p=0.001). Leucopenia was present in 34% (34/100) children. Neutropenia and lymphopenia was present in 19% (19/100) and 22% (22/100) children. Lymphopenia was present in 7.89% (3/38), 16.67% (2/12), 19.05% (4/21) and 44.83% (13/29) of patient with stage 1, 2, 3 and 4 respectively (p=0.020). Eosinophilia was present in 17% (17/100) and thrombocytopenia in 11% (11/100) children. 2 patients with stage 4 disease were with hypoplastic bone marrow. Conclusion: Anemia was the most common hematological abnormality in HIV infected children. Anemia and lymphopenia had a significant association with the stage of the disease. (author)

Imaging of solid kidney tumours in children

International Nuclear Information System (INIS)

Hugosson, C.; Nyman, R.; Jacobsson, B.; Jorulf, H.; Sackey, K.; McDonald, P.

1995-01-01

Eighteen children aged 6 months to 12 years with 20 solid renal tumours; 13 Wilms' tumours (WT), 2 clear cell sarcomas of the kidney, 1 malignant rhabdoid tumour of the kidney and 2 cases of bilateral nephroblastomatosis with Wilms' tumour underwent evaluation with US, CT and MR imaging. Contrast-enhanced CT and non-enhanced MR were equally accurate in determining the size and origin of the tumour but were unreliable in separation of stages I, II and III. US could only accurately assess the size of the tumours. MR characteristics varied somewhat between WTs and non-WTs but contrast-enhanced MR imaging might be useful for separation of WTs from nephroblastomatosis. (orig.)

Screening for autistic spectrum disorder in children aged 14-15 months. II: population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings.

NARCIS (Netherlands)

Dietz, C.; Swinkels, S.H.N.; Daalen, E. van; Engeland, H.M. van; Buitelaar, J.K.

2006-01-01

A two-stage protocol for screening for autistic spectrum disorders (ASD) was evaluated in a random population of 31,724 children aged 14-15 months. Children were first pre-screened by physicians at well-baby clinics using a 4-item screening instrument. Infants that screened positive were then

Title IV Quality Control Project, Stage II. Management Option II: Delivery System Quality Improvements.

Science.gov (United States)

Advanced Technology, Inc., Reston, VA.

Stage Two of the Title IV Quality Control Project is an integrated study of quality in five related Federal financial aid programs for postsecondary students. Section 1 of the paper establishes a framework for defining quality improvements, in order to identify the types of changes that would tend to improve quality across all facets of the…

Children of non-Western origin with end-stage renal disease in the Netherlands, Belgium and a part of Germany have impaired health-related quality of life compared with Western children.

Science.gov (United States)

Schoenmaker, Nikki J; Haverman, Lotte; Tromp, Wilma F; van der Lee, Johanna H; Offringa, Martin; Adams, Brigitte; Bouts, Antonia H M; Collard, Laure; Cransberg, Karlien; van Dyck, Maria; Godefroid, Nathalie; van Hoeck, Koenraad; Koster-Kamphuis, Linda; Lilien, Marc R; Raes, Ann; Taylan, Christina; Grootenhuis, Martha A; Groothoff, Jaap W

