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Sample records for stage uicc iv

  1. Seventh edition (2010) of the AJCC/UICC staging system for gastric adenocarcinoma: is there room for improvement?

    Science.gov (United States)

    Patel, Manali I; Rhoads, Kim F; Ma, Yifei; Ford, James M; Visser, Brendan C; Kunz, Pamela L; Fisher, George A; Chang, Daniel T; Koong, Albert; Norton, Jeffrey A; Poultsides, George A

    2013-05-01

    The gastric cancer AJCC/UICC staging system recently underwent significant revisions, but studies on Asian patients have reported a lack of adequate discrimination between various consecutive stages. We sought to validate the new system on a U.S. population database. California Cancer Registry data linked to the Office of Statewide Health Planning and Development discharge abstracts were used to identify patients with gastric adenocarcinoma (esophagogastric junction and gastric cardia tumors excluded) who underwent curative-intent surgical resection in California from 2002 to 2006. AJCC/UICC stage was recalculated based on the latest seventh edition. Overall survival probabilities were calculated using the Kaplan-Meier method. Of 1905 patients analyzed, 54 % were males with a median age of 70 years. Median number of pathologically examined lymph nodes was 12 (range, 1-90); 40 % of patients received adjuvant chemotherapy, and 31 % received adjuvant radiotherapy. The seventh edition AJCC/UICC system did not distinguish outcome adequately between stages IB and IIA (P = 0.40), or IIB and IIIA (P = 0.34). By merging stage II into 1 category and moving T2N1 to stage IB and T2N2, T1N3 to stage IIIA, we propose a new grouping system with improved discriminatory ability In this first study validating the new seventh edition AJCC/UICC staging system for gastric cancer on a U.S. population with a relatively limited number of lymph nodes examined, we found stages IB and IIA, as well as IIB and IIIA to perform similarly. We propose a revised stage grouping for the AJCC/UICC staging system that better discriminates between outcomes.

  2. Hormone profiling, WHO 2010 grading, and AJCC/UICC staging in pancreatic neuroendocrine tumor behavior

    International Nuclear Information System (INIS)

    Morin, Emilie; Cheng, Sonia; Mete, Ozgur; Serra, Stefano; Araujo, Paula B; Temple, Sara; Cleary, Sean; Gallinger, Steven; Greig, Paul D; McGilvray, Ian; Wei, Alice; Asa, Sylvia L; Ezzat, Shereen

    2013-01-01

    Pancreatic neuroendocrine tumors (pNETs) are the second most common pancreatic neoplasms, exhibiting a complex spectrum of clinical behaviors. To examine the clinico-pathological characteristics associated with long-term prognosis we reviewed 119 patients with pNETs treated in a tertiary referral center using the WHO 2010 grading and the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging systems, with a median follow-up of 38 months. Tumor size, immunohistochemistry (IHC) profiling and patient characteristics-determining stage were analyzed. Primary clinical outcomes were disease progression or death. The mean age at presentation was 52 years; 55% were female patients, 11% were associated with MEN1 (multiple endocrine neoplasia 1) or VHL (Von Hippel–Lindau); mean tumor diameter was 3.3 cm (standard deviation, SD) (2.92). The clinical presentation was incidental in 39% with endocrine hypersecretion syndromes in only 24% of cases. Nevertheless, endocrine hormone tissue immunoreactivity was identified in 67 (56.3%) cases. According to WHO 2010 grading, 50 (42%), 38 (31.9%), and 3 (2.5%) of tumors were low grade (G1), intermediate grade (G2), and high grade (G3), respectively. Disease progression occurred more frequently in higher WHO grades (G1: 6%, G2: 10.5%, G3: 67%, P = 0.026) and in more advanced AJCC stages (I: 2%, IV: 63%, P = 0.033). Shorter progression free survival (PFS) was noted in higher grades (G3 vs. G2; 21 vs. 144 months; P = 0.015) and in more advanced AJCC stages (stage I: 218 months, IV: 24 months, P < 0.001). Liver involvement (20 vs. 173 months, P < 0.001) or histologically positive lymph nodes (33 vs. 208 months, P < 0.001) were independently associated with shorter PFS. Conversely, tissue endocrine hormone immunoreactivity, independent of circulating levels was significantly associated with less aggressive disease. Age, gender, number of primary tumors, and heredity were not significantly associated with

  3. Unintentional Long-Term Esophageal Stenting due to a Complete Response in a Patient with Stage UICC IV Adenocarcinoma of the Gastroesophageal Junction

    Directory of Open Access Journals (Sweden)

    Anna Paeschke

    2016-05-01

    Full Text Available Endoscopic stent implantation is a common short-treatment option in palliative settings in patients with esophageal cancer. Advanced disease is associated with low survival rates; therefore, data on the long-term outcome are limited. So far, cases of long-term remission or even cure of metastasized adenocarcinoma of the gastroesophageal junction or stomach (AGS have only been reported from Asia. A 51-year-old male patient primarily diagnosed with metastasized adenocarcinoma of the gastroesophageal junction (GEJ [type I, cT3cN+cM1 (hep, CEA positive, UICC stage IV] received palliative esophageal stenting with a self-expandable metal stent. As disease progressed after four cycles with epirubicin, oxaliplatin, and capecitabin, treatment was changed to 5-FU and Irinotecan. The patient did not return after 5 cycles of FOLFIRI, but presented 4 years later with mild dysphagia. Endoscopy surprisingly revealed no relevant stenosis or stent migration. Repeated histological analyses of a residual mass at the GEJ did not detect malignancy. Since the initially diagnosed hepatic metastases were no longer detectable by computed tomography, cure from esophageal cancer was assumed. Dysphagia was ascribed to esophageal motility disorder by a narrowed esophageal lumen after long-term stenting. Thus, endoscopic stent implantation is an important method in palliative treatment of dysphagia related to AGS. New systemic treatment strategies like trastuzumab in Her2neu positive cases or new VEGF-inhibitors like ramucirumab will lead to more long-time survivors with AGS. In conclusion, future endoscopic treatment strategies in AGS represent a challenge for the development of new stent techniques in either extraction or programmed complete dissolution.

  4. Prognostic value of tumor size in patients with remnant gastric cancer: is the seventh UICC stage sufficient for predicting prognosis?

    Directory of Open Access Journals (Sweden)

    Jun Lu

    Full Text Available The 7th UICC N stage may be unsuitable for remnant gastric cancer (RGC because the original disease and previous operation usually cause abnormal lymphatic drainage. However, the prognostic significance of the current TNM staging system in RGC has not been studied.Prospective data from 153 RGC patients who underwent curative gastrectomy from Jan 1995 to Aug 2009 were reviewed. All patients were classified according to tumor size (3&≤5 cm as N1;>5&≤7 cm as N2; and>7 cm as N3. The overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs were calculated using the Cox proportional hazard model.Tumor sizes ranged from 1.0 to 15.0 cm (median 5.0 cm. Tumor size, depth of invasion and lymph node (LN metastasis were significant prognostic factors based on both the univariate and multivariate analyses (P<0.05. In the survival analysis, the seventh edition UICC-TNM classification provided a detailed classification; however, some subgroups of the UICC-TNM classification did not have significantly different survival rates. The combination of the seventh edition T classification and the suggested N classification, with ideal relative risk (RR results and P value, was distinctive for subgrouping the survival rates except for the IA versus IB and II A versus IIB. A modified staging system based on tumor size, predicted survival more accurately than the conventional TNM staging system.In RGCs, tumor size is an independent prognostic factor and a modified TNM system based on tumor size accurately predicts survival.

  5. Hepatic imaging in stage IV-S neuroblastoma

    International Nuclear Information System (INIS)

    Franken, E.A. Jr.; Smith, W.L.; Iowa Univ., Iowa City; Cohen, M.D.; Kisker, C.T.; Platz, C.E.

    1986-01-01

    Stage IV-S neuroblastoma describes a group of infants with tumor spread limited to liver, skin, or bone marrow. Such patients, who constitute about 25% of affected infants with neuroblastoma, may expect spontaneous tumor remission. We report 18 infants with Stage IV-S neuroblastoma, 83% of whom had liver involvement. Imaging investigations included Technetium 99m sulfur colloid scan, ultrasound, and CT. Two patterns of liver metastasis were noted: ill-defined nodules or diffuse tumor throughout the liver. Distinction of normal and abnormal liver with diffuse type metastasis could be quite difficult, particularly with liver scans. We conclude that patients with Stage IV-S neuroblastoma have ultrasound or CT examination as an initial workup, with nuclear medicine scans reserved for followup studies. (orig.)

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

    Science.gov (United States)

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

    2008-01-01

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

  7. Benefit of adjuvant chemotherapy in patients with T4 UICC II colon cancer.

    Science.gov (United States)

    Teufel, Andreas; Gerken, Michael; Hartl, Janine; Itzel, Timo; Fichtner-Feigl, Stefan; Stroszczynski, Christian; Schlitt, Hans Jürgen; Hofstädter, Ferdinand; Klinkhammer-Schalke, Monika

    2015-05-20

    Colorectal cancer is the third most common cancer and a major cause of morbidity and mortality worldwide. Adjuvant chemotherapy is considered the standard of care in patients with UICC stage III colon cancer after R0 resection. Adjuvant therapy was not shown to be beneficial in patients with UICC stage II colon cancer. However, there is an ongoing discussion as to whether adjuvant chemotherapy may be beneficial for a subgroup of UICC II patients in a "high-risk situation" (such as T4). We investigated a Bavarian population-based (2.1 million inhabitants) cohort of 1937 patients with UICC II CRC treated between 2002 and 2012 in regard of the benefit of adjuvant chemotherapy for large (T4) tumors. Patients older than 80 years of age were excluded. Of 1937 patients, 240 had a T4 tumor (12%); 77 of all T4 patients received postoperative chemotherapy (33%). Kaplan-Meier analysis and Cox regression models were used for survival analyses. Patients with a T4 tumor who received postoperative chemotherapy had a highly significant survival benefit in respect of overall survival (pbenefit from adjuvant treatment. Chemotherapy, age at diagnosis, and tumor grading remained independent risk factors in the multivariate cox regression analysis. Our retrospective study demonstrated the significant benefit of adjuvant chemotherapy in the T4 subgroup of patients with UICC II colon cancer. Our data suggest that adjuvant chemotherapy should be seriously considered in these patients.

  8. Benefit of adjuvant chemotherapy in patients with T4 UICC II colon cancer

    International Nuclear Information System (INIS)

    Teufel, Andreas; Gerken, Michael; Hartl, Janine; Itzel, Timo; Fichtner-Feigl, Stefan; Stroszczynski, Christian; Schlitt, Hans Jürgen; Hofstädter, Ferdinand; Klinkhammer-Schalke, Monika

    2015-01-01

    Colorectal cancer is the third most common cancer and a major cause of morbidity and mortality worldwide. Adjuvant chemotherapy is considered the standard of care in patients with UICC stage III colon cancer after R0 resection. Adjuvant therapy was not shown to be beneficial in patients with UICC stage II colon cancer. However, there is an ongoing discussion as to whether adjuvant chemotherapy may be beneficial for a subgroup of UICC II patients in a “high-risk situation” (such as T4). We investigated a Bavarian population-based (2.1 million inhabitants) cohort of 1937 patients with UICC II CRC treated between 2002 and 2012 in regard of the benefit of adjuvant chemotherapy for large (T4) tumors. Patients older than 80 years of age were excluded. Of 1937 patients, 240 had a T4 tumor (12 %); 77 of all T4 patients received postoperative chemotherapy (33 %). Kaplan-Meier analysis and Cox regression models were used for survival analyses. Patients with a T4 tumor who received postoperative chemotherapy had a highly significant survival benefit in respect of overall survival (p < 0.001) and recurrence-free survival (p = 0.008). However, no difference was observed between oxaliplatin-containing and non-oxaliplatin-containing treatment regimens. G2 and G3 tumors were found to particularly benefit from adjuvant treatment. Chemotherapy, age at diagnosis, and tumor grading remained independent risk factors in the multivariate cox regression analysis. Our retrospective study demonstrated the significant benefit of adjuvant chemotherapy in the T4 subgroup of patients with UICC II colon cancer. Our data suggest that adjuvant chemotherapy should be seriously considered in these patients. The online version of this article (doi:10.1186/s12885-015-1404-9) contains supplementary material, which is available to authorized users

  9. UICC-ARO Symposium at the UICC 2016 World Cancer Congress

    Science.gov (United States)

    Akaza, Hideyuki; Kawahara, Norie; Fukuda, Takashi; Horie, Shigeo; Thabrany, Hasbullah; Nozaki, Shinjiro

    2017-11-26

    The 2016 World Cancer Congress, organised by UICC, was held in Paris in November 2016, under the theme “Mobilizing action – Inspiring Change.” As part of Track 4 presentations on the theme of “Strengthening cancer control: optimizing outcomes of health systems,” UICC-Asian Regional Office (UICC-ARO) held a symposium to discuss the issue of mobilizing action to realize UHC in Asia. Introducing the symposium, Hideyuki Akaza noted that universal health coverage (UHC) is included in the Sustainable Development Goals and one of the key issues for achieving UHC will be how to balance patient needs with the economic burden of cancer. Speakers from Japan and Indonesia addressed various issues, including the current status and challenges for medical economic evaluation in Asia, the importance of resource stratification, prospects for precision medicine, and the outlook for cancer control and UHC in developing and emerging countries in Asia. Key issues raised included how to respond to the rising costs of treating cancer as new and increasingly expensive drugs come to the market. Speakers and participants noted that health technology assessment programs are being developed around Asia in order to evaluate the cost-effectiveness of drugs in the face of budgetary constraints within increasingly pressurized national health systems. The importance of screening and early detection was also noted as effective means that have the potential to reduce reliance on expensive drugs for advanced cancers. The symposium was chaired jointly by Hideyuki Akaza and Shinjiro Nozaki (WHO Kobe Centre). Creative Commons Attribution License

  10. Congenital bilateral neuroblastoma (stage IV-S): case report

    International Nuclear Information System (INIS)

    Lee, Jeong Hee; Lee, Hee Jung; Woo, Seong Ku; Lee, Sang Rak; Kim, Heung Sik

    2002-01-01

    Congenital neonatal neuroblastoma is not uncommon but bilateral adrenal neuroblastoma is rare, accounting for about ten percent of neuroblastomas in children. We report the US the MR findings of a stage IV-S congenital bilateral neuroblastoma occurring in a one-day-old neonate

  11. High cost of stage IV pressure ulcers.

    Science.gov (United States)

    Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce

    2010-10-01

    The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars. Copyright © 2010 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

    be equal to p-N1 and pCK-N2 which also may be equal to p-N2. Micrometastasis may affect the UICC staging currently in use. (authors)

  13. Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals

    Science.gov (United States)

    Rice, Thomas W.; Ishwaran, Hemant; Blackstone, Eugene H.; Hofstetter, Wayne L.; Kelsen, David P.; Apperson-Hansen, Carolyn

    2017-01-01

    SUMMARY We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was “pinched,” with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. PMID:27905171

  14. Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

    Science.gov (United States)

    Rice, Thomas W; Ishwaran, Hemant; Blackstone, Eugene H; Hofstetter, Wayne L; Kelsen, David P; Apperson-Hansen, Carolyn

    2016-11-01

    We report analytic and consensus processes that produced recommendations for clinical stage groups (cTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) provided data on 22,123 clinically staged patients with epithelial esophageal cancers. Risk-adjusted survival for each patient was developed using random survival forest analysis from which (1) data-driven clinical stage groups were identified wherein survival decreased monotonically and was distinctive between and homogeneous within groups and (2) data-driven anatomic clinical stage groups based only on cTNM. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced (3) consensus clinical stage groups. Compared with pTNM, cTNM survival was "pinched," with poorer survival for early cStage groups and better survival for advanced ones. Histologic grade was distinctive for data-driven grouping of cT2N0M0 squamous cell carcinoma (SCC) and cT1-2N0M0 adenocarcinoma, but consensus removed it. Grouping was different by histopathologic cell type. For SCC, cN0-1 was distinctive for cT3 but not cT1-2, and consensus removed cT4 subclassification and added subgroups 0, IVA, and IVB. For adenocarcinoma, N0-1 was distinctive for cT1-2 but not cT3-4a, cStage II subgrouping was necessary (T1N1M0 [IIA] and T2N0M0 [IIB]), advanced cancers cT3-4aN0-1M0 plus cT2N1M0 comprised cStage III, and consensus added subgroups 0, IVA, and IVB. Treatment decisions require accurate cStage, which differs from pStage. Understaging and overstaging are problematic, and additional factors, such as grade, may facilitate treatment decisions and prognostication until clinical staging techniques are uniformly applied and improved. © 2016 International Society for Diseases of the Esophagus.

  15. Wearable wireless User Interface Cursor-Controller (UIC-C).

    Science.gov (United States)

    Marjanovic, Nicholas; Kerr, Kevin; Aranda, Ricardo; Hickey, Richard; Esmailbeigi, Hananeh

    2017-07-01

    Controlling a computer or a smartphone's cursor allows the user to access a world full of information. For millions of people with limited upper extremities motor function, controlling the cursor becomes profoundly difficult. Our team has developed the User Interface Cursor-Controller (UIC-C) to assist the impaired individuals in regaining control over the cursor. The UIC-C is a hands-free device that utilizes the tongue muscle to control the cursor movements. The entire device is housed inside a subject specific retainer. The user maneuvers the cursor by manipulating a joystick imbedded inside the retainer via their tongue. The joystick movement commands are sent to an electronic device via a Bluetooth connection. The device is readily recognizable as a cursor controller by any Bluetooth enabled electronic device. The device testing results have shown that the time it takes the user to control the cursor accurately via the UIC-C is about three times longer than a standard computer mouse controlled via the hand. The device does not require any permanent modifications to the body; therefore, it could be used during the period of acute rehabilitation of the hands. With the development of modern smart homes, and enhancement electronics controlled by the computer, UIC-C could be integrated into a system that enables individuals with permanent impairment, the ability to control the cursor. In conclusion, the UIC-C device is designed with the goal of allowing the user to accurately control a cursor during the periods of either acute or permanent upper extremities impairment.

  16. Two-stage precipitation of neptunium (IV) oxalate

    International Nuclear Information System (INIS)

    Luerkens, D.W.

    1983-07-01

    Neptunium (IV) oxalate was precipitated using a two-stage precipitation system. A series of precipitation experiments was used to identify the significant process variables affecting precipitate characteristics. Process variables tested were input concentrations, solubility conditions in the first stage precipitator, precipitation temperatures, and residence time in the first stage precipitator. A procedure has been demonstrated that produces neptunium (IV) oxalate particles that filter well and readily calcine to the oxide

  17. Recommendations for neoadjuvant pathologic staging (ypTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

    Science.gov (United States)

    Rice, Thomas W; Ishwaran, Hemant; Kelsen, David P; Hofstetter, Wayne L; Apperson-Hansen, Carolyn; Blackstone, Eugene H

    2016-11-01

    We report analytic and consensus processes that produced recommendations for neoadjuvant pathologic stage groups (ypTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 7,773 had pathologic assessment after neoadjuvant therapy. Risk-adjusted survival for each patient was developed. Random forest analysis identified data-driven neoadjuvant pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. An additional analysis produced data-driven anatomic neoadjuvant pathologic stage groups based only on ypT, ypN, and ypM categories. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus neoadjuvant pathologic stage groups. Grade and location were much less discriminating for stage grouping ypTNM than pTNM. Data-driven stage grouping without grade and location produced nearly identical groups for squamous cell carcinoma and adenocarcinoma. However, ypTNM groups and their associated survival differed from pTNM. The need for consensus process was minimal. The consensus groups, identical for both cell types were as follows: ypStage I comprised ypT0-2N0M0; ypStage II ypT3N0M0; ypStage IIIA ypT0-2N1M0; ypStage IIIB ypT3N1M0, ypT0-3N2, and ypT4aN0M0; ypStage IVA ypT4aN1-2, ypT4bN0-2, and ypTanyN3M0; and ypStage IVB ypTanyNanyM1. Absence of equivalent pathologic (pTNM) categories for the peculiar neoadjuvant pathologic categories ypTisN0-3M0 and ypT0N0-3M0, dissimilar stage group compositions, and markedly different early- and intermediate-stage survival necessitated a unified, unique set of stage grouping for patients of either cell type who receive neoadjuvant therapy. © 2016 International Society for Diseases of the Esophagus.

  18. Locally advanced breast cancer (stage III and stage IV)

    International Nuclear Information System (INIS)

    Baracat, F.F.; Grabert, H.; Lima, G.R. de; Pontes, M.; Ferraro, O.; Santana, A.; Brook, E.S.

    1987-01-01

    The results concerning to the treatment of 193 patients with locally advanced breast cancer-stage III and stage IV are analysed. All the patients were treated with radical radiotherapy plus total mastectomy about 6 weeks later; 53 pacients received also chemotherapy (CMF - 12 courses) and 52 were oophorectomized. (M.A.C) [pt

  19. Comparison of the 6th and 7th editions of the UICC-AJCC TNM classification for esophageal cancer

    NARCIS (Netherlands)

    K. Talsma (Koen); P. van Hagen (Pieter); B.A. Grotenhuis (Brechtje); E.W. Steyerberg (Ewout); H.W. Tilanus (Hugo); J.J.B. van Lanschot (Jan); B.P.L. Wijnhoven (Bas)

    2012-01-01

    textabstractBackground. The new 7th edition of the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC) tumor, node, metastasis (TNM) staging system is the ratification of data-driven recommendations from the Worldwide Esophageal Cancer Collaboration database.

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

    Science.gov (United States)

    2017-05-03

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

  1. Loading the Saturn I S-IV Stage into Pregnant Guppy

    Science.gov (United States)

    1965-01-01

    The photograph shows the loading operation of the Saturn I S-IV stage (second stage) into the Pregnant Guppy at the Redstone Airfield, Huntsville, Alabama. The Pregnant Guppy was a Boeing B-377 Stratocruiser modified to transport various stages of Saturn launch vehicles. The modification project called for lengthening the fuselage to accommodate the S-IV stage. After the flight test of that modification, phase two called for the enlargement of the plane's cabin section to approximately double its normal volume. The fuselage separated just aft of the wing's trailing edge to load and unload the S-IV and other cargoes.

  2. Comparison of outcomes in patients with stage III versus limited stage IV non-small cell lung cancer

    International Nuclear Information System (INIS)

    Cheruvu, Praveena; Metcalfe, Su K; Metcalfe, Justin; Chen, Yuhchyau; Okunieff, Paul; Milano, Michael T

    2011-01-01

    Standard therapy for metastatic non small cell lung cancer (NSCLC) includes palliative systemic chemotherapy and/or radiotherapy. Recent studies of patients with limited metastases treated with curative-intent stereotactic body radiation therapy (SBRT) have shown encouraging survival. We hypothesized that patients treated with SBRT for limited metastases have comparable outcomes with those treated with curative-intent radiation for Stage III NSCLC. We retrospectively reviewed the records of NSCLC patients treated with curative-intent radiotherapy at the University of Rochester from 2000-2008. We identified 3 groups of patients with NSCLC: stage III, stage IV, and recurrent stage IV (initial stage I-II). All stage IV NSCLC patients treated with SBRT had ≤ 8 lesions. Of 146 patients, 88% had KPS ≥ 80%, 30% had > 5% weight loss, and 95% were smokers. The 5-year OS from date of NSCLC diagnosis for stage III, initial stage IV and recurrent stage IV was 7%, 14%, and 27% respectively. The 5-year OS from date of metastatic diagnosis was significantly (p < 0.00001) superior among those with limited metastases (≤ 8 lesions) versus stage III patients who developed extensive metastases not amenable to SBRT (14% vs. 0%). Stage IV NSCLC is a heterogeneous patient population, with a selected cohort apparently faring better than Stage III patients. Though patients with limited metastases are favorably selected by virtue of more indolent disease and/or less bulky disease burden, perhaps staging these patients differently is appropriate for prognostic and treatment characterization. Aggressive local therapy may be indicated in these patients, though prospective clinical studies are needed

  3. Clinical verification of the superiority of the current International Union Against Cancer staging criteria in an Australian population of patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Corry, J.; Porceddu, S.; Peters, L.J.; Fisher, R.; Rischin, D.

    2004-01-01

    The purpose of this study is to assess the prognostic abilities of the fourth and fifth edition International Union Against Cancer (UICC) staging systems for nasopharyngeal carcinoma (NPC) in Australian patients. All patients planned for curative treatment at the Peter MacCallum Cancer Centre from April 1985 to December 1999 were included in this study. There were 181 patients eligible for this study. The median follow up was 7.6 years. Histological subgroups were World Health Organization (WHO) 1 (23), WHO 2 (12), and WHO 3 (146). Presentation with stage IV disease was 83% by UICC fourth edition staging and 34% by UICC fifth edition staging. The 5 years failure-free survival (FFS) rates for stage 1, 2, 3 and 4 disease by the fourth edition was 77, 100, 93, and 49% respectively,and by the fifth edition was 85, 76. 57 and 36%, respectively. The 5 years overall survival (OS) for stage 1, 2, 3, and 4 disease by the fourth edition was 77. 100, 100 and 61%; respectively.and by the fifth edition was 85, 82, 67 and 53%, respectively. Stage 4 patients by the fourth edition were reclassified as stages 2, 3 and 4 by the fifth edition with hazard ratios of 0.77, 1.01 and 1.79, respectively. In multifactor analysis, the fifth edition staging system was significantly related to FFS and OS after allowing for the fourth edition (FFS: P= 0.002; OS: P = 0.005), but the fourth edition was not significantly related to FFS or OS after allowing for the fifth edition (FFS: P = 0.96; OS: P = 0.96). This study confirms the prognostic superiority of the fifth edition UICC staging system over the fourth edition staging system in an Australian NPC population. Copyright (2004) Blackwell Science Pty Ltd

  4. Circulating Tumor DNA in Predicting Outcomes in Patients With Stage IV Head and Neck Cancer or Stage III-IV Non-small Cell Lung Cancer

    Science.gov (United States)

    2018-01-12

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  5. Response of the primary tumor in symptomatic and asymptomatic stage IV colorectal cancer to combined interventional endoscopy and palliative chemotherapy

    International Nuclear Information System (INIS)

    Cameron, Silke; Hünerbein, Diana; Mansuroglu, Tümen; Armbrust, Thomas; Scharf, Jens-Gerd; Schwörer, Harald; Füzesi, László; Ramadori, Giuliano

    2009-01-01

    The treatment of the primary tumor in advanced metastatic colorectal cancer (CRC) is still a matter of discussion. Little attention has thus far been paid to the endoscopically observable changes of the primary in non-curatively resectable stage IV disease. 20 patients [14 men, 6 women, median age 67 (39–82) years] were observed after initial diagnosis of non-curatively resectable metastasized symptomatic (83%) or asymptomatic (17%) CRC, from June 2002 to April 2009. If necessary, endoscopic tumor debulking was performed. 5-FU based chemotherapy was given immediately thereafter. In 10 patients, chemotherapy was combined with antibody therapy. Response of the primary was observed in all patients. Local symptoms were treated endoscopically whenever necessary (obstruction or bleeding), and further improved after chemotherapy was started: Four patients showed initial complete endoscopic disappearance of the primary. In an additional 6 patients, only adenomatous tissue was histologically detected. In both these groups, two patients revealed local tumor relapse after interruption of therapy. Local tumor regression or stable disease was achieved in the remaining 10 patients. 15 patients died during the observation time. In 13 cases, death was related to metastatic disease progression. The mean overall survival time was 19.6 (3–71) months. No complications due to the primary were observed. This study shows that modern anti-cancer drugs combined with endoscopic therapy are an effective and safe treatment of the symptomatic primary and ameliorate local complaints without the need for surgical intervention in advanced UICC stage IV CRC

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

    Directory of Open Access Journals (Sweden)

    Maio Michele

    2012-11-01

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

  7. Aflibercept and FOLFOX6 Treatment for Previously Untreated Stage IV Colorectal Cancer

    Science.gov (United States)

    2018-04-03

    Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Stage IV Colon Cancer; Stage IV Rectal Cancer

  8. Stage IV work-hardening related to disorientations in dislocation structures

    DEFF Research Database (Denmark)

    Pantleon, W.

    2004-01-01

    The effect of deformation-induced disorientations on the work-hardening of metals is modelled based on dislocation dynamics. Essentially, Kocks’ dislocation model describing stage III hardening is extended to stage IV by incorporation of excess dislocations related to the disorientations....... Disorientations evolving from purely statistical reasons — leading to a square root dependence of the average disorientation angle on strain — affect the initial work-hardening rate (and the saturation stress) of stage III only slightly. On the other hand, deterministic contributions to the development...... of disorientations, as differences in the activated slip systems across boundaries, cause a linear increase of the flow stress at large strains. Such a constant work-hardening rate is characteristic for stage IV....

  9. Coefficient of work-hardening in stage-IV

    CSIR Research Space (South Africa)

    Nabarro, FRN

    1994-04-15

    Full Text Available The theory of work hardening in stage IV depends on the relation between the relative misorientation Psi of neighbouring subgrains and the plastic strain gamma (Psi = B gamma exp). The value of the constant B is suggested to be better related...

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

    Science.gov (United States)

    2014-11-07

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

  11. Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

    Science.gov (United States)

    Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

    2016-06-01

    Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

  12. Comparison of the 7(th) and proposed 8(th) editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery.

    Science.gov (United States)

    Jin, Ying; Chen, Ming; Yu, Xinmin

    2016-09-19

    The present study aims to compare the 7(th) and the proposed 8(th) edition of the AJCC/UICC TNM staging system for NSCLC in a cohort of patients from a single institution. A total of 408 patients with NSCLC who underwent radical surgery were analyzed retrospectively. Survivals were analyzed using the Kaplan -Meier method and were compared using the log-rank test. Multivariate analysis was performed by the Cox proportional hazard model. The Akaike information criterion (AIC) and C-index were applied to compare the two prognostic systems with different numbers of stages. The 7(th) AJCC T categories, the proposed 8(th) AJCC T categories, N categories, visceral pleural invasion, and vessel invasion were found to have statistically significant associations with disease-free survival (DFS) on univariate analysis. In the 7(th) edition staging system as well as in the proposed 8(th) edition, T categories, N categories, and pleural invasion were independent factors for DFS on multivariate analysis. The AIC value was smaller for the 8(th) edition compared to the 7(th) edition staging system. The C-index value was larger for the 8(th) edition compared to the 7(th) edition staging system. Based on the data from our single center, the proposed 8(th) AJCC T classification seems to be superior to the 7(th) AJCC T classification in terms of DFS for patients with NSCLC underwent radical surgery.

  13. Performance on a Stage IV Object-Permanence Task with Standard and Nonstandard Covers.

    Science.gov (United States)

    And Others; Rader, Nancy

    1979-01-01

    Examined the role of perceptual-motor development in a typical Stage IV task. The performance of ten infants was compared on a Stage IV object permanence task when a cloth cover was used and when a small card cover was used. (JMB)

  14. Tumor markers as a diagnostic key for hilar Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Juntermanns B

    2010-08-01

    Full Text Available Abstract Objective Hilar cholangiocarcinoma is the fourth most common gastrointestinal malignancy. CA19-9 and CEA are helpful devices in the management of gastrointestinal malignancies and belong to clinical routine in surgical oncology. But the validity of these parameters in terms of tumor extension and prognosis of bile duct malignancies still remains unclear. Methods From 1998 to 2008, we obtained preoperative CA19-9 and CEA serum levels in 136 patients with hilar cholangiocarcinoma. We correlated tumor stage, resectability rate and survival with preoperative CA 19-9 and CEA serum levels. Results CA19-9 (UICC I: 253 ± 561 U/ml; UICC II: 742 ± 1572 U/ml; UICC III: 906 ± 1708 U/ml; UICC IV: 1707 ± 3053 U/ml and CEA levels (UICC I: 2.9 ± 3.8 U/ml; UICC II: 4.6 ± 6.5 U/ml; UICC III: 18.1 ± 29.6 U/ml; UICC IV: 22.7 ± 53.9 U/ml increase significantly with rising tumor stage. Patients with pre operative serum levels of CA19-9 (> 1000 U/ml and CEA (> 14.4 ng/ml showed a significant poorer resectability rate and survival than patients with lower CA19-9 and CEA serum levels respectively. Conclusion CA19-9 and CEA serum levels are associated with the tumor stage. If preoperatively obtained CA19-9 and CEA serum levels are highly elevated patients have an even worse survival and the frequency of irresectability is significantly higher.

  15. Treatment of Stage IV Non-small Cell Lung Cancer

    Science.gov (United States)

    Evans, Tracey; Gettinger, Scott; Hensing, Thomas A.; VanDam Sequist, Lecia; Ireland, Belinda; Stinchcombe, Thomas E.

    2013-01-01

    Background: Stage IV non-small cell lung cancer (NSCLC) is a treatable, but not curable, clinical entity in patients given the diagnosis at a time when their performance status (PS) remains good. Methods: A systematic literature review was performed to update the previous edition of the American College of Chest Physicians Lung Cancer Guidelines. Results: The use of pemetrexed should be restricted to patients with nonsquamous histology. Similarly, bevacizumab in combination with chemotherapy (and as continuation maintenance) should be restricted to patients with nonsquamous histology and an Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1; however, the data now suggest it is safe to use in those patients with treated and controlled brain metastases. Data at this time are insufficient regarding the safety of bevacizumab in patients receiving therapeutic anticoagulation who have an ECOG PS of 2. The role of cetuximab added to chemotherapy remains uncertain and its routine use cannot be recommended. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as first-line therapy are the recommended treatment of those patients identified as having an EGFR mutation. The use of maintenance therapy with either pemetrexed or erlotinib should be considered after four cycles of first-line therapy in those patients without evidence of disease progression. The use of second- and third-line therapy in stage IV NSCLC is recommended in those patients retaining a good PS; however, the benefit of therapy beyond the third-line setting has not been demonstrated. In the elderly and in patients with a poor PS, the use of two-drug, platinum-based regimens is preferred. Palliative care should be initiated early in the course of therapy for stage IV NSCLC. Conclusions: Significant advances continue to be made, and the treatment of stage IV NSCLC has become nuanced and specific for particular histologic subtypes and clinical patient characteristics and according to the

  16. Evaluation on prognosis of esophageal squamous cell carcinoma patients after three-dimensional conformal radiotherapy with different clinical stage system

    International Nuclear Information System (INIS)

    Wang Yuxiang; Zhu Shuchai; Qiu Rong; Liu Zhikun; Shen Wenbin

    2011-01-01

    Objective: To evaluate the prognostic significance of 3 clinical stage system in 3-dimensional conformal radiotherapy (3DCRT) for esophageal squamous cell carcinoma. Methods: From January 2004 to August 2007, 179 cases of esophageal squamous cell carcinoma were treated with 3DCRT. Before radiation, each patient was staged with UICC 2003 TNM stage, stage of Chinese esophageal cancer cooperation group (cooperation group' stage), and Zhu's clinical stage respectively. Concordance of each clinical stage and prognosis was analyzed with SPSS 11.5. Results In 179 cases of esophageal cancer, Concordance was better in T stage (Kappa = 0.271) than in TNM stage (Kappa = 0.167) between cooperation group' stage and Zhu's stage. Among them, 98 cases was staged with UICC stage, concordance of T stage was better between UICC-T and cooperation group' T stage (Kappa =0.261) than between UICCT and Zhu's T stage (Kappa = 0.045) ;concordance of TNM stage was better between UICC-TNM and Zhu's TNM stage (Kappa = 0.597) than between UICC-TNM and cooperation group' TNM stage (Kappa =0.299). With multivariate analysis, T (χ 2 value is 11.58, 26.00 and 51.05, all P 2 value is 15.28, 16.10 and 16.10, all P 2 value is 5.59, 27.78 and 27.78, all P 2 value is 15.77, 34, 35 and 51.10, all P 1 - T 3 was difficult to definite and the prognosis was not significantly different in T 1 - T 3 stage. Conclusions: In this study, 3 kinds of clinical stage could evaluate prognosis of esophageal cancer after radiotherapy; cooperation group' stage and Zhu's stage need further application, with further accuracy needed. (authors)

  17. Efficacy and predictive value of clinical stage in non-surgical patients with esophageal cancer

    International Nuclear Information System (INIS)

    Liu Xiao; Wang Guiqi; He Shun

    2014-01-01

    Objective: To investigate the efficacy and predictive value of clinical stage in non-surgical patients with esophageal cancer (EC). Methods: A retrospective study was conducted in 358 EC patients who underwent radical surgery in our hospital from April 2003 to October 2010 and who had preoperative work-up including endoscopic esophageal ultrasound (EUS), esophagoscopy, thoracic CT scans,and contrast esophagography and had detailed information on postoperative pathological stages. The predictive value of preoperative clinical T/N stage based on EUS + CT for postoperative pathological stage was analyzed. The disease free survival (DFS) and overall survival (OS) were analyzed according to the UICC TNM classification (2002/ 2009) and the clinical stage based on imaging findings. Results: The median follow-up was 47 months.A total of 305 (85.2%) of all patients were analyzed by clinical stage based on EUS + CT.Among them, the predictive value of clinical T stage for pathological T stage was 0-88.6%, highest (88.6%) for T1 stage and lowest for T4 stage. The predictive value of clinical N stage (N 0 /N1) was 62.5-100%. The significant differences in OS and DFS rates based on both 2002 and 2009 UICC TNM classifications were noted (P=0.000 and 0.000). There were significant differences in OS between stage groups, except the comparison between two stage Ⅳ patients and other groups, according to 2002 UICC TNM classification. There were usually insignificant differences in OS between stage groups, according to 2009 UICC TNM classification. For the 305 patients staged clinically based on EUS and CT according to 2002 UICC TNM classification, significant differences in OS and DFS rates were noted (P=0.000 and 0.000). Conclusions: Imaging modalities show good predictive value for N stage (N0/N1),even though they cannot accurately provide the number of metastatic lymph nodes. The clinical stage based on EUS + CT can effectively predict the prognosis of non-surgical EC patients

  18. Combined effect of angioinfarction with immunotherapy in patients with stage IV renal cell carcinoma

    International Nuclear Information System (INIS)

    Oh, Joo Hyeong; Yoon, Yup; Jeong, Yu Mee; Ko, Young Tae; Chang, Sung Goo

    1994-01-01

    To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive balloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma

  19. Prognostic impact of tumor MET expression among patients with stage IV gastric cancer

    DEFF Research Database (Denmark)

    Erichsen, Rune; Kelsh, Michael A; Oliner, Kelly S

    2016-01-01

    PURPOSE: We aimed to investigate the prevalence and prognostic impact of tumor mesenchymal epithelial transition factor (MET) expression in stage IV gastric cancers in a real-world clinical setting because existing evidence is sparse. METHODS: The study included archived cancer specimens from 103...... stage IV gastric cancer patients (2003-2010). We analyzed MET-protein expression by immunohistochemistry (MET-positive if ≥25% of tumor cells showed MET expression). We calculated overall survival using the Kaplan-Meier method and hazard ratios comparing mortality among MET-positive and MET.......6 months), corresponding to an adjusted hazard ratio of 2.2 (95% confidence interval, 1.3-3.7). CONCLUSIONS: Tumor MET expression is prevalent and has substantial prognostic impact in stage IV gastric cancer patients....

  20. Palliative Care in Improving Quality of Life and Symptoms in Patients With Stage III-IV Pancreatic or Ovarian Cancer

    Science.gov (United States)

    2014-12-18

    Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Stage III Pancreatic Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer

  1. 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)

  2. Concepts to meet non-road stage IV / Tier 4 emission legislation; Konzepte fuer die Emissionsgesetzgebung. Non-Road Stage IV / Tier 4

    Energy Technology Data Exchange (ETDEWEB)

    Cartus, T.; Herrmuth, H.; Stein, G. [AVL List GmbH, Graz (Austria); Scherm, P. [Euromot - European Association of Internal Combustion Engine Mfrs., Frankfurt am Main (Germany)

    2007-12-15

    By December 2007, the EC will have to submit a new proposal for Stage IV emissions limits for Non-Road Mobile Machinery. Industry is committed to contributing to this process and has asked AVL to carry out a study as a neutral engineering company. The main topics of this study are described in this article. (orig.)