2014-02-01

Many children with end-stage renal disease (ESRD) living in Western Europe are of non-Western European origin. They have unfavourable somatic outcomes compared with ESRD children of Western origin. In this study, we compared the Health-related Quality of Life (HRQoL) of both groups. All children (5-18 years) with ESRD included in the RICH-Q project (Renal Insufficiency therapy in Children-Quality assessment and improvement) or their parents were asked to complete the generic version of the Paediatric Quality-of-Life Inventory 4.0 (PedsQL). RICH-Q comprises the Netherlands, Belgium and a part of Germany. Children were considered to be of non-Western origin if they or at least one parent was born outside Western-European countries. Impaired HRQoL for children with ESRD of Western or non-Western origin was defined as a PedsQL score less than fifth percentile for healthy Dutch children of Western or non-Western origin, respectively. Of the 259 eligible children, 230 agreed to participate. One hundred and seventy-four children responded (response rate 67%) and 55 (32%) were of non-Western origin. Overall, 31 (56%) of the ESRD children of non-Western origin, and 58 (49%) of Western origin had an impaired total HRQoL score. Total HRQoL scores of children with ESRD of Western origin and non-Western origin were comparable, but scores on emotional functioning and school functioning were lower in non-Western origin (P=0.004 and 0.01, respectively). The adjusted odds ratios (95% confidence interval) for ESRD children of non-Western origin to have impaired emotional functioning and school functioning, compared with Western origin, were 3.3(1.5-7.1) and 2.2(1.1-4.2), respectively. Children with ESRD of non-Western origin in three Western countries were found to be at risk for impaired HRQoL on emotional and school functioning. These children warrant special attention.

Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age.

Science.gov (United States)

Yamanishi, Tadashi; Nishio, Juntaro; Sako, Michiyo; Kohara, Hiroshi; Hirano, Yoshiko; Yamanishi, Yukiko; Adachi, Tadafumi; Miya, Shigenori; Mukai, Takao

2011-02-01

Determining the optimal timing and procedure of palatal surgery for children with cleft lip and palate has long raised a major controversy. An early two-stage palatoplasty protocol has been a recent trend in an attempt to obtain preferable maxillary growth without compromising adequate speech development. In this study, we aim to address whether the resulting maxillofacial growth and speech development obtained by an early 2-stage palatoplasty protocol are better than those obtained by conventional 1-stage push-back palatoplasty. Seventy-two nonsyndromic children with complete unilateral cleft lip and palate were enrolled in this study. They were divided into 2 groups: 30 children, who were treated with early 2-stage palatoplasty, in which soft palate closure was performed using a modified Furlow's procedure at 12 months of age and hard palate closure was performed at 18 months of age (Early Tow Stage [ETS] group: 22 boys, 8 girls), and 42 children, who underwent 1-stage Wardill-Kilner push-back palatoplasty at 12 months of age (Push Back [PB] group: 31 boys, 11 girls). Cephalometric analysis for maxillofacial growth and assessments of speech development were performed for each child at 4 years of age. The ETS group showed a lager maxillary length than the PB group [anterior nasal spine (ANS)-ptm': ETS, 46.7 ± 2.0 mm; PB, 43.6 ± 2.3 mm]. The ANS in the ETS group was positioned more anteriorly than that in the PB group (N'-ANS: ETS, 2.5 ± 1.8 mm; PB, 0.26 ± 2.5 mm), whereas the posterior edge of the maxilla positioned anteroposteiorly was comparable between the 2 groups. The anterior facial height was significantly greater in the ETS group than in the PB group (N-N': ETS, 43.3 ± 2.9 mm; PB, 40.1 ± 2.3 mm, S-S': ETS, 29.7 ± 3.2 mm; PB, 31.0 ± 3.2 mm). No statistically significant differences were observed in the incidence of either velopharyngeal incompetence or articulation errors between the 2 groups at 4 years of age. Our results show that the early 2

Social-emotional instability in individuals with Rett syndrome: parents' experiences with second stage behaviour.

Science.gov (United States)

Munde, V; Vlaskamp, C; Ter Haar, A

2016-01-01

While the medical profession often terms behaviours in individuals with Rett syndrome (RTT) in the second stage as 'autistic-like', parents disagree with this description. The present study focuses on a comparison of parents' experiences with the social-emotional behaviour of the child with RTT in the second and subsequent stages. In collaboration with the Dutch Rett Syndrome Organization, 51 parents of children with RTT in the Netherlands took part in the present study. Parents completed an online questionnaire to clarify their experiences of the social-emotional behaviour of their children during and after the second stage of RTT. Both quantitative and qualitative analysis techniques have been used. The results of the paired-samples t-test show that parents see significantly less social-emotional behaviour in the children during the second stage of RTT than in the subsequent stages. Parents reported that their children did not seek as much interaction. From the parents' descriptions, it would seem that the children are willing but unable to interact with their environment. Like previous research, our study leads to doubts about the appropriateness of the label 'autistic-like' for the behaviour of individuals in the second stage of RTT. While behaviours of individuals with autism and individuals with RTT may resemble each other, quality and intentions may differ. Still, future studies are needed for further clarification. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

CASSAVA BREEDING II: PHENOTYPIC CORRELATIONS THROUGH THE DIFFERENT STAGES OF SELECTION

Directory of Open Access Journals (Sweden)

Orlando Joaqui Barandica

2016-12-01

Full Text Available Breeding cassava relies on a phenotypic recurrent selection that takes advantage of the vegetative propagation of this crop. Successive stages of selection (single row trial- SRT; preliminary yield trial – PYT; advanced yield trial – AYT; and uniform yield trials UYT, gradually reduce the number of genotypes as the plot size, number of replications and locations increase. An important feature of this scheme is that, because of the clonal, reproduction of cassava, the same identical genotypes are evaluated throughout these four successive stages of selection. For this study data, from 14 years (more than 30,000 data points of evaluation in a sub-humid tropical environment was consolidated for a meta-analysis. Correlation coefficients for fresh root yield (FRY, dry matter content (DMC, harvest index (HIN and plant type score (PTS along the different stages of selection were estimated. DMC and PTS measured in different trials showed the highest correlation coefficients, indicating a relatively good repeatability. HIN had an intermediate repeatability, whereas FRY had the lowest value. The association between HIN and FRY was lower than expected, suggesting that HIN in early stages was not reliable as indirect selection for FRY in later stages. There was a consistent decrease in the average performance of clones grown in PYTs compared with the earlier evaluation of the same genotypes at SRTs. A feasible explanation for this trend is the impact of the environment on the physiological and nutritional status of the planting material and/or epigenetic effects. The usefulness of HIN is questioned. Measuring this variable takes considerable efforts at harvest time. DMC and FRY showed a weak positive association in SRT (r= 0.21 but a clearly negative one at UYT (r= -0.42. The change if the relationship between these variables is the result of selection. In later stages of selection, the plant is forced to maximize productivity on a dry weight basis

Acupuncture in Reducing Chemotherapy-Induced Peripheral Neuropathy in Participants With Stage I-III Breast Cancer

Science.gov (United States)

2018-05-30

Anatomic Stage I Breast Cancer AJCC v8; Anatomic Stage IA Breast Cancer AJCC v8; Anatomic Stage IB Breast Cancer AJCC v8; Anatomic Stage II Breast Cancer AJCC v8; Anatomic Stage IIA Breast Cancer AJCC v8; Anatomic Stage IIB Breast Cancer AJCC v8; Anatomic Stage III Breast Cancer AJCC v8; Anatomic Stage IIIA Breast Cancer AJCC v8; Anatomic Stage IIIB Breast Cancer AJCC v8; Anatomic Stage IIIC Breast Cancer AJCC v8; Grade 1 Peripheral Motor Neuropathy, CTCAE; Grade 1 Peripheral Sensory Neuropathy, CTCAE; Grade 2 Peripheral Motor Neuropathy, CTCAE; Grade 2 Peripheral Sensory Neuropathy, CTCAE; Prognostic Stage I Breast Cancer AJCC v8; Prognostic Stage IA Breast Cancer AJCC v8; Prognostic Stage IB Breast Cancer AJCC v8; Prognostic Stage II Breast Cancer AJCC v8; Prognostic Stage IIA Breast Cancer AJCC v8; Prognostic Stage IIB Breast Cancer AJCC v8; Prognostic Stage III Breast Cancer AJCC v8; Prognostic Stage IIIA Breast Cancer AJCC v8; Prognostic Stage IIIB Breast Cancer AJCC v8; Prognostic Stage IIIC Breast Cancer AJCC v8

One-stage sequential bilateral thoracic expansion for asphyxiating thoracic dystrophy (Jeune syndrome).