  3. Cost analysis of surgically treated pressure sores stage III and IV.

    Science.gov (United States)

    Filius, A; Damen, T H C; Schuijer-Maaskant, K P; Polinder, S; Hovius, S E R; Walbeehm, E T

    2013-11-01

    Health-care costs associated with pressure sores are significant and their financial burden is likely to increase even further. The aim of this study was to analyse the direct medical costs of hospital care for surgical treatment of pressure sores stage III and IV. We performed a retrospective chart study of patients who were surgically treated for stage III and IV pressure sores between 2007 and 2010. Volumes of health-care use were obtained for all patients and direct medical costs were subsequently calculated. In addition, we evaluated the effect of location and number of pressure sores on total costs. A total of 52 cases were identified. Average direct medical costs in hospital were €20,957 for the surgical treatment of pressure sores stage III or IV; average direct medical costs for patients with one pressure sore on an extremity (group 1, n = 5) were €30,286, €10,113 for patients with one pressure sore on the trunk (group 2, n = 32) and €40,882 for patients with multiple pressure sores (group 3, n = 15). The additional costs for patients in group 1 and group 3 compared to group 2 were primarily due to longer hospitalisation. The average direct medical costs for surgical treatment of pressure sores stage III and IV were high. Large differences in costs were related to the location and number of pressure sores. Insight into the distribution of these costs allows identification of high-risk patients and enables the development of specific cost-reducing measures. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Fosaprepitant Dimeglumine, Palonosetron Hydrochloride, and Dexamethasone in Preventing Nausea and Vomiting Caused by Cisplatin in Patients With Stage III or Stage IV Head and Neck Cancer Undergoing Chemotherapy and Radiation Therapy

    Science.gov (United States)

    2017-04-13

    Nausea and Vomiting; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx

  5. Primary Tumor Thickness is a Prognostic Factor in Stage IV Melanoma: A Retrospective Study of Primary Tumor Characteristics.

    Science.gov (United States)

    Luen, Stephen; Wong, Siew Wei; Mar, Victoria; Kelly, John W; McLean, Catriona; McArthur, Grant A; Haydon, Andrew

    2018-01-01

    Stage IV melanoma exhibits a diverse range of tumor biology from indolent to aggressive disease. Many important prognostic factors have already been identified. Despite this, the behavior of metastatic melanoma remains difficult to predict. We sought to determine if any primary tumor characteristics affect survival following the diagnosis of stage IV melanoma. All patients diagnosed with stage IV melanoma between January 2003 and December 2012 were identified from the Victorian Melanoma Service database. Retrospective chart review was performed to collect data on primary tumor characteristics (thickness, ulceration, mitotic rate, melanoma subtype, or occult primary). Known and suspected prognostic factors were additionally collected (time to diagnosis of stage IV disease, age, sex, stage, receipt of chemotherapy, and era of recurrence). The effect of primary tumor characteristics on overall survival from the date of diagnosis of stage IV disease was assessed. A total of 227 patients with a median follow-up of 5 years from diagnosis of stage IV disease were identified. Median overall survival of the cohort was 250 days.Of the primary tumor characteristics assessed, only tumor thickness affected survival from diagnosis of stage IV disease, hazard ratio=1.09 (1.02 to 1.16), P=0.008. This remained significant in multivariate analysis, P=0.007. Other primary tumor characteristics did not significantly influence survival. Primary tumor thickness is a significant prognostic factor in stage IV melanoma. Our data suggest that the biology of the primary melanoma may persist to influence the behavior of metastatic disease.

  6. Registrar Staging Assistant (SEER*RSA) - SEER

    Science.gov (United States)

    Use this site for cases diagnosed 2018 and forward to code Extent of Disease 2018, Summary Stage 2018, Site-Specific Data Items, and Grade. Use it for 2016 and 2017 cases to determine UICC TNM 7th edition stage, Collaborative Stage v.02.05.50, and Site-Specific predictive and prognostic factors.

  7. Stage IV in electrical resistivity return to alpha-iron

    International Nuclear Information System (INIS)

    Poltavtseva, V.P.

    2004-01-01

    Full text: In compliance with the model of two interstitial atoms, in returning the electrical resistivity increment, the stage IV, related to migration of mono vacancies, should exist. Unfortunately, for alpha-iron there is no any reliable proof of existence of the stage IV (450-630 K) up to now. As a rule, the annealing stages revealed within this temperature range are considered as related to impurity effects. This paper is aimed at detection of the stage IV in returning the electrical resistivity increment in alpha-iron by means of irradiation of the materials differing in purity degree (99.99 and 99.8 %) by 30 MeV protons capable to create large amount of point defects and small clusters in BCC metals. By author opinion, it will make it possible to reach the radiation defect/vacancy concentrations comparable with contents of impurities (C and N) and, thus, to obtain an information about their migration. As a result of irradiation by protons at 270 K up to the fluence comprising 2.3·10 21 m -2 (0.001 dpa), the following has been found: - an increase in the electrical resistivity at 330 K is 0.84 and 0.61 nΩ·m for the alpha-iron purity degree 99.99 and 99.8 % respectively; - in the 99.99 % purity degree alpha-iron the process of electrical resistivity restoration comes to an end completely at 563 K, whereas in alpha-iron with larger content of impurity - at nearly 600 K; - in the 99.99% purity degree alpha iron electrical resistivity return spectrum a single wide peak centered at 445 K and two smeared peaks below 400 and higher than 490 K are revealed. As the impurity content increases, the 464 K peak changes the 445 K peak, which is about twice lower. Besides, a peak at 377 K occurs, and the peak at a temperature higher than 500 K, in contrast to the 99.99 % purity degree alpha-iron, has a point of inflection at 590 K. On a base of the data obtained, one may conclude that the stage centered around 445 K is of intrinsic nature, and the 99.99 % purity degree

  8. Is complete resection of high-risk stage IV neuroblastoma associated with better survival?

    Science.gov (United States)

    Yeung, Fanny; Chung, Patrick Ho Yu; Tam, Paul Kwong Hang; Wong, Kenneth Kak Yuen

    2015-12-01

    The role of surgery in the management of stage IV neuroblastoma is controversial. In this study, we attempted to study if complete tumor resection had any impact on event-free survival (EFS) and overall survival (OS). A retrospective analysis of patients with stage IV neuroblastoma between November 2000 and July 2014 in a tertiary referral center was performed. Demographics data, extent of surgical resection, and outcomes were analyzed. A total of 34 patients with stage IV neuroblastoma according to International Neuroblastoma Staging System (INSS) were identified. The median age at diagnosis and operation was 3.5 (±1.9) years and 3.8 (±2.0) years, respectively. Complete gross tumor resection (CTR) was achieved in twenty-four patients (70.1%), in which one of the patients had nephrectomy and another had distal pancreatectomy. Gross total resection (GTR) with removal of >95% of tumor was performed in six patients (17.6%) and subtotal tumor resection (STR) with removal of >50%, but <95% of tumor was performed in four patients (11.8%). There was no statistical significance in terms of 5-year EFS and OS among the 3 groups. There was no surgery-related mortality or morbidity. From our center's experience, as there was no substantial survival benefit in stage IV neuroblastoma patients undergoing complete tumor resection, organ preservation and minimalization of morbidity should also be taken into consideration. Copyright © 2015. Published by Elsevier Inc.

  9. False negative rate of syndesmotic injury in pronation-external rotation stage IV ankle fractures

    Directory of Open Access Journals (Sweden)

    Kwang-Soon Song

    2013-01-01

    Full Text Available Background: To investigate false negative rate in the diagnosis of diastasis on initial static anteroposterior radiograph and reliability of intraoperative external rotational stress test for detection of concealed disruption of syndesmosis in pronation external rotation (PER stage IV (Lauge-Hansen ankle fractures. Materials and Methods: We prospectively studied 34 PER stage IV ankle fractures between September 2001 and September 2008. Twenty (59% patients show syndesmotic injury on initial anteroposterior radiographs. We performed an intraoperative external rotation stress test in other 14 patients with suspicious PER stage IV ankle fractures, which showed no defined syndesmotic injury on anteroposterior radiographs inspite of a medial malleolar fracture, an oblique fibular fracture above the syndesmosis and fracture of the posterior tubercle of the tibia. Results: All 14 fractures showed different degrees of tibiofibular clear space (TFCS and tibiofibular overlapping (TFO on the external rotation stress test radiograph compared to the initial plain anteroposterior radiograph. It is important to understand the fracture pattern characterstic of PER stage IV ankle fractures even though it appears normal on anteroposterior radiographs, it is to be confirmed for the concealed syndesmotic injury through a routine intraoperative external rotational stress radiograph.

  10. Men and women show similar survival outcome in stage IV breast cancer.

    Science.gov (United States)

    Wu, San-Gang; Zhang, Wen-Wen; Liao, Xu-Lin; Sun, Jia-Yuan; Li, Feng-Yan; Su, Jing-Jun; He, Zhen-Yu

    2017-08-01

    To evaluate the clinicopathological features, patterns of distant metastases, and survival outcome between stage IV male breast cancer (MBC) and female breast cancer (FBC). Patients diagnosed with stage IV MBC and FBC between 2010 and 2013 were included using the Surveillance, Epidemiology, and End Results program. Univariate and multivariate Cox regression analyses were used to analyze risk factors for overall survival (OS). A total of 4997 patients were identified, including 60 MBC and 4937 FBC. Compared with FBC, patients with MBC were associated with a significantly higher rate of estrogen receptor-positive, progesterone receptor-positive, unmarried, lung metastases, and a lower frequency of liver metastases. Univariate and multivariate analyses showed no significant difference in OS between MBC and FBC. In the propensity score-matched population, there was also no difference in survival between MBC and FBC. Multivariate analysis of MBC showed that OS was longer for patients aged 50-69 years and with estrogen receptor-positive disease. There was no significant difference in survival outcome between stage IV MBC and FBC, but significant differences in clinicopathological features and patterns of metastases between the genders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Differential Impact of Anastomotic Leak in Patients With Stage IV Colonic or Rectal Cancer

    DEFF Research Database (Denmark)

    Nordholm-Carstensen, Andreas; Rolff, Hans Christian; Krarup, Peter-Martin

    2017-01-01

    BACKGROUND: Anastomotic leak has a negative impact on the prognosis of patients who undergo colorectal cancer resection. However, data on anastomotic leak are limited for stage IV colorectal cancers. OBJECTIVE: The purpose of this study was to investigate the impact of anastomotic leak on survival....... PATIENTS: Patients who were diagnosed with stage IV colorectal cancer between 2009 and 2013 and underwent elective resection of their primary tumors were included. MAIN OUTCOME MEASURES: The primary outcome was all-cause mortality depending on the occurrence of anastomotic leak. Secondary outcomes were...... the administration of and time to adjuvant chemotherapy, metastasectomy rate, and risk factors for leak. RESULTS: Of the 774 patients with stage IV colorectal cancer who were included, 71 (9.2%) developed anastomotic leaks. Anastomotic leak had a significant impact on the long-term survival of patients with colon...

  12. A novel technique for the treatment of stages III to IV hemorrhoids

    Science.gov (United States)

    Lin, Guoqiang; Ge, Qiongxiang; He, Xiaokang; Qi, Haixin; Xu, Li

    2017-01-01

    Abstract To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan–Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Data from clinical recording and follow-up included operative time, intraoperative blood loss, hospitalization information, postoperative pain, and postoperative complications. Operative time, intraoperative blood loss and hospitalization time in ACS group were significantly less than those in MMH group (P hemorrhoids. PMID:28658138

  13. Disorientations and their role on the work-hardening in stage IV

    DEFF Research Database (Denmark)

    Pantleon, W.

    2005-01-01

    statistical reasons still lead to stage III behavior and a saturation of the ow stress, but deterministic contributions to the development of disorienta- tions, as dierences in activated slip systems across boundaries, cause a linear increase of the flow stress at large strains. Such a constant work......The eect of deformation-induced disorientations on work-hardening of metals is modelled by dislocation dynamics. By incorporating excess dislocations related to disori- entations, Kocks' dislocation model describing stage III hardening is extended to stage IV. Disorientations evolving from purely...

  14. 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

    Uterine Sarcoma; Stage IV Bladder Cancer; Stage IV Gastric Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer; Stage IV Renal Cell Cancer; Stage IV Urethral Cancer; Stage IVA Cervical Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVA Uterine Sarcoma; Stage IVB Cervical Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer; Stage IVB Uterine Sarcoma; Ureter Cancer; Stage IIA Lung Carcinoma; Stage IIB Lung Carcinoma; Stage IIIA Lung Carcinoma; Stage IIIB Lung Carcinoma

  15. 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

  16. 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

  17. Cost analysis of surgically treated pressure sores stage III and IV.

    NARCIS (Netherlands)

    Filius, A.; Damen, T.H.; Schuijer-Maaskant, K.P.; Polinder, S.; Hovius, S.E.R.; Walbeehm, E.T.

    2013-01-01

    Health-care costs associated with pressure sores are significant and their financial burden is likely to increase even further. The aim of this study was to analyse the direct medical costs of hospital care for surgical treatment of pressure sores stage III and IV. We performed a retrospective chart

  18. Cetuximab and Radiation Therapy in Treating Patients With Stage III-IV Head and Neck Cancer

    Science.gov (United States)

    2017-11-15

    Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Verrucous Carcinoma of the Larynx; Tongue Cancer

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

    Science.gov (United States)

    2017-06-05

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

  20. Incidence and severity of stage IV bronchopulmonary dysplasia in infants of very low birth weight

    International Nuclear Information System (INIS)

    Parker, B.R.; Stevens, S.K.; Northway, W.H.

    1989-01-01

    To evaluate the incidence and severity of stage IV bronchopulmonary dysplasia (BPD) in infants of very low birth weight, the authors reviewed the clinical course and chest radiographs of 138 such infants. In the lowest weight group ( 1500 g, 10%). However, the severity of BPD (graded by the Toce-Edwards Scale) was highest (6.3) in the < 1500-g group (< 900 g, 5.4; 1200-1500 g, 5.9). These data showed that, although the incidence of stage IV BVD significantly decreased as birth weight increased, the severity of chronic changes was independent of birth weight

  1. ACTOplus Met XR in Treating Patients With Stage I-IV Oral Cavity or Oropharynx Cancer Undergoing Definitive Treatment

    Science.gov (United States)

    2018-03-02

    Oral Cavity Neoplasm; Oropharyngeal Neoplasm; Stage I Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage I Oropharyngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage II Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage II Oropharyngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IV Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Oropharyngeal Squamous Cell Carcinoma AJCC v7

  2. Survival outcome of women with stage IV uterine carcinosarcoma who received neoadjuvant chemotherapy followed by surgery.

    Science.gov (United States)

    Matsuo, Koji; Johnson, Marian S; Im, Dwight D; Ross, Malcolm S; Bush, Stephen H; Yunokawa, Mayu; Blake, Erin A; Takano, Tadao; Klobocista, Merieme M; Hasegawa, Kosei; Ueda, Yutaka; Shida, Masako; Baba, Tsukasa; Satoh, Shinya; Yokoyama, Takuhei; Machida, Hiroko; Ikeda, Yuji; Adachi, Sosuke; Miyake, Takahito M; Iwasaki, Keita; Yanai, Shiori; Takeuchi, Satoshi; Nishimura, Masato; Nagano, Tadayoshi; Takekuma, Munetaka; Shahzad, Mian M K; Pejovic, Tanja; Omatsu, Kohei; Kelley, Joseph L; Ueland, Frederick R; Roman, Lynda D

    2018-03-01

    To examine survival of women with stage IV uterine carcinosarcoma (UCS) who received neoadjuvant chemotherapy followed by hysterectomy. This is a nested case-control study within a retrospective cohort of 1192 UCS cases. Women who received neoadjuvant chemotherapy followed by hysterectomy based-surgery for stage IV UCS (n = 26) were compared to those who had primary hysterectomy-based surgery without neoadjuvant chemotherapy for stage IV UCS (n = 120). Progression-free survival (PFS) and cause-specific survival (CSS) were examined. The most common regimen for neoadjuvant chemotherapy was carboplatin/paclitaxel (53.8%). Median number of neoadjuvant chemotherapy cycles was 4. PFS was similar between the neoadjuvant chemotherapy group and the primary surgery group (unadjusted-hazard ratio [HR] 1.19, 95% confidence interval [CI] 0.75-1.89, P = 0.45). Similarly, CSS was comparable between the two groups (unadjusted-HR 1.13, 95%CI 0.68-1.90, P = 0.64). When the types of neoadjuvant chemotherapy regimens were compared, women who received a carboplatin/paclitaxel regimen had better survival outcomes compared to those who received other regimens: PFS, unadjusted-HR 0.38, 95%CI 0.15-0.93, P = 0.027; and CSS, unadjusted-HR 0.21, 95%CI 0.07-0.61, P = 0.002. Our study found that there is no statistically significant difference in survival between women with stage IV UCS who are tolerated neoadjuvant chemotherapy and those who undergo primary surgery. © 2017 Wiley Periodicals, Inc.

  3. [Oligometastasized colorectal cancer-modern treatment strategies].

    Science.gov (United States)

    Binnebösel, M; Lambertz, A; Dejong, K; Neumann, U P

    2018-06-05

    The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.

  4. A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer.

    Science.gov (United States)

    Kommalapati, Anuhya; Tella, Sri Harsha; Goyal, Gaurav; Ganti, Apar Kishor; Krishnamurthy, Jairam; Tandra, Pavan Kumar

    2018-05-02

    The role of locoregional treatment (LRT) remains controversial in de novo stage IV breast cancer (BC). We sought to analyze the role of LRT and prognostic factors of overall survival (OS) in de novo stage IV BC patients treated with LRT utilizing the National Cancer Data Base (NCDB). The objective of the current study is to create and internally validate a prognostic scoring model to predict the long-term OS for de novo stage IV BC patients treated with LRT. We included de novo stage IV BC patients reported to NCDB between 2004 and 2015. Patients were divided into LRT and no-LRT subsets. We randomized LRT subset to training and validation cohorts. In the training cohort, a seventeen-point prognostic scoring system was developed based on the hazard ratios calculated using Cox-proportional method. We stratified both training and validation cohorts into two "groups" [group 1 (0-7 points) and group 2 (7-17 points)]. Kaplan-Meier method and log-rank test were used to compare OS between the two groups. Our prognostic score was validated internally by comparing the OS between the respective groups in both the training and validation cohorts. Among 67,978 patients, LRT subset (21,200) had better median OS as compared to that of no-LRT (45 vs. 24 months; p < 0.0001). The group 1 and group 2 in the training cohort showed a significant difference in the 3-year OS (p < 0.0001) (68 vs. 26%). On internal validation, comparable OS was seen between the respective groups in each cohort (p = 0.77). Our prognostic scoring system will help oncologists to predict the prognosis in de novo stage IV BC patients treated with LRT. Although firm treatment-related conclusions cannot be made due to the retrospective nature of the study, LRT appears to be associated with a better OS in specific subgroups.

  5. Prognosis and therapy for ruptured hepatocellular carcinoma: Problems with staging and treatment strategy

    Energy Technology Data Exchange (ETDEWEB)

    Hiraoka, Atsushi, E-mail: hirage@m.ehime-u.ac.jp [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan); Kawamura, Tomoe; Aibiki, Toshihiko; Okudaira, Tomonari; Toshimori, Akiko; Yamago, Hiroka; Nakahara, Hiromasa; Suga, Yoshifumi; Azemoto, Nobuaki; Miyata, Hideki; Miyamoto, Yasunao; Ninomiya, Tomoyuki [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan); Murakami, Tadashi; Ishimaru, Yoshihiro [Department of Radiology, Ehime Prefectural Central Hospital (Japan); Kawasaki, Hideki [Department of Surgery, Ehime Prefectural Central Hospital (Japan); Hirooka, Masashi; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi [Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime (Japan); Michitaka, Kojiro [Gastroenterology Center, Ehime Prefectural Central Hospital, Kasuga-cho 83, Matsuyama, Ehime 790-0024 (Japan)

    2015-03-15

    Highlights: •Although a patient with a ruptured HCC is generally considered to have a poor prognosis and treated as T4 in the 7th edition of the AJCC/UICC, some ruptured cases show a good clinical course. •There are no clear criteria established for treating a ruptured hepatocellular carcinoma (HCC) which is classified as T4 in TNM stage of UICC 7th. •This article describes that better prognosis can be expected with curative treatment in patients with a ruptured HCC, especially those with a single tumor, and without decompensated liver cirrhosis and PVTT/extrahepatic metastasis. T4 classification should not include all types of ruptured HCC. -- Abstract: Background: There are no clear criteria established for treating a ruptured hepatocellular carcinoma (HCC). To elucidate the clinical features of affected patients, we examined prognosis and therapy choices. Materials/methods: We enrolled 67 patients treated for a ruptured HCC (HCV 44, HBV 5, HBV + HCV 1, alcohol 2, others 15; naïve HCC 34, recurrent 33) from 2000 to 2013, and investigated their clinical background and prognosis. Results: Median survival time (MST) for all cases was 4 months. For patients who survived for more than 1 year after rupture, the percentages of Child-Pugh C and positive for portal vein tumor thrombosis (PVTT)/extrahepatic metastasis were less than for those who died within 1 year. Child-Pugh classification (A:B:C = 14:15:5 vs. 4:9:20, P < 0.001) was better, while the percentage of patients with multiple tumors was lower [19/34 (55.9%) vs. 29/33 (87.9%), respectively; P < 0.001] in the naïve group. The 1- and 3-year survival rates were better in the naïve as compared to the recurrent group (60.6% and 33.3% vs. 12.6% and 0%, respectively; P < 0.01). MST according to modified TNM stage (UICC 7th) calculated after exclusion of T4 factor of rupture, stage I was better than others (22.7 vs. (II) 2.2, (III) 1.2, and (IV) 0.7 months) (P = 0.010). Conclusion: In patients with a ruptured

  6. Impact of the new international association for the study of lung cancer staging system in non-small cell lung cancer: With comparison to the union for international cancer control 6th tumor, node, metastasis edition

    International Nuclear Information System (INIS)

    Lee, Myung Jae; Lee, So Won; Shim, Sung Shine; Ryu, Yon Ju; Kim, Yoo Kyung

    2014-01-01

    To investigate the impact of the proposed International Association for the Study of Lung Cancer (IASLC) tumor, node, metastasis (TNM) system on staging and outcome of non small cell lung cancer (NSCLC). With a total of 501 NSCLC patients with staging according to Union for International Cancer Control (UICC), 6th TNM (TNM-6) were reclassified according to the IASLC proposed TNM staging (TNM-7). The impact of TNM-7 in comparison with TNM-6 was evaluated at three levels: change in substage, staging, and outcome. The outcome measure was to compare the stage-specific overall survival of NSCLC between the two groups of patients. A total of 214 (42.7%) patients had changed TNM staging, and 101 (20.2%) patients had changed stage groupings in TNM-7 compared to TNM-6. Among 100 patients showing changed stage grouping, 72 (14.4%) showed upstage and 29 (5.8%) demonstrated downstage. The TNM-7 system resulted in better separation of survival curves among stage-specific NSCLC than TNM-6 system, especially in separation of stage IIA vs. IIB (p 0.023) and stage IIIB vs. IV (p < 0.001). TNM-7 for lung cancer appears to be superior in defining stage-specific survival groups than TNM-6, especially between stage IIA vs. stage IIB and stage IIIB vs. stage IV.

  7. Clinical and Histological Characteristics of Nasopharyngeal Cancer ...

    African Journals Online (AJOL)

    8(26.7%),cranial nerve involvement 7(23.3%) and visual impairment 6(20%). According to the UICC 1997 staging for nasopharyngeal carcinoma,23(76.7%) and 7(23.3%) were T3 and T4 or stages III and IV respectively.The histological diagnoses were squamous cell carcinoma 23(76.7%) cases, non-Hodgkins lymphoma ...

  8. Differential Impact of Anastomotic Leak in Patients With Stage IV Colonic or Rectal Cancer: A Nationwide Cohort Study.

    Science.gov (United States)

    Nordholm-Carstensen, Andreas; Rolff, Hans Christian; Krarup, Peter-Martin

    2017-05-01

    Anastomotic leak has a negative impact on the prognosis of patients who undergo colorectal cancer resection. However, data on anastomotic leak are limited for stage IV colorectal cancers. The purpose of this study was to investigate the impact of anastomotic leak on survival and the decision to administer chemotherapy and/or metastasectomy after elective surgery for stage IV colorectal cancer. This was a nationwide, retrospective cohort study. Data were obtained from the Danish Colorectal Cancer Group, the Danish Pathology Registry, and the National Patient Registry. Patients who were diagnosed with stage IV colorectal cancer between 2009 and 2013 and underwent elective resection of their primary tumors were included. The primary outcome was all-cause mortality depending on the occurrence of anastomotic leak. Secondary outcomes were the administration of and time to adjuvant chemotherapy, metastasectomy rate, and risk factors for leak. Of the 774 patients with stage IV colorectal cancer who were included, 71 (9.2%) developed anastomotic leaks. Anastomotic leak had a significant impact on the long-term survival of patients with colon cancer (p = 0.04) but not on those with rectal cancer (p = 0.91). Anastomotic leak was followed by the decreased administration of adjuvant chemotherapy in patients with colon cancer (p = 0.007) but not in patients with rectal cancer (p = 0.47). Finally, anastomotic leak had a detrimental impact on metastasectomy rates after colon cancer but not on resection rates of rectal cancer. Retrospective data on the selection criteria for primary tumor resection and metastatic tumor load were unavailable. The impact of anastomotic leak on patients differed between stage IV colon and rectal cancers. Survival and eligibility to receive chemotherapy and metastasectomy differed between patients with colon and rectal cancers. When planning for primary tumor resection, these factors should be considered.

  9. Features and prognostic impact of distant metastases in 45 dogs with de novo stage IV cutaneous mast cell tumours: A prospective study.

    Science.gov (United States)

    Pizzoni, S; Sabattini, S; Stefanello, D; Dentini, A; Ferrari, R; Dacasto, M; Giantin, M; Laganga, P; Amati, M; Tortorella, G; Marconato, L

    2018-03-01

    Distant metastases in dogs with cutaneous mast cell tumors (cMCT) are rare and incurable. The aims of this prospective study were to clarify the clinico-pathological features of stage IV cMCTs and to identify possible prognostic factors for progression-free interval (PFI) and survival time (ST). Dogs were eligible for recruitment if they had a previously untreated, histologically confirmed cMCT and if they underwent complete staging demonstrating stage IV disease. Dogs were uniformly followed-up, whereas treatment was not standardized and included no therapy, surgery, radiation therapy, chemotherapy, tyrosine-kinase inhibitors or a combination of these. 45 dogs with stage IV cMCT were enrolled. All dogs had distant metastatic disease, and 41 (91.1%) dogs had also metastasis in the regional lymph node. Histopathological grade and mutational status greatly varied among dogs. Median ST was 110 days. Notably, PFI and ST were independent of well-known prognostic factors, including anatomic site, histological grade, and mutational status. Conversely, tumor diameter >3 cm, more than 2 metastatic sites, bone marrow infiltration, and lack of tumor control at the primary site were confirmed to be negative prognostic factors by multivariate analysis. Currently, there is no satisfactory treatment for stage IV cMCT. Asymptomatic dogs with tumor diameter <3 cm and a low tumor burden, without bone marrow infiltration may be candidates for multimodal treatment. Stage IV dogs without lymph node metastasis may enjoy a surprisingly prolonged survival. The achievement of local tumor control seems to predict a better outcome in dogs with stage IV cMCT. © 2017 John Wiley & Sons Ltd.

  10. A proteomics panel for predicting optimal primary cytoreduction in stage III/IV ovarian cancer

    DEFF Research Database (Denmark)

    Risum, Signe; Høgdall, Estrid; Engelholm, Svend A

    2009-01-01

    for CA-125. In addition, serum was analyzed for 7 biomarkers using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. These biomarkers were combined into a single-valued ovarian-cancer-risk index (OvaRI). CA-125 and OvaRI were evaluated as predictors of cytoreduction in 75......The objective of this prospective study was to evaluate CA-125 and a 7-marker panel as predictors of incomplete primary cytoreduction in patients with stage III/IV ovarian cancer (OC). From September 2004 to January 2008, serum from 201 patients referred to surgery for a pelvic tumor was analyzed...... stage III/IV patients using receiver operating characteristic curves. Complete primary cytoreduction (no macroscopic residual disease) was achieved in 31% (23/75) of the patients. The area under the receiver operating characteristic curve was 0.66 for CA-125 and 0.75 for OvaRI. The sensitivity...

  11. [Outcome of operative treatment for supination-external rotation Lauge-Hansen stage IV ankle fractures].

    Science.gov (United States)

    Kołodziej, Łukasz; Boczar, Tomasz; Bohatyrewicz, Andrzej; Zietek, Paweł

    2010-01-01

    Ankle fractures are among the most common musculoskeletal injures. These fractures occur with an overall age- and sex-adjusted incidence rate around 180 per 100 000 person-years. The most frequent mechanism is considered to be supination-external rotation (60 to 80% of all ankle fractures) consisting of pathologic external rotation of the foot initially placed in some degree of supination. According to Lauge-Hansen classification, ankle joint structures are damaged in a sequence where the final, stage IV injuries, represents transverse fracture of the medial malleolus or its equivalent-rupture of the deltoid ligament. The aim of this study is to compare the results of two subtypes of supination-external rotation stage IV fractures. 43 patients treated surgically in 2006 to 2007 at Authors institution because of stage IV supination-external rotation ankle fracture were submitted to retrospective analysis. There were 25 patients with bimalleolar fracture (type 1) and in 18 patients with lateral malleolar fracture with accompanying rupture of the deltoid ligament (type 2). The mean age was 46 years (from 20 to 82 years). Average follow up period was 37 months (from 24 to 46 months). For the evaluation of treatment AOFAS hind-foot score (American Orthopedic Foot and Ankle Society) was used. The mean AOFAS score scale for Type 1 fractures was 85 points and for type 2 was significantly higher and amounted to 91 points (p ankle fractures with medial malleolar fracture, requires the implementation of additional diagnostic and therapeutic strategies and procedures in order to improve the outcome of results.

  12. Comparison of five systems for staging lymph node metastasis in gastric cancer.

    Science.gov (United States)

    Yu, W; Choi, G S; Whang, I; Suh, I S

    1997-09-01

    There are several systems for staging lymph node metastasis in gastric cancer. Their relative merits are not clear. In this retrospective analysis, the nodal status was classified according to the Union Internacional Contra la Cancrum (UICC) and Japanese staging systems, the number and frequency of lymph node metastasis, and the level of involved nodes. Each staging system was scored as good (+1), fair (0) or poor (-1) with respect to prognostic value, theoretical value, convenience, reproducibility and surgical applicability. There were no differences between the five staging systems in predicting survival. The Japanese staging system was most arbitrary owing to the complexity of the system, although it had an advantage in surgical application. The same disadvantage was found in the UICC system and the level system. Determination of the number and frequency of involved nodes was convenient and reproducible, but the number of lymph nodes dissected must be considered when the number of positive nodes is used for staging. The classification of metastasis to the regional lymph nodes as N0 (no nodal metastasis), N1 (metastasis in 1-25 per cent of dissected nodes) and N2 (metastasis in more than 25 per cent of dissected nodes) would be a simple, convenient, reproducible staging system with an ability to predict surgical results.

  13. Weak instruments and the first stage F-statistic in IV models with a nonscalar error covariance structure

    NARCIS (Netherlands)

    Bun, M.; de Haan, M.

    2010-01-01

    We analyze the usefulness of the first stage F-statistic for detecting weak instruments in the IV model with a nonscalar error covariance structure. More in particular, we question the validity of the rule of thumb of a first stage F-statistic of 10 or higher for models with correlated errors

  14. Multidisciplinary management of very advanced stage III and IV melanoma: Proof-of-principle.

    Science.gov (United States)

    Gutman, Haim; Ben-Ami, Eytan; Shapira-Frommer, Roni; Schachter, Jacob

    2012-08-01

    Patients with potentially resectable advanced stage III and IV melanoma are a selected subgroup that gain maximal advantage if treated in a melanoma center. Surgery combined with chemo/chemobiotherapy may yield durable remission and long-term palliation. Thirty-seven non-randomly selected patients underwent systemic therapy with the aim of consolidating treatment by surgery. Data were collected prospectively, and analyzed retrospectively. The median follow-up from diagnosis was 50 (3-307) months and 15 (1-156) months when calculated from the last intervention. Twenty-two males and 15 females, with a median age at diagnosis of 44 (20-71) years, with 13 trunk, 13 extremity, 3 head and neck and 8 unknown primary melanomas were included. There were 17 stage III and 20 stage IV patients with a median Breslow thickness of 3.7 (0.45-26) mm. Chemo/chemobiotherapy achieved 7 clinical complete responses (cCRs), 28 partial responses (PRs) and 2 instances of stable disease. Six of the 7 cCRs were operated on, securing pathological complete response in 5 and PR in one. Four of these five and the PR patient still have no evidence of disease (NED). Twenty-one of 30 PR patients were rendered NED by surgery; 14 of these 21 patients succumbed to melanoma, and one is alive with stable disease. Overall, 11 of 37 patients have not succumbed to melanoma, with a median of 72 (14-156) months survival following the last intervention. Of the eight patients with unknown primary melanomas, five have not succumbed to melanoma, with a median of 89 (30-156) months survival following the last intervention. Patients with marginally resectable stage III and IV melanoma have a significant 30% chance, according to this series, for durable remission if treated by a multidisciplinary team in a melanoma center using induction chemobiotherapy and surgery. Results are more favorable for patients with an unknown primary lesion. In view of the currently approved new effective treatments for melanoma, this

  15. [Surgical treatment of the primary tumor in stage IV breast cancer].

    Science.gov (United States)

    Jiménez Anula, Juan; Sánchez Andújar, Belén; Machuca Chiriboga, Pablo; Navarro Cecilia, Joaquín; Dueñas Rodríguez, Basilio

    2015-01-01

    The aim of the study was to analyze the impact of loco-regional surgery on survival of patients with stage IV breast cancer. Retrospective study that included patients with breast cancer and synchronous metastases. Patients with ECOG above 2 and high-risk patients were excluded. The following variables were evaluated: age, tumor size, nodal involvement, histological type, histological grade, hormone receptor status, HER2 overexpression, number of affected organs, location of metastases and surgical treatment. The impact of surgery and several clinical and pathologic variables on survival was analyzed by Cox regression model. A total of 69 patients, of whom 36 (52.2%) underwent surgery (study group) were included. After a mean follow-up of 34 months, the median survival of the series was 55 months and no significant differences between the study group and the group of patients without surgery (P=0.187) were found. Two factors associated with worse survival were identified: the number of organs with metastases (HR=1.69, IC 95%: 1.05-2.71) and triple negative breast cancer (HR=3.49, IC 95%: 1.39-8.74). Loco-regional surgery, however, was not associated with survival. Loco-regional surgical treatment was not associated with improved survival inpacientes with stage IV breast cancer. The number of organs with metastases and tumors were triple negative prognostic factors for survival. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Metastatic volume: an old oncologic concept and a new prognostic factor for stage IV melanoma patients.

    Science.gov (United States)

    Panasiti, V; Curzio, M; Roberti, V; Lieto, P; Devirgiliis, V; Gobbi, S; Naspi, A; Coppola, R; Lopez, T; di Meo, N; Gatti, A; Trevisan, G; Londei, P; Calvieri, S

    2013-01-01

    The last melanoma staging system of the 2009 American Joint Committee on Cancer takes into account, for stage IV disease, the serum levels of lactate dehydrogenase (LDH) and the site of distant metastases. Our aim was to compare the significance of metastatic volume, as evaluated at the time of stage IV melanoma diagnosis, with other clinical predictors of prognosis. We conducted a retrospective multicentric study. To establish which variables were statistically correlated both with death and survival time, contingency tables were evaluated. The overall survival curves were compared using the Kaplan-Meier method. Metastatic volume and number of affected organs were statistically related to death. In detail, patients with a metastatic volume >15 cm(3) had a worse prognosis than those with a volume lower than this value (survival probability at 60 months: 6.8 vs. 40.9%, respectively). The Kaplan-Meier method confirmed that survival time was significantly related to the site(s) of metastases, to elevated LDH serum levels and to melanoma stage according to the latest system. Our results suggest that metastatic volume may be considered as a useful prognostic factor for survival among melanoma patients.

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-01

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

  19. Phase II study of ipilimumab in adolescents with unresectable stage III or IV malignant melanoma

    DEFF Research Database (Denmark)

    Geoerger, Birgit; Bergeron, Christophe; Gore, Lia

    2017-01-01

    BACKGROUND: Ipilimumab is approved for the treatment of advanced melanoma in adults; however, little information on the efficacy and safety of ipilimumab in younger patients is available. METHODS: Patients aged 12 to <18 years with previously treated or untreated, unresectable stage III or IV mal...

  20. Anti-SEMA4D Monoclonal Antibody VX15/2503 With Nivolumab or Ipilimumab in Treating Patients With Stage III or IV Melanoma

    Science.gov (United States)

    2018-04-26

    Metastatic Melanoma; Stage III Cutaneous Melanoma AJCC v7; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7

  1. BigBOSS: The Ground-Based Stage IV BAO Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Schlegel, David; Bebek, Chris; Heetderks, Henry; Ho, Shirley; Lampton, Michael; Levi, Michael; Mostek, Nick; Padmanabhan, Nikhil; Perlmutter, Saul; Roe, Natalie; Sholl, Michael; Smoot, George; White, Martin; Dey, Arjun; Abraham, Tony; Jannuzi, Buell; Joyce, Dick; Liang, Ming; Merrill, Mike; Olsen, Knut; Salim, Samir

    2009-04-01

    The BigBOSS experiment is a proposed DOE-NSF Stage IV ground-based dark energy experiment to study baryon acoustic oscillations (BAO) and the growth of structure with an all-sky galaxy redshift survey. The project is designed to unlock the mystery of dark energy using existing ground-based facilities operated by NOAO. A new 4000-fiber R=5000 spectrograph covering a 3-degree diameter field will measure BAO and redshift space distortions in the distribution of galaxies and hydrogen gas spanning redshifts from 0.2< z< 3.5. The Dark Energy Task Force figure of merit (DETF FoM) for this experiment is expected to be equal to that of a JDEM mission for BAO with the lower risk and cost typical of a ground-based experiment.

  2. Blood flow and glucose metabolism in stage IV breast cancer: Heterogeneity of response during chemotherapy

    NARCIS (Netherlands)

    N.C. Krak (Nanda); J. van der Hoeven (John); O.S. Hoekstra (Otto); J.W.R. Twisk (Jos); E.E. van der Wall (Ernst); A.A. Lammertsma (Adriaan)

    2008-01-01

    textabstractObjective: The purpose of the study was to compare early changes in blood flow (BF) and glucose metabolism (MRglu) in metastatic breast cancer lesions of patients treated with chemotherapy. Methods: Eleven women with stage IV cancer and lesions in breast, lymph nodes, liver, and bone

  3. 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…

  4. Effects of cardiac resynchronization therapy in patients with inotrope-dependent class IV end-stage heart failure

    Directory of Open Access Journals (Sweden)

    Ikutaro Nakajima

    2013-12-01

    Conclusion: CRT did not result in significant reverse remodeling in patients with inotrope-dependent class IV end-stage HF. However, it contributed to dramatically improve the cardiovascular outcomes at least in the short-term period in some patients.

  5. Advanced-stage III/IV follicular lymphoma. Treatment strategies for individual patients

    Energy Technology Data Exchange (ETDEWEB)

    Heinzelmann, Frank; Bamberg, Michael; Weinmann, Martin [Dept. of Radiation Oncology, Univ. of Tuebingen (Germany); Ottinger, Hellmut [Dept. of Bone Marrow Transplantation, Univ. of Essen (Germany); Engelhard, Marianne [Dept. of Radiation Oncology, Univ. of Essen (Germany); Soekler, Martin [Dept. of Internal Medicine II, Univ. of Tuebingen (Germany)

    2010-05-15

    Background: in patients with advanced-stage III/IV follicular lymphoma (FL), there are many treatment options available. The current challenge is to choose the optimal strategy for the individual patient. Methods: the literature was reviewed with respect to treatment strategies in patients with advanced FL by screening the PubMed databank. Results: in advanced-stage III/IV FL, median survival may approach 8-10 years. Treatment strategies include a watch-and-wait strategy, chemoimmunotherapy, monotherapy with rituximab, and - as an experimental approach so far - radioimmunotherapy. The use of autologous hematopoietic stem cell transplantation (HSCT) for patients in first remission or chemosensitive relapse prolongs progression-free survival while the effect on overall survival remains unclear compared to standard chemotherapy. However, long-term results are flawed by high relapse rates and risk of secondary malignancies. In patients with relapsed/chemoresistant disease, allogeneic HSCT constitutes the only curative approach but is associated with high treatment-related mortality. In the palliative setting, low-dose involved-field irradiation constitutes an effective treatment option in order to control local symptoms with potential long-lasting response. Conclusion: in case of advanced-disease FL, asymptomatic patients can be managed expectantly. In symptomatic patients, chemoimmunotherapy is regarded as standard therapy. In symptomatic elderly patients with relevant comorbidities, rituximab {+-} single-agent chemotherapy, or low-dose involved-field radiotherapy might be appropriate. For younger patients with chemoresistant/relapsed disease, allogeneic HSCT might be considered, since advances in supportive care and better patient selection have resulted in improved outcomes. (orig.)