Science.gov (United States)

Muthialu, Nagarajan; Mussa, Shafi; Owens, Catherine M; Bulstrode, Neil; Elliott, Martin J

2014-10-01

Jeune syndrome (asphyxiating thoracic dystrophy) is a rare disorder characterized by skeletal dysplasia, reduced diameter of the thoracic cage and extrathoracic organ involvement. Fatal, early respiratory insufficiency may occur. Two-stage lateral thoracic expansion has been reported, addressing each side sequentially over 3-12 months. While staged repair theoretically provides less invasive surgery in a small child with respiratory distress, we utilized a single stage, bilateral procedure aiming to rapidly maximize lung development. Combined bilateral surgery also offered the chance of rapid recovery, and reduced hospital stay. We present our early experience of this modification of existing surgical treatment for an extremely rare condition, thought to be generally fatal in early childhood. Nine children (6 males, 3 females; median age 30 months [3.5-75]) underwent thoracic expansion for Jeune syndrome in our centre. All patients required preoperative respiratory support (5 with tracheostomy, 8 requiring positive pressure ventilation regularly within each day/night cycle). Two children underwent sequential unilateral (2-month interval between stages) and 7 children bilateral thoracic expansion by means of staggered osteotomies of third to eighth ribs and plate fixation of fourth to fifth rib and sixth to seventh rib, leaving the remaining ribs floating. There was no operative mortality. There were 2 deaths within 3 months of surgery, due to pulmonary hypertension (1 following two-stage and 1 following single-stage thoracic expansion). At the median follow-up of 11 months (1-15), 3 children have been discharged home from their referring unit and 2 have significantly reduced respiratory support. One child remains on non-invasive ventilation and another is still ventilated with a high oxygen requirement. Jeune syndrome is a difficult condition to manage, but bilateral thoracic expansion offers an effective reduction in ventilator requirements in these children

Radiotherapy in early stage dupuytren's contracture

International Nuclear Information System (INIS)

Adamietz, B.; Sauer, R.; Gruenert, J.

2001-01-01

Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [de

Video game performances are preserved in ADHD children compared with controls.

Science.gov (United States)

Bioulac, Stéphanie; Lallemand, Stéphanie; Fabrigoule, Colette; Thoumy, Anne-Laure; Philip, Pierre; Bouvard, Manuel Pierre

2014-08-01

Although ADHD and excessive video game playing have received some attention, few studies have explored the performances of ADHD children when playing video games. The authors hypothesized that performances of ADHD children would be as good as those of control children in motivating video games tasks but not in the Continuous Performance Test II (CPT II). The sample consisted of 26 ADHD children and 16 control children. Performances of ADHD and control children were compared on three commercially available games, on the repetition of every game, and on the CPT II. ADHD children had lower performances on the CPT II than did controls, but they exhibited equivalent performances to controls when playing video games at both sessions and on all three games. When playing video games, ADHD children present no difference in inhibitory performances compared with control children. This demonstrates that cognitive difficulties in ADHD are task dependent. © 2012 SAGE Publications.

Setting the stage for school health-promoting programmes for deaf children in Spain.

Science.gov (United States)

Munoz-Baell, Irma M; Alvarez-Dardet, Carlos; Ruiz, M Teresa; Ferreiro-Lago, Emilio; Aroca-Fernandez, Eva

2008-12-01

Implementing health-promoting programmes for the most excluded and at-risk social groups forms a key part of any efforts to address underserved populations and reduce health inequalities in society. However, many at-risk children, particularly children in deaf communities, are not reached, or are poorly served, by health-promoting programmes within the school setting. This is so because schools are effective as health-promoting environments for d/Deaf children only to the extent that they properly address their unique communication needs and ensure they are both able and enabled to learn in a communication-rich and supportive psycho-social environment. This article examines how the usually separate strands of school health promotion and d/Deaf education might be woven together and illustrates research with deaf community members that involves them and gives their perspective. The primary objective of this study was to map deaf pilot bilingual education programmes in Spain-one of the first countries to ratify the Convention on the Rights of Persons with Disabilities (United Nations. (2006) Convention on the Rights of Persons with Disabilities, Resolution A/RES/61/106.)-with particular attention to their compliance to the Convention's article 24. Following pre-testing, 516 key informants were surveyed by mail (response rate: 42.08%) by using a snow-ball key-informant approach, within a Participatory Action Research framework, at a national, regional and local level. The results show that although some schools have achieved recommended standards, bilingual programmes are in various stages of formulation and implementation and are far from being equally distributed across the country, with only four regions concentrating more than 70% of these practices. This uneven geographical distribution of programmes probably reflects more basic differences in the priority given by regions, provinces, and municipalities to the deaf community's needs and rights as an important

Evaluation of a modified two-stage inferior alveolar nerve block technique: A preliminary investigation

Directory of Open Access Journals (Sweden)

Ashwin Rao

2017-01-01

Full Text Available Introduction: The two-stage technique of inferior alveolar nerve block (IANB administration does not address the pain associated with “needle insertion” and “local anesthetic solution deposition” in the “first stage” of the injection. This study evaluated a “modified two stage technique” to the reaction of children during “needle insertion” and “local anesthetic solution deposition” during the “first stage” and compared it to the “first phase” of the IANB administered with the standard one-stage technique. Materials and Methods: This was a parallel, single-blinded comparative study. A total of 34 children (between 6 and 10 years of age were randomly divided into two groups to receive an IANB either through the modified two-stage technique (MTST (Group A; 15 children or the standard one-stage technique (SOST (Group B; 19 children. The evaluation was done using the Face Legs Activity Cry Consolability (FLACC; which is an objective scale based on the expressions of the child scale. The obtained data was analyzed using Fishers Exact test with the P value set at <0.05 as level of significance. Results: 73.7% of children in Group B indicated moderate pain during the “first phase” of SOST and no children indicated such in the “first stage” of group A. Group A had 33.3% children who scored “0” indicating relaxed/comfortable children compared to 0% in Group B. In Group A, 66.7% of children scored between 1–3 indicating mild discomfort compared to 26.3% in group B. The difference in the scores between the two groups in each category (relaxed/comfortable, mild discomfort, moderate pain was highly significant (P < 0.001. Conclusion: Reaction of children in Group A during “needle insertion” and “local anesthetic solution deposition” in the “first stage” of MTST was significantly lower than that of Group B during the “first phase” of the SOST.

„Careers of young delinquents”, i.e. the phenomenon of excluding pre-school children who are at risk of social maladjustment during the early stages of education

Directory of Open Access Journals (Sweden)

Małgorzata Michel

2014-06-01

Full Text Available The article presents research on the process of social exclusion from the first stage of the education of children at risk of social maladjustment. The author presents strategies and tactics used by teachers of preschool education to eliminate the exclusion of children who cause educational problems. The author analyzes the data in accordance with the methodology of grounded theory in the context of game theory.

Development of a nomogram combining clinical staging with 18F-FDG PET/CT image features in non-small-cell lung cancer stage I-III

International Nuclear Information System (INIS)

Desseroit, Marie-Charlotte; Visvikis, Dimitris; Majdoub, Mohamed; Hatt, Mathieu; Tixier, Florent; Perdrisot, Remy; Cheze Le Rest, Catherine; Guillevin, Remy