  6. Hypofractionated Image Guided Radiation Therapy in Treating Patients With Stage IV Breast Cancer

    Science.gov (United States)

    2017-06-26

    Central Nervous System Metastases; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Invasive Lobular Breast Carcinoma; Invasive Lobular Breast Carcinoma With Predominant in Situ Component; Liver Metastases; Lobular Breast Carcinoma in Situ; Lung Metastases; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Recurrent Breast Cancer; Stage IV Breast Cancer; Tubular Ductal Breast Carcinoma; Tumors Metastatic to Brain

  7. Metastasis features of 546 patients with stage IV non-small cell lung cancer at first visit and the significance in radiotherapy

    International Nuclear Information System (INIS)

    Li Fenghu; Lu Bing; Fu Heyi; Han Lei; Li Qingsong; Li Huiqin

    2012-01-01

    Objective: To investigate the clinical metastasis features and the possibility of 3 dimensional radiotherapy of stage IV non-small cell lung cancer (NSCLC). Methods: The clinical materials of 546 patients with stage IV NSCLC and the relationship b T and N stage and metastasis were retrospectively analyzed. Results In 546 patients with stage IV NSCLC, the number with bone metastasis was 294, the number with brain metastasis was 167, the number with lung metastasis was 137, the number with liver metastasis was 79, the number with adrenal gland metastasis was 66, 37 with lymph node metastasis, 35 with subcutaneous metastasis and 10 with other organ metastasis. The number with single organ metastasis was 379 (69.4%) ,in which 37.7% with bone metastasis, 19.8% with brain metastasis, 16.9% with lung metastasis, 7.4% with liver metastasis, 7.4% with adrenal gland metastasis, 4.5% with lymph node metastasis, 5.5% with subcutaneous metastasis and 0.8% with other organ metastasis. The bone metastasis probability of T 3+4 patient was similar with T 1+2 (69.4%, 30.6%, χ 2 = 7.65, P = 0.067), but N 2+3 patient was more than N 0+1 (69.7%, 30.3%, χ 2 = 7.89, P = 0.044). The brain metastasis probability of T 3+4 patient was more than T 1+2 (70.7%, 29.3%, χ 2 = 10.64, P = 0.018), but N 2+3 patient was similar with N 0+1 (54.5%, 45.5%, χ 2 = 7.14, P = 0.079), and N 1+3+3 patient was more than N 0 (86.8%, 13.2%, χ 2 = 10.26, P = 0.024). Conclusions: In 546 patients with stage IV NSCLC, the most common metastatic organ is bone, the second is brain, the third is lung, the forth is liver, followed by adrenal gland; single organ metastasis is more common than multiple organ metastasis. The later the T stage is, the more severe is the metastasis. Through 3 dimensional radiotherapy, not only the quality of life of some stage IV patients is improved, but also the survival time was prolonged observably. (authors)

  8. The lipolytic activity of Rhizopus microsporus var rhizopodiformis isolat UICC No. 6

    Directory of Open Access Journals (Sweden)

    Doni Prayudi

    2002-12-01

    Full Text Available A study was carried out to examine the effect of peptone concentration (2,5% or 5%, inoculum concentration (0,1%, 0,5% or 1% and incubation period (0 – 96 hours, interval 12 hours on the lipolytic activity of Rhizopus microsporus var rhizopodiformis isolat UICC No. 6. Fermentation was done using the basal medium from Samad and the lipolytic activity on olive oil substrate was measured employing titration method with 0,05M NaOH. Lipolytic activity is expressed as unit/ml and one unit is defined as 1 Ωmol fatty acid liberated per minute. Results show that optimum lipolytic activity was obtained from 1 % inoculum, 5% peptone after 72 hours incubation period.

  9. 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.

  10. 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.

  11. Challenges and outlook for the UICC-Asian Regional Office.

    Science.gov (United States)

    Akaza, Hideyuki

    2013-01-01

    At the United Nations High-level Meeting on Non-communicable Disease Prevention and Control in 2011 the link between health and socioeconomic issues was raised, becoming a global political issue. Health equity is one challenge that has hitherto not been addressed directly, although there is a growing shared recognition that cancer in Asia is an urgent social issue. At the UICC-ARO we are working to promote and widen networks of individuals and organizations in Asia and involve them in cooperation for this purpose. As part of our current activities, we are addressing the question of the "Economic burden of cancer in Asian countries: How should we face the current situation? " from a variety of angles and seeking to bring together a wealth of multidisciplinary knowledge about cancer in Asia and its related socioeconomic factors. It is essential to ensure that the real picture of cancer in Asia, which is currently not accurately understood, is conveyed clearly to all concerned, and also that the differences between cancer in Asia and in the West are highlighted.

  12. Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Grutsch James F

    2009-01-01

    Full Text Available Abstract Background A frequent manifestation of advanced lung cancer is malnutrition, timely identification and treatment of which can lead to improved patient outcomes. Bioelectrical impedance analysis (BIA is an easy-to-use and non-invasive technique to evaluate changes in body composition and nutritional status. We investigated the prognostic role of BIA-derived phase angle in advanced non-small cell lung cancer (NSCLC. Methods A case series of 165 stages IIIB and IV NSCLC patients treated at our center. The Kaplan Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of phase angle, independent of stage at diagnosis and prior treatment history. Results 93 were males and 72 females. 61 had stage IIIB disease at diagnosis while 104 had stage IV. The median phase angle was 5.3 degrees (range = 2.9 – 8. Patients with phase angle 5.3 had 12.4 months (95% CI: 10.5 to 18.7; n = 84; (p = 0.02. After adjusting for age, stage at diagnosis and prior treatment history we found that every one degree increase in phase angle was associated with a relative risk of 0.79 (95% CI: 0.64 to 0.97, P = 0.02. Conclusion We found BIA-derived phase angle to be an independent prognostic indicator in patients with stage IIIB and IV NSCLC. Nutritional interventions targeted at improving phase angle could potentially lead to an improved survival in patients with advanced NSCLC.

  13. Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology.

    Directory of Open Access Journals (Sweden)

    Johnny Kao

    Full Text Available There is an urgent need for a robust, clinically useful predictive model for survival in a heterogeneous group of patients with metastatic cancer referred to radiation oncology.From May 2012 to August 2013, 143 consecutive patients with stage IV cancer were prospectively evaluated by a single radiation oncologist. We retrospectively analyzed the effect of 29 patient, laboratory and tumor-related prognostic factors on overall survival using univariate analysis. Variables that were statistically significant on univariate analysis were entered into a multivariable Cox regression to identify independent predictors of overall survival.The median overall survival was 5.5 months. Four prognostic factors significantly predicted survival on multivariable analysis including ECOG performance status (0-1 vs. 2 vs. 3-4, number of active tumors (1 to 5 vs. ≥ 6, albumin levels (≥ 3.4 vs. 2.4 to 3.3 vs. 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001.These data suggest that a model that considers performance status, extent of disease, primary tumor site and serum albumin represents a simple model to accurately predict survival for patients with stage IV cancer who are potential candidates for radiation therapy.

  14. Forty cases of maxillary sinus carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Go; Yamada, Shoichiro; Sawatsubashi, Motohiro; Miyazaki, Junji; Tsuda, Kuniyoshi; Inokuchi, Akira [Saga Medical School (Japan)

    2002-01-01

    Forty patients with squamous cell carcinoma in the maxillary sinus were investigated between 1989 and 1999. They consisted of 28 males and 12 females. Their ages ranged from 18 to 84 years (mean 62 years). According to the 1987 UICC TNM classification system, 3 patients were classified as stage II, 3 were stage III and 34 were stage IV. The overall three-year and five-year survival rates were 52% and 44%, respectively. Local recurrence was observed in 11 stage IV cases and 10 of them were not controlled. For further improving the prognosis of such patients, new techniques such as skull base surgery, super selective intraarterial chemotherapy, and concurrent chemo-radiation should be included in the treatment regimen. (author)

  15. Clinical Significance of the Neutrophil-to-Lymphocyte Ratio in Endocrine Therapy for Stage IV Breast Cancer.

    Science.gov (United States)

    Iimori, Nozomi; Kashiwagi, Shinichiro; Asano, Yuka; Goto, Wataru; Takada, Koji; Takahashi, Katsuyuki; Hatano, Takaharu; Takashima, Tsutomu; Tomita, Shuhei; Motomura, Hisashi; Hirakawa, Kosei; Ohira, Masaichi

    2018-01-01

    Studies have found that patients with cancer exhibit abnormal leukocyte fractions, such as elevated neutrophil count and diminished lymphocyte count, and that the neutrophil-to-lymphocyte ratio (NLR) provides a surrogate marker for prognosis and response to treatment of patients after radical surgery for several different types of cancer. However, few reports have addressed the association between the NLR and response to endocrine therapy. In this study, we carried out a clinical investigation to confirm whether or not the NLR predicted the response to endocrine therapy of stage IV breast cancer. The study subjects were 34 patients who underwent endocrine therapy as initial drug therapy for stage IV breast cancer. The correlation between NLR and prognosis, including the efficacy of endocrine therapy, was evaluated retrospectively. Among the 34 patients, the NLR was high in 10 (29.4%) and low in 24 (70.6%). In analysis of outcomes, the group with low NLR had a significant prolongation of progression-free survival (p=0.003), time to treatment failure (p=0.031), and overall survival (p=0.013) compared to the group with high NLR. Univariate analysis of progression-free survival found that responding to treatment [hazard ratio (HR)=4.310, p=0.004] and low NLR (HR=3.940, p=0.016) were factors associated with a favorable prognosis. Multivariate analysis also showed that responding to treatment (HR=4.329, p=0.006) and low NLR (HR=3.930, p=0.008) were independent factors associated with a favorable prognosis. Our results suggested that the NLR may represent a predictive marker for response to endocrine therapy in stage IV breast cancer. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  16. Roundtable discussion at the UICC World Cancer Congress: looking toward the realization of universal health coverage for cancer in Asia.

    Science.gov (United States)

    Akaza, Hideyuki; Kawahara, Norie; Nozaki, Shinjiro; Sonoda, Shigeto; Fukuda, Takashi; Cazap, Eduardo; Trimble, Edward L; Roh, Jae Kyung; Hao, Xishan

    2015-01-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized a Roundtable Discussion as part of the official program of the UICC World Cancer Congress 2014 in Melbourne, Australia. The theme for the Roundtable Discussion was - Looking Toward the Realization of Universal Health Care (UHC) for Cancer in Asia - and it was held on December 5, 2014. The meeting was held based on the recognition that although each country may take a different path towards the realization of UHC, one point that is common to all is that cancer is projected to be the most difficult disease to address under the goals of UHC and that there is, therefore, an urgent and pressing need to come to a common understanding and awareness with regard to UHC concepts that are a priority component of a post-MDG development agenda. The presenters and participants addressed the issue of UHC for cancer in Asia from their various perspectives in academia and international organizations. Discussions covered the challenges to UHC in Asia, collaborative approaches by international organizations, the need for uniform and relevant data, ways to create an Asia Cancer Barometer that could be applied to all countries in Asia. The session concluded with the recognition that research on UHC in Asia should continue to be used as a tool for cancer cooperation in Asia and that the achievement of UHC would require research and input not only from the medical community, but from a broad sector of society in a multidisciplinary approach. Discussions on this issue will continue towards the Asia-Pacific Cancer Conference in Indonesia in August 2015.

  17. Evaluation of concomitant use of non-specific immunopotentiator on 172 cases of primary lung cancer (Stage III, IV) treated with radiation combined with chemotherapy

    International Nuclear Information System (INIS)

    Ogawa, Yasuhiro; Kimura, Shuji; Imajo, Yoshinari; Hamada, Fumio; Miyaji, Chihiro

    1982-01-01

    The clinical effect of concomitant use of non-specific immunopotentiator OK-432 and/or PSK was studied about 172 cases of primary lung cancer (Stage III, IV). In 91 cases in stage III, fifty percent survival period was found to be 11.5 months for 63 cases with OK-432 and/or PSK, and 7.5 months for 28 cases without immunotherapy, respectively. In 81 cases in stage IV, fifty percent survival period was found to be 6.7 months for 45 cases with OK-432 and/or PSK, and 3.3 months for 36 cases without immunotherapy, respectively. (author)

  18. Karakterisasi ekstrak kasar lipase Rhizopus stolonifer UICC 137

    Directory of Open Access Journals (Sweden)

    Sri Sumiarsih

    2001-12-01

    Full Text Available There is an increasing commercial interest in enzymatic production of biologically active component, because there are a number of well-known advantages compared to chemical synthesis. One of the most valuable synthetic features of enzyme is their ability to discriminate between enantiomers of racemic substrates. Lipase have become of great interest to the chemical industries wing their usefulness in both hydrolytic and synthesis reactions. The aim of this work was to study the production of lipase by Rhizopus stolonifer UICC 137, and determine the crude lipase preparation characteristics. The lipolytic activity was determined by titrimetric method toward oil-arabic gum emultion as a substrate. The strain produced lipase at appreciable lipolytic when cultivated for 72 hours in medium containing 3% glucose and 1% olive oil. Our data suggest that the strain produced lipase since the exponential phase of its growth. Lipase with optimum lipolytic activity was obtained at late stationary phase. The optimum condition for lipolytic activity measurement were pH of 7.5 and temperature 37oC, the crude enzyme had a specific activity 20.2 unit/ mg protein, the Vmax was 15.1 mol/ min and KM was 12.5 mg/ ml. The crude enzyme retained 79.9%, 68.0% and 52.6% of its lipolytic activity, when incubated for 90 minutes at temperature of 40, 50, and 60oC respectively.

  19. Papillary cystadenoma of the epididymis in a 12-year-old survivor of stage IV neuroblastoma

    Directory of Open Access Journals (Sweden)

    Nnenaya Agochukwu

    2018-04-01

    Full Text Available Papillary cystadenoma of the epididymis (PCE is the second most common benign neoplasm of the epididymis [1]. It is very uncommon and has never been reported in a prepubertal male. It may occur sporadically, but more often occurs in association with von Hippel- Lindau (VHL disease [2]. There have been over 60 reports of patients with such tumors, with the youngest patient being 16 years old.We present the case of a 12- year old male with a history of stage IV neuroblastoma. He presented with a left paratesticular mass that was discovered on routine follow up physical exam with his pediatric oncologist. He was asymptomatic at the time of presentation with no signs or symptoms of hypoandrogenism. A computed tomography scan of the abdomen and pelvis was negative for lymphadenopathy and additional disease sites. Given the patient's history of stage IV neuroblastoma, there was suspicion of yolk sac tumor or metastases; he underwent an open radical left orchiectomy. Frozen section was consistent with yolk sac tumor, however final pathology revealed normal testicle with PCE.To date, this patient is the youngest reported patient with this diagnosis; furthermore papillary cystadenoma of the epididymis has never been reported in a patient with neuroblastoma. Keywords: Papillary cystadenoma, Epididymis, Prepubertal male, Neuroblastoma

  20. Utility of Inflammatory Marker- and Nutritional Status-based Prognostic Factors for Predicting the Prognosis of Stage IV Gastric Cancer Patients Undergoing Non-curative Surgery.

    Science.gov (United States)

    Mimatsu, Kenji; Fukino, Nobutada; Ogasawara, Yasuo; Saino, Yoko; Oida, Takatsugu

    2017-08-01

    The present study aimed to compare the utility of various inflammatory marker- and nutritional status-based prognostic factors, including many previous established prognostic factors, for predicting the prognosis of stage IV gastric cancer patients undergoing non-curative surgery. A total of 33 patients with stage IV gastric cancer who had undergone palliative gastrectomy and gastrojejunostomy were included in the study. Univariate and multivariate analyses were performed to evaluate the relationships between the mGPS, PNI, NLR, PLR, the CONUT, various clinicopathological factors and cancer-specific survival (CS). Among patients who received non-curative surgery, univariate analysis of CS identified the following significant risk factors: chemotherapy, mGPS and NLR, and multivariate analysis revealed that the mGPS was independently associated with CS. The mGPS was a more useful prognostic factor than the PNI, NLR, PLR and CONUT in patients undergoing non-curative surgery for stage IV gastric cancer. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  1. Prognostic Impact of 21-Gene Recurrence Score in Patients With Stage IV Breast Cancer: TBCRC 013.

    Science.gov (United States)

    King, Tari A; Lyman, Jaclyn P; Gonen, Mithat; Voci, Amy; De Brot, Marina; Boafo, Camilla; Sing, Amy Pratt; Hwang, E Shelley; Alvarado, Michael D; Liu, Minetta C; Boughey, Judy C; McGuire, Kandace P; Van Poznak, Catherine H; Jacobs, Lisa K; Meszoely, Ingrid M; Krontiras, Helen; Babiera, Gildy V; Norton, Larry; Morrow, Monica; Hudis, Clifford A

    2016-07-10

    The objective of this study was to determine whether the 21-gene Recurrence Score (RS) provides clinically meaningful information in patients with de novo stage IV breast cancer enrolled in the Translational Breast Cancer Research Consortium (TBCRC) 013. TBCRC 013 was a multicenter prospective registry that evaluated the role of surgery of the primary tumor in patients with de novo stage IV breast cancer. From July 2009 to April 2012, 127 patients from 14 sites were enrolled; 109 (86%) patients had pretreatment primary tumor samples suitable for 21-gene RS analysis. Clinical variables, time to first progression (TTP), and 2-year overall survival (OS) were correlated with the 21-gene RS by using log-rank, Kaplan-Meier, and Cox regression. Median patient age was 52 years (21 to 79 years); the majority had hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (72 [66%]) or hormone receptor-positive/HER2-positive (20 [18%]) breast cancer. At a median follow-up of 29 months, median TTP was 20 months (95% CI, 16 to 26 months), and median survival was 49 months (95% CI, 40 months to not reached). An RS was generated for 101 (93%) primary tumor samples: 22 (23%) low risk (< 18), 29 (28%) intermediate risk (18 to 30); and 50 (49%) high risk (≥ 31). For all patients, RS was associated with TTP (P = .01) and 2-year OS (P = .04). In multivariable Cox regression models among 69 patients with estrogen receptor (ER)-positive/HER2-negative cancer, RS was independently prognostic for TTP (hazard ratio, 1.40; 95% CI, 1.05 to 1.86; P = .02) and 2-year OS (hazard ratio, 1.83; 95% CI, 1.14 to 2.95; P = .013). The 21-gene RS is independently prognostic for both TTP and 2-year OS in ER-positive/HER2-negative de novo stage IV breast cancer. Prospective validation is needed to determine the potential role for this assay in the clinical management of this patient subset. © 2016 by American Society of Clinical Oncology.

  2. Palliative Care Intervention in Improving Symptom Control and Quality of Life in Patients With Stage II-IV Non-small Cell Lung Cancer and Their Family Caregivers

    Science.gov (United States)

    2017-10-16

    Caregiver; Psychological Impact of Cancer and Its Treatment; Recurrent Non-small Cell Lung Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer

  3. Prognostic impact of metastatic pattern in stage IV breast cancer at initial diagnosis.

    Science.gov (United States)

    Leone, Bernardo Amadeo; Vallejo, Carlos Teodoro; Romero, Alberto Omar; Machiavelli, Mario Raúl; Pérez, Juan Eduardo; Leone, Julieta; Leone, José Pablo

    2017-02-01

    To analyze the prognostic influence of metastatic pattern (MP) compared with other biologic and clinical factors in stage IV breast cancer at initial diagnosis (BCID) and evaluate factors associated with specific sites of metastases (SSM). We evaluated women with stage IV BCID with known metastatic sites, reported to the Surveillance, Epidemiology and End Results program from 2010 to 2013. MP was categorized as bone-only, visceral, bone and visceral (BV), and other. Univariate and multivariate analyses determined the effects of each variable on overall survival (OS). Logistic regression examined factors associated with SSM. We included 9143 patients. Bone represented 37.5% of patients, visceral 21.9%, BV 28.8%, and other 11.9%. Median OS by MP was as follows: bone 38 months, visceral 21 months, BV 19 months, and other 33 months (P < 0.0001). Univariate analysis showed that higher number of metastatic sites had worse prognosis. In multivariate analysis, older age (hazard ratio 1.9), black race (hazard ratio 1.17), grade 3/4 tumors (hazard ratio 1.6), triple-negative (hazard ratio 2.24), BV MP (hazard ratio 2.07), and unmarried patients (hazard ratio 1.25) had significantly shorter OS. As compared with HR+/HER2- tumors, triple-negative and HR-/HER2+ had higher odds of brain, liver, lung, and other metastases. HR+/HER2+ had higher odds of liver metastases. All three subtypes had lower odds of bone metastases. There were substantial differences in OS according to MP. Tumor subtypes have a clear influence among other factors on SSM. We identified several prognostic factors that could guide therapy selection in treatment naïve patients.

  4. Efficacy of Icotinib treatment in patients with stage IIIb/IV non-small cell lung cancer.

    Science.gov (United States)

    Qin, Na; Yang, Xinjie; Zhang, Quan; Li, Xi; Zhang, Hui; Lv, Jialin; Wu, Yuhua; Wang, Jinghui; Zhang, Shucai

    2014-05-01

    To evaluate the efficacy and safety of Icotinib - an orally administered, highly potent selective inhibitor of epidermal growth factor receptor (EGFR) and its active mutations, in the treatment of patients with advanced non-small cell lung cancer (NSCLC). A total of 101 patients with stage IIIb/IV NSCLC were treated with 125 mg Icotinib three times a day until disease progression or intolerable toxicity. Response rate was evaluated using response evaluation criteria in solid tumors and progression-free survival (PFS) was collected. The overall response rate (ORR) and disease control rate (DCR) were 37.6% (38/101) and 79.2% (80/101), respectively. The median PFS was 6.5 months. Multivariate analysis showed that female gender (P= 0.048, 95% confidence interval [CI] 1.010-6.016) and occurrence of rash (P= 0.002, 95% CI 1.667-9.809) were the independent predictive factors for ORR, while a performance status (PS) score of 0-1 (P= 0.001, 95% CI 0.024-0.402) and rash (P= 0.042, 95% CI 1.089-76.557) were the independent predictive factors for DCR. In addition, PS scores of 0-1 (P Icotinib were rash (35.6%) and diarrhea (17.8%), which was tolerable. Treatment of stage IIIb/IV NSCLC patients with Icotinib was effective and tolerable, specifically in patients with EGFR mutation.

  5. Infantile tibia vara: Treatment of Langenskiold stage IV

    Directory of Open Access Journals (Sweden)

    Umrani Salil

    2008-01-01

    Full Text Available An eight year old girl presented with a progressively increasing deformity of the left proximal tibia since last 2 years. She had no history of trauma, fever and swelling of left knee. There were no obvious signs of rickets/muscular dystrophy. She had 25 degrees of tibia vara clinically with lateral thrust and a prominent fibular head. The radiograph of left knee revealed tibia vara with medial beaking and a significant depression of the medial tibial epiphysis and metaphysis. A computed tomography (CTscan revealed significant depression of the medial tibial epiphysis but no bony bar in the physis or fusion of the medical tibial epiphysis. There was a posterior slope in addition to the medial one. She was treated with elevation of the medial tibial hemiplateau with subtuberosity valgus derotation dome osteotomy. She also underwent a lateral proximal tibial hemiphysiodesis (temporary stapling. A prophylactic subcutaneons anterolateral compartment fasciotomy was also performed. All osteotomies united in 2 months. All deformities were corrected and she regained a knee range of 0 to 130 degrees. At final followup (4 years, there was no recurrence of varus deformity, knee was stable, with 1cm of leg length discrepancy. In Langenskiold stage IV tibia vara, elevation of medial tibial plateau, a subtuberosity valgus derotation osteotomy and a concomitant lateral hemiephiphysiodesis has given good results.

  6. Spectrum of bone marrow changes in patients of chronic kidney disease (stage iii, iv and v)

    International Nuclear Information System (INIS)

    Latif, R.K.; Khan, S.A.; Ahmad, S.Q.; Arshad, U.

    2017-01-01

    To see the various hematological changes in the bone marrow of patients with chronic kidney disease (CKD) stage III, IV and V. Study Design: Cross sectional observational study.Place and Duration of Study: Study was conducted in the department of haematology (Pathology), Army Medical College, Rawalpindi and duration was one year, from Mar 2015 to Feb 2016. Material and Methods: Patients of both sexes and all age groups with CKD stage III, IV and V were included in this study. Patients' histories were recorded. Complete blood counts, bone marrow aspiration and trephine biopsy were done and evaluated microscopically. Mean blood counts of the patients in three groups of CKD were compared. Frequencies of various bone marrow (BM) findings in patients of CKD were calculated. Results: Out of 57 patients, 41 (71.9%) were males while 16 (28%) were females. Mean age was 60 years. There was no statistically significant difference between the mean hemoglobin, mean white cell count and mean platelets count of the patients in three groups of CKD. Reactive changes due to underlying CKD and inflammation were the most frequent findings in the BM of the patients. Conclusion: Anaemia of mild to moderate severity and reactive changes in the BM are the most frequent haematological findings encountered in patients suffering from advanced stage CKD. Since CKD is predominantly a disease of the elderly so it is not rare to find the co-morbidities including plasmacytosis, malignancies and their effects on the BM in patients of CKD. (author)

  7. Superselective intra-arterial infusion chemotherapy for stage III/IV squamous cell carcinomas of the oral cavity: Midterm results

    International Nuclear Information System (INIS)

    Ikushima, I.; Korogi, Y.; Ishii, A.; Hirai, T.; Yamura, M.; Nishimura, R.; Baba, Y.; Yamashita, Y.; Shinohara, M.

    2008-01-01

    Purpose: We performed superselective intra-arterial infusion chemotherapy (SIC) according to a protocol in which drug distribution is evaluated by the use of interventional radiology (IVR)-computed tomography (CT) system, and the chemotherapy is combined with medium-dose conformal radiation therapy (CRT). We analyzed retrospectively the factors that affect the midterm survival ratio, including local response, for stage III and IV squamous cell carcinomas of the oral cavity. Materials and methods: Forty consecutive patients with stage III and IV squamous cell carcinomas of the oral cavity and who had undergone both SIC and CRT were enrolled. A microcatheter was placed in the appropriate feeding artery of the tumor and cisplatin (50 mg/body) was infused twice. CRT was administered with a dual-energy (4 and 10 MV) linear accelerator. The total and daily doses delivered were 30 and 2.0 Gy, respectively. Histopathologic effects were classified into five grades: grade 0 or 1 was defined as a poor response, and grade II or higher as a good response. Age, sex, stage, local response to treatment, mode of invasion and lymph node metastasis were analyzed, and differences in the midterm survival ratio were assessed. Results: The 3-year survival ratio of the 40 cases was 67%. A good local response (III or IV) was achieved in 75% of the cases. The survival ratio of the good local response group was significantly better than that of the poor response group (p = 0.04). Mode of invasion (p = 0.03) and lymph node metastasis (p = 0.01) were also predictive of survival. In the multivariable analysis of survival, however, no variables including good local response (p = 0.12), were predictive. Conslusion: Our new protocol improved local response, but it did not contribute to the survival ratio

  8. Diet and Physical Activity Change or Usual Care in Improving Progression-Free Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    Science.gov (United States)

    2018-02-14

    Fallopian Tube Clear Cell Adenocarcinoma; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Serous Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Brenner Tumor; Ovarian Clear Cell Adenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer AJCC v6 and v7; Stage IIA Ovarian Cancer AJCC V6 and v7; Stage IIB Fallopian Tube Cancer AJCC v6 and v7; Stage IIB Ovarian Cancer AJCC v6 and v7; Stage IIC Fallopian Tube Cancer AJCC v6 and v7; Stage IIC Ovarian Cancer AJCC v6 and v7; Stage IIIA Fallopian Tube Cancer AJCC v7; Stage IIIA Ovarian Cancer AJCC v6 and v7; Stage IIIA Primary Peritoneal Cancer AJCC v7; Stage IIIB Fallopian Tube Cancer AJCC v7; Stage IIIB Ovarian Cancer AJCC v6 and v7; Stage IIIB Primary Peritoneal Cancer AJCC v7; Stage IIIC Fallopian Tube Cancer AJCC v7; Stage IIIC Ovarian Cancer AJCC v6 and v7; Stage IIIC Primary Peritoneal Cancer AJCC v7; Stage IV Fallopian Tube Cancer AJCC v6 and v7; Stage IV Ovarian Cancer AJCC v6 and v7; Stage IV Primary Peritoneal Cancer AJCC v7; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

  9. Prediction of survival in patients with Stage IV kidney cancer

    Directory of Open Access Journals (Sweden)

    L. V. Mirilenko

    2015-01-01

    Full Text Available The efficiency of treatment was evaluated and the predictors of adjusted survival (AS were identified in patients with disseminated kidney cancer treated at the Republican Research and Practical Center for Oncology and Medical Radiology in 1999 to 2011 (A.E. Okeanov, P.I. Moiseev, L.F. Levin. Malignant tumors in Belarus, 2001–2012. Edited by O.G. Sukonko. Seven factors (regional lymph node metastases; distant bone metastases; a high-grade tumor; sarcomatous tumor differentiation; hemoglobin levels of < 125 g/l in women and < 150 g/l in men; an erythrocyte sedimentation rate of 40 mm/h; palliative surgery were found to have an independent, unfavorable impact on AS. A multidimensional model was built to define what risk group low (no more than 2 poor factors, moderate (3–4 poor factors, and high (more than 4 poor factors the patients with Stage IV kidney cancer belonged to. In these groups, the median survival was 34.7, 17.2, and 4.0 months and 3-year AS rates were 48.6, 24.6, and 3.2 %, respectively. 

  10. Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis.

    Science.gov (United States)

    Roux, Pauline; Perrin, Jeanne; Mancini, Julien; Agostini, Aubert; Boubli, Léon; Courbiere, Blandine

    2017-07-01

    To assess the factors associated with a poor prognosis for a cumulative IVF live birth rate (LBR) in women with stage III and IV endometriosis according to the revised classification of the American Fertility Society (rAFS). A retrospective cohort study was conducted between January 1, 2010, and December 31, 2014, in our Reproductive Medicine Center. We analyzed different factors associated with a poor prognosis for a cumulative IVF LBR in women with rAFS stage III and IV endometriosis. A total of 101 patients were included, representing 232 IVF-ICSI cycles and 212 embryo transfers. The primary endpoint was the cumulative LBR per cycle and per patient. The cumulative LBR per cycle was 14.7% (n = 34) and that per patient was 31.7% (n = 32). The cumulative LBR was significantly decreased by active smoking [ adj OR = 3.4, 95% CI (1.12-10.60), p = 0.031], poor ovarian response (POR) according to the Bologna criteria [ adj OR = 11.5, 95% CI (1.37-96.83), p = 0.024], and rAFS stage IV [ adj OR = 3.2, 95% CI (1.13-8.95), p = 0.024]. The cumulative LBR per women was 59.4% without factors associated with a poor prognosis and 25.6% in the case of one factor, and it decreased to 7.7% in the case of two or three factors (p endometriosis had a negative impact on the IVF-ICSI cumulative LBR for women with rAFS stage III and IV endometriosis. Because smoking dramatically decreases the LBR with endometriosis, stopping smoking before IVF-ICSI should be strongly advised.

  11. Locally Advanced Stage IV Squamous Cell Carcinoma of the Head and Neck: Impact of Pre-Radiotherapy Hemoglobin Level and Interruptions During Radiotherapy

    International Nuclear Information System (INIS)

    Rades, Dirk; Stoehr, Monika; Kazic, Nadja; Hakim, Samer G.; Walz, Annette; Schild, Steven E.; Dunst, Juergen

    2008-01-01

    Purpose: Stage IV head and neck cancer patients carry a poor prognosis. Clear understanding of prognostic factors can help to optimize care for the individual patient. This study investigated 11 potential prognostic factors including pre-radiotherapy hemoglobin level and interruptions during radiotherapy for overall survival (OS), metastases-free survival (MFS), and locoregional control (LC) after radiochemotherapy. Methods and Materials: Eleven factors were investigated in 153 patients receiving radiochemotherapy for Stage IV squamous cell head and neck cancer: age, gender, Karnofsky performance score (KPS), tumor site, grading, T stage, N stage, pre-radiotherapy hemoglobin level, surgery, chemotherapy type, and interruptions during radiotherapy >1 week. Results: On multivariate analysis, improved OS was associated with KPS 90-100 (relative risk [RR], 2.36; 95% confidence interval [CI], 1.20-4.93; p = .012), hemoglobin ≥12 g/dL (RR, 1.88; 95% CI, 1.01-3.53; p = .048), and no radiotherapy interruptions (RR, 2.59; 95% CI, 1.15-5.78; p = .021). Improved LC was significantly associated with lower T stage (RR, 2.17; 95% CI, 1.16-4.63; p = .013), hemoglobin ≥12 g/dL (RR, 4.12; 95% CI, 1.92-9.09; p 1 week. It appears important to avoid anemia and radiotherapy interruptions to achieve the best treatment results

  12. Preoperative chemoradiotherapy using superselective intraarterial infusion via superficial temporal artery for stage III, IV oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tohnai, Iwai; Shigetomi, Toshio [Nagoya Univ. (Japan). Graduate School of Medicine; Hayashi, Yasushi [Nagoya Second Red Cross Hospital (Japan)] (and others)

    2002-03-01

    Thirty-eight patients with stage III, IV oral cancer were treated by preoperative chemoradiotherapy using superselective intraarterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy) and chemotherapy using CBDCA (total dose: 460 mg/m{sup 2}) were performed daily, followed by surgery. Catheter-insertion of 34 patients was done successfully. Four catheter insertions were not done successfully because of the anomaly of the artery such as common trunk of the lingual artery and the facial artery. The clinical effects were CR in 9 patients (26.5%) and PR in 25 (73.5%), and histopathological effects after surgery were grade III, IV in 10 (29.4%), grade IIb in 23 (67.6%), and grade IIa in 2 (5.8%). The 5-year cumulative survival rate was 67.8%. This superselective intra arterial infusion method could be the technique of choice for the treatment of oral cancer. (author)

  13. Preoperative chemoradiotherapy using superselective intraarterial infusion via superficial temporal artery for stage III, IV oral cancer

    International Nuclear Information System (INIS)

    Tohnai, Iwai; Shigetomi, Toshio

    2002-01-01

    Thirty-eight patients with stage III, IV oral cancer were treated by preoperative chemoradiotherapy using superselective intraarterial infusion via the superficial temporal artery. Radiotherapy (total dose: 40 Gy) and chemotherapy using CBDCA (total dose: 460 mg/m 2 ) were performed daily, followed by surgery. Catheter-insertion of 34 patients was done successfully. Four catheter insertions were not done successfully because of the anomaly of the artery such as common trunk of the lingual artery and the facial artery. The clinical effects were CR in 9 patients (26.5%) and PR in 25 (73.5%), and histopathological effects after surgery were grade III, IV in 10 (29.4%), grade IIb in 23 (67.6%), and grade IIa in 2 (5.8%). The 5-year cumulative survival rate was 67.8%. This superselective intra arterial infusion method could be the technique of choice for the treatment of oral cancer. (author)

  14. Radiotherapy for stage IV oropharyngeal cancer

    International Nuclear Information System (INIS)

    Nakamura, Kaori; Akimoto, Tetsuo; Motegi, Atsushi

    2008-01-01

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

  15. Micro-mechanical modelling of ductile failure in 6005A aluminium using a physics based strain hardening larw including stage IV

    DEFF Research Database (Denmark)

    Simar, Aude; Nielsen, Kim Lau; de Meester, Bruno

    2010-01-01

    The strain hardening and damage behaviour of isothermally heat treated 6005A aluminium is investigated in order to link the thermal treatment conditions, microstructure and fracture strain. The need for a plastic flow rule involving a stage IV hardening at large strain was found essential to gene...

  16. Long-lasting complete response status of advanced stage IV gall bladder cancer and colon cancer after combined treatment including autologous formalin-fixed tumor vaccine: two case reports.

    Science.gov (United States)

    Imaoka, Yuki; Kuranishi, Fumito; Miyazaki, Tsubasa; Yasuda, Hiroko; Ohno, Tadao

    2017-09-11

    The prognosis of advanced (stage IV) cancer of the digestive organs is very poor. We have previously reported a case of advanced breast cancer with bone metastasis that was successfully treated with combined treatments including autologous formalin-fixed tumor vaccine (AFTV). Herein, we report the success of this approach in advanced stage IV (heavily metastasized) cases of gall bladder cancer and colon cancer. Case 1: A 61-year-old woman with stage IV gall bladder cancer (liver metastasis and lymph node metastasis) underwent surgery in May 2011, including partial resection of the liver. She was treated with AFTV as the first-line adjuvant therapy, followed by conventional chemotherapy. This patient is still alive without any recurrence, as confirmed with computed tomography, for more than 5 years. Case 2: A 64-year-old man with stage IV colon cancer (multiple para-aortic lymph node metastases and direct abdominal wall invasion) underwent non-curative surgery in May 2006. Following conventional chemotherapy, two courses of AFTV and radiation therapy were administered sequentially. This patient has had no recurrence for more than 5 years. We report the success of combination therapy including AFTV in cases of liver-metastasized gall bladder cancer and abdominal wall-metastasized colon cancer. Both patients experienced long-lasting, complete remission. Therefore, combination therapies including AFTV should be considered in patients with advanced cancer of the digestive organs.

  17. 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

  18. 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

  19. Lung-MAP: Talazoparib in Treating Patients With HRRD Positive Recurrent Stage IV Squamous Cell Lung Cancer

    Science.gov (United States)

    2018-05-31

    ATM Gene Mutation; ATR Gene Mutation; BARD1 Gene Mutation; BRCA1 Gene Mutation; BRCA2 Gene Mutation; BRIP1 Gene Mutation; CHEK1 Gene Mutation; CHEK2 Gene Mutation; FANCA Gene Mutation; FANCC Gene Mutation; FANCD2 Gene Mutation; FANCF Gene Mutation; FANCM Gene Mutation; NBN Gene Mutation; PALB2 Gene Mutation; RAD51 Gene Mutation; RAD51B Gene Mutation; RAD54L Gene Mutation; Recurrent Squamous Cell Lung Carcinoma; RPA1 Gene Mutation; Stage IV Squamous Cell Lung Carcinoma AJCC v7

  20. Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer: Analysis of therapeutic results in 112 cases

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Nakashima, Hideyuki; Oguri, Senri; Kioi, Mitomu; Hirota, Makoto; Koike, Izumi; Hata, Masaharu; Tohnai, Iwai

    2014-01-01

    Purpose: To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Materials and methods: One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m 2 , cisplatin, total 150 mg/m 2 ) and daily concurrent radiotherapy (total of 60 Gy) for 6 weeks. Results: The median follow-up for all patients was 46.2 months (range, 10–76 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients. Conclusion: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control

  1. Stereotactic body radiotherapy for centrally located stage I NSCLC. A multicenter analysis

    Energy Technology Data Exchange (ETDEWEB)

    Schanne, Daniel H.; Nestle, Ursula; Grosu, Anca L. [Universitaetsklinik Freiburg, Klinik fuer Strahlenheilkunde, Freiburg (Germany); Allgaeuer, Michael [Barmherzige Brueder, Klinik fuer Strahlentherapie, Regensburg (Germany); Andratschke, Nicolaus; Molls, Michael [TU Muenchen, Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Muenchen (Germany); Appold, Steffen [Universitaetsklinikum Dresden, Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Dresden (Germany); Dieckmann, Ute [Allgemeines Krankenhaus Wien, Univ. Klinik fuer Strahlentherapie, Wien (Austria); Ernst, Iris [Universitaetsklinikum Muenster, Klinik fuer Strahlentherapie, Muenster (Germany); Ganswindt, Ute [LMU Muenchen, Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Muenchen (Germany); Holy, Richard [Universitaetsklinikum Aachen, Klinik fuer Strahlentherapie, Aachen (Germany); Nevinny-Stickel, Meinhard [Medizinischen Universitaet Innsbruck, Univ. Klinik fuer Strahlentherapie und Radioonkologie, Innsbruck (Austria); Semrau, Sabine [Universitaetsklinikum Erlangen, Strahlenklinik Erlangen, Erlangen (Germany); Sterzing, Florian [Universitaetsklinikum Heidelberg, Klinik fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany); Wittig, Andrea [Philipps-Universitaet Marburg, Klinik fuer Strahlentherapie und Radioonkologie, Marburg (Germany); Guckenberger, Matthias [Universitaet Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany)

    2014-08-27

    The purpose of this work is to analyze patterns of care and outcome after stereotactic body radiotherapy (SBRT) for centrally located, early-stage, non-small cell lung cancer (NSCLC) and to address the question of potential risk for increased toxicity in this entity. A total of 90 patients with centrally located NSCLC were identified among 613 cases in a database of 13 German and Austrian academic radiotherapy centers. The outcome of centrally located NSCLC was compared to that of cases with peripheral tumor location from the same database. Patients with central tumors most commonly presented with UICC stage IB (50 %), while the majority of peripheral lesions were stage IA (56 %). Average tumor diameters were 3.3 cm (central) and 2.8 cm (peripheral). Staging PET/CT was available for 73 and 74 % of peripheral and central tumors, respectively. Biopsy was performed in 84 % (peripheral) and 88 % (central) of cases. Doses varied significantly between central and peripheral lesions with a median BED{sub 10} of 72 Gy and 84 Gy, respectively (p < 0.001). Fractionation differed as well with medians of 5 (central) and 3 (peripheral) fractions (p < 0.001). In the Kaplan-Meier analysis, 3-year actuarial overall survival was 29 % (central) and 51 % (peripheral; p = 0.004) and freedom from local progression was 52 % (central) and 84 % (peripheral; p < 0.001). Toxicity after treatment of central tumors was low with no grade III/IV and one grade V event. Mortality rates were 0 and 1 % after 30 and 60 days, respectively. Local tumor control in patients treated with SBRT for centrally located, early-stage NSCLC was favorable, provided ablative radiation doses were prescribed. This was, however, not the case in the majority of patients, possibly due to concerns about treatment-related toxicity. Reported toxicity was low, but prospective trials are needed to resolve the existing uncertainties and to establish safe high-dose regimens for this cohort of patients. (orig.) [German] Ziel

  2. The hyperfractionation in the oropharynx carcinomas treatment: stages III and IV

    International Nuclear Information System (INIS)

    Pinto, L.H.J.