2016-01-01

Our goal was to develop a nomogram by exploiting intratumour heterogeneity on CT and PET images from routine 18 F-FDG PET/CT acquisitions to identify patients with the poorest prognosis. This retrospective study included 116 patients with NSCLC stage I, II or III and with staging 18 F-FDG PET/CT imaging. Primary tumour volumes were delineated using the FLAB algorithm and 3D Slicer trademark on PET and CT images, respectively. PET and CT heterogeneities were quantified using texture analysis. The reproducibility of the CT features was assessed on a separate test-retest dataset. The stratification power of the PET/CT features was evaluated using the Kaplan-Meier method and the log-rank test. The best standard metric (functional volume) was combined with the least redundant and most prognostic PET/CT heterogeneity features to build the nomogram. PET entropy and CT zone percentage had the highest complementary values with clinical stage and functional volume. The nomogram improved stratification amongst patients with stage II and III disease, allowing identification of patients with the poorest prognosis (clinical stage III, large tumour volume, high PET heterogeneity and low CT heterogeneity). Intratumour heterogeneity quantified using textural features on both CT and PET images from routine staging 18 F-FDG PET/CT acquisitions can be used to create a nomogram with higher stratification power than staging alone. (orig.)

Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

International Nuclear Information System (INIS)

Freedman, Gary M.; Anderson, Penny R.; Bleicher, Richard J.; Litwin, Samuel; Li Tianyu; Swaby, Ramona F.; Ma, Chang-Ming Charlie; Li Jinsheng; Sigurdson, Elin R.; Watkins-Bruner, Deborah; Morrow, Monica; Goldstein, Lori J.

2012-01-01

Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged ≥18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

Energy Technology Data Exchange (ETDEWEB)

Freedman, Gary M., E-mail: Gary.Freedman@uphs.upenn.edu [Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Anderson, Penny R. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Bleicher, Richard J. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Litwin, Samuel; Li Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Swaby, Ramona F. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ma, Chang-Ming Charlie; Li Jinsheng [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Sigurdson, Elin R. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Watkins-Bruner, Deborah [School of Nursing, Emory University, Atlanta, Georgia (United States); Morrow, Monica [Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goldstein, Lori J. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

2012-11-15

Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

The ability of conservation and seriation in the transition from the pre-operational stage to the stage of concrete logical operations

OpenAIRE

Zadnikar Rupnik, Daša

2016-01-01

In the theoretical part of the thesis I closely addressed the Piaget's theory from the field of children's thinking. I described four stages of cognitive development as defined by Piaget. I focused on cognitive operations which are characteristic of the transition from the pre-operational stage to the stage of concrete logical operations, namely conservation and seriation. I summarized certain reviews of the Piaget's theory and described the use of the Piaget's theory in education. A part of ...

Evaluation of Revised International Staging System (R-ISS) for transplant-eligible multiple myeloma patients.

Science.gov (United States)

González-Calle, Verónica; Slack, Abigail; Keane, Niamh; Luft, Susan; Pearce, Kathryn E; Ketterling, Rhett P; Jain, Tania; Chirackal, Sintosebastian; Reeder, Craig; Mikhael, Joseph; Noel, Pierre; Mayo, Angela; Adams, Roberta H; Ahmann, Gregory; Braggio, Esteban; Stewart, A Keith; Bergsagel, P Leif; Van Wier, Scott A; Fonseca, Rafael

2018-04-06

The International Myeloma Working Group has proposed the Revised International Staging System (R-ISS) for risk stratification of multiple myeloma (MM) patients. There are a limited number of studies that have validated this risk model in the autologous stem cell transplant (ASCT) setting. In this retrospective study, we evaluated the applicability and value for predicting survival of the R-ISS model in 134 MM patients treated with new agents and ASCT at the Mayo Clinic in Arizona and the University Hospital of Salamanca in Spain. The patients were reclassified at diagnosis according to the R-ISS: 44 patients (33%) had stage I, 75 (56%) had stage II, and 15 (11%) had stage III. After a median follow-up of 60 months, R-ISS assessed at diagnosis was an independent predictor for overall survival (OS) after ASCT, with median OS not reached, 111 and 37 months for R-ISS I, II and III, respectively (P R-ISS II and having high-risk chromosomal abnormalities (CA) had a significant shorter median OS than those with R-ISS II without CA: 70 vs. 111 months, respectively. Therefore, this study lends further support for the R-ISS as a reliable prognostic tool for estimating survival in transplant myeloma patients and suggests the importance of high-risk CA in the R-ISS II group.