    1990-01-01

    From April 1986 until May 1989. 112 patients with stages III and IV oropharynx carcinomas were included in a protocol comparing the use of Hyperfractionation and Conventional Fractionation. The doses were 6600 rad in 33 fractions of 200 rad for the conventional fractionation and 7040 rad in 64 fractions, two fractions of 110 rad per day for the hyperfractionation. As of January 1990 an analysis was performed in 98 patients, with a median follow-up of 14 months. The probability of complete responses in the oropharynx was 74%, with 84% for the hyperfractionation and 64% for the conventional fractionation ( p < 0,05). Survival was improved in 42 months for those patients treated with hyperfractionation: 27% versus 8% (p < 0,05). In patients with lesions out of the base of the tongue and in those with Karnofsky performance status of 50%, 60% and 70%, survival was improved with the use of hyperfractionation (p = 0,02 and p 0,006 respectively. The study demonstrates the superiority of hyperfractionation over the classical fractionation in the treatment of patients with carcinoma of the oropharynx. (author)

  3. Incidence, therapy and prognosis of colorectal cancer in different age groups. A population-based cohort study of the Rostock Cancer Registry

    International Nuclear Information System (INIS)

    Fietkau, R.; Zettl, H.; Kloecking, S.; Kundt, G.

    2004-01-01

    Purpose: Determination of frequency, treatment modalities used and prognoses of colorectal cancer in a population-specific analysis in relation to age. Material and methods: In 1999 and 2000, 644/6,016 patients were documented as having colorectal carcinomas in the Cancer Registry of Rostock. 39 patients were excluded (16 cases: 'in situ' carcinomas; 23 cases: insufficient data). Three age groups were formed: <60 years, 60-74 years; ≥75 years. Results: The relative percentage of colorectal cancer increases with advanced age (<60 years 7%; 60-74 years 12%, ≥75 years 15%; p<0.001). In older patients with stage III carcinomas, adjuvant treatment was done less frequently in accordance with the treatment recommendations (<60 years 83-89%; 60-74 years 67-77%; ≥75 years 29-36% according to stage and tumor localization); in stage IV, the use of chemotherapy was reduced (<60 years 87.5-100%; 60-74 years 38-47%; ≥75 years 33-37%). In the univariate analysis, age ≥75 years (4-year survival rates: <60 years 68±4.1%; 60-74 years 58±2.8%; ≥75 years 38±3.7%), UICC stage and surgical treatment had a significant effect on prognosis. Adjuvant treatment had no significant effect on the whole population but on patients with UICC stage III and IV. In the multivariate analysis, however, the only independent prognostic parameters were age ≥75 years (p=0.001), performance of chemotherapy (colon cancer) or radiochemotherapy (rectal cancer; p=0.004-0.001), and tumor stage (p=0.045-0.001). Sex (p=0.063) and age between 60 and 74 years (p=0.067) had a borderline influence. Conclusion: With increasing age, there is a departure in daily practice from the treatment recommendations. The patient's prognosis is dependent upon age (especially ≥75 years), tumor stage, and therapy. (orig.)

  4. Incidence, therapy and prognosis of colorectal cancer in different age groups. A population-based cohort study of the Rostock Cancer Registry

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R.; Zettl, H.; Kloecking, S. [University of Rostock (Germany). Department of Radiotherapy; Kundt, G. [University of Rostock (Germany). Institute of Medical Informatics and Biometry

    2004-08-01

    Purpose: Determination of frequency, treatment modalities used and prognoses of colorectal cancer in a population-specific analysis in relation to age. Material and methods: In 1999 and 2000, 644/6,016 patients were documented as having colorectal carcinomas in the Cancer Registry of Rostock. 39 patients were excluded (16 cases: 'in situ' carcinomas; 23 cases: insufficient data). Three age groups were formed: <60 years, 60-74 years; {>=}75 years. Results: The relative percentage of colorectal cancer increases with advanced age (<60 years 7%; 60-74 years 12%, {>=}75 years 15%; p<0.001). In older patients with stage III carcinomas, adjuvant treatment was done less frequently in accordance with the treatment recommendations (<60 years 83-89%; 60-74 years 67-77%; {>=}75 years 29-36% according to stage and tumor localization); in stage IV, the use of chemotherapy was reduced (<60 years 87.5-100%; 60-74 years 38-47%; {>=}75 years 33-37%). In the univariate analysis, age {>=}75 years (4-year survival rates: <60 years 68{+-}4.1%; 60-74 years 58{+-}2.8%; {>=}75 years 38{+-}3.7%), UICC stage and surgical treatment had a significant effect on prognosis. Adjuvant treatment had no significant effect on the whole population but on patients with UICC stage III and IV. In the multivariate analysis, however, the only independent prognostic parameters were age {>=}75 years (p=0.001), performance of chemotherapy (colon cancer) or radiochemotherapy (rectal cancer; p=0.004-0.001), and tumor stage (p=0.045-0.001). Sex (p=0.063) and age between 60 and 74 years (p=0.067) had a borderline influence. Conclusion: With increasing age, there is a departure in daily practice from the treatment recommendations. The patient's prognosis is dependent upon age (especially {>=}75 years), tumor stage, and therapy. (orig.)

  5. Complete resection of the primary lesion improves survival of certain patients with stage IV non-small cell lung cancer.

    Science.gov (United States)

    Chikaishi, Yasuhiro; Shinohara, Shinji; Kuwata, Taiji; Takenaka, Masaru; Oka, Soichi; Hirai, Ayako; Yoneda, Kazue; Kuroda, Kouji; Imanishi, Naoko; Ichiki, Yoshinobu; Tanaka, Fumihiro

    2017-12-01

    The standard treatment for patients with stage IV non-small cell lung cancer (NSCLC) is systemic chemotherapy. However, certain patients, such as those with oligometastasis or M1a disease undergo resection of the primary lesion. We conducted a retrospective review of the records of 1,471 consecutive patients with NSCLC who underwent resection of the primary lesion for between June 2005 and May 2016. The present study included 38 patients with stage IV NSCLC who underwent complete resection of the primary lesion as first-line treatment. The median follow-up duration for the 38 patients (27 men) was 17.7 months (range, 1-82.3 months). The T factors were T1/T2/T3/T4 in 4/16/12/6 patients, respectively. The N factors were N0/N1/N2/N3 in 16/8/12/2 patients, respectively. The M factors were M1a/M1b/M1c in 19/13/6 patients, respectively. Of the 19 M1a patients, 11 were classified as cM0. We introduced the novel classification M-better/M-worse. M-better includes cM0 patients and M1b and M1c patients in whom all lesions have been locally controlled. M-worse includes cM1a patients and M1b and M1c patients in whom lesions cannot be locally controlled. The new M-better/M-worse statuses were 24/14 patients, respectively. The histology of NSCLC was adenocarcinoma/squamous cell carcinoma/others in 30/5/3 patients, respectively. The 5-year overall survival rate was 29%, and the median survival time was 725 days. Squamous cell carcinoma and M-worse were significant factors predicting poor outcomes (P=0.0017, P=0.0007, respectively). Even for stage IV NSCLC patients, resection of the primary lesion may be beneficial, especially for those with M-better status and those not diagnosed with squamous-cell carcinoma (SCC).

  6. Vitamin D Status in Patients With Stage IV Colorectal Cancer: Findings From Intergroup Trial N9741

    Science.gov (United States)

    Ng, Kimmie; Sargent, Daniel J.; Goldberg, Richard M.; Meyerhardt, Jeffrey A.; Green, Erin M.; Pitot, Henry C.; Hollis, Bruce W.; Pollak, Michael N.; Fuchs, Charles S.

    2011-01-01

    Purpose Previous studies have suggested that higher plasma 25-hydroxyvitamin D3 [25(OH)D] levels are associated with decreased colorectal cancer risk and improved survival, but the prevalence of vitamin D deficiency in advanced colorectal cancer and its influence on outcomes are unknown. Patients and Methods We prospectively measured plasma 25(OH)D levels in 515 patients with stage IV colorectal cancer participating in a randomized trial of chemotherapy. Vitamin D deficiency was defined as 25(OH)D lower than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as ≥ 30 ng/mL. We examined the association between baseline 25(OH)D level and selected patient characteristics. Cox proportional hazards models were used to calculate hazard ratios (HR) for death, disease progression, and tumor response, adjusted for prognostic factors. Results Among 515 eligible patients, 50% of the study population was vitamin D deficient, and 82% were vitamin D insufficient. Plasma 25(OH)D levels were lower in black patients compared to white patients and patients of other race (median, 10.7 v 21.1 v 19.3 ng/mL, respectively; P < .001), and females compared to males (median, 18.3 v 21.7 ng/mL, respectively; P = .0005). Baseline plasma 25(OH)D levels were not associated with patient outcome, although given the distribution of plasma levels in this cohort, statistical power for survival analyses were limited. Conclusion Vitamin D deficiency is highly prevalent among patients with stage IV colorectal cancer receiving first-line chemotherapy, particularly in black and female patients. PMID:21422438

  7. Determinants of morbidity and survival after elective non-curative resection of stage IV colon and rectal cancer.

    Science.gov (United States)

    Kleespies, Axel; Füessl, Kathrin E; Seeliger, Hendrik; Eichhorn, Martin E; Müller, Mario H; Rentsch, Markus; Thasler, Wolfgang E; Angele, Martin K; Kreis, Martin E; Jauch, Karl-Walter

    2009-09-01

    The benefit of elective primary tumor resection for non-curable stage IV colorectal cancer (CRC) remains largely undefined. We wanted to identify risk factors for postoperative complications and short survival. Using a prospective database, we analyzed potential risk factors in 233 patients, who were electively operated for non-curable stage IV CRC between 1996 and 2002. Patients with recurrent tumors, resectable metastases, emergency operations, and non-resective surgery were excluded. Risk factors for increased postoperative morbidity and limited postoperative survival were identified by multivariate analyses. Patients with colon cancer (CC = 156) and rectal cancer (RC = 77) were comparable with regard to age, sex, comorbidity, American Society of Anesthesiologists score, carcinoembryonic antigen levels, hepatic spread, tumor grade, resection margins, 30-day mortality (CC 5.1%, RC 3.9%) and postoperative chemotherapy. pT4 tumors, carcinomatosis, and non-anatomical resections were more common in colon cancer patients, whereas enterostomies (CC 1.3%, RC 67.5%, p 50%, and comorbidity >1 organ. Prognostic factors for limited postoperative survival were hepatic tumor load >50%, pT4 tumors, lymphatic spread, R1-2 resection, and lack of chemotherapy. Palliative resection is associated with a particularly unfavorable outcome in rectal cancer patients presenting with a locally advanced tumor (pT4, expected R2 resection) or an extensive comorbidity, and in all CRC patients who show a hepatic tumor load >50%. For such patients, surgery might be contraindicated unless the tumor is immediately life-threatening.

  8. Phase II Study of HER-2/neu Intracellular Domain Peptide-Based Vaccine Administered to Stage IV HER2 Positive Breast Cancer Patients Receiving Trastuzumab

    National Research Council Canada - National Science Library

    Disis, Mary L

    2007-01-01

    The primary purpose of this grant is to determine the overall survival benefit in Stage IV HER2 positive breast cancer patients vaccinated with a HER2 ICD peptide-based vaccine while receiving maintenance trastuzumab...

  9. Phase II Study of HER-2/neu Intracellular Domain Peptide-Based Vaccine Administered to Stage IV HER2 Positive Breast Cancer Patients Receiving Trastuzumab

    National Research Council Canada - National Science Library

    Disis, Mary L

    2006-01-01

    The primary purpose of this grant is to determine the overall survival benefit in Stage IV HER2 positive breast cancer patients vaccinated with a HER2 ICD peptide-based vaccine while receiving maintenance trastuzumab...

  10. Trends in prescribing systemic treatment and overall survival for non-small cell lung cancer stage IIIB/IV in the Netherlands : 2008-2012

    NARCIS (Netherlands)

    Peters, Bas J M; Cramer-Vd Welle, Christine M; Smit, Arthur A J; Schramel, Franz M N H; van de Garde, Ewoudt M W

    2017-01-01

    BACKGROUND: The present study aims to give a detailed overview of day-to-day practice in the systemic treatment of NSCLC stage IIIB/IV and its clinical outcomes in six large teaching hospitals in the Netherlands in the period 2008-2012. METHODS: A retrospective observational cohort study was

  11. Influence of {sup 18}F-FDG PET/CT on therapy management in patients with stage III/IV malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Schuele, Susann-Cathrin; Nikolaou, Konstantin; Pfannenberg, Christina [Eberhard-Karls-University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Eigentler, Thomas Kurt; Garbe, Claus [Eberhard-Karls-University Tuebingen, Skin Cancer Programme, Department of Dermatology, Tuebingen (Germany); Fougere, Christian la [Eberhard-Karls-University Tuebingen, Department of Nuclear Medicine, Tuebingen (Germany)

    2016-03-15

    To evaluate the influence of {sup 18}F-FDG PET/CT in comparison to CT alone on treatment decisions in patients with advanced melanoma and to analyse the 5-year survival data in comparison to literature data. Therapy management in 64 consecutive patients (primary staging n = 52; surveillance n = 12) with stage III/IV melanoma who underwent {sup 18}F-FDG PET/CT between 2004 and 2005 in our department was retrospectively analysed. Treatment decisions were made by two dermatooncologists for each patient twice, first based on the CT results and then based on the PET/CT results. Therapy changes based on the PET/CT results were classified as ''major'' (e.g. change from metastasectomy to systemic therapy) or ''minor'' (e.g. change from first to second line chemotherapy). The 5-year survival data of different patient cohorts were calculated. In the 52 patients in the primary staging group, the results of {sup 18}F-FDG PET/CT led to therapy change in 59 % and a major therapy change in 52 %. {sup 18}F-FDG PET/CT led to the avoidance of futile operations in 13 patients with suspicious lesions on CT that were deemed nontumorous on PET/CT. In the 12 patients in the surveillance group, the results of {sup 18}F-FDG PET/CT led to therapy change in 33 % and a major change in 17 %. The 5-year survival rates were 30 % in the entire cohort, 34 % in the primary staging group, and 17 % in the surveillance group. A significant overall survival benefit was observed in patients in whom {sup 18}F-FDG PET/CT excluded metastases or in whom metastases could be completely removed compared with patients who were not eligible for surgery (41 % vs. 10 %). Primary staging of patients with stage III/IV melanoma should be performed with {sup 18}F-FDG PET/CT, leading to higher diagnostic accuracy and enabling individualized therapeutic management, especially optimal patient selection for metastasectomy. This strategy may extend long-term survival even in patients

  12. Influence of wellness education on first-line icotinib hydrochloride patients with stage IV non-small cell lung cancer and their family caregivers.

    Science.gov (United States)

    Yanwei, Li; Minghui, Fang; Manman, Quan; Zhuchun, Yan; Dongying, Liu; Zhanyu, Pan

    2018-04-11

    This study aims to examine the effects of wellness education (WE) intervention on the behavioral change, psychological status, performance status on patients with stage IV non-small cell lung cancer (NSCLC) undergoing icotinib hydrochloride treatment and their relationships with family caregivers. We conducted an intervention study involving 126 individuals with confirmed activating epidermal growth factor receptor mutation-positive stage IV NSCLC who received icotinib hydrochloride as first-line therapy between January 2014 and January 2016; their caregivers were also included in the study. For a period of 12 weeks, participants were randomly assigned into WE and control groups. The patients and family members in the WE group were provided with WE information about treatment, diet, social needs, rehabilitation, physical/mental health education, communication strategies, and patient care advice at least 3 times per week during treatment. Qualitative feedback of the participants was recorded during the intervention. Food Composition Database, the Family Environment Scale, patients/caregivers quality-of-life (Functional Assessment of Cancer Therapy-Lung/Caregiver Quality of Life Index-Cancer Scale), and Hospital Anxiety and Depression Scale (HADS) were measured at baseline and for 12 weeks. Data were analyzed to compare the different outcomes. Of the 126 caregivers (64 WE and 62 control), 120 completed the study. We observed significant differences between the WE group and control group with respect to low daily calorie intake (31.0% vs 77.4%, p 0.05). After 12 weeks, WE intervention had improved scores on Functional Assessment of Cancer Therapy-Lung-EWB and Caregiver Quality of Life Index-Cancer Scale adaptation. In addition, the patients also showed improvements in HADS. WE interventions in patients with stage IV NSCLC undergoing icotinib hydrochloride treatment and their family resulted in strong intentions to engage in health-promoting behaviors related to

  13. Sapanisertib and Osimertinib in Treating Patients With Stage IV EGFR Mutation Positive Non-small Cell Lung Cancer After Progression on a Previous EGFR Tyrosine Kinase Inhibitor

    Science.gov (United States)

    2018-04-25

    EGFR Activating Mutation; EGFR Exon 19 Deletion Mutation; EGFR NP_005219.2:p.G719X; EGFR NP_005219.2:p.L858R; EGFR NP_005219.2:p.L861Q; EGFR T790M Mutation Negative; Recurrent Non-Small Cell Lung Carcinoma; Stage III Non-Small Cell Lung Cancer AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IV Non-Small Cell Lung Cancer AJCC v7

  14. The number of cycles of neoadjuvant chemotherapy is associated with prognosis of stage IIIc-IV high-grade serous ovarian cancer.

    Science.gov (United States)

    Xu, Xia; Deng, Fei; Lv, Mengmeng; Chen, Xiaoxiang

    2017-02-01

    No consensus exists on the number of chemotherapy cycles to be administered before and after interval debulking surgery (IDS) in patients with advanced stage epithelial ovarian cancer. The present study aims to explore the optimal number of cycles of neoadjuvant chemotherapy (NAC) and post-operation chemotherapy to treat the International Federation of Gynecology and Obstetrics stage IIIc-IV high-grade serous ovarian cancer (HG-SOC). A total of 129 IIIc-IV stage HG-SOC cases were retrospectively analyzed. Cases were comprised of patients who underwent NAC followed by IDS and who achieved clinical complete response (CCR) at the end of primary therapy. Patients were recruited from the Jiangsu Institute of Cancer Research between 1993 and 2013. Optimal IDS-associated factors were explored with logistic regression. The association between progression-free survival (PFS), overall survival (OS) duration, and covariates was assessed by Cox proportional hazards model and log-rank test. The median number of NAC cycle was 3 (range 1-8). CA-125 decreasing kinetics (p = 0.01) was independently associated with optimal IDS. CA-125 decreasing kinetics, optimal IDS, and NAC cycles was independently associated with OS (p cycles was shorter than those of patients who underwent cycles (12.3 versus 17.2 months). The PFS and OS of patients who underwent cycles of adjuvant chemotherapy post-IDS were shorter than those of patients who underwent ≥5 cycles (14.2 and 20.3 versus 21.2 and 28.8 months). NAC cycles, CA-125 decreasing kinetics, and optimal debulking are independently associated with the prognosis of patients with advanced stage HG-SOC who underwent NAC/IDS and achieved CCR. The number of administered NAC cycles should not exceed 4.

  15. Treatment of stage IV non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.

    Science.gov (United States)

    Socinski, Mark A; Evans, Tracey; Gettinger, Scott; Hensing, Thomas A; VanDam Sequist, Lecia; Ireland, Belinda; Stinchcombe, Thomas E

    2013-05-01

    Stage IV non-small cell lung cancer (NSCLC) is a treatable, but not curable, clinical entity in patients given the diagnosis at a time when their performance status (PS) remains good. A systematic literature review was performed to update the previous edition of the American College of Chest Physicians Lung Cancer Guidelines. The use of pemetrexed should be restricted to patients with nonsquamous histology. Similarly, bevacizumab in combination with chemotherapy (and as continuation maintenance) should be restricted to patients with nonsquamous histology and an Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1; however, the data now suggest it is safe to use in those patients with treated and controlled brain metastases. Data at this time are insufficient regarding the safety of bevacizumab in patients receiving therapeutic anticoagulation who have an ECOG PS of 2. The role of cetuximab added to chemotherapy remains uncertain and its routine use cannot be recommended. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as first-line therapy are the recommended treatment of those patients identified as having an EGFR mutation. The use of maintenance therapy with either pemetrexed or erlotinib should be considered after four cycles of first-line therapy in those patients without evidence of disease progression. The use of second- and third-line therapy in stage IV NSCLC is recommended in those patients retaining a good PS; however, the benefit of therapy beyond the third-line setting has not been demonstrated. In the elderly and in patients with a poor PS, the use of two-drug, platinum-based regimens is preferred. Palliative care should be initiated early in the course of therapy for stage IV NSCLC. Significant advances continue to be made, and the treatment of stage IV NSCLC has become nuanced and specific for particular histologic subtypes and clinical patient characteristics and according to the presence of specific genetic mutations.

  16. [Clinic significance of nm23, collage IV and PCNA expression in non-small cell lung cancer].

    Science.gov (United States)

    Yu, Q; Ma, L; Jing, S; Xu, Y; Geng, D

    2001-12-20

    To study the significance of nm23, collagen IV and PCNA expressions in non-small cell lung cancer. Expressions of the nm23, collagen IV and PCNA in 84 cases of non-small cell lung cancer were examined with SP immunohistochemical technique. Of the 84 cases, there were squamous cell carcinoma 42, adenocarcinoma 42, stage I 27, stage II 24, stage III 24, and stage IV 9. Statistical analysis was performed with Chi-Square test. Expressions of the nm23, collagen IV and PCNA in 84 cases of non-small cell lung cancer were 60. 7% ( 51/ 84) , 75. 0% ( 63/ 84) and 53. 6% ( 45/ 84) respectively. There was negative correlation between the lymph node metastasis and the expressions of nm23 and collagen IV in squamous cell carcinoma, and the expressions of collagen IV and PCNA were associated with tumor differentiation. No correlation was found between TNM stage and expressions of nm23, collagen IV and PCNA. The results indicate that nm23, collagen IV and PCNA participate the modulation of metastasis of non-small cell lung cancer and that they may be used to evaluate the potential of metastasis.

  17. Staging of Lung Cancer

    Science.gov (United States)

    ... 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 ...

  18. [A case of a geriatric patient with stage IV anal canal cancer showing complete response to chemoradiation therapy].

    Science.gov (United States)

    Kuroda, Masatoshi; Hirai, Ryuji; Ikeda, Eiji; Tsuji, Hisashi; Takagi, Shoji; Yamano, Toshihisa; Yoshitomi, Seiji

    2012-11-01

    We present a case in which chemoradiation therapy was effective in a geriatric patient with Stage IV anal canal cancer. The patient is an 81-year-old woman who complained of proctorrhagia and anal pain. She was referred to us by her family doctor who suspected rectal cancer. Tumors as large as 6.5 cm in diameter mainly on the right side of the rectum as well as 2 palpable enlarged lymph nodes on the right inguinal area, were found during the initial physical examination. Squamous cell carcinoma was elevated to 16 ng/mL. A CT scan revealed that irregularly shaped masses as large as 7 cm in diameter were externally exposed on the right side of the rectum along with enlarged lymph nodes on the right inguinal area and metastasis at S7 lesion in the liver. Squamous cell carcinoma was diagnosed from biopsy results. Due to her age, the chemotherapy regimen was S-1+CDDP with radiation therapy and 4-port irradiation (50.4 Gy) of the primary tumor, interior of the pelvis, and inguinal lymph nodes. Partial response was observed upon completion of treatment, and complete response was obtained after 6 months. She is currently an outpatient taking S-1: 60 mg/day orally. There is no indication of cancer recurrence after 1 year and 3 months, and she continues to visit an outpatient clinic for regular follow-ups. These results demonstrate the effectiveness of chemoradiation therapy for geriatric patients with Stage IV anal canal cancer.

  19. Metabolic tumor volume measured by F 18 FDG PET/CT can further stratify the prognosis of patients with stage IV Non Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Su Woong; Kim, Ja Hae; Chong, Ar I; Kwon, Seong Young; Min, Jung Joon; Song, Ho Chun; Bom, Hee Seung [Chonnam National Univ. Hwasun Hospital, Gwangju (Korea, Republic of)

    2012-12-15

    This study aimed to further stratify prognostic factors in patients with stage IV non small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F 18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were mea measured by receiver operating characteristic (ROC) curve anal analysis. Kaplan Meier survival (PET). The univariate and multivariate cox proportional hazards models were used to select the significant prognostic factors. Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV lung and TLG lung) were significant factors for prediction of PFS ( <0.001 =0.038, respectively). Patients showing lower values of MTV lung and TLG lung than the cutoff values had significantly longer mean PFS than those with higher values. hazard ratios (95% confidence interval) of MTV lung and TLG lung measured by univariate analysis were 6.4 (2.5 16.3) and 2.4 (1.0 5.5), respectively. multivariate analysis revealed that MTV lung was the only significant factor for prediction of prognosis. Hazard ratio was 13,5 (1.6 111.1, =0,016). patients with stage IV NSCLC could be further stratified into subgroups of significantly better and worse prognosis by MTV of primary lung lesion.

  20. Metabolic tumor volume measured by F 18 FDG PET/CT can further stratify the prognosis of patients with stage IV Non Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Yoo, Su Woong; Kim, Ja Hae; Chong, Ar I; Kwon, Seong Young; Min, Jung Joon; Song, Ho Chun; Bom, Hee Seung

    2012-01-01

    This study aimed to further stratify prognostic factors in patients with stage IV non small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F 18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were mea measured by receiver operating characteristic (ROC) curve anal analysis. Kaplan Meier survival (PET). The univariate and multivariate cox proportional hazards models were used to select the significant prognostic factors. Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV lung and TLG lung) were significant factors for prediction of PFS ( <0.001 =0.038, respectively). Patients showing lower values of MTV lung and TLG lung than the cutoff values had significantly longer mean PFS than those with higher values. hazard ratios (95% confidence interval) of MTV lung and TLG lung measured by univariate analysis were 6.4 (2.5 16.3) and 2.4 (1.0 5.5), respectively. multivariate analysis revealed that MTV lung was the only significant factor for prediction of prognosis. Hazard ratio was 13,5 (1.6 111.1, =0,016). patients with stage IV NSCLC could be further stratified into subgroups of significantly better and worse prognosis by MTV of primary lung lesion

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Perioperative chemotherapy vs. neoadjuvant chemoradiation in gastroesophageal junction adenocarcinoma. A population-based evaluation of the Munich Cancer Registry

    Energy Technology Data Exchange (ETDEWEB)

    Muench, Stefan [Technical University Munich, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Habermehl, Daniel; Combs, Stephanie E. [Technical University Munich, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Oberschleissheim (Germany); Agha, Ayman [Staedtisches Klinikum Muenchen, Department of Surgery, Klinikum Bogenhausen, Munich (Germany); Belka, Claus [Ludwig-Maximilians-University (LMU), Department of Radiation Oncology, Klinikum Grosshadern, Munich (Germany); Eckel, Renate; Schubert-Fritschle, Gabriele; Engel, Jutta [Munich Cancer Registry (MCR), Munich Tumour Centre (TZM), Department of Medical Informatics, Biometry and Epidemiology, Klinikum Grosshadern, Ludwig Maximilians University, Munich (Germany); Friess, Helmut [Technische Universitaet Muenchen, Department of Surgery, Klinikum rechts der Isar, Munich (Germany); Gerbes, Alexander [Ludwig Maximilians University (LMU), Department of Gastroenterology and Endocrinology, Klinikum Grosshadern, Munich (Germany); Nuessler, Natascha C. [Staedtisches Klinikum Muenchen, Department of Surgery, Klinikum Neuperlach, Munich (Germany); Schepp, Wolfgang [Staedtisches Klinikum Muenchen, Department of Gastroenterology, Klinikum Bogenhausen, Munich (Germany); Schmid, Roland M. [Technische Universitaet Muenchen, Department of Internal Medicine II, Klinikum rechts der Isar, Munich (Germany); Schmitt, Wolfgang [Staedtisches Klinikum Muenchen, Department of Gastroenterology, Klinikum Neuperlach, Munich (Germany); Weber, Bernhard [Klinik Bad Trissl, Department of Internal Medicine, Oberaudorf (Germany); Werner, Jens [Ludwig Maximilians University (LMU), Department of Surgery, Klinikum Grosshadern, Munich (Germany)

    2018-02-15

    To date, it remains unclear whether locally advanced adenocarcinoma of the gastroesophageal junction (AEG) should be treated with neoadjuvant chemoradiation (nCRT), analogous to esophageal cancer, or with perioperative chemotherapy (pCT), analogous to gastric cancer. The purpose of this study was to analyze the data of the Munich Cancer Registry (MCR) and to compare pCT and nCRT in AEG patients. A total of 2,992 AEG patients, treated between 1998 and 2014, were included in the study. Baseline and tumor parameters as well as overall survival (OS) and tumor recurrence were compared between 56 patients undergoing nCRT and 64 patients undergoing pCT with UICC stage II/III cancer. In addition, uni- and multivariate analyses using Cox regression models were performed to evaluate the effect of tumor characteristics and treatment regimens on OS. In patients with UICC stage II/III AEG treated with either nCRT or pCT, no significant differences were seen for baseline and tumor characteristics. While there was a significantly higher cumulative incidence of locoregional treatment failure after pCT (32.8%; 95% CI: 18.0-48.4%) compared with nCRT (7.4%; 95% CI: 2.3-16.5%; p = 0.007), there was no significant difference for distant treatment failure (52.9%; 95% CI: 35.4-67.7% and 38.4%; 95% CI: 23.7-52.9%; p = 0.347). When analyzing the whole cohort, patients who received pCT were younger (58.3 years vs. 63.0 years; p = 0.016), had a higher chance of complete tumor resection (81% vs. 67%; p = 0.033), more resected lymph nodes (p = 0.036), and fewer lymph node metastases (p = 0.038) compared with patients who received nCRT. Nevertheless, there was still a strong trend toward a higher incidence of local treatment failure after pCT (25.8%; 95% CI: 14.7-38.3% vs. 12.6%; 95% CI: 5.5-22.8%; p = 0.053). Comparable to the results for patients with UICC stage II/III, no difference was seen for the incidence of distant treatment failure. When excluding patients with UICC stage IV cancer, no

  3. ACTOplus Met XR in Treating Patients With Stage I-IV Oral Cavity or Oropharynx Cancer Undergoing Definitive Treatment | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase IIb trial studies how well ACTOplus met XR works in treating in patients with stage I-IV oral cavity or oropharynx cancer that are undergoing definitive treatment. Chemoprevention is the use of drugs to keep oral cavity or oropharynx cancer from forming or coming back. The use of ACTOplus met XR may slow disease progression in patients with oral cavity or

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

    Science.gov (United States)

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

    2017-04-01

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

  5. A germline mutation in the BRCA1 3'UTR predicts Stage IV breast cancer.

    Science.gov (United States)

    Dorairaj, Jemima J; Salzman, David W; Wall, Deirdre; Rounds, Tiffany; Preskill, Carina; Sullivan, Catherine A W; Lindner, Robert; Curran, Catherine; Lezon-Geyda, Kim; McVeigh, Terri; Harris, Lyndsay; Newell, John; Kerin, Michael J; Wood, Marie; Miller, Nicola; Weidhaas, Joanne B

    2014-06-10

    A germline, variant in the BRCA1 3'UTR (rs8176318) was previously shown to predict breast and ovarian cancer risk in women from high-risk families, as well as increased risk of triple negative breast cancer. Here, we tested the hypothesis that this variant predicts tumor biology, like other 3'UTR mutations in cancer. The impact of the BRCA1-3'UTR-variant on BRCA1 gene expression, and altered response to external stimuli was tested in vitro using a luciferase reporter assay. Gene expression was further tested in vivo by immunoflourescence staining on breast tumor tissue, comparing triple negative patient samples with the variant (TG or TT) or non-variant (GG) BRCA1 3'UTR. To determine the significance of the variant on clinically relevant endpoints, a comprehensive collection of West-Irish breast cancer patients were tested for the variant. Finally, an association of the variant with breast screening clinical phenotypes was evaluated using a cohort of women from the High Risk Breast Program at the University of Vermont. Luciferase reporters with the BRCA1-3'UTR-variant (T allele) displayed significantly lower gene expression, as well as altered response to external hormonal stimuli, compared to the non-variant 3'UTR (G allele) in breast cancer cell lines. This was confirmed clinically by the finding of reduced BRCA1 gene expression in triple negative samples from patients carrying the homozygous TT variant, compared to non-variant patients. The BRCA1-3'UTR-variant (TG or TT) also associated with a modest increased risk for developing breast cancer in the West-Irish cohort (OR=1.4, 95% CI 1.1-1.8, p=0.033). More importantly, patients with the BRCA1-3'UTR-variant had a 4-fold increased risk of presenting with Stage IV disease (p=0.018, OR=3.37, 95% CI 1.3-11.0). Supporting that this finding is due to tumor biology, and not difficulty screening, obese women with the BRCA1-3'UTR-variant had significantly less dense breasts (p=0.0398) in the Vermont cohort. A variant in

  6. Primary colectomy in patients with stage IV colon cancer and unresectable distant metastases improves overall survival: results of a multicentric study.

    Science.gov (United States)

    Karoui, Mehdi; Roudot-Thoraval, Françoise; Mesli, Farida; Mitry, Emmanuel; Aparicio, Thomas; Des Guetz, Gaetan; DesGuetz, Gaetan; Louvet, Christophe; Landi, Bruno; Tiret, Emmanuel; Sobhani, Iradj

    2011-08-01

    Whether patients with stage IV colon cancer and unresectable distant metastases should be managed by primary colectomy followed by chemotherapy or immediate chemotherapy without resection of the primary tumor is still controversial. This study aimed to evaluate predictive factors associated with survival in patients with stage IV colon cancer and unresectable distant metastases. This large retrospective multicentric study included 6 academic hospitals. This study was conducted at 6 Paris University Hospitals (Assistance Publique-Hôpitaux de Paris; Saint Antoine, Henri Mondor, Ambroise Paré, Hôpital Europeen Gorges Pompidou, Bichat, and Avicenne). Between 1998 and 2007, 208 patients with good performance status and stage IV colon cancer with unresectable distant metastases received chemotherapy, either as initial management or after primary tumor resection. Survival was estimated by use of the Kaplan-Meier method. Factors associated with survival were tested by means of a log-rank test. Results were expressed as median values with 95% confidence intervals. Factors independently related to survival were tested using a Cox regression model adjusted for a propensity score. Of the 208 patients, 85 underwent colectomy before chemotherapy, whereas 123 were treated with use of primary chemotherapy with or without biotherapy. At univariate analysis, the following factors were significantly associated with survival: primary colectomy (P = .031), secondary curative surgery (P < .001), well-differentiated primary tumor (P < .001), exclusive liver metastases (P < .027), absence of need for colonic stent (P = .009), and addition of antiangiogenic (P = .001) or anti-epidermal growth factor receptor (P = .013) drugs to chemotherapy. After Cox multivariate analysis and after adjusting for the propensity score, all of these factors, with the exception of two, colonic stent and anti-epidermal growth factor receptor drug, were found to be independently associated with overall

  7. Hypofractionated stereotactic body radiation therapy for elderly patients with stage IIB–IV nonsmall cell lung cancer who are ineligible for or refuse other treatment modalities

    Directory of Open Access Journals (Sweden)

    Karam SD

    2014-10-01

    Full Text Available Sana D Karam,1 Zachary D Horne,2 Robert L Hong,2 Don McRae,2 David Duhamel,3 Nadim M Nasr2 1Department of Radiation Oncology, University of Colorado, Denver, CO, USA; 2Department of Radiation Oncology, 3Department of Pulmonary/Critical Care Medicine, Virginia Hospital Center, Arlington, VA, USA Objective: In elderly patients with stage IIB–IV nonsmall cell lung cancer who cannot tolerate chemotherapy, conventionally fractionated radiotherapy is the treatment of choice. We present our experience with hypofractionated stereotactic body radiation therapy (SBRT in the treatment of this patient population. Methods: Thirty-three patients with a median age of 80 years treated with fractionated SBRT were retrospectively analyzed. Most patients were smokers and had preexisting lung disease and either refused treatment or were ineligible. A median prescribed dose of 40 Gy was delivered to the prescription isodose line over a median of five treatments. The majority of patients (70% did not receive chemotherapy. Results: With a median follow-up of 9 months (range: 4–40 months, the actuarial median overall survival (OS and progression-free survival were 12 months for both. One year actuarial survival outcomes were 75%, 58%, 44%, and 48% for local control, regional control, progression-free survival, and OS, respectively. Increased volume of disease was a statistically significant predictor of worse OS. Three patients developed a grade 1 cough that peaked 3 weeks after treatment and resolved within 1 month. One patient developed grade 1 tracheal mucositis and three patients developed grade 1 pneumonitis. Both resolved 6 weeks after treatment. Three patients died within the first month of treatment, but the cause of death did not appear to be related to the treatment. Conclusion: Hypofractionated SBRT is a relatively safe and convenient treatment option for elderly patients with inoperable stage IIB–IV nonsmall cell lung cancer. However, given the small

  8. Bone radioisotope scanning: usefulness in the evaluation and observation of patients with breast cancer in clinical stage II, III, IV; Gammagrafia osea: utilidad en la evaluacion y seguimiento de pacientes con cancer de mama en estadio clinico II, III, IV

    Energy Technology Data Exchange (ETDEWEB)

    Cano P, R A

    1996-12-31

    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.

  9. Comparison of squamous cell carcinoma with non-Hodgkin's lymphoma of tonsillar region

    International Nuclear Information System (INIS)

    Tsukiyama, Iwao; Yamashita, Kohsuke; Kajiura, Yuuichi; Ogino, Takashi; Akine, Yasuyuki; Egawa, Sunao; Ono, Isamu

    1987-01-01

    A total of 98 patients with malignant tumors of the tonsil (Squamous cell carcinoma, 34 patients, Non-Hodgkin's lymphoma, 64 patients) werw treated with radiation therapy between 1962 and 1979 at the National Cancer Center Hospital. All were staged by the TNM system, using UICC Classification 1978. With regard to stage distribution, Stage III is most frequent (47.1 %) in squamous cell carcinoma, Stage IV is most frequent (48.4 %) in Non-Hodgkin's lymphoma. Much more advanced cases were included in Non-Hodgkin's lymphoma. Five year survival rate for patients with squamous cell carcinoma and Non-Hodgkin's lymphoma were 49 % and 62 %, respectively. 50 % survival months with squamous cell carcinoma and Non-Hodgkin's lymphoma were 58.7 months and 195.5 months, respectively. Better prognosis was observed in Non-Hodgkin's lymphoma than squamous cell cacinoma. (author)

  10. A Case Series of Survival Outcomes in Patients with Advanced-stage IIIb/IV Non-small-cell Lung Cancer Treated with HangAm-Plus

    Directory of Open Access Journals (Sweden)

    Bang Sun-Hwi

    2012-06-01

    Full Text Available Background and Objectives: Non-small-cell lung cancer (NSCLC represents approximately 80% of all lung cancers. Unfortunately, at their time of diagnosis, most patients have advanced to unresectable disease with a very poor prognosis. The oriental herbal medicine HangAm-Plus (HAP has been developed for antitumor purposes, and several previous studies have reported its therapeutic effects. In this study, the efficacy of HAP was evaluated as a third-line treatment for advanced-stage IIIb/IV NSCLC. Methods: The study involved six patients treated at the East- West Cancer Center (EWCC from April 2010 to October 2011. Inoperable advanced-stage IIIb/IV NSCLC patients received 3,000 or 6,000 mg of HAP on a daily basis over a 12-week period. Computed tomography (CT scans were obtained from the patients at the time of the initial administration and after 12 weeks of treatment. We observed and analyzed the patients overall survival (OS and progression-free survival (PFS. Results: Of the six patients, three expired during the study, and the three remaining patients were alive as of October 31, 2011. The OS ranged from 234 to 512 days, with a median survival of 397 days and a one-year survival rate of 66.7%. In the 12-week-interval chest CT assessment, three patients showed stable disease (SD, and the other three showed progressive disease (PD. The PFS of patients ranged from 88 to 512 days, the median PFS being 96 days. Longer OS and PFS were correlated with SD. Although not directly comparable, the OS and the PFS of this study were greater than those of the docetaxel or the best supportive care group in other studies. Conclusion: HAP may prolong the OS and the PFS of inoperable stage IIIb/IV NSCLC patients without significant adverse effects. In the future, more controlled clinical trials with larger samples from multi-centers should be conducted to evaluate the efficacy and the safety of HAP.

  11. Predictors of Local Recurrence After Rituximab-Based Chemotherapy Alone in Stage III and IV Diffuse Large B-Cell Lymphoma: Guiding Decisions for Consolidative Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Jegadeesh, Naresh; Rajpara, Raj; Esiashvili, Natia; Shi, Zheng [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Yuan [Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Department of Biostatistics and Bioinformatics Shared Resource, Emory University, Atlanta, Georgia (United States); Okwan-Duodu, Derrick [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Flowers, Christopher R. [Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Department of Medical Oncology, Emory University, Atlanta, Georgia (United States); Khan, Mohammad K., E-mail: drkhurram2000@gmail.com [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2015-05-01

    Purpose: The role of consolidative radiation therapy (RT) for stage III and IV diffuse large B-cell lymphoma (DLBCL) in the era of rituximab is not well defined. There is evidence that some patients with bulky disease may benefit, but patient selection criteria are not well established. We sought to identify a subset of patients who experienced a high local failure rate after receiving rituximab-based chemotherapy alone and hence may benefit from the addition of consolidative RT. Methods and Materials: Two hundred eleven patients with stage III and IV DLBCL treated between August 1999 and January 2012 were reviewed. Of these, 89 had a complete response to systemic therapy including rituximab and received no initial RT. Kaplan-Meier analysis and Cox proportional hazards regression were performed, with local recurrence (LR) as the primary outcome. Results: The median follow-up time was 43.9 months. Fifty percent of patients experienced LR at 5 years. In multivariate analysis, tumor ≥5 cm and stage III disease were associated with increased risk of LR. The 5-year LR-free survival was 47.4% for patients with ≥5-cm lesions versus 74.7% for patients with <5-cm lesions (P=.01). In patients with <5-cm tumors, the maximum standardized uptake value (SUVmax) was ≥15 in all patients with LR. The 5-year LR-free survival was 100% in SUV<15 versus 68.8% in SUV≥15 (P=.10). Conclusions: Advanced-stage DLBCL patients with stage III disease or with disease ≥5 cm appear to be at an increased risk for LR. Patients with <5-cm disease and SUVmax ≥15 may be at higher risk for LR. These patients may benefit from consolidative RT after chemoimmunotherapy.

  12. Predictors of Local Recurrence After Rituximab-Based Chemotherapy Alone in Stage III and IV Diffuse Large B-Cell Lymphoma: Guiding Decisions for Consolidative Radiation

    International Nuclear Information System (INIS)

    Jegadeesh, Naresh; Rajpara, Raj; Esiashvili, Natia; Shi, Zheng; Liu, Yuan; Okwan-Duodu, Derrick; Flowers, Christopher R.; Khan, Mohammad K.

    2015-01-01

    Purpose: The role of consolidative radiation therapy (RT) for stage III and IV diffuse large B-cell lymphoma (DLBCL) in the era of rituximab is not well defined. There is evidence that some patients with bulky disease may benefit, but patient selection criteria are not well established. We sought to identify a subset of patients who experienced a high local failure rate after receiving rituximab-based chemotherapy alone and hence may benefit from the addition of consolidative RT. Methods and Materials: Two hundred eleven patients with stage III and IV DLBCL treated between August 1999 and January 2012 were reviewed. Of these, 89 had a complete response to systemic therapy including rituximab and received no initial RT. Kaplan-Meier analysis and Cox proportional hazards regression were performed, with local recurrence (LR) as the primary outcome. Results: The median follow-up time was 43.9 months. Fifty percent of patients experienced LR at 5 years. In multivariate analysis, tumor ≥5 cm and stage III disease were associated with increased risk of LR. The 5-year LR-free survival was 47.4% for patients with ≥5-cm lesions versus 74.7% for patients with <5-cm lesions (P=.01). In patients with <5-cm tumors, the maximum standardized uptake value (SUVmax) was ≥15 in all patients with LR. The 5-year LR-free survival was 100% in SUV<15 versus 68.8% in SUV≥15 (P=.10). Conclusions: Advanced-stage DLBCL patients with stage III disease or with disease ≥5 cm appear to be at an increased risk for LR. Patients with <5-cm disease and SUVmax ≥15 may be at higher risk for LR. These patients may benefit from consolidative RT after chemoimmunotherapy

  13. Steered molecular dynamics simulations of a type IV pilus probe initial stages of a force-induced conformational transition.

    Directory of Open Access Journals (Sweden)

    Joseph L Baker

    2013-04-01

    Full Text Available Type IV pili are long, protein filaments built from a repeating subunit that protrudes from the surface of a wide variety of infectious bacteria. They are implicated in a vast array of functions, ranging from bacterial motility to microcolony formation to infection. One of the most well-studied type IV filaments is the gonococcal type IV pilus (GC-T4P from Neisseria gonorrhoeae, the causative agent of gonorrhea. Cryo-electron microscopy has been used to construct a model of this filament, offering insights into the structure of type IV pili. In addition, experiments have demonstrated that GC-T4P can withstand very large tension forces, and transition to a force-induced conformation. However, the details of force-generation, and the atomic-level characteristics of the force-induced conformation, are unknown. Here, steered molecular dynamics (SMD simulation was used to exert a force in silico on an 18 subunit segment of GC-T4P to address questions regarding the nature of the interactions that lead to the extraordinary strength of bacterial pili. SMD simulations revealed that the buried pilin α1 domains maintain hydrophobic contacts with one another within the core of the filament, leading to GC-T4P's structural stability. At the filament surface, gaps between pilin globular head domains in both the native and pulled states provide water accessible routes between the external environment and the interior of the filament, allowing water to access the pilin α1 domains as reported for VC-T4P in deuterium exchange experiments. Results were also compared to the experimentally observed force-induced conformation. In particular, an exposed amino acid sequence in the experimentally stretched filament was also found to become exposed during the SMD simulations, suggesting that initial stages of the force induced transition are well captured. Furthermore, a second sequence was shown to be initially hidden in the native filament and became exposed upon

  14. Steered molecular dynamics simulations of a type IV pilus probe initial stages of a force-induced conformational transition.

    Science.gov (United States)

    Baker, Joseph L; Biais, Nicolas; Tama, Florence

    2013-04-01

    Type IV pili are long, protein filaments built from a repeating subunit that protrudes from the surface of a wide variety of infectious bacteria. They are implicated in a vast array of functions, ranging from bacterial motility to microcolony formation to infection. One of the most well-studied type IV filaments is the gonococcal type IV pilus (GC-T4P) from Neisseria gonorrhoeae, the causative agent of gonorrhea. Cryo-electron microscopy has been used to construct a model of this filament, offering insights into the structure of type IV pili. In addition, experiments have demonstrated that GC-T4P can withstand very large tension forces, and transition to a force-induced conformation. However, the details of force-generation, and the atomic-level characteristics of the force-induced conformation, are unknown. Here, steered molecular dynamics (SMD) simulation was used to exert a force in silico on an 18 subunit segment of GC-T4P to address questions regarding the nature of the interactions that lead to the extraordinary strength of bacterial pili. SMD simulations revealed that the buried pilin α1 domains maintain hydrophobic contacts with one another within the core of the filament, leading to GC-T4P's structural stability. At the filament surface, gaps between pilin globular head domains in both the native and pulled states provide water accessible routes between the external environment and the interior of the filament, allowing water to access the pilin α1 domains as reported for VC-T4P in deuterium exchange experiments. Results were also compared to the experimentally observed force-induced conformation. In particular, an exposed amino acid sequence in the experimentally stretched filament was also found to become exposed during the SMD simulations, suggesting that initial stages of the force induced transition are well captured. Furthermore, a second sequence was shown to be initially hidden in the native filament and became exposed upon stretching.

  15. Can Locoregional Treatment of the Primary Tumor Improve Outcomes for Women With Stage IV Breast Cancer at Diagnosis?

    International Nuclear Information System (INIS)

    Nguyen, David H.A.; Truong, Pauline T.; Alexander, Cheryl; Walter, Caroline V.; Hayashi, Emily; Christie, Jennifer; Lesperance, Mary

    2012-01-01

    Purpose: To examine the effect of locoregional treatment (LRT) of the primary tumor on survival in patients with Stage IV breast cancer at diagnosis. Methods and Materials: The study cohort comprised 733 women referred to the British Columbia Cancer Agency between 1996 and 2005 with newly diagnosed clinical or pathologic M1 breast cancer. Tumor and treatment characteristics, overall survival (OS), and locoregional progression-free survival were compared between patients treated with (n = 378) and without (n = 355) LRT of the primary disease. Multivariable analysis was performed with Cox regression modeling. Results: The median follow-up time was 1.9 years. LRT consisted of surgery alone in 67% of patients, radiotherapy alone in 22%, and both in 11%. LRT was used more commonly in women with age <50 years, Eastern Cooperative Oncology Group (ECOG) performance status 0–1, Stage T1–2 tumors, N0–1 disease, limited M1 burden, and asymptomatic M1 disease (all p < 0.05). Systemic therapy was used in 92% of patients who underwent LRT and 85% of patients who did not. In patients treated with LRT compared with those without LRT, the 5-year OS rates were 21% vs. 14% (p < 0.001), and the rates of locoregional progression-free survival were 72% vs. 46% (p < 0.001). Among 378 patients treated with LRT, the rates of 5-year OS were higher in patients with age <50, ECOG performance status 0–1, estrogen receptor–positive disease, clear surgical margins, single subsite, bone-only metastasis, and one to four metastatic lesions (all p < 0.003). On multivariable analysis, LRT was associated with improved OS (hazard ratio, 0.78; 95% confidence interval, 0.64–0.94, p = 0.009). Conclusion: Locoregional treatment of the primary disease is associated with improved survival in some women with Stage IV breast cancer at diagnosis. Among those treated with LRT, the most favorable rates of survival were observed in subsets with young age, good performance status, estrogen receptor

  16. An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting

    International Nuclear Information System (INIS)

    Allal, A.S.

    2000-01-01

    Background: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. Patients and Methods: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.9 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2x1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). Results: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. Conclusions: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials. (orig.) [de

  17. Stage III & IV colon and rectal cancers share a similar genetic profile: a review of the Oregon Colorectal Cancer Registry.

    Science.gov (United States)

    Gawlick, Ute; Lu, Kim C; Douthit, Miriam A; Diggs, Brian S; Schuff, Kathryn G; Herzig, Daniel O; Tsikitis, Vassiliki L

    2013-05-01

    Determining the molecular profile of colon and rectal cancers offers the possibility of personalized cancer treatment. The purpose of this study was to determine whether known genetic mutations associated with colorectal carcinogenesis differ between colon and rectal cancers and whether they are associated with survival. The Oregon Colorectal Cancer Registry is a prospectively maintained, institutional review board-approved tissue repository with associated demographic and clinical information. The registry was queried for any patient with molecular analysis paired with clinical data. Patient demographics, tumor characteristics, microsatellite instability status, and mutational analysis for p53, AKT, BRAF, KRAS, MET, NRAS, and PIK3CA were analyzed. Categorical variables were compared using chi-square tests. Continuous variables between groups were analyzed using Mann-Whitney U tests. Kaplan-Meier analysis was used for survival studies. Comparisons of survival were made using log-rank tests. The registry included 370 patients: 69% with colon cancer and 31% with rectal cancer. Eighty percent of colon cancers and 68% of rectal cancers were stages III and IV. Mutational analysis found no significant differences in detected mutations between colon and rectal cancers, except that there were significantly more BRAF mutations in colon cancers compared with rectal cancers (10% vs 0%, P colon versus rectal cancers when stratified by the presence of KRAS, PIK3CA, and BRAF mutations. Stage III and IV colon and rectal cancers share similar molecular profiles, except that there were significantly more BRAF mutations in colon cancers compared with rectal cancers. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    International Nuclear Information System (INIS)

    Flandin, Isabelle; Hartmann, Olivier; Michon, Jean; Pinkerton, Ross; Coze, Carole; Stephan, Jean Louis; Fourquet, Bernard; Valteau-Couanet, Dominique; Bergeron, Christophe; Philip, Thierry; Carrie, Christian

    2006-01-01

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma

  19. Comparative Analysis of Inpatient Costs for Obstetrics and Gynecology Surgery Patients Treated With IV Acetaminophen and IV Opioids Versus IV Opioid-only Analgesia for Postoperative Pain.

    Science.gov (United States)

    Hansen, Ryan N; Pham, An T; Lovelace, Belinda; Balaban, Stela; Wan, George J

    2017-10-01

    Recovery from obstetrics and gynecology (OB/GYN) surgery, including hysterectomy and cesarean section delivery, aims to restore function while minimizing hospital length of stay (LOS) and medical expenditures. Our analyses compare OB/GYN surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia with those who received IV opioid-only analgesia and estimate differences in LOS, hospitalization costs, and opioid consumption. We performed a retrospective analysis of the Premier Database between January 2009 and June 2015, comparing OB/GYN surgery patients who received postoperative pain management with combination IV acetaminophen and IV opioids with those who received only IV opioids starting on the day of surgery and continuing up to the second postoperative day. We performed instrumental variable 2-stage least-squares regressions controlling for patient and hospital covariates to compare the LOS, hospitalization costs, and daily opioid doses (morphine equivalent dose) of IV acetaminophen recipients with that of opioid-only analgesia patients. We identified 225 142 OB/GYN surgery patients who were eligible for our study of whom 89 568 (40%) had been managed with IV acetaminophen and opioids. Participants averaged 36 years of age and were predominantly non-Hispanic Caucasians (60%). Multivariable regression models estimated statistically significant differences in hospitalization cost and opioid use with IV acetaminophen associated with $484.4 lower total hospitalization costs (95% CI = -$760.4 to -$208.4; P = 0.0006) and 8.2 mg lower daily opioid use (95% CI = -10.0 to -6.4), whereas the difference in LOS was not significant, at -0.09 days (95% CI = -0.19 to 0.01; P = 0.07). Compared with IV opioid-only analgesia, managing post-OB/GYN surgery pain with the addition of IV acetaminophen is associated with decreased hospitalization costs and reduced opioid use.

  20. Surgery for patients with gastric cancer in the terminal stage of the illness - TNM stage IV.

    Science.gov (United States)

    Budisin, N I; Majdevac, I Z; Budisin, E S; Manic, D; Patrnogic, A; Radovanovic, Z

    2009-01-01

    To assess any survival advantage in patients with incurable gastric cancer who had undergone resection, bypass or exploratory surgery. In nonresectable patients with pain, the effect of celiac plexus neurolysis was assessed. We retrospectively analysed data of 330 patients, operated between 1992 and 2006. The patients were followed until death or last examination. Incurable gastric cancer was defined as TNM stage IV disease: locally advanced (LA), with solitary distant metastasis (SM) or with multiple metastases and/or peritoneal carcinomatosis (MMC). The patients were divided into these 3 groups. Their postoperative survival was calculated and compared in relation to the surgical technique used. Factors which influenced mortality and survival were identified. 131 patients (39.7%) had locally LA cancer, 98 (29.7%) SM, and 101 (30.6%) belonged to the MMC group. The surgical procedures included 138 (41.8%) exploratory laparotomies, 84 (25.5%) bypass procedures and 108 (32.7%) resections. Thirty-three (10%) unresectable patients with pain underwent celiac plexus neurolysis. The mean survival was 21.8 months after resections, 7 months after by-passes and 4.8 after exploratory laparotomies (p = 0.0001). It was 14.57 months (p=0.001) in the LA group, 12.53 (p = 0.005) in the SM group, and 5.2 in the MMC group. Survival was shorter in patients with preoperative weight loss of more than 20 kg (3.2 months, p 0.05), while significantly increased mortality occurred in patients with weight loss of over 20 kg (32%, p=0.03). Celiac plexus neurolysis was immediately effective in 30 out of 33 (91%) patients (p=0.0001), while 3 months later it was still effective in 15 (45.5%) patients (p=0.08). Resections are suggested in the LA and SM groups, and neurolysis in all nonresected patients with pain.

  1. Staging of intestinal- and diffuse-type gastric cancers with the OLGA and OLGIM staging systems.

    Science.gov (United States)

    Cho, S-J; Choi, I J; Kook, M-C; Nam, B-H; Kim, C G; Lee, J Y; Ryu, K W; Kim, Y-W

    2013-11-01

    Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk estimation. To validate the OLGA and OLGIM staging systems in a region with high risk of GC. This retrospective study included 474 GC patients and age- and sex-matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis. More GC patients had OLGA stages III-IV (46.2%) than controls (26.6%, P diffuse-type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC [odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively] in multivariate analysis. The association was more significant for intestinal-type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse-type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal-type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse-type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend. As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high-risk regions, especially for intestinal-type gastric cancer. © 2013 John Wiley & Sons Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Enhancement MRI evaluation of neuroblastoma staging in children

    International Nuclear Information System (INIS)

    Li Xin; Wang Chunxiang; Zhao Bin; Liu Peifang

    2002-01-01

    Objective: To evaluate the value and limitation of Gd-DTPA enhanced MRI for neuroblastoma staging in children. Methods: Twelve cases of neuroblastoma proved by operation or bone marrow aspiration were examined by gadolinium-enhanced MRI. The age ranged from seven months to five years, mean 3.7 years. Eight tumors originated from adrenal, and four from posterior mediastinum. Conventional sequences, double dose gadolinium-enhanced MRI, and 3D CEMRA were used in all patients. Six cases were examined by CT in same time. Imaging staging on surgic-histopathological-based International Neuroblastoma Staging System (INSS) was performed. Results: Six patients were staged by CT, including stage I-II in 2 cases, stage III in 4 cases, and stage IV in none. Twelve patients were staged by conventional MRI, including stage I-II in 2 cases, stage III in 9 cases, and stage IV in 1 case. Twelve patients were staged by double dose gadolinium-enhanced MRI, including stage I-II in 1 case, stage III in 1 case, and stage IV in 10 cases. Conclusion: Gadolinium-enhanced MRI was a single best imaging modality for neuroblastoma, most useful for distal to diaphragm metastasis, dumbbell tumor intraspinal extension, and bone marrow metastasis that was not detected by aspirate examination. Enhancement MRI was important in evaluating the therapy and was also helpful in assessing the therapeutic efficacy and relapse. 3D CEMRA helps demonstrate large vascular encasement and tumor erosion into important organs, and it is useful in assessing the respectability. Long examination time and lack in showing the characteristic calcium were the limitations

  5. A prospective randomized study concerning the point a dose in high-dose rate intracavitary therapy for carcinoma of the uterine cervix. The final results

    International Nuclear Information System (INIS)

    Chatani, M.; Matayoshi, Y.; Masaki, N.; Teshima, T.; Inoue, T.

    1994-01-01

    Between January 1983 and February 1989, a total of 165 patients with carcinoma of the unterine cervix was entered in a prospective randomized study concerning the point A dose of HDR therapy (6 Gy/fraktion vs 7.5 Gy/fraction) and external irradiation dose at Department of Radiation Therapy, The Center for Adult Diseases, Osaka. UICC stage distribution of patients was as follows: Stage IA=4, stage IB=33, stage IIA=18, stage IIB=38, stage III=57, stage IV=15. Overall 5-year cause specific survivals were as follows: Stage IA=100%, stage IB=96%, stage IIA=92%, stage IIB=79%, stage III=57%, stage IV=27%. In each stage, 5-year survival rates in groups A and B were 100%, 93% in stage I, 82% and 85% in stage II, 62% and 52% in stage II and 22% and 31% in stage IV, respectively. There were no statistically significant differences among these survival curves in each stage. Five-year local failure rates were 16% in group A and 16% in group B (p=0.9096), and corresponding distant failure rates were 23% in group A and 19% in group B (p=0.2955). Moderate-to-severe complications requiring treatment (Kottmeier's grade 2 or more) were noted in 6 patients (7%) in group A and 6 patients (7%) in group B. All of the bladder and rectal complications needed medical treatment (Kottmeier's grade 2). Severe complications receiving surgery were noted in 4 patients (A: 1; B: 3), i.e., small intestine 3 and sigmoid colon 1 patient. Another 1 patient (A) was dead of ileus. There were no statistically significant differences between 2 treatment schedules in survival rates, failure patterns and complications rates. This fact suggests that small number of fractions (7.5 Gy/fraction) may be advantageous because of short duration and a low load of treatment. (orig.) [de

  6. Safety assessment for Generation IV nuclear systems

    International Nuclear Information System (INIS)

    Leahy, T.J.

    2012-01-01

    The Generation IV International Forum (GIF) Risk and Safety Working Group (RSWG) was created to develop an effective approach for the safety of Generation IV advanced nuclear energy systems. Recent RSWG work has focused on the definition of an integrated safety assessment methodology (ISAM) for evaluating the safety of Generation IV systems. ISAM is an integrated 'tool-kit' consisting of 5 analytical techniques that are available and matched to appropriate stages of Generation IV system concept development: 1) qualitative safety features review - QSR, 2) phenomena identification and ranking table - PIRT, 3) objective provision tree - OPT, 4) deterministic and phenomenological analyses - DPA, and 5) probabilistic safety analysis - PSA. The integrated methodology is intended to yield safety-related insights that help actively drive the evolving design throughout the technology development cycle, potentially resulting in enhanced safety, reduced costs, and shortened development time

  7. 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.

  8. Regional nodal relapse in surgically staged Merkel cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. Colorectal cancer stage at diagnosis in migrants versus non-migrants (KoMigra): study protocol of a cross-sectional study in Germany

    International Nuclear Information System (INIS)

    Dahlhaus, Anne; Gerlach, Ferdinand M; Blettner, Maria; Siebenhofer, Andrea; Guethlin, Corina; Schall, Arthur; Taubenroth, Maja; Ewijk, Reyn van; Zeeb, Hajo; Albay, Zeycan; Schulz-Rothe, Sylvia; Beyer, Martin

    2014-01-01

    In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle. The current study investigates whether stage at diagnosis differs between migrants and non-migrants with colorectal cancer in an area of high migration and attempts to identify factors that can explain any differences. Data on tumour and migration status will be collected for 1,200 consecutive patients that have received a new, histologically verified diagnosis of colorectal cancer in a high migration area in Germany in the previous three months. The recruitment process is expected to take 16 months and will include gastroenterological private practices and certified centres for intestinal diseases. Descriptive and analytical analysis will be performed: the distribution of variables for migrants versus non-migrants and participants versus non-participants will be analysed using appropriate χ2-, t-, F- or Wilcoxon tests. Multivariable, logistic regression models will be performed, with the dependent variable being the dichotomized stage of the tumour (UICC stage I versus more advanced than UICC stage I). Odds ratios and associated 95%-confidence intervals will be calculated. Furthermore, ordered logistic regression models will be estimated, with the exact stage of the tumour at diagnosis as the dependent variable. Predictors used in the ordered logistic regression will be patient characteristics that are specific to migrants as well as patient characteristics that are not. Interaction models will be estimated in order to investigate whether the effects of patient characteristics on stage of tumour at the time of the initial diagnosis is different in migrants, compared to non-migrants. An association of migration status or

  10. [A comparison between 3.0 T MRI and histopathology for preoperative T staging of potentially resectable esophageal cancer].

    Science.gov (United States)

    Wang, Z Q; Zhang, F G; Guo, J; Zhang, H K; Qin, J J; Zhao, Y; Ding, Z D; Zhang, Z X; Zhang, J B; Yuan, J H; Li, H L; Qu, J R

    2017-03-21

    Objective: To explore the value of 3.0 T MRI using multiple sequences (star VIBE+ BLADE) in evaluating the preoperative T staging for potentially resectable esophageal cancer (EC). Methods: Between April 2015 and March 2016, a total of 66 consecutive patients with endoscopically proven resectable EC underwent 3.0T MRI in the Affiliated Cancer Hospital of Zhengzhou University.Two independent readers were assigned a T staging on MRI according to the 7th edition of UICC-AJCC TNM Classification, the results of preoperative T staging were compared and analyzed with post-operative pathologic confirmation. Results: The MRI T staging of two readers were highly consistent with histopathological findings, and the sensitivity, specificity and accuracy of preoperative T staging MR imaging were also very high. Conclusion: 3.0 T MRI using multiple sequences is with high accuracy for patients of potentially resectable EC in T staging. The staging accuracy of T1, T2 and T3 is better than that of T4a. 3.0T MRI using multiple sequences could be used as a noninvasive imaging method for pre-operative T staging of EC.

  11. THE DEVELOPMENT OF BIOCHEMICAL OXYGEN DEMAND SENSOR USING LOCAL YEAST: Candida fukuyamaensis, UICC Y-247

    Directory of Open Access Journals (Sweden)

    Endang Saepudin

    2011-04-01

    Full Text Available In order to shorten the measurement time of biochemical oxygen demand (BOD, a BOD sensor based on yeastmetabolism was developed. Local yeast, Indonesian Origin, Candida fukuyamaensis UICC Y-247, was used as atransducer. The yeast was immobilized as a thin film in agarose matrix with the auxiliary of Nafion® acting as themembrane for ion exchange process. The film was then attached to gold-modified glassy carbons and used as transduceron the working electrodes. The measurements were conducted by observing the depletion of glucose concentrationusing multipulse amperometric method and then converted to BOD values. Optimum condition was observed in awaiting measurement time of 30 min at an applied potential of 450 mV (vs. Ag/AgCl. Linearity was shown in glucoseconcentration range of 0.1–0.5 mM, which was equivalent to BOD concentration range of 10–50 mg/L. A detectionlimit of 1.13 mg/L BOD could be achieved. Good repeatability was shown by a relative standard deviation (RSD of2.7% (n = 15. However, decreasing current response of ~50% was found after 3 days. Comparing to the conventionalBOD measurement, this BOD sensor can be used as an alternative method for BOD measurements.

  12. Laryngeal preservation with definitive radiotherapy in radiosensitive hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Kunitake, Naonobu; Nakamura, Katsumasa; Shioyama, Yoshiyuki; Kuratomi, Yuichiro; Yamamoto, Tomoya; Honda, Hiroshi; Terashima, Hiromi

    2003-01-01

    Fifty-seven patients with hypopharyngeal cancer treated by irradiation at Kyushu University Hospital between 1985 and 1992 were analyzed retrospectively. They included 53 men and 4 women, and their ages ranged from 39 to 83 years (mean, 63 years). Two patients had stage I, 7 had stage II, 13 had stage III, and 35 had stage IV disease according to the Union Internationale Contre le Cancer (UICC) (1997) classification. Initially, they were irradiated in the conventional way with a dose of 30 Gy, and 17 patients with good response were irradiated to curative dose (more than 60 Gy), and 32 patients with poor response were operated immediately. Medically inoperable or unresectable patients were treated in a semiradical way (n=8). The 5-year overall and cause-specific survival rates were 46% and 51%, respectively. Five-year cause-specific survival rates were 88% for stages I and II (n=9), 67% for stage III (n=13), and 35% for stage IV (n=35). Five-year cause-specific survival according to treatment method was 58% for surgery and 51 % for curative radiotherapy. There was no statistically significant difference between the two rates. These results suggest that initial radiation response is an important factor in deciding on the following treatment method. Curative radiotherapy for hypopharyngeal cancer according to initial radiation response is a desirable treatment strategy. (author)

  13. Which patients benefit most from primary surgery or neoadjuvant chemotherapy in stage IIIC or IV ovarian cancer? An exploratory analysis of the European Organisation for Research and Treatment of Cancer 55971 randomised trial.

    Science.gov (United States)

    van Meurs, Hannah S; Tajik, Parvin; Hof, Michel H P; Vergote, Ignace; Kenter, Gemma G; Mol, Ben Willem J; Buist, Marrije R; Bossuyt, Patrick M

    2013-10-01

    To investigate whether biomarkers consisting of baseline characteristics of advanced stage ovarian cancer patients can help in identifying subgroups of patients who would benefit more from primary surgery or neoadjuvant chemotherapy. We used data of the European Organisation for Research and Treatment of Cancer (EORTC) 55971 trial in which 670 patients were randomly assigned to primary surgery or neoadjuvant chemotherapy. The primary outcome was overall survival. Ten baseline clinical and pathological characteristics were selected as potential biomarkers. Using Subpopulation Treatment Effect Pattern Plots (STEPP), biomarkers with a statistically significant qualitative additive interaction with treatment were considered as potentially informative for treatment selection. We also combined selected biomarkers to form a multimarker treatment selection rule. The size of the largest metastatic tumour and clinical stage were significantly associated with the magnitude of the benefit from treatment, in terms of five-year survival (p for interaction: 0.008 and 0.016, respectively). Stage IIIC patients with metastatic tumours ⩽45 mm benefited more from primary surgery while stage IV patients with metastatic tumours >45 mm benefited more from neoadjuvant chemotherapy. In stage IIIC patients with larger metastatic tumours and in stage IV patients with less extensive metastatic tumours both treatments were equally effective. We estimated that by selecting treatments for patients based on largest metastatic tumour and clinical stage, the potential five-year survival rate in the population of treated patients would be 27.3% (95% confidence interval (CI) 21.9-33.0), 7.8% higher than if all were treated with primary surgery, and 5.6% higher if all were treated with neoadjuvant chemotherapy. Although survival was comparable after primary surgery and neoadjuvant chemotherapy in the overall group of patients with ovarian cancer in the EORTC 55971 trial, we found in this exploratory

  14. A clinical study of nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Ito, Zenya; Wada, Tetsuro; Senarita, Masamitsu

    1999-01-01

    Forty-four patients of nasopharyngeal carcinoma, treated in Tsukuba University Hospital between March 1988 and March 1998, were reviewed in order to assess the adequacy of our treatment protocol. Most of the cases except 5 were histologically diagnosed as squamous cell carcinoma including 25 of lymphoepithelioma (poorly-differentiated squamous cell carcinoma). Thirty-two out of 39 squamous cell carcinoma cases have fallen into Stage IV category (UICC, 1987) , and all of the non-squamous cell carcinoma cases were also categorized as Stage IV. The basic protocol for nasopharyngeal squamous cell carcinoma was the combination of full-dose irradiation and chemotherapy using cisplatin/carboplatin and peplomycin. The metastatic cervical lymphnodes in 9 cases, too massive to control by this treatment, were surgically dissected after the treatment. Recurrence was noted in 9 cases who were rehospitalized and salvaged medically and/or surgically. As a consequence, the overall 5-year survival rate was 71.4% for squamous cell carcinoma. On the other hand, only one of the 5 non-squamous cell carcinoma cases died of the disease. (author)

  15. A prospective study on concurrent chemotherapy and thoracic three-dimensional radiotherapy for stage IV non-small cell lung cancer (1) -survival and toxicity

    International Nuclear Information System (INIS)

    Su Shengfa; Lu Bing; Zhang Bo; Hu Yinyang; Ouyang Weiwei; Li Huiqin; Wang Gang; Long Jinhua

    2011-01-01

    Objective: To evaluate the overall survival and safety among patients for stage IV non-small cell lung cancer (NSCLC) treated with concurrent chemotherapy and thoracic three-dimensional radiotherapy (CCTTRT). Methods: From Jan. 2003 to July 2010, 201 patients with stage IV NSCLC were included. All patients were treated with CCTTRT. Those patients who received only one cycle chemotherapy were not included in survival analysis,but analysis of toxicity. One hundred and eighty-two patients were eligible for survival analysis. All patients received platinum-based two-drug chemotherapy. The median number of cycles was 4. The median dose to planning target volume of primary tumor (DT PTV ) was 63 Gy. Treatment-related gastrointestinal and hematological toxicity were scored according to WHO criteria. Radiation-related pneumonitis and esophagitis were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTC) version 3.0. Survival was calculated by Kaplan-Meier method and compared using the Logrank. Cox regression model was used to examine the effect of CCTTRT on overall survival. Results: The follow-up rate of 201 patients was 97.5%. with 201, 170 and 134 patients finished 2 =10.10, P =0.001). For patients eligible for survival analysis and received 4 - 5 cycles of systemic chemotherapy, MST of patients treated with DT PTV ≥63 Gy was significantly longer than those treated with DT PTV 2 =20.48, P =0.000) and 16.1 months vs.8.8 months (χ 2 =11.75, P =0.001)]. For patients with single organ metastasis, MST was 16 months for those treated with DT PTV ≥63 Gy and 9 months for those with DT PTV 2 =10.51, P=0.000); for patients with multiple organ metastasis, it was 11 months and 7 months, respectively (χ 2 =7.90, P =0.005). Multivariate analysis showed that concurrent 4 - 5 cycles chemotherapy and DTPTV ≥63 Gy (β =0.243, P=0.019) and improved KPS (β =1.268, P=0.000) were independent factors for survival. For the whole

  16. Pretreatment Red Blood Cell Total Folate Concentration Is Associated With Response to Pemetrexed in Stage IV Nonsquamous Non-Small-cell Lung Cancer.

    Science.gov (United States)

    Bagley, Stephen J; Vitale, Steven; Zhang, Suhong; Aggarwal, Charu; Evans, Tracey L; Alley, Evan W; Cohen, Roger B; Langer, Corey J; Blair, Ian A; Vachani, Anil; Whitehead, Alexander S

    2017-03-01

    Pemetrexed inhibits folate-dependent enzymes involved in pyrimidine and purine synthesis. Previous studies of genetic variation in these enzymes as predictors of pemetrexed efficacy have yielded inconsistent results. We investigated whether red blood cell (RBC) total folate, a phenotypic rather than genotypic, marker of cellular folate status was associated with the response to pemetrexed-based chemotherapy in advanced nonsquamous non-small-cell lung cancer (NSCLC). We conducted a prospective cohort study of patients with stage IV nonsquamous NSCLC receiving first-line chemotherapy containing pemetrexed. The pretreatment RBC total folate level was quantified using liquid chromatography mass spectrometry. We then compared the objective response rate (ORR) between patients with RBC total folate concentrations greater than and less than an optimal cutoff value determined from the receiver operating characteristic curve. A logistic regression model was used to adjust for age, sex, and the use of bevacizumab. The ORR was 62% (32 of 52 patients). Receiver operating characteristic analysis was used to establish that a RBC total folate cutoff value of 364.6 nM optimally discriminated between pemetrexed responders and nonresponders. Patients with RBC total folate  364.5 nM (P = .01). This difference persisted after adjusting for age, sex, and the use of bevacizumab (odds ratio, 0.07; 95% confidence interval, 0.01-0.57; P = .01). A low pretreatment RBC total folate was associated with an inferior response to pemetrexed-based chemotherapy in stage IV nonsquamous NSCLC. Larger, multicenter studies are needed to validate RBC total folate as a predictive marker of pemetrexed response. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Current status of NPP generation IV

    International Nuclear Information System (INIS)

    Yohanes Dwi Anggoro; Dharu Dewi; Nurlaila; Arief Tris Yuliyanto

    2013-01-01

    Today development of nuclear technology has reached the stage of research and development of Generation IV nuclear power plants (advanced reactor systems) which is an innovative development from the previous generation of nuclear power plants. There are six types of power generation IV reactors, namely: Very High Temperature Reactor (VHTR), Sodium-cooled Fast Reactor (SFR), Gas-cooled Fast Reactor (GFR), Lead-cooled Fast Reactor (LFR), Molten Salt Reactor (MSR), and Super Critical Water-cooled Reactor (SCWR). The purpose of this study is to know the development of Generation IV nuclear power plants that have been done by the thirteen countries that are members of the Gen IV International Forum (GIF). The method used is review study and refers to various studies related to the current status of research and development of generation IV nuclear power. The result of this study showed that the systems and technology on Generation IV nuclear power plants offer significant advances in sustainability, safety and reliability, economics, and proliferation resistance and physical protection. In addition, based on the research and development experience is estimated that: SFR can be used optimally in 2015, VHTR in 2020, while NPP types GFR, LFR, MSR, and SCWR in 2025. Utilization of NPP generation IV said to be optimal if fulfill the goal of NPP generation IV, such as: capable to generate energy sustainability and promote long-term availability of nuclear fuel, minimize nuclear waste and reduce the long term stewardship burden, has an advantage in the field of safety and reliability compared to the previous generation of NPP and VHTR technology have a good prospects in Indonesia. (author)

  18. Matrix-comparative genomic hybridization from multicenter formalin-fixed paraffin-embedded colorectal cancer tissue blocks

    Directory of Open Access Journals (Sweden)

    Köhne Claus-Henning

    2007-04-01

    Full Text Available Abstract Background The identification of genomic signatures of colorectal cancer for risk stratification requires the study of large series of cancer patients with an extensive clinical follow-up. Multicentric clinical studies represent an ideal source of well documented archived material for this type of analyses. Methods To verify if this material is technically suitable to perform matrix-CGH, we performed a pilot study using macrodissected 29 formalin-fixed, paraffin-embedded tissue samples collected within the framework of the EORTC-GI/PETACC-2 trial for colorectal cancer. The scientific aim was to identify prognostic genomic signatures differentiating locally restricted (UICC stages II-III from systemically advanced (UICC stage IV colorectal tumours. Results The majority of archived tissue samples collected in the different centers was suitable to perform matrix-CGH. 5/7 advanced tumours displayed 13q-gain and 18q-loss. In locally restricted tumours, only 6/12 tumours showed a gain on 13q and 7/12 tumours showed a loss on 18q. Interphase-FISH and high-resolution array-mapping of the gain on 13q confirmed the validity of the array-data and narrowed the chromosomal interval containing potential oncogenes. Conclusion Archival, paraffin-embedded tissue samples collected in multicentric clinical trials are suitable for matrix-CGH analyses and allow the identification of prognostic signatures and aberrations harbouring potential new oncogenes.

  19. FDG-PET in the initial staging of squamous cell oesophageal carcinoma

    International Nuclear Information System (INIS)

    Buchmann, I.; Schreckenberger, M.; Bartenstein, P.; Hansen, T.; Brochhausen, C.; Kneist, W.; Junginger, T.; Oberholzer, K.

    2006-01-01

    Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in N- and M-staging of squamous cell oesophogeal carcinoma. Patients, methods: in 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus, FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: in 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) ± 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDG-PET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma. (orig.)

  20. Stage IVN neuroblastoma: MRI diagnosis of left supraclavicular ''Virchow's'' nodal spread

    International Nuclear Information System (INIS)

    Abramson, S.J.; Berdon, W.E.; Stolar, C.; Ruzal-Shapiro, C.; Garvin, J.

    1996-01-01

    Stage IV neuroblastoma is associated with high mortality; an exception are patients whose stage IV status includes distant positive nodes, but no skeletal metastases - stage IVN neuroblastoma. We describe our experience with preoperative MRI in three patients with extensive abdominal neuroblastoma without cortical bony involvement but with unsuspected metastatic involvement to the left supraclavicular (Virchow's) node. We review findings of left supraclavicular nodal spread in five earlier cases of IVN neuroblastoma. (orig.). With 3 figs., 1 tab

  1. Pretreatment red blood cell total folate is associated with response to pemetrexed in stage IV non-squamous non-small-cell lung cancer

    Science.gov (United States)

    Bagley, Stephen J.; Vitale, Steven; Zhang, Suhong; Aggarwal, Charu; Evans, Tracey L.; Alley, Evan W.; Cohen, Roger B.; Langer, Corey J.; Blair, Ian A.; Vachani, Anil; Whitehead, Alexander S.

    2016-01-01

    Objectives Pemetrexed inhibits folate-dependent enzymes involved in pyrimidine and purine synthesis. Prior studies of genetic variation in these enzymes as predictors of pemetrexed efficacy have yielded inconsistent results. We investigated whether red blood cell (RBC) total folate, a phenotypic rather than genotypic marker of cellular folate status, was associated with response to pemetrexed-based chemotherapy in advanced non-squamous non-small-cell lung cancer (NSCLC). Materials and methods We conducted a prospective cohort study of patients with stage IV non-squamous NSCLC receiving first-line chemotherapy containing pemetrexed. Pretreatment RBC total folate was quantified using liquid chromatography/mass spectrometry. We then compared objective response rate (ORR) between patients with RBC total folate concentrations above and below an optimal cut-off value determined from the receiver operating characteristic (ROC) curve. A logistic regression model was used to adjust for age, sex, and use of bevacizumab. Results The ORR was 62% (32 of 52 patients). ROC analysis was used to establish that a RBC total folate cutoff value of 364.6 nM optimally discriminated between pemetrexed responders and non-responders. Patients with RBC total folate below 364.5 nM had an ORR of 27%, compared to 71% in patients with RBC total folate above this value (p=0.01). This difference persisted after adjusting for age, sex, and use of bevacizumab (OR 0.07, 95% CI 0.01 - 0.57, p=0.01). Conclusions Low pretreatment RBC total folate is associated with inferior response to pemetrexed-based chemotherapy in stage IV non-squamous NSCLC. Larger, multicenter studies are needed to validate RBC total folate as a predictive marker of pemetrexed response. PMID:27863923

  2. Improved survival with combined modality treatment for Stage IV breast cancer

    International Nuclear Information System (INIS)

    Nervi, C.; Arcangeli, G.; Concolino, F.; Cortese, M.

    1979-01-01

    Between 1974 and 1977, 85 patients with breast cancer at first postmastectomy relapse were irradiated (Radiation 3500 to 6000 rad--3/5 weeks) to all clinically evident lesions. Radiation fields were properly shaped to include a maximum 40% active bone marrow. After 3 to 4 weeks rest, chemotherapy was started as adjuvant therapy for residual or subclinical disease (ADR 30 mg/M 2 Day 1 and 8, 5-FU 400 mg/M 2 Day 1 and 8, CY 100 mg/M 2 Day 1 through 14: repeated after 14 days). ADR was discontinued at 500/M 2 and substituted by MTX 30 mg/M 2 Day 1 and 8 for a total of 2 years. Irradiated sites were chest wall in 35, supraclavicular and internal mammary nodes in 22, bone in 56, single lung lesions in 12, brain in 24. Controls were 52 comparable but non-randomized patients treated with chemotherapy only. Forty days after x-irradiation 68 patients (80%) were free of disease (NED) while in 17 cases (20%) some residual was still present (RED). In 28 of 68 cases (41%) NED after x-irradiation and 13 of 17 (76%) in RED group developed second relapse after a median interval of 26 and 20 mos., respectively. Four of 52 patients (8%) in the control group had complete regression with a median interval to second relapse of 7 mos. Median survival was 30 mos., 24 mos., and 13 mos., respectively, for NED, RED and chemotherapy only. Eighteen patients (26%) are free of disease after 36 to 48 mos. in the combined modality group; none in the chemotherapy group. Combined treatment cases did not show untolerable myelodepression. In 10 long-surviving patients a marked subcutaneous and skin fibrosis developed because of drug additive effect. Stage IV breast cancers rendered clinically free of disease with x-irradiation and subsequently treated with chemotherapy survive significantly longer than with chemotherapy alone

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

    Science.gov (United States)

    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.

  4. Identification of type IV collagen exposure as a molecular imaging target for early detection of thoracic aortic dissection

    Science.gov (United States)

    Xu, Ke; Xu, Chen; Zhang, Yanzhenzi; Qi, Feiran; Yu, Bingran; Li, Ping; Jia, Lixin; Li, Yulin; Xu, Fu-jian; Du, Jie

    2018-01-01

    Thoracic aortic dissection (TAD) is an aggressive and life-threatening vascular disease and there is no effective means of early diagnosis of dissection. Type IV collagen (Col-IV) is a major component of the sub-endothelial basement membrane, which is initially exposed followed by endothelial injury as early-stage event of TAD. So, we want to build a noninvasive diagnostic method to detect early dissection by identifying the exposed Col-IV via MRI. Methods: Col-IV-targeted magnetic resonance/ fluorescence dual probe (Col-IV-DOTA-Gd-rhodamine B; CDR) was synthesized by amide reaction and coordination reaction. Flow cytometry analysis was used to evaluate the cell viability of SMC treated with CDR and fluorescence assays were used to assess the Col-IV targeting ability of CDR in vitro. We then examined the sensitivity and specificity of CDR at different stages of TAD via MRI and bioluminescence imaging in vivo. Results: The localization of Col-IV (under the intima) was observed by histology images. CDR bound specifically to Col-IV-expressing vascular smooth muscle cells and BAPN-induced dissected aorta. The CDR signal was co-detected by magnetic resonance imaging (MRI) and bioluminescence imaging as early as 2 weeks after BAPN administration (pre-dissection stage). The ability to detect rupture of dissected aorta was indicated by a strong normalized signal enhancement (NSE) in vivo. Moreover, NSE was negatively correlated with the time of dissection rupture after BAPN administration (r2 = 0.8482). Conclusion: As confirmed by in vivo studies, the CDR can identify the exposed Col-IV in degenerated aorta to monitor the progress of aortic dissection from the early stage to the rupture via MRI. Thus, CDR-enhanced MRI proposes a potential method for dissection screening, and for monitoring disease progression and therapeutic response. PMID:29290819

  5. Gene expression profiles in stages II and III colon cancers

    DEFF Research Database (Denmark)

    Thorsteinsson, Morten; Kirkeby, Lene T; Hansen, Raino

    2012-01-01

    PURPOSE: A 128-gene signature has been proposed to predict outcome in patients with stages II and III colorectal cancers. In the present study, we aimed to reproduce and validate the 128-gene signature in external and independent material. METHODS: Gene expression data from the original material...... were retrieved from the Gene Expression Omnibus (GEO) (n¿=¿111) in addition to a Danish data set (n¿=¿37). All patients had stages II and III colon cancers. A Prediction Analysis of Microarray classifier, based on the 128-gene signature and the original training set of stage I (n¿=¿65) and stage IV (n...... correctly predicted as stage IV-like, and the remaining patients were predicted as stage I-like and unclassifiable, respectively. Stage II patients could not be stratified. CONCLUSIONS: The 128-gene signature showed reproducibility in stage III colon cancer, but could not predict recurrence in stage II...

  6. Osimertinib and Necitumumab in Treating Patients With EGFR-Mutant Stage IV or Recurrent Non-small Cell Lung Cancer Who Have Progressed on a Previous EGFR Tyrosine Kinase Inhibitor

    Science.gov (United States)

    2018-03-07

    EGFR Exon 19 Deletion Mutation; EGFR Exon 20 Insertion Mutation; EGFR NP_005219.2:p.G719X; EGFR NP_005219.2:p.L858R; EGFR NP_005219.2:p.L861Q; EGFR NP_005219.2:p.T790M; EGFR T790M Mutation Negative; Recurrent Non-Small Cell Lung Carcinoma; Stage IV Non-Small Cell Lung Cancer AJCC v7

  7. The microstructural origin of work hardening stages

    DEFF Research Database (Denmark)

    Hughes, D. A.; Hansen, N.

    2018-01-01

    The strain evolution of the flow stress and work hardening rate in stages III and IV is explored by utilizing a fully described deformation microstructure. Extensive measurements by transmission electron microscopy reveal a hierarchical subdivision of grains by low angle incidental dislocation...... addition of the classical Taylor and Hall-Petch formulations. Model predictions agree closely with experimental values of flow stress and work hardening rate in stages III and IV. Strong connections between the evolutionary stages of the deformation microstructure and work hardening rates create a new...... (modern) basis for the classic problem of work hardening in metals and alloys. These connections lead the way for the future development of ultra high strength ductile metals produced via plastic deformation.(c) 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved....

  8. An Integrated Safety Assessment Methodology for Generation IV Nuclear Systems

    International Nuclear Information System (INIS)

    Leahy, Timothy J.

    2010-01-01

    The Generation IV International Forum (GIF) Risk and Safety Working Group (RSWG) was created to develop an effective approach for the safety of Generation IV advanced nuclear energy systems. Early work of the RSWG focused on defining a safety philosophy founded on lessons learned from current and prior generations of nuclear technologies, and on identifying technology characteristics that may help achieve Generation IV safety goals. More recent RSWG work has focused on the definition of an integrated safety assessment methodology for evaluating the safety of Generation IV systems. The methodology, tentatively called ISAM, is an integrated 'toolkit' consisting of analytical techniques that are available and matched to appropriate stages of Generation IV system concept development. The integrated methodology is intended to yield safety-related insights that help actively drive the evolving design throughout the technology development cycle, potentially resulting in enhanced safety, reduced costs, and shortened development time.

  9. The Prognostic Influence of BRAF Mutation and other Molecular, Clinical and Laboratory Parameters in Stage IV Colorectal Cancer.

    Science.gov (United States)

    Karadima, Maria L; Saetta, Angelica A; Chatziandreou, Ilenia; Lazaris, Andreas C; Patsouris, Efstratios; Tsavaris, Nikolaos

    2016-10-01

    Our aim was to evaluate the predictive and prognostic influence of BRAF mutation and other molecular, clinical and laboratory parameters in stage IV colorectal cancer (CRC). 60 patients were included in this retrospective analysis, and 17 variables were examined for their relation with treatment response and survival. KRAS mutation was identified in 40.3 % of cases, BRAF and PIK3CA in 8.8 % and 10.5 % respectively. 29.8 % of patients responded to treatment. Median survival time was 14.3 months. Weight loss, fever, abdominal metastases, blood transfusion, hypoalbuminaimia, BRAF and PIK3CA mutations, CRP and DNA Index were associated with survival. In multivariate analysis, male patients had 3.8 times higher probability of response, increased DNA Index was inversely correlated with response and one unit raise of DNA Index augmented 6 times the probability of death. Our findings potentiate the prognostic role of BRAF, PIK3CA mutations and ploidy in advanced CRC.

  10. 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.

  11. Chemotherapy versus best supportive care in stage IV non-small cell lung cancer, non metastatic to the brain Quimioterapia versus melhor tratamento de suporte em câncer de pulmão estádio clínico IV não metastático para o sistema nervoso central

    Directory of Open Access Journals (Sweden)

    Agnaldo Anelli

    2001-04-01

    Full Text Available Stage IV non-small cell lung cancer is a fatal disease, with a median survival of 14 months. Systemic chemotherapy is the most common approach. However the impact in overall survival and quality of life still a controversy. OBJECTIVES: To determine differences in overall survival and quality of life among patients with stage IV non-small cell lung cancer non-metastatic to the brain treated with best supportive care versus systemic chemotherapy. PATIENTS: From February 1990 through December 1995, 78 eligible patients were admitted with the diagnosis of stage IV non-small cell lung cancer . Patients were divided in 2 groups: Group A (n=31 -- treated with best supportive care , and Group B (n=47 -- treated with systemic chemotherapy. RESULTS: The median survival time was 23 weeks (range 5 -- 153 weeks in Group A and 55 weeks (range 7.4 -- 213 weeks in Group B (p=0.0018. In both groups, the incidence of admission for IV antibiotics and need of blood transfusions were similar. Patients receiving systemic chemotherapy were also stratified into those receiving mytomycin, vinblastin, and cisplatinum, n=25 and those receiving other combination regimens (platinum derivatives associated with other drugs, n=22. Patients receiving mytomycin, vinblastin, and cisplatinum, n=25 had a higher incidence of febrile neutropenia and had their cycles delayed for longer periods of time than the other group. These patients also had a shorter median survival time (51 versus 66 weeks, p=0.005. CONCLUSION: In patients with stage IV non-small cell lung cancer, non-metastatic to the brain, chemotherapy significantly increases survival compared with best supportive care.O câncer de pulmão de células não pequenas em estádio IV é uma doença fatal, com uma sobrevida mediana de seis meses. Quimioterapia é a abordagem mais freqüente, apresentando um impacto na sobrevida controverso e questionável alteração na qualidade de vida. OBJETIVOS: Comparar o impacto na

  12. Stage effect of chronic kidney disease in erectile function

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues Costa

    Full Text Available ABSTRACT Purpose The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. Materials and Methods This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Results Two hundred and forty five patients with chronic kidney disease in conservative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. Conclusions The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression.

  13. Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Min; Lee, Sang Wook; Park, Sun Min [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2017-09-15

    To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

  14. Peritumoral eosinophils predict recurrence in colorectal cancer.

    Science.gov (United States)

    Harbaum, Lars; Pollheimer, Marion J; Kornprat, Peter; Lindtner, Richard A; Bokemeyer, Carsten; Langner, Cord

    2015-03-01

    In colorectal cancer, the presence and extent of eosinophil granulocyte infiltration may render important prognostic information. However, it remains unclear whether an increasing number of eosinophils might simply be linked to the overall inflammatory cell reaction or represent a self-contained, antitumoral mechanism that needs to be documented and promoted therapeutically. Peri- and intratumoral eosinophil counts were retrospectively assessed in 381 primary colorectal cancers from randomly selected patients. Tumors were diagnosed in American Joint Committee on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) stage I in 21%, stage II in 32%, stage III in 33%, and stage IV in 14%. Presence and extent of eosinophils was related to various histopathological parameters as well as patients' outcome. Overall, peri- and intratumoral eosinophils were observed in 86 and 75% cancer specimens. The peritumoral eosinophil count correlated strongly with the intratumoral eosinophil count (R=0.69; Peosinophil counts were significantly associated with lower T and N classification, better tumor differentiation, absence of vascular invasion, as well as improved progression-free and cancer-specific survival. However, only peritumoral eosinophils, but not intratumoral, were an independent prognosticator of favorable progression-free (hazard ratio 0.75; 95% confidence interval 0.58-0.98; P=0.04) and cancer-specific survival (hazard ratio 0.7; 95% confidence interval 0.52-0.93; P=0.01)-independent of the intensity of overall inflammatory cell reaction. This was also found for patients with AJCC/UICC stage II disease, wherein the presence of peritumoral eosinophils was significantly associated with favorable outcome. In conclusion, the number of peritumoral eosinophils had a significant favorable impact on prognosis of colorectal cancer patients independent of the overall tumor-associated inflammatory response. Evaluation of peritumoral eosinophils represents a promising

  15. Can concurrent chemoradiotherapy replace surgery and postoperative radiation for locally advanced stage III/IV tonsillar squamous cell carcinoma?

    Science.gov (United States)

    Park, Geumju; Lee, Sang-Wook; Kim, Sang Yoon; Nam, Soon Yuhl; Choi, Seung-Ho; Kim, Sung-Bae; Roh, Jong-Lyel; Yoon, Dok Hyun; Kim, Su Ssan; Park, Jin-Hong; Kim, Young Seok; Yoon, Sang Min; Song, Si Yeol; Kim, Jong Hoon; Choi, Eun Kyung; DO Ahn, Seung

    2013-03-01

    To compare surgery and postoperative radiotherapy (PORT) with the non-surgical combination of chemotherapy and radiation therapy (CCRT) for locally advanced squamous cell carcinoma (SCC) of the tonsil by measuring treatment outcomes and treatment-related complications. The records of 114 patients with non-metastatic stage III/IV tonsillar SCC treated between July, 1998 and December, 2010 were reviewed retrospectively. Among the 114 patients, 65 received PORT and 49 received CCRT. In the PORT group, treatment included wide surgical resection of the tumor with neck dissection and administration of PORT to the primary tumor bed with a median dose of 60 Gy. In the CCRT group, a median dose of 70 Gy was delivered to the gross tumor, and 46 patients received concurrent chemotherapy with i.v. cisplatin. The median follow-up time was 58 months in the PORT group and 44 months in the CCRT group. There was no significant difference between PORT and CCRT in terms of 5-year locoregional recurrence-free survival (88.4% vs. 91.4%, p=0.68), distant metastasis-free survival (88.9% vs. 92.3%, p=0.60), disease-free survival (79.5% vs. 84.2%, p=0.63) or overall survival (78.9% vs. 88.9%, p=0.45). More CCRT patients than PORT patients experienced grade 3 (or higher) hematological toxicities and grade 2 pharyngitis during treatment. Chronic toxicity, manifested as swallowing difficulty, dry mouth and trismus, was similar between the two treatment groups. CCRT provides similar levels of local and distant control in patients with locally advanced tonsillar SCC as PORT, yet fails to show any superiority in preserving functions such as swallowing, saliva production, and mastication.

  16. Ovarian chocolate cysts. Staging with relaxation time in MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Nasopharyngeal carcinoma in children and adolescents - a single institution experience of 158 patients

    International Nuclear Information System (INIS)

    Liu, Weixin; Tang, Yuan; Gao, Li; Huang, Xiaodong; Luo, Jingwei; Zhang, Shiping; Wang, Kai; Qu, Yuan; Xiao, Jianping; Xu, Guozhen; Yi, Junlin

    2014-01-01

    To evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents. Between January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient’s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed. There were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p = 0.01, stage IV and stage II-III were 77.1% and 90%, p = 0.04, respectively. In multivariate analysis, T4 (p = 0.02) and stage IV (p = 0.04) were the independent adverse prognostic factors for OS. Significant reduction in trismus (27.3% v 3.6%, p = 0.03) and G2 xerostomia (37.9% v 10.3%, p = 0.02) was observed in patients treated by IMRT. Most childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma

  18. Activation and detoxification of UICC crocidolite: the effect of conversion of oxidation state of iron on the toxicity of the fibres

    International Nuclear Information System (INIS)

    Gulumian, M.; Waard, H. de; Pollak, H.

    1993-01-01

    Detoxification of crocidolite, an asbestiform riebeckite with a coating of ferric salt, converted some of the ferrous ions into ferric ions and therefore decreased the activity of the fibres to catalyse the reduction of oxygen and peroxide. The H 2 -activation of crocidolite fibres on the other hand, changed some of the ferric ions into ferrous ions and therefore increased the capacity of the fibres to catalyse these two reactions. Moessbauer spectroscopy (MS) combined with wet chemical analysis, X-ray diffraction, X-ray fluorescence, and neutron activation analysis enabled us to determine the site occupancies of iron and magnesium in UICC (Union Internationale Contre le Cancer) crocidolite and the ratio of the recoil-free fractions f(Fe 2+ )/f(Fe 3+ )=0.86±0.07. These results and further MS studies with detoxified and activated fibres explained the effect of the two processes on the activity of iron in the fibres. (orig.)

  19. Thermodynamic data for predicting concentrations of Th(IV), U(IV), Np(IV), and Pu(IV) in geologic environments

    Energy Technology Data Exchange (ETDEWEB)

    Rai, Dhanpat; Roa, Linfeng; Weger, H.T.; Felmy, A.R. [Battelle, Pacific Northwest National Laboratory (PNNL) (United States); Choppin, G.R. [Florida State University (United States); Yui, Mikazu [Waste Isolation Research Division, Tokai Works, Japan Nuclear Cycle Development Inst., Tokai, Ibaraki (Japan)

    1999-01-01

    This report provides thermodynamic data for predicting concentrations of Th(IV), U(IV), Np(IV), and Pu(IV) in geologic environments, and contributes to an integration of the JNC chemical thermodynamic database, JNC-TDB (previously PNC-TDB), for the performance analysis of geological isolation system for high-level radioactive wastes. Thermodynamic data for the formation of complexes or compounds with hydroxide, chloride, fluoride, carbonate, nitrate, sulfate and phosphate are discussed in this report. Where data for specific actinide(IV) species was lacking, the data were selected based on chemical analogy to other tetravalent actinides. In this study, the Pitzer ion-interaction model is used to extrapolate thermodynamic constants to zero ionic strength at 25degC. (author)

  20. About the structure and stability of complex carbonates of thorium (IV), cerium (IV), zirconium (IV), hafnium (IV)

    International Nuclear Information System (INIS)

    Dervin, Jacqueline

    1972-01-01

    This research thesis addressed the study of complex carbonates of cations of metals belonging to the IV A column, i.e. thorium (IV), zirconium (IV), hafnium (IV), and also cerium (IV) and uranium (VI), and more particularly focused on ionic compounds formed in solution, and also on the influence of concentration and nature of cations on stability and nature of the formed solid. The author first presents methods used in this study, discusses their precision and scope of validity. She reports the study of the formation of different complex ions which have been highlighted in solution, and the determination of their formation constants. She reports the preparation and study of the stability domain of solid complexes. The next part reports the use of thermogravimetric analysis, IR spectrometry, and crystallography for the structural study of these compounds

  1. Safety Design Criteria (SDC) for Gen-IV Sodium-cooled Fast Reactor

    International Nuclear Information System (INIS)

    Nakai, Ryodai

    2013-01-01

    SDC Development Background & Objectives: • Safety Design Criteria (SDC) Development for Gen-IV SFR: – Proposed at the GIF Policy Group (PG) meeting in October 2010 –SDC “harmonization” is increasingly important for: • Realization of enhanced safety designs meeting to Gen-IV safety goals and safety approach common to SFR systems; • Preparation for the forthcoming licensing in the near future; • Because Gen-IV SFR are progressing into conceptual design stage. • The SDC is the Reference criteria: – Of the designs of safety-related Structures, Systems & Components that are specific to the SFR system; – For clarifying the requisites systematically & comprehensively; – When the technology developers apply the basic safety approach and use the codes & standards for conceptual design of the Gen-IV SFR system

  2. CT staging of renal cell carcinoma using the revised 1997 TNM staging criteria: in comparison with the previous one

    International Nuclear Information System (INIS)

    Sung, Deuk Jae; Kim, Yun Hwan; Chung, Hwan Hoon; Chung, Kyoo Byung; Suh, Won Hyuck

    2001-01-01

    To assess the accuracy of preoperative CT staging of RCC and to compare the relationship between T stage and the incidence of metastasis on the basis of the old (1992) and the new (1997) UICC and AJCC tumor classification system. In 112 cases of surgically resected RCC, the stagings of preoperative CT scans were determined retrospectively by two radiologists and were compared with the results of pathologic examinations. In 70 cases which had been followed up over three years after surgery, the incidence of metastasis at initial diagnosis and during the follow-up period was assessed. All cases were reconsidered, and using the old and the new TNM classification, the incidence of metastasis was compared. According to the old TNM classification, 5 cases (4%) were staged at T1, 73(65%) at T2, 21(19%) at T3a, 9(8%) at T3b, 0 at T3c, and 4(4%) at T4. Using the new TNM classification, we also staged 54 cases (48%) at T1 and 24(21%) at T2. Overall, using this new classification, CT correctly staged 79% of patients (88/112) overstaged 15%(17/112) and understaged 6%(7/112). CT had a sensitivity of 84% and specificity of 91% in new T1 tumors, 71% and 95%, respectively, in new T2 tumors, 69% and 88% in T3a tumors, 78% and 98% in T3b tumors, and 75% and 99% in T4 tumors. CT had a sensitivity of 44% and a specificity of 99% in old T1 tumors, and 82% and 71%, respectively, in old T2 tumors. The incidence of metastasis in CT-staged (cT) tumors was 0% (0/4) in old cT1, 8% (3/39) in new cT1, 29% (4/14) in new cT2, 67% (6/9) in cT3a, and 75% (6/8) in cT3b. In the staging of T1 tumors, CT is more sensitive when the new TNM classification is used. Even though the cut off point between T1 and T2 tumors had been in creased from 2.5 to 7.0 cm, T1 tumors staged according to the new system did not show a significantly higher incidence of metastasis than those staged according to the old

  3. 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

  4. [Diagnostic values of serum type III procollagen N-terminal peptide in type IV gastric cancer].

    Science.gov (United States)

    Akazawa, S; Fujiki, T; Kanda, Y; Kumai, R; Yoshida, S

    1985-04-01

    Since increased synthesis of collagen has been demonstrated in tissue of type IV gastric cancer, we attempted to distinguish type IV gastric cancer from other cancers by measuring serum levels of type III procollagen N-terminal peptide (type III-N-peptide). Mean serum levels in type IV gastric cancer patients without metastasis were found to be elevated above normal values and developed a tendency to be higher than those in types I, II and III gastric cancer patients without metastasis. Highly positive ratios were found in patients with liver diseases including hepatoma and colon cancer, biliary tract cancer, and esophageal cancer patients with liver, lung or bone metastasis, but only 2 out of 14 of these cancer patients without such metastasis showed positive serum levels of type III-N-peptide. Positive cases in patients with type IV gastric cancer were obtained not only in the group with clinical stage IV but also in the groups with clinical stages II and III. In addition, high serum levels of type III-N-peptide in patients with type IV gastric cancer were seen not only in the cases with liver, lung or bone metastasis but also in cases with disseminated peritoneal metastasis alone. These results suggest that if the serum level of type III-N-peptide is elevated above normal values, type IV gastric cancer should be suspected after ruling out liver diseases, myelofibrosis and liver, lung or bone metastasis.

  5. Daily concurrent chemoradiotherapy using superselective intra-arterial infusion via superficial temporal artery. Preoperative therapy for stage III, IV oral cancer

    International Nuclear Information System (INIS)

    Tohnai, Iwai; Mitsudo, Kenji; Nishiguchi, Hiroaki; Fukui, Takafumi; Yamamoto, Noriyuki; Ueda, Minoru; Fuwa, Nobukazu

    2005-01-01

    Recently, daily concurrent chemoradiotherapy using new superselective intra-arterial infusion via superficial temporal arterial artery is attracting attention. The catheter with curved tip is inserted superselectively to the feeding artery of the tumor via the superficial temporal artery, allowing long-term catheterization. Forty-one patients with stage III, IV oral cancer were treated. Radiotherapy (total dose: 40 Gy/4 weeks) and superselective intra-arterial infusion chemotherapy using docetaxel (total dose: 60 mg/m 2 , 15 mg/m 2 /week) and cisplatin (total dose: 100 mg/m 2 , 5 mg/m 2 /day) were concurrently performed daily, followed by surgery. In 35 patients, intra-arterial infusion was successful (success rate: 85.4%) and no major complication was observed. The clinical effects were complete response (CR) in 29 patients (82.9%), and pathological effects of resected tumor after surgery were pathological CR in 31 (88.6%). This method promises to be a new strategy of choice for the treatment of oral cancer. (author)

  6. The newly proposed clinical and post-neoadjuvant treatment staging classifications for gastric adenocarcinoma for the American Joint Committee on Cancer (AJCC) staging.

    Science.gov (United States)

    In, Haejin; Ravetch, Ethan; Langdon-Embry, Marisa; Palis, Bryan; Ajani, Jaffer A; Hofstetter, Wayne L; Kelsen, David P; Sano, Takeshi

    2018-01-01

    New stage grouping classifications for clinical (cStage) and post-neoadjuvant treatment (ypStage) stage for gastric adenocarcinoma have been proposed for the eighth edition of the AJCC manual. This article summarizes the analysis for these stages. Gastric adenocarcinoma patients diagnosed in 2004-2009 were identified from the National Cancer Database (NCDB). The cStage cohort included both surgical and nonsurgical cases, and the ypStage cohort included only patients who had chemotherapy or radiation therapy before surgery. Survival differences between the stage groups were determined by the log-rank test and prognostic accuracy was assessed by concordance index. Analysis was performed using SAS 9.4 (SAS, Cary, NC, USA). Five strata for cStage and four strata for ypStage were developed. The 5-year survival rates for cStages were 56.77%, 47.39%, 33.1%, 25.9%, and 5.0% for stages I, IIa, IIb, III, and IV, respectively, and the rates for ypStage were 74.2%, 46.3%, 19.2%, and 11.6% for stages I, II, III, and IV, respectively. The log-rank test showed that survival differences were well stratified and stage groupings were ordered and distinct (p < 0.0001). The proposed cStage and ypStage classification was sensitive and specific and had high prognostic accuracy (cStage: c index = 0.81, 95% CI, 0.79-0.83; ypStage: c index = 0.80, 95% CI, 0.73-0.87). The proposed eighth edition establishes two new staging schemata that provide essential prognostic data for patients before treatment and for patients who have undergone surgery following neoadjuvant therapy. These additions are a significant advance to the AJCC staging manual and will provide critical guidance to clinicians in making informed decisions throughout the treatment course.

  7. Prognostic Value of Bismuth Typing and Modified T-stage in Hilar Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Shengen Yi

    2015-01-01

    Conclusion: The majority of our patients with HCC were characterized as Subtype IV in Bismuth typing and Stage T3 in modified T-stage. Both Bismuth typing and modified T-stage showed prognostic value in HCC. Compared with Bismuth typing, modified T-stage is a better indicator of the resectability of HCC.

  8. Results of paclitaxel (day 1 and 8 and carboplatin given on every three weeks in advanced (stage III-IV non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Salepci Taflan

    2005-01-01

    Full Text Available Abstract Background Both paclitaxel (P and carboplatin (C have significant activity in non-small cell lung cancer (NSCLC. The weekly administration of P is active, dose intense, and has a favorable toxicity profile. We retrospectively reviewed the data of 51 consecutive patients receiving C and day 1 and 8 P chemotherapy (CT regimen in advanced stage NSCLC to evaluate the efficacy and toxicity. Methods Patients treated in our institutions having pathologically proven NSCLC, no CNS metastases, adequate organ function and performance status (PS ECOG 0–2 were given P 112.5 mg/m2 intravenously (IV over 1 hour on day 1 and 8, followed by C AUC 5 IV over 1 hour, repeated in every three weeks. PC was given for maximum of 6 cycles. Results Median age was 58 (age range 39–77 and 41 patients (80% were male. PS was 0/1/2 in 29/17/5 patients and stage was IIIA/IIIB/IV in 3/14/34 patients respectively. The median number of cycles administered was 3 (1–6. Seven patients (14% did not complete the first 3 cycles either due to death, progression, grade 3 hypersensitivity reactions to P or lost to follow up. Best evaluable response was partial response (PR in 45% and stable disease (SD in 18%. Twelve patients (24% received local RT. Thirteen patients (25% received 2nd line CT at progression. At a median follow-up of 7 months (range, 1–20, 25 (49% patients died and 35 patients (69% progressed. Median overall survival (OS was 11 ± 2 months (95% CI; 6 to 16, 1-year OS ratio was 44%. Median time to progression (TTP was 6 ± 1 months (95% CI; 4 to 8, 1-year progression free survival (PFS ratio was 20%. We observed following grade 3 toxicities: asthenia (10%, neuropathy (4%, anorexia (4%, anemia (4%, hypersensitivity to P (2%, nausea/vomiting (2%, diarrhea (2% and neutropenia (2%. Two patients (4% died of febrile neutropenia. Doses of CT were reduced or delayed in 12 patients (24%. Conclusions P on day 1 and 8 and C every three weeks is practical and fairly

  9. Results of radiation therapy combined with neoadjuvant hormonal therapy for stage III prostate cancer. Comparison of two different definitions of PSA failure

    International Nuclear Information System (INIS)

    Mitsumori, Michihide; Sasaki, Yoshihide; Mizowaki, Takashi

    2006-01-01

    We herein report the clinical outcome of radical radiation therapy combined with neoadjuvant hormonal therapy (NHT) for stage III (International Union Against Cancer [UICC] 1997: UICC 97) prostate cancer. Prostate-specific antigen (PSA) failure-free survival was assessed according to two different definitions, and the appropriateness of each definition is discussed. Between October 1997 and December 2000, 27 patients with stage III prostate cancer were enrolled in this study. The median pretreatment PSA level was 29 ng/ml (range, 7.4-430 ng/ml). The Gleason score (GS) was 7 or more in 22 patients (81%). All patients received 3 months of NHT with a luteinizing hormone-releasing hormone (LH-RH) analogue, in combination with an antiandrogen (flutamide), given during the first 2 weeks, followed by 70-Gy external-beam radiation therapy (EBRT) in 35 fractions. The initial 46 Gy was given with a four-field technique, while the remainder was given with a dynamic conformal technique. No adjuvant hormonal therapy (AHT) was given. The median follow-up time was 63 months. PSA levels decreased to the normal range (<4 ng/ml) after irradiation in all but one patient. The 5-year PSA failure-free survival was 34.8% according to the American Society for Therapeutic Radiology and Oncology (ASTRO) definition and it was 43.0% according to the ''nadir plus 2'' definition. Discordance of the results between the two definitions was seen in two patients. The 5-year overall and cause-specific survivals were 83.0% and 93.3%, respectively. No severe acute or late adverse effects were observed. Seventy Gy of EBRT following 3 months of NHT produced therapeutic results comparable to those reported in other studies which used long-term AHT. The value of long-term AHT for Japanese men should be tested in a clinical trial. (author)

  10. Long-term survival in inoperable squamous cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Ono, Ryosuke; Egawa, Sunao

    1988-01-01

    Radiotherapy is the first treatment of choice in cases of inoperable lung cancer. This paper reported the indications and limitations of radiotherapy for squamous cell carcinoma of the lung, based on the results of long-term survivors among non-resected squamous cell carcinoma. Materials consisted of 372 cases of squamous cell carcinoma of the lung treated with radiotherapy at the National Cancer Center Hospital between May 1962 and December 1980. Histopathological diagnosis was confirmed by biopsy in all cases. Among the 372 cases, 8 survived more than 5 years. Analyzing these 8 cases according to the TNM classification of the UICC, 7 were stage I, 1 was stage II, and there were no long-term survivors with stage III or IV. Of the 8 cases only one is alive. Analyzing 7 the fatal cases, 2 succumbed due to hepatic or brain metatasis following local recurrence and one had double primary cancer of the pancreas. The remaining 4 cases did not show recurrence or metastasis and succumbed due to pneumonia or myocardial infarct. (author)

  11. Radiotherapy for esophageal cancer

    International Nuclear Information System (INIS)

    Oshitani, Takashi; Kuwata, Yoichiro; Kano, Kyoko

    1988-01-01

    Esophageal carcinoma were treated by high-dose-rate intracavitary irradiation using specially designed balloon application at Hyogo medical Center for Adults. 32 patients were treated from January 1982 through July 1986. According to the stage of UICC (1978), 10 patients were classified into stage I, 7 into II, 13 into III and 2 into IV. Acturial 5 year survival rate was 17.9 % in all 32 patients and that of 23 patients who received radical radiotherapy was 24 %. Local CR rate was 66 %. However, since 9 (53 %) of 17 CR patients were relapsed, local control rate for 2 years was 25 %. Mild adverse effects were experienced in 9 (47 %) of 19 CR patients. Our balloon applicator was easily fixed, could have an adequate space from esophageal mucosa and clarify the tumor site by filling with 20 % gastrografin. It is concluded that high-dose-rate intracavitary irradiation with our balloon applicator is an effective boost therapy and decline a lethal adverse effect in radiotherapy for esophageal carcinoma. (author)

  12. Complete pathological response (ypT0N0M0) after preoperative chemotherapy alone for stage IV rectal cancer.

    Science.gov (United States)

    Naiken, Surennaidoo P; Toso, Christian; Rubbia-Brandt, Laura; Thomopoulos, Theodoros; Roth, Arnaud; Mentha, Gilles; Morel, Philippe; Gervaz, Pascal

    2014-01-17

    Complete pathological response occurs in 10-20% of patients with rectal cancer who are treated with neoadjuvant chemoradiation therapy prior to pelvic surgery. The possibility that complete pathological response of rectal cancer can also occur with neoadjuvant chemotherapy alone (without radiation) is an intriguing hypothesis. A 66-year old man presented an adenocarcinoma of the rectum with nine liver metastases (T3N1M1). He was included in a reverse treatment, aiming at first downsizing the liver metastases by chemotherapy, and subsequently performing the liver surgery prior to the rectum resection. The neoadjuvant chemotherapy consisted in a combination of oxaliplatin, 5-FU, irinotecan, leucovorin and bevacizumab (OCFL-B). After a right portal embolization, an extended right liver lobectomy was performed. On the final histopathological analysis, all lesions were fibrotic, devoid of any viable cancer cells. One month after liver surgery, the rectoscopic examination showed a near-total response of the primary rectal adenocarcinoma, which convinced the colorectal surgeon to perform the low anterior resection without preoperative radiation therapy. Macroscopically, a fibrous scar was observed at the level of the previously documented tumour, and the histological examination of the surgical specimen did not reveal any malignant cells in the rectal wall as well as in the mesorectum. All 15 resected lymph nodes were free of tumour, and the final tumour stage was ypT0N0M0. Clinical outcome was excellent, and the patient is currently alive 5 years after the first surgery without evidence of recurrence. The presented patient with stage IV rectal cancer and liver metastases was in a unique situation linked to its inclusion in a reversed treatment and the use of neoadjuvant chemotherapy alone. The observed achievement of a complete pathological response after chemotherapy should promote the design of prospective randomized studies to evaluate the benefits of chemotherapy

  13. Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer.

    Science.gov (United States)

    Alawadi, Zeinab; Phatak, Uma R; Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy; Kao, Lillian S; Massarweh, Nader N; Feig, Barry W; Rodriguez-Bigas, Miguel A; Skibber, John M; Chang, George J

    2017-04-01

    Although the safety of combination chemotherapy without primary tumor resection (PTR) in patients with stage IV colon cancer has been established, questions remain regarding a potential survival benefit with PTR. The objective of this study was to compare mortality rates in patients who had colon cancer with unresectable metastases who did and did not undergo PTR. An observational cohort study was conducted among patients with unresectable metastatic colon cancer identified from the National Cancer Data Base (2003-2005). Multivariate Cox regression analyses with and without propensity score weighting (PSW) were performed to compare survival outcomes. Instrumental variable analysis, using the annual hospital-level PTR rate as the instrument, was used to account for treatment selection bias. To account for survivor treatment bias, in situations in which patients might die soon after diagnosis from different reasons, a landmark method was used. In the total cohort, 8641 of 15,154 patients (57%) underwent PTR, and 73.8% of those procedures (4972 of 6735) were at landmark. PTR was associated with a significant reduction in mortality using Cox regression (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.44-0.47) or PSW (HR, 0.46; 95% CI, 0. 44-0.49). However, instrumental variable analysis revealed a much smaller effect (relative mortality rate, 0.91; 95% CI, 0.87-0.96). Although a smaller benefit was observed with the landmark method using Cox regression (HR, 0.6; 95% CI, 0.55-0.64) and PSW (HR, 0.59; 95% CI, 0.54-0.64), instrumental variable analysis revealed no survival benefit (relative mortality rate, 0.97; 95% CI, 0.87-1.06). Among patients with unresectable metastatic colon cancer, after adjustment for confounder effects, PTR was not associated with improved survival compared with systemic chemotherapy; therefore, routine noncurative PTR is not recommended. Cancer 2017;123:1124-1133. © 2016 American Cancer Society. © 2016 American Cancer Society.

  14. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

  15. Autoimmune gastritis: histology phenotype and OLGA staging.

    Science.gov (United States)

    Rugge, M; Fassan, M; Pizzi, M; Zorzetto, V; Maddalo, G; Realdon, S; De Bernard, M; Betterle, C; Cappellesso, R; Pennelli, G; de Boni, M; Farinati, F

    2012-06-01

    Among Western populations, the declining incidence of Helicobacter pylori infection coincides with a growing clinical impact of autoimmune gastritis. To describe the histological phenotype of autoimmune gastritis, also to test the prognostic impact of OLGA staging in the autoimmune setting. A single-institutional series (spanning the years 2003-2011) of 562 consecutive patients (M:F ratio: 1:3.7; mean age = 57.6 ± 14.4 years) with serologically confirmed autoimmune gastritis underwent histology review and OLGA staging. Helicobacter pylori infection was ascertained histologically in 44/562 cases (7.8%). Forty six biopsy sets (8.2%) featured OLGA stages III-IV; they included all four cases of incidental epithelial neoplasia (three intraepithelial and one invasive; three of these four cases had concomitant H. pylori infection). There were 230 (40.9%) and 139 (24.7%) cases, respectively, of linear and micro-nodular enterochromaffin-like cell hyperplasia; 19 (3.4%) type I carcinoids were detected. The series included 116 patients who underwent repeated endoscopy/biopsy sampling (mean time elapsing between the two procedures = 54 months; range 24-108). Paired histology showed a significant (P = 0.009) trend towards a stage progression [the stage increased in 25/116 cases (22%); it remained unchanged in 87/116 cases (75%)]. In autoimmune gastritis, the cancer risk is restricted to high-risk gastritis stages (III-IV), and is associated mainly with concomitant H. pylori infection. OLGA staging consistently depicts the time-dependent organic progression of the autoimmune disease and provides key information for secondary gastric cancer prevention strategies. © 2012 Blackwell Publishing Ltd.

  16. Phase 2 Study of Docetaxel, Cisplatin, and Concurrent Radiation for Technically Resectable Stage III-IV Squamous Cell Carcinoma of the Head and Neck

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    Inohara, Hidenori, E-mail: hinohara@ent.med.osaka-u.ac.jp [Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Faculty of Medicine, Suita, Osaka (Japan); Takenaka, Yukinori; Yoshii, Tadashi; Nakahara, Susumu; Yamamoto, Yoshifumi; Tomiyama, Yoichiro [Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Faculty of Medicine, Suita, Osaka (Japan); Seo, Yuji; Isohashi, Fumiaki; Suzuki, Osamu; Yoshioka, Yasuo; Sumida, Iori; Ogawa, Kazuhiko [Department of Radiation Oncology, Osaka University Faculty of Medicine, Suita, Osaka (Japan)

    2015-04-01

    Purpose: We investigated the efficacy and safety of weekly low-dose docetaxel and cisplatin therapy concurrent with conventionally fractionated radiation in patients with technically resectable stage III-IV squamous cell carcinoma of the head and neck. Methods and Materials: Between March 2004 and October 2011, we enrolled 117 patients, of whom 116 were analyzable (43 had oropharyngeal cancer, 54 had hypopharyngeal cancer, and 19 had laryngeal cancer), and 85 (73%) had stage IV disease. Radiation consisted of 66 Gy in 33 fractions. Docetaxel, 10 mg/m{sup 2}, followed by cisplatin, 20 mg/m{sup 2}, administered on the same day were given once a week for 6 cycles. The primary endpoint was overall complete response (CR) rate after chemoradiation therapy. Human papillomavirus (HPV) DNA in oropharyngeal cancer was examined by PCR. Results: Of 116 patients, 82 (71%) completed treatment per protocol; 102 (88%) received the full radiation therapy dose; and 90 (78%) and 12 (10%) patients received 6 and 5 chemotherapy cycles, respectively. Overall CR rate was 71%. After median follow-up of 50.9 months (range: 15.6-113.9 months for surviving patients), 2-year and 4-year overall survival rates were 82% and 68%, respectively. Cumulative 2-year and 4-year local failure rates were 27% and 28%, respectively, whereas distant metastasis rates were 15% and 22%, respectively. HPV status in oropharyngeal cancer was not associated with treatment efficacy. Acute toxicity included grade 3 and 4 in-field mucositis in 73% and 5% of patients, respectively, whereas myelosuppression and renal injury were minimal. No patients died of toxicity. Feeding tube dependence in 8% and tracheostomy in 1% of patients were evident at 2 years postchemoradiation therapy in patients who survived without local treatment failure. Conclusions: Local control and survival with this regimen were satisfactory. Although acute toxicity, such as mucositis, was common, late toxicity, such as laryngoesophageal

  17. An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting

    Energy Technology Data Exchange (ETDEWEB)

    Allal, A.S. [Geneva Univ. Hospital (Switzerland). Div. of Radiation Oncology; Monney, M.; Rosset, A.; Ozsahin, M. [Hopital Cantonal Universitaire, Lausanne (Switzerland). Inst. de Radiographie; Guillemin, C. [Cantonal Radiotherapy Department Sion (Switzerland)

    2000-01-01

    Background: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. Patients and Methods: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.9 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2x1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). Results: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. Conclusions: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials. (orig.) [German] Hintergrund: Die Wirksamkeit der akzelerierten Bestrahlung in bezug auf die Bewaeltigung der Tumorzellrepopulation waehrend einer Radiotherapie ist vor kurzem nachgewiesen worden. Das Verhaeltnis zwischen therapeutischem Effekt und Toxizitaet duerfte fuer fuenfwoechige Schemen

  18. Detection of EGFR mutations with mutation-specific antibodies in stage IV non-small-cell lung cancer

    Directory of Open Access Journals (Sweden)

    Viteri Santiago

    2010-12-01

    Full Text Available Abstract Background Immunohistochemistry (IHC with mutation-specific antibodies may be an ancillary method of detecting EGFR mutations in lung cancer patients. Methods EGFR mutation status was analyzed by DNA assays, and compared with IHC results in five non-small-cell lung cancer (NSCLC cell lines and tumor samples from 78 stage IV NSCLC patients. Results IHC correctly identified del 19 in the H1650 and PC9 cell lines, L858R in H1975, and wild-type EGFR in H460 and A549, as well as wild-type EGFR in tumor samples from 22 patients. IHC with the mAb against EGFR with del 19 was highly positive for the protein in all 17 patients with a 15-bp (ELREA deletion in exon 19, whereas in patients with other deletions, IHC was weakly positive in 3 cases and negative in 9 cases. IHC with the mAb against the L858R mutation showed high positivity for the protein in 25/27 (93% patients with exon 21 EGFR mutations (all with L858R but did not identify the L861Q mutation in the remaining two patients. Conclusions IHC with mutation-specific mAbs against EGFR is a promising method for detecting EGFR mutations in NSCLC patients. However these mAbs should be validated with additional studies to clarify their possible role in routine clinical practice for screening EGFR mutations in NSCLC patients.

  19. A COMPARATIVE STUDY OF EFFICACY OF HYOSCINE BROMIDE (IV VERSUS TRAMADOL (IM VERSUS PARACETAMOL (IV ON CERVICAL DILATATION IN ACTIVE LABOUR

    Directory of Open Access Journals (Sweden)

    Sampathukumari S

    2016-09-01

    Full Text Available Labour is a natural process, which involves a series of regular and progressive uterine contractions causing effacement and dilatation of cervix leading to birth of the baby. In order to minimise the perinatal morbidity and mortality caused by the prolonged labour, several drugs have been tried to hasten the process of cervical dilatation and this study in one such exercise. AIM OF THE STUDY 1 To compare the efficacy of Hyoscine Bromide (IV vs. Tramadol (IM vs. Paracetamol (IV on cervical dilatation in active labour. 2 To compare the duration of active phase of labour. 150 full-term women with gestational age 37-42 weeks, primi and multi singleton pregnancy with cephalic presentation in active labour were included in the study. Cases were divided into 3 groups - Group A: 50 cases of labour accelerated by Hyoscine Bromide 20 mg (IV, Group B: 50 cases of labour accelerated by Tramadol 50 mg (IM and Group C: 50 cases of labour accelerated by Paracetamol 500 mg (IV. Mean duration of active phase of 1st stage of labour was 3 hrs. 8 mins. (primi and 2 hrs. 3 mins. (multi in Hyoscine Bromide group and 4 hrs. 8 mins. (primi and 3 hrs. 5 mins. (multi in Tramadol group and 4 hrs. 2 mins. (primi and 2 hrs. 5 mins. (multi in Paracetamol group. Mean rate of cervical dilatation was 1.5 cm/hr (primi and 2.6 cm/hr (multi in Hyoscine Bromide group, 1.2 cm/hr (primi and 1.6 cm/hr (multi in Tramadol group and 1.3 cm/hr (primi and 1.6 cm/hr (multi in the Paracetamol group. The difference between the groups A and B and A and C is significant (p=0.0001 and thus it is concluded that Hyoscine Bromide hastened the rate of cervical dilatation and reduced the duration of active phase of 1 st stage of labour. Divide the abstract into materials and methods, results and conclusion.

  20. Primary photochemical processes for Pt(iv) diazido complexes prospective in photodynamic therapy of tumors.

    Science.gov (United States)

    Shushakov, Anton A; Pozdnyakov, Ivan P; Grivin, Vjacheslav P; Plyusnin, Victor F; Vasilchenko, Danila B; Zadesenets, Andrei V; Melnikov, Alexei A; Chekalin, Sergey V; Glebov, Evgeni M

    2017-07-25

    Diazide diamino complexes of Pt(iv) are considered as prospective prodrugs in oxygen-free photodynamic therapy (PDT). Primary photophysical and photochemical processes for cis,trans,cis-[Pt(N 3 ) 2 (OH) 2 (NH 3 ) 2 ] and trans,trans,trans-[Pt(N 3 ) 2 (OH) 2 (NH 3 ) 2 ] complexes were studied by means of stationary photolysis, nanosecond laser flash photolysis and ultrafast kinetic spectroscopy. The process of photolysis is multistage. The first stage is the photosubstitution of an azide ligand to a water molecule. This process was shown to be a chain reaction involving redox stages. Pt(iv) and Pt(iii) intermediates responsible for the chain propagation were recorded using ultrafast kinetic spectroscopy and nanosecond laser flash photolysis. The mechanism of photosubstitution is proposed.

  1. Gene expression patterns in CD4+ peripheral blood cells in healthy subjects and stage IV melanoma patients.

    Science.gov (United States)

    Felts, Sara J; Van Keulen, Virginia P; Scheid, Adam D; Allen, Kathleen S; Bradshaw, Renee K; Jen, Jin; Peikert, Tobias; Middha, Sumit; Zhang, Yuji; Block, Matthew S; Markovic, Svetomir N; Pease, Larry R

    2015-11-01

    Melanoma patients exhibit changes in immune responsiveness in the local tumor environment, draining lymph nodes, and peripheral blood. Immune-targeting therapies are revolutionizing melanoma patient care increasingly, and studies show that patients derive clinical benefit from these newer agents. Nonetheless, predicting which patients will benefit from these costly therapies remains a challenge. In an effort to capture individual differences in immune responsiveness, we are analyzing patterns of gene expression in human peripheral blood cells using RNAseq. Focusing on CD4+ peripheral blood cells, we describe multiple categories of immune regulating genes, which are expressed in highly ordered patterns shared by cohorts of healthy subjects and stage IV melanoma patients. Despite displaying conservation in overall transcriptome structure, CD4+ peripheral blood cells from melanoma patients differ quantitatively from healthy subjects in the expression of more than 2000 genes. Moreover, 1300 differentially expressed genes are found in transcript response patterns following activation of CD4+ cells ex vivo, suggesting that widespread functional discrepancies differentiate the immune systems of healthy subjects and melanoma patients. While our analysis reveals that the transcriptome architecture characteristic of healthy subjects is maintained in cancer patients, the genes expressed differentially among individuals and across cohorts provide opportunities for understanding variable immune states as well as response potentials, thus establishing a foundation for predicting individual responses to stimuli such as immunotherapeutic agents.

  2. Nuclear grade and DNA ploidy in stage IV breast cancer with only visceral metastases at initial diagnosis.

    Science.gov (United States)

    De Lena, M; Barletta, A; Marzullo, F; Rabinovich, M; Leone, B; Vallejo, C; Machiavelli, M; Romero, A; Perez, J; Lacava, J; Cuevas, M A; Rodriguez, R; Schittulli, F; Paradisco, A

    1996-01-01

    The presence of early metastases to distant sites in breast cancer patients is an infrequent event whose mechanisms are still not clear. The aim of this study was to evaluate the biologic and clinical role of DNA ploidy and cell nuclear grade of primary tumors in the metastatic process of a series of stage IV previously untreated breast cancer patients with only visceral metastases. DNA flow cytometry analysis on paraffin-embedded material and cell nuclear grading of primary tumors was performed on a series of 50 breast cancer patients with only visceral metastases at the time of initial diagnosis. Aneuploidy was found in 28/46 (61%) of evaluable cases and was independent of site of involvement, clinical response, time of progression and overall survival of patients. Of the 46 cases evaluable for nuclear grade, 5 (11%), 16 (35%) and 25 (54%) were classified as G1 (well-differentiated) G2 and G3, respectively. Nuclear grade also was unrelated to response to therapy and overall survival, whereas time to progression was significantly longer in G1-2 than G3 tumors with the logrank test (P < 0.03) and multivariate analysis. Our results seem to stress the difficulty to individualize different prognostic subsets from a series of breast cancer patients with only visceral metastases at initial diagnosis according to DNA flow cytometry and nuclear grade.

  3. Magnetic resonance for T-staging of nasopharyngeal carcinoma. The most informative pair of sequences

    International Nuclear Information System (INIS)

    Lau, Kam Y.; Kan, Wai K.; Sze, Wai M.

    2004-01-01

    The objective of this study was to evaluate the most informative pair of sequences in magnetic resonance (MR) for T-staging of nasopharyngeal carcinoma (NPC). The MR images of 134 patients with newly diagnosed NRC, from 1996 to 2002, were retrospectively reviewed. All the patients were scanned using 1.5 Tesla MR systems. The images of the nasopharynx were reviewed by two qualified radiologists to determine the positive findings and the T-stage by Union Internationale Contre le Cancer (UICC) (6th edition) System, using each sequence separately. The T-stage derived from a single MR sequence was then compared with the T-stage based on the five selected sequences to assess the number and percentage of patients who were being understaged. Therefore, the overall percentage accuracy of each single sequence could be determined. A pair of sequences providing information to achieve almost 100% diagnostic accuracy was then derived. The overall percentage accuracy of five individual sequences of the nasopharynx is as follows: contrast-enhanced (CE) fat suppression (FS) axial T1 (94.8%), CE FS coronal T1 (88.1%), FS axial T2 (85.8%), non-contrast enhanced (NE) axial T1 (78.4%) and NE coronal T1 (77.6%). CE FS axial T1 has the best accuracy. All the structures that are missed in CE FS axial T1 which lead to apparent understaging, are appreciated in NE axial T1-weighted images. Individual sequences supplement each other in the NPC staging. CE FS axial T1 is the most informative individual sequence. Combination of CE FS axial T1 and NE axial T1 of the nasopharynx provides sufficient information to achieve almost 100% diagnostic accuracy in T-staging; therefore, both should be included in the MR-staging protocol. (author)

  4. Colorectal cancer stages transcriptome analysis.

    Directory of Open Access Journals (Sweden)

    Tianyao Huo

    Full Text Available Colorectal cancer (CRC is the third most common cancer and the second leading cause of cancer-related deaths in the United States. The purpose of this study was to evaluate the gene expression differences in different stages of CRC. Gene expression data on 433 CRC patient samples were obtained from The Cancer Genome Atlas (TCGA. Gene expression differences were evaluated across CRC stages using linear regression. Genes with p≤0.001 in expression differences were evaluated further in principal component analysis and genes with p≤0.0001 were evaluated further in gene set enrichment analysis. A total of 377 patients with gene expression data in 20,532 genes were included in the final analysis. The numbers of patients in stage I through IV were 59, 147, 116 and 55, respectively. NEK4 gene, which encodes for NIMA related kinase 4, was differentially expressed across the four stages of CRC. The stage I patients had the highest expression of NEK4 genes, while the stage IV patients had the lowest expressions (p = 9*10-6. Ten other genes (RNF34, HIST3H2BB, NUDT6, LRCh4, GLB1L, HIST2H4A, TMEM79, AMIGO2, C20orf135 and SPSB3 had p value of 0.0001 in the differential expression analysis. Principal component analysis indicated that the patients from the 4 clinical stages do not appear to have distinct gene expression pattern. Network-based and pathway-based gene set enrichment analyses showed that these 11 genes map to multiple pathways such as meiotic synapsis and packaging of telomere ends, etc. Ten of these 11 genes were linked to Gene Ontology terms such as nucleosome, DNA packaging complex and protein-DNA interactions. The protein complex-based gene set analysis showed that four genes were involved in H2AX complex II. This study identified a small number of genes that might be associated with clinical stages of CRC. Our analysis was not able to find a molecular basis for the current clinical staging for CRC based on the gene expression patterns.

  5. The utility of serum CA-125 in predicting extra-uterine disease in apparent early-stage endometrial cancer.

    Science.gov (United States)

    Nicklin, James; Janda, Monika; Gebski, Val; Jobling, Thomas; Land, Russell; Manolitsas, Tom; McCartney, Anthony; Nascimento, Marcelo; Perrin, Lewis; Baker, Jannah F; Obermair, Andreas

    2012-08-15

    Surgical staging in early-stage uterine cancer is controversial. Preoperative serum CA-125 may be of clinical value in predicting the presence of extra-uterine disease in patients with apparent early-stage endometrial cancer. Between October 6, 2005, and June 17, 2010, 760 patients were enrolled in an international, multicentre, prospective randomized trial (LACE) comparing laparotomy with laparoscopy in the management of endometrial cancer apparently confined to the uterus. Of these, 657 patients with endometrial adenocarcinoma had a preoperative serum CA-125 value recorded. Multiple cross-validation analysis was undertaken to correlate preoperative serum CA-125 with stage of disease (Stage I vs. Stage II+) after surgery. Patients' median preoperative serum CA-125 was 14 U/ml. A cutoff point of 30 U/ml was associated with the smallest misclassification error, and using this cutoff, 98 patients (14.9%) had elevated CA-125 levels. Of those, 36 (36.7%) had evidence of extra-uterine disease. Of the 116 patients (17.7%) with evidence of extra-uterine disease, 31.0% had an elevated CA-125 level. On univariate and multivariable logistic regression analysis, only preoperative CA-125 level, but no other preoperative clinical characteristics were found to be associated with extra-uterine spread of disease. Utilizing a cutoff point of 30 U/ml achieved a sensitivity, specificity, positive predictive value and negative predictive value of 31.0, 88.5, 36.7 and 85.7%, respectively. Elevated CA-125 above 30 U/ml in patients with apparent early-stage disease is a risk factor for the presence of extra-uterine disease and may assist clinicians in the management of patients with clinical Stage I endometrial cancer. Copyright © 2011 UICC.

  6. 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.

    Science.gov (United States)

    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.

  7. Daily concurrent chemoradiotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via the superficial temporal artery for stage III and IV oral cancer. Possibility of organ preservation in advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Tohnai, Iwai; Fuwa, Nobukazu

    2006-01-01

    Superselective intra-arterial chemotherapy via the superficial temporal artery has become feasible for daily concurrent radiotherapy and chemotherapy for head and neck cancer. This novel method was used for oral cancer, and its efficacy was evaluated. Treatment consisted of superselective intra-arterial infusions (Docetaxel (DOC) total 60 mg/m 2 , Cisplatin (CDDP) total 100 mg/m 2 ) and concurrent radiotherapy (total 40 Gy) for four weeks as preoperative therapy. Thirty-four patients with stage III and IV oral cancer received surgery after this treatment, and pathological CR was obtained in 31 patients (91%). The possibility of organ preservation for advanced oral cancer was evaluated from this result. Patients with oral cancer stage III and IV were treated for four-week daily concurrent chemoradiotherapy, and the clinical response was evaluated after treatment. Clinical CR of primary sites was obtained in 15 patients, and the same treatment was continued one or two weeks. Thirteen patients (80%) were disease-free in the primary sites, and two (20%) relapsed. Two patients died of distant metastasis, and one died of local recurrence. This method can preserve organs and minimize functional disturbance, thus contributing to patient QOL. (author)

  8. Pu(IV) reduction with hydroxyurea and its application in U/Pu separation

    International Nuclear Information System (INIS)

    Zhu Zhaowu; He Jianyu; Zhang Zefu; Song Tianbao; Zhang Yu; Zheng Weifang

    2004-01-01

    The reduction of Pu(IV) with hydroxyurea (HU) in the mixed phase of 30% TBP/OK-HNO 3 system was studied. The study results show that HU can reduce Pu(IV) to Pu(III) and the reduction rate can be expressed as -dc(Pu(IV))/dt=kc(HU)c -3.2 (HNO 3 )c mix 2 (Pu(IV))c mix -1 (Pu(III)), where k is the rate constant, and k=(896 ± 59) mol 2.3 ·L -2.3 ·min -1 at 15 degree C. With HU serves as a reductant, 16 stages count-current cascade experiment was performed using centrifugal tube to simulate U/Pu separation in the 1B contactor of Purex process. The separation factor of Pu from U and the separation factor of U from Pu reach to 5.4 x 10 4 and 1.8 x 10 5 , respectively. The amount of Pu is about 11 μg in per kg U product. (authors)

  9. Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer.

    Science.gov (United States)

    Adekolujo, Orimisan Samuel; Tadisina, Shourya; Koduru, Ujwala; Gernand, Jill; Smith, Susan Jane; Kakarala, Radhika Ramani

    2017-07-01

    The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan-Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.

  10. Test Review: Advanced Clinical Solutions for WAIS-IV and WMS-IV

    Science.gov (United States)

    Chu, Yiting; Lai, Mark H. C.; Xu, Yining; Zhou, Yuanyuan

    2012-01-01

    The authors review the "Advanced Clinical Solutions for WAIS-IV and WMS-IV". The "Advanced Clinical Solutions (ACS) for the Wechsler Adult Intelligence Scale-Fourth Edition" (WAIS-IV; Wechsler, 2008) and the "Wechsler Memory Scale-Fourth Edition" (WMS-IV; Wechsler, 2009) was published by Pearson in 2009. It is a…

  11. Direct complexonometric determination of thorium (IV), uranium (IV), neptunium (IV), plutonium (IV) by titration of diethylenetriaminepentaacetic acid with xylenol orange as indicator

    International Nuclear Information System (INIS)

    Rykov, A.G.; Piskunov, E.M.; Timofeev, G.A.

    1975-01-01

    The purpose of the present work was to develop a method of determining Th(IV), U(IV), Np(N) and Pu(IV) in acid solutions by titration with diethylenetriamine pentacetic acid, the indicator being xylenol orange. It has been established that Th, U, Np and Pu can be determined to within 0.5-1.5%. Th and U in quantities of tens of milligrams can be determined with greater accuracy, attaining hundredths of one per cent. During titration the determination is not hindered by singly- and doubly-charged metal ions, trivalent lanthanides and actinides, except plutonium. The proposed method can be used to determine U(IV) in the presence of considerable quantities of U(VI) and Np(IV) in the presence of Np(V). Total concentrations of uranium or neptunium are determined by reducing uranium (VI) or neptunium (V) by a standard method (for example, using metallic lead, cadmium or zinc amalgam) to the tetravalent state and applying the method described in the paper. (E.P.)

  12. Long-term outcomes after laparoscopic total mesorectal excision for ...

    African Journals Online (AJOL)

    standard deviation (SD) 11) years, range 25 - 81 years) with rectal cancer were evaluated and prospectively followed up in our hospital (mean follow-up ... There were 54 cases of cancer defined as UICC stage II and 68 cases defined as stage III.

  13. Roles of chemoradio therapy for stage III or IV advanced head and neck cancers

    International Nuclear Information System (INIS)

    Tachikawa, Takuya; Iwai, Hiroshi; Tsuji, Hiroyuki; Minamino, Masayuki; Yamamoto, Takashi; Yukawa, Hisaya; Inoue, Toshiya; Yamashita, Toshio

    2002-01-01

    The effectiveness of chemoradio therapy (CRT), which was performed on 31 patients with advanced head and neck cancers of stage III or IV at Kansai Medical University between September 1999 and December 2000, was examined. The CRT consisted of continuous infusion of 5FU (500 mg/m 2 ) for 120 hours, prior to drip infusion of CDDP (50 mg/m 2 ) for 2 hours and conventional radiotherapy (2 Gy/day, 5 days/w). The 31 patients with these cancers were divided into two groups; a non-operative group (16 patients) and an operative group (15 patients). The patients in the non-operative group (16 patients) and an operative group (15 patients). The patients in the non-operative group underwent CRT (60-70 Gy of total radiation dose and two courses of chemotherapy) without surgery. The patients in the operative group received surgical treatment followed by CRT (40 Gy of total radiation dose and one course of chemotherapy). The results of CRT indicated 87.1% of the response rate (RR), and 29.0% of the complete response rate (CR) in the group. The CR rate was lower than in other reports. However, the combination of CRT and the subsequent operation indicated a disease-free survival rate of 61.3% and reduction of the recurrence rate to 17.4%. Eight of 9 patients of CR after CRT without surgery revealed NED. On the other hand, the results indicated that all 10 patients of PR after CRT showed tumor residue, 9 of 10 patients of PR showed NED after additional surgery. Therefore, it is likely that the patients of CR do not need the additional surgery, however, the patients of PR are strongly recommended the surgery to improve the local control rate as well as survival rate. Although adverse reactions of CRT on patients included mucositis, leucopenia, thrombopenia and dermatitis, the symptoms ranged within grade 3. (author)

  14. Phenotypic and functional characteristics of blood natural killer cells from melanoma patients at different clinical stages.

    Directory of Open Access Journals (Sweden)

    Giulia Fregni

    Full Text Available Melanomas are aggressive skin tumors characterized by high metastatic potential. Immunotherapy is a valuable alternative for metastatic melanoma patients resistant to chemotherapy. Natural Killer (NK cells are efficient anti-tumor cytotoxic effectors. We previously showed that blood NK cells from stage IV metastatic melanoma patients display decreased NK receptors and that chemotherapy modifies the functional status of blood NK cells. To investigate the role of NK cells along melanoma progression, we have here studied NK cells from patients at different stages of the disease. First, we showed that ex vivo NK cells from certain stage III-IV patients displayed low degranulation potential. Using a dynamic label-free assay, we found that immunoselected IL-2 activated blood NK cells from patients efficiently lysed melanoma cells through NKp46 and NKG2D receptors, independently to the clinical stage. Moreover, the ex vivo phenotype of circulating NK cells from 33 patients (stage I to IV was extensively analyzed. NK cells from patients displayed higher variability in the percentages of Natural Cytotoxicity Receptors (NCR and Natural Killer Group 2D (NKG2D receptor expression compared to donor NK cells. The main defect was the decreased expression of NCR1 (NKp46 by NK cells from metastatic patients. Interestingly, we found a positive correlation between the NK cell percentages of NKp46 and the duration of stage IV in melanoma patients. Finally, we showed that NK cells infiltrated primary melanomas and displayed a predominant peritumoral distribution. These results are new arguments for the development of NK-based therapies in melanoma patients.

  15. Treatment-Related Predictive and Prognostic Factors in Trimodality Approach in Stage IIIA/N2 Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Jeremić, Branislav; Casas, Francesc; Dubinsky, Pavol; Gomez-Caamano, Antonio; Čihorić, Nikola; Videtic, Gregory; Igrutinovic, Ivan

    2018-01-01

    While there are no established pretreatment predictive and prognostic factors in patients with stage IIIA/pN2 non-small cell lung cancer (NSCLC) indicating a benefit to surgery as a part of trimodality approach, little is known about treatment-related predictive and prognostic factors in this setting. A literature search was conducted to identify possible treatment-related predictive and prognostic factors for patients for whom trimodality approach was reported on. Overall survival was the primary endpoint of this study. Of 30 identified studies, there were two phase II studies, 5 "prospective" studies, and 23 retrospective studies. No study was found which specifically looked at treatment-related predictive factors of improved outcomes in trimodality treatment. Of potential treatment-related prognostic factors, the least frequently analyzed factors among 30 available studies were overall pathologic stage after preoperative treatment and UICC downstaging. Evaluation of treatment response before surgery and by pathologic tumor stage after induction therapy were analyzed in slightly more than 40% of studies and found not to influence survival. More frequently studied factors-resection status, degree of tumor regression, and pathologic nodal stage after induction therapy as well as the most frequently studied factor, the treatment (in almost 75% studies)-showed no discernible impact on survival, due to conflicting results. Currently, it is impossible to identify any treatment-related predictive or prognostic factors for selecting surgery in the treatment of patients with stage IIIA/pN2 NSCLC.

  16. High-dose superselective intra-arterial cisplatin and concomitant radiation therapy for carcinoma of the oral cavity

    International Nuclear Information System (INIS)

    Suzuki, Gen; Tanaka, Norimitsu; Ogo, Etuyo

    2007-01-01

    The purpose of this study was to evaluate the effect of high-dose superselective intra-arterial cisplatin and concomitant radiation therapy for carcinoma of the oral cavities. The subjects consisted of 18 patients with carcinoma of the oral, and cavity treated with superselective intra-arterial infusion of high dose cisplatin (100 mg/body) concomitant with delivery of external beam radiotherapy (median total dose, 60.8 Gy) between 2001 and 2004. Sodium thiosulfate was administered intravenously to provide effective cisplatin neutlization. They were International Union Against Cancer (UICC)1997 stage II-IV (stage II: 4 patients, stage III: 4 patients, stage IV: 10 patients). Patients ranged from 43-81 years of age, with a median of 60 years, and included 14 men and 4 women. A follow-up period was 6 months minimum from the atart of the radiation therapy, the median follow up period at 28 months. The three-year overall survival rate was 71%. The three-year disease free rate and local control rate were 60% and 65%, respectively. Three-year local control rate of the T2-3 was achieved at 83%, and that for T4 at 50%. There was borderline significant difference in local control rate between T2-3 and T4 (p=0.05). We conclude that the high-dose superselective intra-arterial cisplatin and concomitant radiation therapy provides effective results in organ preservation for cancer of oral cavities. Further studies are also required to determine the validity of this method. (author)

  17. Our Experiences with Erlotinib in Second and Third Line Treatment Patients with Advanced Stage Iiib/ Iv Non-Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Bakir Mehić

    2008-11-01

    Full Text Available HeadHER1/EGFR is known to play a pivotal role in tumorigenesis and is overexpressed in up to 80% of NSCLCs. The study of an Expanded Access Clinical Program of Erlotinib in NSCLC is a phase IV openlabel, non-randomized, multicenter trial in patients with advanced (inoperable stage IIIb/IV NSCLC who were eligible for treatment with erlotinib but had no access to trial participation. Patients for the study from Bosnia and Herzegovina (B&H were selected from two Clinical centres (Sarajevo and Banja Luka. The aim of study was to evaluated efficacy and tolerability of erlotinib monotherapy in this setting. All patients who received at least one dose of erlotinib and data were entered in the database as of the CRF cut-off date of 14th May 2008 were included in analysis of data (n = 19. This population is defined as the Intent to Treat (ITT population and includes all patients who had at least one dose of erlotinib regardless of whether major protocol violations were incurred. The findings are consistent with the results of the randomized, placebo-controlled BR.21 study. Indicating that erlotinib is an effective option for patients with advanced NSCLC who are unsuitable for, or who have previously failed standard chemotherapy. In B&H group of patients DCR was almost 84%, and PFS was approximately 24,7 weeks (compared with 44% and 9,7 weeks for erlotinib reported in phase III. Almost three quarter of the patients received erlotinib as their second line of therapy. Overall, erlotinib was well tolerated; there were no patients who withdrew due to a treatment-related AE (mainly rash and there were few dose reductions. 24% of patients experienced an SAE (most commonly gastrointestinal (GI disorders.

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

    Science.gov (United States)

    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.

  19. Therapy of non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Coffey, J.; Hodgson, D.C.; Gospodarowicz, M.K.

    2003-01-01

    Non-Hodgkin's lymphomas are a heterogeneous group of malignancies of the lymphoid system. The exact etiology for most lymphomas has not been determined, but both viral and bacterial infections have been shown to be important etiologic factors. The WHO classification of hematopoietic and lymphoid tumours classifies lymphomas into B-cell and T-cell neoplasms. B-cell lymphomas account for more than 85% of all lymphomas. The Ann Arbor staging classification has been adopted by the AJCC and UICC as a standard for classifying extent of anatomic disease. The two most common histologic disease entities are follicular lymphomas and diffuse large B-cell lymphomas. The management of follicular lymphomas is used as a paradigm for the management of all indolent lymphomas. Radiation therapy is used for stage I and II disease, while alkylating agent chemotherapy, immunotherapy and radioimmunotherapy are most frequently used in stage III and IV disease that requires treatment. Most patients with follicular lymphoma enjoy prolonged survival, but at present there is no evidence that those with stage III and IV follicular lymphoma can be cured. Diffuse large B-cell lymphomas serve as a paradigm for treating aggressive lymphomas. Stage I and II diffuse large cell lymphomas are generally treated with combined modality therapy with doxorubicin-based chemotherapy followed by involved field radiation therapy, while those with stage III and IV disease are treated with chemotherapy alone. Patients who fail initial management are treated with further chemotherapy. High-dose chemotherapy with stem cell rescue has been shown to be particularly effective as salvage treatment for diffuse large cell lymphomas. The management of a heterogeneous group of primary extranodal lymphomas in general follows the above treatment principles, with additional treatment being required for those with a high risk of CNS failures, or involvement of contralateral paired organs. The management of MALT lymphomas

  20. Implementation of an Integrative Oncological Concept in the Daily Care of a German Certified Breast Cancer Center.

    Science.gov (United States)

    Schad, Friedemann; Thronicke, Anja; Merkle, Antje; Steele, Megan L; Kröz, Matthias; Herbstreit, Cornelia; Matthes, Harald

    2018-01-01

    In recent decades the concept of integrative medicine has attracted growing interest in patients and professionals. At the Gemeinschaftskrankenhaus Havelhöhe (GKH), a hospital specialized in anthroposophical medicine, a breast cancer center (BCC) has been successfully certified for more than 5 years. The objective of the present study was to analyze how integrative strategies were implemented in the daily care of primary breast cancer patients. Clinical, demographic, and follow-up data as well as information on non-pharmacological interventions were analyzed. In addition, BCC quality measures were compared with data of the National Breast Cancer Benchmarking Report 2016. Between 2011 and 2016, 741 primary breast cancer patients (median age 57.4 years) were treated at the GKH BCC. 91.5% of the patients showed Union for International Cancer Control (UICC) stage 0, I, II, or III and 8.2% were in UICC stage IV. 97% of the patients underwent surgery, 53% radiation, 38% had hormone therapy, and 25% received cytostatic drugs. 96% of the patients received non-pharmacological interventions and 32% received Viscum album L. Follow-up was performed in up to 93% of the patients 2 years after first diagnosis. Compared to nationwide benchmarking BCCs, the GKH BCC met the requirements in central items. The results of the present study show that integrative therapies offered by the concept of anthroposophical medicine can be implemented in the daily care and treatment of a certified BCC. However, as national guidelines on integrative concepts in oncology are missing, further studies are needed for a systematic evaluation of integrative treatment and care concepts in this field. © 2018 The Author(s). Published by S. Karger GmbH, Freiburg.

  1. Risk stratification of patients with locally aggressive differentiated thyroid cancer. Results of the MSDS trial

    International Nuclear Information System (INIS)

    Riemann, B.; Kraemer, J.A.; Schober, O.; Schmid, K.W.; Dralle, H.; Dietlein, M.; Schicha, H.; Sauerland, C.; Frankewitsch, T.

    2010-01-01

    The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well defined group of patients with locally aggressive thyroid carcinomas (pT4; AJCC/UICC 1997). The aim of the present study was to compare the survival of patients with minimum and extensive extrathyroidal growth according to the new AJCC/UICC TNM staging system 2009. Patients, methods: The follow-up data of 347 patients were analysed. Patients were reclassified according to the current AJCC/UICC 2009 classification. The event-free and overall survival was evaluated using Kaplan-Meier analysis. In addition, postoperative complications and status of disease were documented. Results: 327 patients were assigned to stage pT3 and 20 patients to stage pT4a, respectively. Median follow-up was 6.1 years (range 0.04-9.8 years). 92.5% of patients reached complete remission. There were 7.8% recurrences in the thyroid bed, in locoregional lymph nodes and/or in distant sites. The overall survival was >98% both in pT3 and pT4a patients (p = n. s.). In contrast, the event-free survival was significantly less favourable in pT4a patients (p < 0.001). Using multivariate analysis the following parameters were significant predictors of event-free survival: histological tumour type, degree of extrathyroidal extension and nodal metastasis (p < 0.05). Conclusions: The MSDS patients with locally aggressive differentiated thyroid cancer showed an excellent overall survival during a median follow-up of 6.1 years. According to the current AJCC/UICC 2009 classification, pT3 patients with minimal extrathyroidal extension revealed a significantly better event-free survival than pT4a patients with extensive extrathyroidal growth. (orig.)

  2. Antidepressive and BDNF effects of enriched environment treatment across ages in mice lacking BDNF expression through promoter IV

    Science.gov (United States)

    Jha, S; Dong, B E; Xue, Y; Delotterie, D F; Vail, M G; Sakata, K

    2016-01-01

    Reduced promoter IV-driven expression of brain-derived neurotrophic factor (BDNF) is implicated in stress and major depression. We previously reported that defective promoter IV (KIV) caused depression-like behavior in young adult mice, which was reversed more effectively by enriched environment treatment (EET) than antidepressants. The effects of promoter IV-BDNF deficiency and EET over the life stages remain unknown. Since early-life development (ED) involves dynamic epigenetic processes, we hypothesized that EET during ED would provide maximum antidepressive effects that would persist later in life due to enhanced, long-lasting BDNF induction. We tested this hypothesis by determining EET effects across three life stages: ED (0–2 months), young adult (2–4 months), and old adult (12–14 months). KIV mice at all life stages showed depression-like behavior in the open-field and tail-suspension tests compared with wild-type mice. Two months of EET reduced depression-like behavior in ED and young adult, but not old adult mice, with the largest effect in ED KIV mice. This effect lasted for 1 month after discontinuance of EET only in ED mice. BDNF protein induction by EET in the hippocampus and frontal cortex was also the largest in ED mice and persisted only in the hippocampus of ED KIV mice after discontinuance of EET. No gender-specific effects were observed. The results suggest that defective promoter IV causes depression-like behavior, regardless of age and gender, and that EET during ED is particularly beneficial to individuals with promoter IV-BDNF deficiency, while additional treatment may be needed for older adults. PMID:27648918

  3. The Prognostic and Predictive Value of Soluble Type IV Collagen in Colorectal Cancer

    DEFF Research Database (Denmark)

    Rolff, Hans Christian; Christensen, Ib Jarle; Vainer, Ben

    2016-01-01

    PURPOSE: To investigate the prognostic and predictive biomarker value of type IV collagen in colorectal cancer. EXPERIMENTAL DESIGN: Retrospective evaluation of two independent cohorts of patients with colorectal cancer included prospectively in 2004-2005 (training set) and 2006-2008 (validation....... RESULTS: High levels of type IV collagen showed independent prognostic significance in both cohorts with hazard ratios (HRs; for a one-unit change on the log base 2 scale) of 2.25 [95% confidence intervals (CIs), 1.78-2.84; P ... and validation set, respectively. The prognostic impact was present both in patients with metastatic and nonmetastatic disease. The predictive value of the marker was investigated in stage II and III patients. In the training set, type IV collagen was prognostic both in the subsets of patients receiving...

  4. Fast reactor development and worldwide cooperation in Generation-IV International Forum

    International Nuclear Information System (INIS)

    Sagayama, Yutaka

    2013-01-01

    Objectives of Gen-IV systems development: Goals: Four challenging technology goals have been defined to be applied to innovative nuclear reactor concepts in the 21st century: 1) Safety and Reliability (safe and reliable operation, no offsite emergency response); 2) Sustainability (effective fuel utilization, minimization of nuclear waste); 3) Proliferation Resistance & Physical Protection (to assure unattractive and the least desirable route for diversion or theft of weapons-usable materials, and provide increased physical protection against acts of terrorism); 4) Economic Competitiveness (life-cycle cost advantage over other energy resources). Phase: Each Generation-IV reactor system is one of three stages. 1) Viability Phase; 2) Performance Phase; 3) Demonstration Phase. Target: Commercial Deployment is expected around 2030s or beyond

  5. [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].

    Science.gov (United States)

    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.

  6. Phase 3 Trial of Postoperative Chemotherapy Alone Versus Chemoradiation Therapy in Stage III-IV Gastric Cancer Treated With R0 Gastrectomy and D2 Lymph Node Dissection

    International Nuclear Information System (INIS)

    Kim, Tae Hyun; Park, Sook Ryun; Ryu, Keun Won; Kim, Young-Woo; Bae, Jae-Moon; Lee, Jun Ho; Choi, Il Ju; Kim, Yeon-Joo; Kim, Dae Yong

    2012-01-01

    Purpose: To compare chemotherapy alone with chemoradiation therapy in stage III-IV(M0) gastric cancer treated with R0 gastrectomy and D2 lymph node dissection. Methods and Materials: The chemotherapy arm received 5 cycles of fluorouracil and leucovorin (FL), and the chemoradiation therapy arm received 1 cycle of FL, then radiation therapy of 45 Gy concurrently with 2 cycles of FL, followed by 2 cycles of FL. Intent-to-treat analysis and per-protocol analyses were performed. Results: Between May 6, 2002 and June 29, 2006, a total of 90 patients were enrolled. Forty-four were randomly assigned to the chemotherapy arm and 46 to the chemoradiation therapy arm. Treatment was completed as planned by 93.2% of patients in the chemotherapy arm and 87.0% in the chemoradiation therapy arm. Overall intent-to-treat analysis showed that addition of radiation therapy to chemotherapy significantly improved locoregional recurrence-free survival (LRRFS) but not disease-free survival. In subgroup analysis for stage III, chemoradiation therapy significantly prolonged the 5-year LRRFS and disease-free survival rates compared with chemotherapy (93.2% vs 66.8%, P=.014; 73.5% vs 54.6%, P=.056, respectively). Conclusions: Addition of radiation therapy to chemotherapy could improve the LRRFS in stage III gastric cancer treated with R0 gastrectomy and D2 lymph node dissection.

  7. The Role of Type IV Collagen in Developing Lens in Mouse Fetuses

    Directory of Open Access Journals (Sweden)

    Mehdi Jalali

    2009-09-01

    Full Text Available Objective(sExtracellular matrix (ECM and basement membrane (BM play important roles in many developmental processes during development and after birth. Among the components of the BM, collagen fibers specially type IV are the most important parts. The aim of this study was to determine the time when collagen type IV appears in the BM of lens structure during mouse embryonic development.Materials and MethodsIn this experimental study, 22 female Balb/C mice were randomly selected and were kept under normal condition, finding vaginal plug was assumed as day zero of pregnancy. From embryonic day 10 to 20, all specimens were sacrificed by cervical dislocation and their heads were fixed, serially sectioned and immunohistochemistry study for tracing collagen type IV in lens were carried out.ResultsOur data revealed that collagen type IV appeared at the early stage of gestation day 12 in BM of anterior epithelial lens cells and the amount of this protein gradually increased until days 15-17 in ECM and posterior capsule epithelium. After this period, severe reaction was not observed in any part of the lens.ConclusionThese findings establish the important role of collagen IV in developing optic cup and any changes during critical period of pregnancy may be result in severe visual system defect

  8. Regional variations in cancer survival: Impact of tumour stage, socioeconomic status, comorbidity and type of treatment in Norway.

    Science.gov (United States)

    Skyrud, Katrine Damgaard; Bray, Freddie; Eriksen, Morten Tandberg; Nilssen, Yngvar; Møller, Bjørn

    2016-05-01

    Cancer survival varies by place of residence, but it remains uncertain whether this reflects differences in tumour, patient and treatment characteristics (including tumour stage, indicators of socioeconomic status (SES), comorbidity and information on received surgery and radiotherapy) or possibly regional differences in the quality of delivered health care. National population-based data from the Cancer Registry of Norway were used to identify cancer patients diagnosed in 2002-2011 (n = 258,675). We investigated survival from any type of cancer (all cancer sites combined), as well as for the six most common cancers. The effect of adjusting for prognostic factors on regional variations in cancer survival was examined by calculating the mean deviation, defined by the mean absolute deviation of the relative excess risks across health services regions. For prostate cancer, the mean deviation across regions was 1.78 when adjusting for age and sex only, but decreased to 1.27 after further adjustment for tumour stage. For breast cancer, the corresponding mean deviations were 1.34 and 1.27. Additional adjustment for other prognostic factors did not materially change the regional variation in any of the other sites. Adjustment for tumour stage explained most of the regional variations in prostate cancer survival, but had little impact for other sites. Unexplained regional variations after adjusting for tumour stage, SES indicators, comorbidity and type of treatment in Norway may be related to regional inequalities in the quality of cancer care. © 2015 UICC.

  9. Complete remission in a colon cancer patient with a large, irresectable liver metastasis after XELOX/cetuximab/bevacizumab treatment.

    Science.gov (United States)

    Weihrauch, Martin R; Stippel, Dirk; Fries, Jochen W U; Arnold, Dirk; Bovenschulte, Henning; Coutelle, Oliver; Hacker, Ulrich

    2008-09-01

    Stage IV colorectal cancer is usually an incurable disease. However, patients with resectable metastases have 5-year disease-free survival rates of up to 30%. Even with primarily irresectable disease, cure can be achieved in patients who become operable after neoadjuvant treatment. To improve the prognosis of these patients, highly effective neoadjuvant regimens need to be developed. Here, we report the case of a 62-year-old male patient who had been diagnosed with International Union against Cancer (UICC) stage III colon cancer 7 years previously and now presented with a large, irresectable liver metastasis and enlarged perihepatic lymph nodes. After neoadjuvant treatment with cetuximab, bevacizumab and XELOX, the patient showed a complete remission and underwent surgery. Histopathologically, the resected tissue and lymph nodes were free of residual tumor. To our knowledge, this is the first report of a complete pathological response in a patient with irresectable colorectal cancer after intensive chemotherapy/anti-EGFR/ VEGF antibody therapy. This combination regimen may help to improve the survival rates for patients with irresectable disease. Copyright 2008 S. Karger AG, Basel.

  10. A clinical study of oral carcinoma

    International Nuclear Information System (INIS)

    Sato, Shigenori; Ito, Zenya; Takahashi, Kazuhiko; Ohkubo, Hideki; Wada, Tetsuro; Senarita, Masamitsu; Hara, Akira; Kusakari, Jun; Ohara, Kiyosi

    1999-01-01

    Seventy patients of oral carcinoma, including lip and tongue cancer, were treated at University of Tsukuba Hospital from March 1988 to March 1998. Treatment for each patient was determined according to TNM classification (UICC, 1987). Eight cases of non-squamous cell carcinoma, which were insensitive to radiation or chemotherapy, were surgically treated. Out of 70 cases, sixty-two were pathologically categorized as squamous cell carcinoma (SCC). For SCC cases of stage I or II, full-dose irradiation, including brachytherapy as well as conventional irradiation, was fundamentally the treatment of choice, but in six cases surgical treatment was performed after irradiation of 50 Gy in order to assure curability. In cases of stage III or IV, the treatment of choice was a combination of the surgery and radiotherapy. Fifteen cases, however, were treated only by conventional radiotherapy, brachytherapy (RALS) and/or chemotherapy, because of the patient's refusal to surgery, local or systemic condition, his or her age, and so on. Our treatment plans have consequently resulted in the overall 5-year survival rate of 75.2% for oral SCC. (author)

  11. Comparison of endoscopic ultrasonography and multislice spiral computed tomography for the preoperative staging of gastric cancer - results of a single institution study of 610 Chinese patients.

    Directory of Open Access Journals (Sweden)

    Xing-Yu Feng

    Full Text Available BACKGROUND: This study compared the performance of endoscopic ultrasonography (EUS and multislice spiral computed tomography (MSCT in the preoperative staging of gastric cancer. METHODOLOGY/PRINCIPAL FINDINGS: A total of 610 patients participated in this study, all of whom had undergone surgical resection, had confirmed gastric cancer and were evaluated with EUS and MSCT. Tumor staging was evaluated using the Tumor-Node-Metastasis (TNM staging and Japanese classification. The results from the imaging modalities were compared with the postoperative histopathological outcomes. The overall accuracies of EUS and MSCT for the T staging category were 76.7% and 78.2% (P=0.537, respectively. Stratified analysis revealed that the accuracy of EUS for T1 and T2 staging was significantly higher than that of MSCT (P<0.001 for both and that the accuracy of MSCT in T3 and T4 staging was significantly higher than that of EUS (P<0.001 and 0.037, respectively. The overall accuracy of MSCT was 67.2% when using the 13th edition Japanese classification, and this percentage was significantly higher than the accuracy of EUS (49.3% and MSCT (44.6% when using the 6th edition UICC classification (P<0.001 for both values. CONCLUSIONS/SIGNIFICANCE: Our results demonstrated that the overall accuracies of EUS and MSCT for preoperative staging were not significantly different. We suggest that a combination of EUS and MSCT is required for preoperative evaluation of TNM staging.

  12. Oxochloroalkoxide of the Cerium (IV and Titanium (IV as oxides precursor

    Directory of Open Access Journals (Sweden)

    Machado Luiz Carlos

    2002-01-01

    Full Text Available The Cerium (IV and Titanium (IV oxides mixture (CeO2-3TiO2 was prepared by thermal treatment of the oxochloroisopropoxide of Cerium (IV and Titanium (IV. The chemical route utilizing the Cerium (III chloride alcoholic complex and Titanium (IV isopropoxide is presented. The compound Ce5Ti15Cl16O30 (iOPr4(OH-Et15 was characterized by elemental analysis, FTIR and TG/DTG. The X-ray diffraction patterns of the oxides resulting from the thermal decomposition of the precursor at 1000 degreesC for 36 h indicated the formation of cubic cerianite (a = 5.417Å and tetragonal rutile (a = 4.592Å and (c = 2.962 Å, with apparent crystallite sizes around 38 and 55nm, respectively.

  13. Maintenance based Bevacizumab versus complete stop or continuous therapy after induction therapy in first line treatment of stage IV colorectal cancer: A meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Tamburini, Emiliano; Rudnas, Britt; Santelmo, Carlotta; Drudi, Fabrizio; Gianni, Lorenzo; Nicoletti, Stefania V L; Ridolfi, Claudio; Tassinari, Davide

    2016-08-01

    In stage IV colorectal cancer, bevacizumab-based maintenance therapy, complete stop therapy and continuous therapy are considered all possible approaches after first line induction chemotherapy. However, there are no clear data about which approach is preferable. All randomized phase III trials comparing bevacizumab-based maintenance therapy (MB) with complete stop therapy (ST) or with continuous therapy (CT) were considered eligible and included into the analysis. Primary endpoint was the Time to failure strategies (TFS). Secondary endpoints were Overall Survival (OS) and Progression free survival (PFS). Meta-analysis was performed in line with the PRISMA statement. 1892 patients of five trials were included into the analysis. A significant improvement in TFS (HR 0.79; CI 95% 0.7-0.9 p=0.0005) and PFS (HR 0.56; CI 95% 0.44-0.71 p<0.00001) were observed in favour of MB versus ST. A trend, but not statistically significant, in favour of MB versus ST was also observed for OS (HR 0.88; CI 95% 0.77-1.01, p=0.08). Comparing maintenance therapy versus continuous therapy no statistically differences were observed in the outcomes evaluated (OS 12 months OR 1.1 p=0.62, OS 24 months OR 1 p=1, OS 36 months OR 0.54 p=0.3, TFS 12 months OR 0.76 p=0.65). Our meta-analysis suggests that use of MB approach increases TFS, PFS compared to ST. Although without observing any statistically advantage, it should be highlighted that MB versus ST showed a trend in favour of MB. We observed no difference between MB and CT. MB should be considered the standard regimen in patients with stage IV colorectal cancer after first line induction therapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. BAHAN AJAR BERBASIS PENDIDIKAN KARAKTER UNTUK SISWA KELAS IV SEKOLAH DASAR

    Directory of Open Access Journals (Sweden)

    Pity Asriani

    2017-11-01

    Full Text Available This study aims to produce character education based teaching materials for grade IV elementary school. The writer used the 4D model (Thiagarajan, et al., 1974 for his research and development. The 4D model consists of four stages. They are defining, designing, developing, and disseminating. Types of data used are qualitative. Data were collected by validity testing, questionnaire, observation, and character assessment. This study produced a character education based teaching materials for grade IV elementary school. That is the student book and the teacher book. The results showed that character education based teaching materials for grade IV elementary school is compliant to use in learning since it has met the expected criteria according to the assessment of the material experts, linguists, media experts, teachers, and students. Penelitian ini bertujuan menghasilkan bahan ajar berbasis pendidikan karakter untuk kelas IV Sekolah Dasar. Model penelitian dan pengembangan yang digunakan adalah model pengembangan 4D (Thiagarajan, dkk., 1974. Model 4-D ini terdiri atas tahap pendefinisian (define, perancangan (design, pengembangan (develop, dan penyebaran (disseminate. Jenis data yang digunakan yaitu data kualitatif. Data dikumpulkan melalui uji validasi, angket, observasi, dan penilaian karakter. Penelitian ini menghasilkan bahan ajar berbasis pendidikan karakter untuk kelas IV Sekolah Dasar yang terdiri atas Buku Siswa dan Buku Guru. Hasil penelitian menunjukkan bahwa bahan ajar berbasis pendidikan karakter untuk kelas IV Sekolah Dasar ini telah memenuhi persyaratan untuk digunakan dalam pembelajaran karena telah memenuhi kriteria menurut penilaian ahli materi, ahli bahasa, ahli desain, guru, dan siswa.

  15. Examination of the accuracy of coding hospital-acquired pressure ulcer stages.

    Science.gov (United States)

    Coomer, Nicole M; McCall, Nancy T

    2013-01-01

    Pressure ulcers (PU) are considered harmful conditions that are reasonably prevented if accepted standards of care are followed. They became subject to the payment adjustment for hospitalacquired conditions (HACs) beginning October 1, 2008. We examined several aspects of the accuracy of coding for pressure ulcers under the Medicare Hospital-Acquired Condition Present on Admission (HAC-POA) Program. We used the "4010" claim format as a basis of reference to show some of the issues of the old format, such as the underreporting of pressure ulcer stages on pressure ulcer claims and how the underreporting varied by hospital characteristics. We then used the rate of Stage III and IV pressure ulcer HACs reported in the Hospital Cost and Utilization Project State Inpatient Databases data to look at the sensitivity of PU HAC-POA coding to the number of diagnosis fields. We examined Medicare claims data for FYs 2009 and 2010 to examine the degree that the presence of stage codes were underreported on pressure ulcer claims. We selected all claims with a secondary diagnosis code of pressure ulcer site (ICD-9 diagnosis codes 707.00-707.09) that were not reported as POA (POA of "N" or "U"). We then created a binary indicator for the presence of any pressure ulcer stage diagnosis code. We examine the percentage of claims with a diagnosis of a pressure ulcer site code with no accompanying pressure ulcer stage code. Our results point to underreporting of PU stages under the "4010" format and that the reporting of stage codes varied across hospital type and location. Further, our results indicate that under the "5010" format, a higher number of pressure ulcer HACs can be expected to be reported and we should expect to encounter a larger percentage of pressure ulcers incorrectly coded as POA under the new format. The combination of the capture of 25 diagnosis codes under the new "5010" format and the change from ICD-9 to ICD-10 will likely alleviate the observed underreporting of

  16. Long-term outcome and patterns of failure in patients with advanced head and neck cancer

    International Nuclear Information System (INIS)

    Hauswald, Henrik; Simon, Christian; Hecht, Simone; Debus, Juergen; Lindel, Katja

    2011-01-01

    To access the long-time outcome and patterns of failure in patients with advanced head and neck squamous cell carcinoma (HNSCC). Between 1992 and 2005 127 patients (median age 55 years, UICC stage III n = 6, stage IV n = 121) with primarily inoperable, advanced HNSCC were treated with definite platinum-based radiochemotherapy (median dose 66.4 Gy). Analysed end-points were overall survival (OS), disease-free survival (DFS), loco-regional progression-free survival (LPFS), development of distant metastases (DM), prognostic factors and causes of death. The mean follow-up time was 34 months (range, 3-156 months), the 3-, 5- and 10-year OS rates were 39%, 28% and 14%, respectively. The median OS was 23 months. Forty-seven patients achieved a complete remission and 78 patients a partial remission. The median LPFS was 17 months, the 3-, 5- and 10-year LPFS rates were 41%, 33% and 30%, respectively. The LPFS was dependent on the nodal stage (p = 0.029). The median DFS was 11 months (range, 2-156 months), the 3-, 5- and 10-year DFS rates were 30%, 24% and 22%, respectively. Prognostic factors in univariate analyses were alcohol abuse (n = 102, p = 0.015), complete remission (n = 47, p < 0.001), local recurrence (n = 71, p < 0.001), development of DM (n = 45, p < 0.001; median OS 16 months) and borderline significance in nodal stage N2 versus N3 (p = 0.06). Median OS was 26 months with lung metastases (n = 17). Nodal stage was a predictive factor for the development of DM (p = 0.025). Cause of death was most commonly tumor progression. In stage IV HNSCC long-term survival is rare and DM is a significant predictor for mortality. If patients developed DM, lung metastases had the most favourable prognosis, so intensified palliative treatment might be justified in DM limited to the lungs

  17. A single centre experience with sequential and concomitant chemoradiotherapy in locally advanced stage IV tonsillar cancer

    Directory of Open Access Journals (Sweden)

    Coyle Catherine

    2010-12-01

    Full Text Available Abstract Background Chemo-radiotherapy offers an alternative to primary surgery and adjuvant therapy for the management of locally advanced stage IV squamous cell carcinomas of the tonsil. Methods A retrospective analysis was performed of the outcomes of 41 patients with locoregionally advanced squamous cell carcinoma of the tonsil treated non-surgically at the Yorkshire Cancer Centre between January 2004 and December 2005. Due to long radiotherapy waiting times, patients received induction chemotherapy with cisplatin and 5-fluorouracil followed by either cisplatin concurrent chemoradiotherapy or radiotherapy alone. Results Median age was 55 years (range 34-76 years and 28 (68% patients were male. 35/41 patients (85% received 2 or more cycles of induction chemotherapy. Following induction chemotherapy, 32/41 patients (78% had a clinical response. Concomitant chemotherapy was given to 30/41 (73%. All patients received the planned radiotherapy dose with no delays. There were no treatment related deaths. Six (15% patients had gastrostomy tubes placed before treatment, and 22 (54% required nasogastric tube placement during or after treatment for nutritional support. 17 patients required unplanned admissions during treatment for supportive care. At 4 months post treatment assessment 35 out of 41 (85% patients achieved complete clinical and radiographic response. Median follow-up is 38 months (8-61 months. Local and regional control rate in complete responders at 3 years was 91%. Distant metastases have been found in 4 (9.8% patients. Three year progression-free survival rate in all patients is 75%. The 3-year cause specific survival and overall survival are 75% and 66% respectively. Conclusion Cisplatin-based induction and concurrent chemoradiotherapy provides excellent tumour control with acceptable toxicity for patients with locally advanced tonsillar cancer.

  18. Induction chemotherapy followed by alternating chemo-radiotherapy in non-endemic undifferentiated carcinoma of the nasopharynx: optimal compliance and promising 4-year results.

    Science.gov (United States)

    Ponzanelli, Anna; Vigo, Viviana; Marcenaro, Michela; Bacigalupo, Almalina; Gatteschi, Beatrice; Ravetti, Jean-Luis; Corvò, Renzo; Benasso, Marco

    2008-08-01

    Concomitant chemo-radiotherapy is the standard treatment for advanced nasopharyngeal carcinoma (NPC). Induction chemotherapy may improve the results further by enhancing both loco-regional and distant control. Fifty patients with untreated, stage IV (UICC 1992) undifferentiated NPC were initially treated with three courses of epidoxorubicin, 90 mg/m(2), day 1 and cisplatin, 40 mg/m(2), days 1 and 2, every three weeks and then underwent three courses of cisplatin, 20 mg/m(2)/day, days 1-4 and fluorouracil, 200mg/m(2)/day, days 1-4 (weeks 1, 4, 7), alternated to three splits of radiation (week 2-3, 5-6, 8-9-10) up to 70 Gy. All patients but one received 3 cycles of induction chemotherapy. Toxicities from induction chemotherapy were grade III or IV mucositis (2%), grade III or IV nausea/vomiting (22%), grade III or IV hematological toxicity (6%). At the end of induction phase 12% of CRs, 84% of PRs were recorded. Toxicities from alternating chemo-radiotherapy were grade III or IV mucositis (30%), grade III or IV nausea/vomiting (8%), grade III or IV hematological toxicity (24%). Overall, 86% of CRs and 14% of PRs were observed. Four-year progression free survival and overall survival rates are 71% and 81%, respectively. In a small number of patients studied, no correlation between the level of EGFR overexpression and outcomes was detected. In locally advanced UNPC our combined program including induction chemotherapy followed by alternating chemo-radiotherapy is active and gives promising long-term outcomes with acceptable toxicity and optimal patients' compliance. This program merits to be tested in a phase III trial.

  19. Shunt and series resistance of photovoltaic module evaluated from the I-V curve; I-V tokusei kara hyokashita taiyo denchi no shunt teiko to chokuretsu teiko

    Energy Technology Data Exchange (ETDEWEB)

    Asano, K; Kawamura, H; Yamanaka, S; Kawamura, H; Ono, H [Meijo University, Nagoya (Japan)

    1997-11-25

    With an objective of discussing I-V characteristics when a shadow has appeared on part of a photovoltaic module, evaluations were given as a first stage of the study on saturation current, shunt resistance and series resistance for the solar cell module. As a result of measuring change in amount of power generated in a sunny day with a shadow appearing over the solar cell module, reduction in power generation capability of about 23% was verified. In other words, the I-V characteristics of the solar cell module change largely because of existence of the shadow caused on the module. The I-V characteristics curve may be expressed and calculated as a function of the shunt resistance and series resistance. By curve-fitting measurement data for a case of changing insolation without existence of partial shadow, values of the shunt resistance and series resistance were derived. As a result, it was found that the calculations agree well with measurements. It was made also clear that each parameter shows temperature dependence. 6 refs., 10 figs., 1 tab.

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

    DEFF Research Database (Denmark)

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

    2000-01-01

    A study on cod egg mortality was carried out in the Bornholm Basin (southern central Baltic Sea) toward the end of July 1996. An initial egg aggregation marked by a satellite-tracked drifter buoy was sampled repeatedly over an Ii-day period; profiles of temperature, salinity and dissolved oxygen...... were concurrently recorded. Three replicate estimates of mortality were obtained for each pair of subsequent developmental stages from newly spawned eggs to early larvae. A consistent pattern of stage-specific mortality coincided well with previous experimental observations. Average daily mortality...... rates were 7.2% (eggs IA/IB), 38.7% (eggs (IB/II), 25.6% (eggs II/III), 40.0% (eggs III/IV), and 42.3% (eggs IV/early larvae). The cumulative mortality until hatch amounted to 99.9%. Results from hydrodynamic modelling, however, indicated that the drifter's trajectory was influenced by wind stress...

  1. Free-Format RPG IV How to Bring Your RPG Programs Into the 21st Century

    CERN Document Server

    Martin, Jim

    2005-01-01

    Traditional-format style RPG IV programmers who need information on the free-format style of coding will find everything they need in this free format how-to guide. The rules and syntax of free format RPG IV are explained as is how this new style of coding has the potential to improve overall programmer productivity from initial development through maintenance stages. Many style issues, such as named indicators and built in functions are covered, as well as such issues as program flow, data manipulation, math operations, and input and output.

  2. Transuranium perrhenates: Np(IV), Pu(IV) and (III), Am (III)

    International Nuclear Information System (INIS)

    Silvestre, Jean-Paul; Freundlich, William; Pages, Monique

    1977-01-01

    Synthesis in aqueous solution and by solid state reactions, crystallographical characterization and study of the stability of some transuranium perrhenates: Asup(n+)(ReO 4 - )sub(n) (A=Np(IV), Pu(IV), Pu(III), Am(III) [fr

  3. Dependence of the sacroiliac indices of the X-ray stage of ankylosing spondylitis (Behterev's disease)

    International Nuclear Information System (INIS)

    Mlychkov, Kh.

    1983-01-01

    A total of 241 patients (482 sacroiliac indices) in different X-ray stage of the disease were studied and the data obtained were correlated with the sacroiliac indices in a control group of 104 normal subjects (208 sacroiliac indices). Sacroiliac indices were obtained by quantitative examination of the zones of interest of the sacroiliac joints and the sacrum, 3 hours after intravenous injection of 99 sup(m)Tc-pyrophosphate in indicator activities of 1.85 MBq/kg. The sacroiliac index levels increased with advancing X-ray stage of the disease within the I-III stage span; in the IV-th X-ray stage there was obvious decrease in these values. There appeared to exist statistically significant differences in the sacroiliac index values during all X-ray stages of the disease, as compared to the data obtained in the control group of healthy individuals (P<0.001). The significance level of the differences between neighbouring stages was low. Peak percentage of negative findings was observed in the zero stage (14.3) and in stage IV (11.7). The high percentage of positive findings in zero stage patients (15.7 per cent) is an evidence of the major sensitivity of quantitative scintigraphy in comparison with X-ray method of examination. (author)

  4. Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers.

    Science.gov (United States)

    Romanò, C L; Gala, L; Logoluso, N; Romanò, D; Drago, L

    2012-12-01

    The best method for treating chronic periprosthetic knee infection remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures. We reviewed full-text papers and those with an abstract in English published from 1966 through 2011 that reported the success rate of infection eradication after one-stage or two-stage revision with two different types of spacers. In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was used (91.2 versus 87%). The methodological limitations of this study and the heterogeneous material in the studies reviewed notwithstanding, this systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of follow-up. IV.

  5. Hope for progress after 40 years of futility? Novel approaches in the treatment of advanced stage III and IV non-small-cell-lung cancer: Stereotactic body radiation therapy, mediastinal lymphadenectomy, and novel systemic therapy

    Directory of Open Access Journals (Sweden)

    Simon Fung Kee Fung

    2012-01-01

    Full Text Available Non-small-cell lung cancer (NSCLC remains a leading cause of cancer mortality. The majority of patients present with advanced (stage III-IV disease. Such patients are treated with a variety of therapies including surgery, radiation, and chemotherapy. Despite decades of work, however, overall survival in this group has been resistant to any substantial improvement. This review briefly details the evolution to the current standard of care for advanced NSCLC, advances in systemic therapy, and novel techniques (stereotactic body radiation therapy [SBRT], and transcervical extended mediastinal lymphadenectomy [TEMLA] or video-assisted mediastinal lymphadenectomy [VAMLA] that have been used in localized NSCLC. The utility of these techniques in advanced stage therapy and potential methods of combining these novel techniques with systemic therapy to improve survival are discussed.

  6. Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

    Directory of Open Access Journals (Sweden)

    S. K. Seelig

    2010-01-01

    Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years identified. The primary tumor was located in the pancreatic head (n=9, 45%, in pancreatic tail (n=9, 45%, and in the papilla Vateri (n=2, 10%. Metastases were located in the liver (n=14, 70%, peritoneum (n=5, 25%, and omentum majus (n=2, 10%. Lymphnode metastases were present in 16 patients (80%. All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; P=.1. Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.

  7. Policy-induced market introduction of Generation IV reactor systems

    International Nuclear Information System (INIS)

    Heek, Aliki Irina van; Roelofs, Ferry

    2011-01-01

    Almost 10 years ago the U.S. Department of Energy (DOE) started the Generation IV Initiative (GenIV) with 9 other national governments with a positive ground attitude towards nuclear energy. Some of these Generation IV systems, like the fast reactors, are nearing the demonstration stage. The question on how their market introduction will be implemented becomes increasingly urgent. One main topic for future reactor technologies is the treatment of radioactive waste products. Technological solutions to this issue are being developed. One possible process is the transformation of long-living radioactive nuclides into short living ones; a process known as transmutation, which can be done in a nuclear reactor only. Various Generation IV reactor concepts are suitable for this process, and of these systems most experience has been gained with the sodium-cooled fast reactor (SFR). However, both these first generation SFR plants and their Generation IV successors are designed as electricity generating plants, and therefore supposed to be commercially viable in the electricity markets. Various studies indicate that the generation costs of a combined LWR-(S)FR nuclear generating park (LWR: light water reactor) will be higher than that of an LWR-only park. To investigate the effects of the deployment of the different reactors and fuel cycles on the waste produced, resources used and costs incurred as a function of time, a dynamic fuel cycle assessment is performed. This study will focus on the waste impact of the introduction of a fraction of fast reactors in the European nuclear reactor park with a cost increase as described in the previous paragraph. The nuclear fuel cycle scenario code DANESS is used for this, as well as the nuclear park model of the EU-27 used for the previous study. (orig.)

  8. DSM-IV defined conduct disorder and oppositional defiant disorder: an investigation of shared liability in female twins.

    Science.gov (United States)

    Knopik, V S; Bidwell, L C; Flessner, C; Nugent, N; Swenson, L; Bucholz, K K; Madden, P A F; Heath, A C

    2014-04-01

    DSM-IV specifies a hierarchal diagnostic structure such that an oppositional defiant disorder (ODD) diagnosis is applied only if criteria are not met for conduct disorder (CD). Genetic studies of ODD and CD support a combination of shared genetic and environmental influences but largely ignore the imposed diagnostic structure. We examined whether ODD and CD share an underlying etiology while accounting for DSM-IV diagnostic specifications. Data from 1446 female twin pairs, aged 11-19 years, were fitted to two-stage models adhering to the DSM-IV diagnostic hierarchy. The models suggested that DSM-IV ODD-CD covariation is attributed largely to shared genetic influences. This is the first study, to our knowledge, to examine genetic and environmental overlap among these disorders while maintaining a DSM-IV hierarchical structure. The findings reflect primarily shared genetic influences and specific (i.e. uncorrelated) shared/familial environmental effects on these DSM-IV-defined behaviors. These results have implications for how best to define CD and ODD for future genetically informed analyses.

  9. Chemical Compositions and Macrophage Activation of Polysaccharides from Leon's Mane Culinary-Medicinal Mushroom Hericium erinaceus (Higher Basidiomycetes) in Different Maturation Stages.

    Science.gov (United States)

    Li, Qiao-Zhen; Wu, Di; Chen, Xia; Zhou, Shuai; Liu, Yanfang; Yang, Yan; Cui, Fengjie

    2015-01-01

    We studied the effect of the maturation stage on the chemical compositions and macrophage activation activity of polysaccharides from the culinary-medicinal mushroom Hericium erinaceus. Results showed that total polysaccharides increased, whereas protein content decreased with the maturation stage development of fruiting body. Nine polysaccharide fractions, 3 from each of the maturity stages IV (small fungal spine stage), V (mid-fungal spine stage) and VI (mature), were prepared using the gradient ethanol precipitation method. The polysaccharide fraction HP4A isolated from the maturating-stage (stage IV) fruiting body had a significant difference from the fractions HP5A (stage V) and HP6A (stage VI) in the molecular weight distribution and monosaccharide compositions. Immunostimulating tests revealed that the polysaccharide fraction HP6 isolated from the mature stage (stage VI) fruiting body presented higher macrophage activation activity. Our findings provided important information for the harvest and use of H. erinaceus with higher qualities and functional benefits.

  10. Coordination and solvent extraction behaviour of oxozirconium(IV), thorium(IV) and dioxouranium(VI)

    International Nuclear Information System (INIS)

    Dash, K.C.

    1989-01-01

    The systematic liquid-liquid extraction behaviour of oxozirconium (IV), thorium(IV) and dioxouranium(VI) have been investigated using a number of synthesised and commercial chelating extractants. The synergism or antagonism for these processes in presence of neutral donor ligands have also been identified and the conditions for separation and isolation of pure individual metal ions have been established. The coordination behaviour of oxozirconium(IV), thorium(IV) and dioxouranium(VI) with a large number of mono- and polydentate ligands have been studied. With oxozirconium(IV), invariably always a cyclic, tetranuclear species is obtained, derived from the tetrameric structure of the parent ZrOCl 2 .8H 2 O which is actually (Zr 4 (OH) 8 (H 2 O) 16 )Cl 8 .12H 2 O. No simple, monomeric oxozirconium(IV) complex was obtained. Uranium(VI) and thorium(IV) form a wide variety of complexes of higher coordination numbers and several bi- and trinuclear complexes were also characterised where the two adjacent metal centres are joined to each other by a double hydroxo-bridge. (author). 69 refs., 3 figs., 4 tabs

  11. Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

    Science.gov (United States)

    Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

    2017-05-01

    Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

  12. 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.

  13. Variations in Oncologist Recommendations for Chemotherapy for Stage IV Lung Cancer: What Is the Role of Performance Status?

    Science.gov (United States)

    Tisnado, Diana; Malin, Jennifer; Kahn, Katherine; Landrum, Mary Beth; Fletcher, Robert; Klabunde, Carrie; Clauser, Steven; Rogers, Selwyn O; Keating, Nancy L

    2016-07-01

    Chemotherapy prolongs survival in patients with advanced non-small-cell lung cancer. However, few studies have included patients with poor performance status. This study examined rates of oncologists' recommendations for chemotherapy by patient performance status and symptoms and how physician characteristics influence chemotherapy recommendations. We surveyed medical oncologists involved in the care of a population-based cohort of patients with lung cancer from the CanCORS (Cancer Care Outcomes Research and Surveillance) study. Physicians were queried about their likelihood to recommend chemotherapy to patients with stage IV lung cancer with varying performance status (Eastern Cooperative Oncology Group performance status 0 [good] v 3 [poor]) and presence or absence of tumor-related pain. Repeated measures logistic regression was used to estimate the independent associations of patients' performance status and symptoms and physicians' demographic and practice characteristics with chemotherapy recommendations. Nearly all physicians (adjusted rate, 97% to 99%) recommended chemotherapy for patients with good performance status, and approximately half (adjusted rate, 38% to 53%) recommended chemotherapy for patients with poor performance status (P factors, physician and practice characteristics were less strongly associated with chemotherapy recommendations in adjusted analyses. Strong consensus among oncologists exists for chemotherapy in patients with advanced non-small-cell lung cancer and good performance status. However, the relatively high rate of chemotherapy recommendations for patients with poor performance status despite the unfavorable risk-benefit profile highlights the need for ongoing work to define high-value care in oncology and to implement and evaluate strategies to align incentives for such care. Copyright © 2016 by American Society of Clinical Oncology.

  14. The EPOS-CC Score: An Integration of Independent, Tumor- and Patient-Associated Risk Factors to Predict 5-years Overall Survival Following Colorectal Cancer Surgery.

    Science.gov (United States)

    Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Ikenaga, Masakazu; Koike, Shoichiro; Nakamura, Seiji; Koseki, Masato

    2015-06-01

    Surgical audit is an essential task for the estimation of postoperative outcome and comparison of quality of care. Previous studies on surgical audits focused on short-term outcomes, such as postoperative mortality. We propose a surgical audit evaluating long-term outcome following colorectal cancer surgery. The predictive model for this audit is designated as 'Estimation of Postoperative Overall Survival for Colorectal Cancer (EPOS-CC)'. Thirty-one tumor-related and physiological variables were prospectively collected in 889 patients undergoing elective resection for colorectal cancer between April 2005 and April 2007 in 16 Japanese hospitals. Postoperative overall survival was assessed over a 5-years period. The EPOS-CC score was established by selecting significant variables in a uni- and multivariate analysis and allocating a risk-adjusted multiplication factor to each variable using Cox regression analysis. For validation, the EPOS-CC score was compared to the predictive power of UICC stage. Inter-hospital variability of the observed-to-estimated 5-years survival was assessed to estimate quality of care. Among the 889 patients, 804 (90%) completed the 5-years follow-up. Univariate analysis displayed a significant correlation with 5-years survival for 14 physiological and nine tumor-related variables (p model for the prediction of survival. Risk-adjusted multiplication factors between 1.5 (distant metastasis) and 0.16 (serum sodium level) were accorded to the different variables. The predictive power of EPOS-CC was superior to the one of UICC stage; area under the curve 0.87, 95% CI 0.85-0.90 for EPOS-CC, and 0.80, 0.76-0.83 for UICC stage, p < 0.001. Quality of care did not differ between hospitals. The EPOS-CC score including the independent variables age, performance status, serum sodium level, TNM stage, and lymphatic invasion is superior to the UICC stage in the prediction of 5-years overall survival. This higher accuracy might be explained by the

  15. AtchitIV gene expression is stimulated under abiotic stresses and is spatially and temporally regulated during embryo development

    Directory of Open Access Journals (Sweden)

    Liliane B. de A. Gerhardt

    2004-01-01

    Full Text Available The expression of AtchitIV gene was analysed in Arabidopsis plants submitted to abiotic stresses. Transcript accumulation was detected in leaves in response to UV light exposure, exogenous salicylic acid administration and wounding. Transgenic Arabidopsis plants carrying AtchitIV promoter::gus fusion also showed differential expression of the reporter gene in response to these treatments. The AtchitIV expression was also analysed during Arabidopsis embryo development. GUS assay demonstrated AtchitIV promoter activation in zygotic embryos from torpedo stage up to full maturation. Promoter deletion analysis indicated that all the 5' cis-acting elements responsible for the specific tissue expression are located in a region of 1083 bp, adjacent to the start of transcription. A negative regulatory region located between portions -1083 and -600 was also observed.

  16. Failure of misonidazole-sensitized radiotherapy to impact upon outcome among stage III-IV squamous cancers of the head and neck

    International Nuclear Information System (INIS)

    Fazekas, J.; Pajak, T.F.; Wasserman, T.; Marcial, V.; Davis, L.; Kramer, S.; Rotman, M.; Stetz, J.

    1987-01-01

    As part of the RTOG research effort in the treatment of advanced, inoperable squamous cancer of the head and neck region, the hypoxic cell sensitizer, misonidazole, was selected for investigation as an adjuvant to definitive irradiation. Based upon a pilot experience (78-02) showing a 67% complete response rate among 36 AJC Stage III-IV patients receiving full-dose irradiation and 6 weekly p.o. doses of misonidazole, a phase III trial was carried out from '79-'83. Three hundred and six patients were entered, 42% of whom had oropharyngeal primaries and with 78% of all cases representing T3 or T4 (inoperable) lesions. Only 16% of the entire series presented with N0 necks. Fractionation was altered among the misonidazole-receiving patients, in contrast to standard 5 treatments per week among control patients, such that 2 separate treatments were given on each day of p.o. misonidazole administration (2.0 gm/m2/wk X 6 doses, 2.5 Gy in a.m., 2.1 Gy in p.m.). Total tumor doses were identical among the two treatment arms except that a limitation of 40.0 Gy to spinal cord was specified for sensitized radiotherapy vs. 45.0 Gy for control patients. Primary tumor clearance was observed to be 55-60%, with minor variations according to tumor stage and site. The local regional control rate among radiotherapy-alone patients was 26% at 2 years compared to 22% (2 years) within the misonidazole-receiving group. Analysis of survival revealed no advantage to the sensitized patients, with 55 +/- 2% surviving 1 year and 22 +/- 1% living 3 years following treatment in both treatment categories. Distant metastases as first site of failure (12-13%) and the local failure among initial complete responders (46%) showed no advantage to the misonidazole group. Although a misonidazole dosage of 2.0 gm/m2/wk X 6 (12 gm/m2 total) is well tolerated, no clinical benefit was demonstrated in this randomized trial

  17. Synthesis and characterization of chiral thorium(IV) and uranium(IV) benzamidinate complexes

    Energy Technology Data Exchange (ETDEWEB)

    Schoene, Sebastian; Maerz, Juliane; Kaden, Peter; Patzschke, Michael; Ikeda-Ohno, Atsushi [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Chemistry of the F-Elements

    2017-06-01

    Two chiral benzamidinate complexes of tetravalent actinides (Th(IV) and U(IV)) were synthesized using a salt metathesis reaction of the corresponding actinide(IV) tetrachlorides and the potassium salt of the chiral benzamidine (S,S)-N,N-Bis-(1-phenylethyl)-benzamidine ((S)-HPEBA). The structure of the complexes was determined with single crystal X-ray diffraction. These are the first examples of chiral amidinate complexes of actinides.

  18. iväkoti Riemula

    OpenAIRE

    Alanko, Reetta; Ihanamäki, Katja

    2012-01-01

    Opinnäytetyössä kuvataan yleisesti päivähoidon kehitystä Suomessa sekä päivähoitoa yrittäjän näkökulmasta, tuoden esille sen tämän päivän haasteet ja mahdollisuudet. Työssä on pohdittu yhteistyön merkitystä kunnan kanssa ja sitä, miten kunta voi osaltaan joko rajoittaa tai edesauttaa yksityisen päivähoitoyrityksen toimintaa. Opinnäytetyössä kerrotaan teoriassa Päiväkoti Riemula nimisen, erityispäivähoitopalveluita tarjoavan yrityksen perustamiseen liittyvistä suunnitelmista. Suunnitelluss...

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

    Directory of Open Access Journals (Sweden)

    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

  20. IARC Report to the Union for International Cancer Control (UICC) on the Interphone Study

    International Nuclear Information System (INIS)

    Wild, Christopher

    2011-01-01

    Mobile phone use has increased dramatically in many countries since its introduction in the early-to-mid 1980's. The expanding use of this technology has been accompanied by concerns about health and safety. In the late 1990's, several expert groups critically reviewed the evidence on health effects of low-level exposure to radiofrequency (RF) electromagnetic fields emitted by mobile phones, and recommended research into the possible adverse health effects of mobile telephone use. As a result, the International Agency for Research on Cancer (IARC) coordinated a feasibility study in 1998 and 1999, which concluded that an international study of the relationship between mobile phone use and brain tumour risk would be feasible and informative. Interphone was therefore initiated as an international set of case-control studies focussing on four types of tumours in tissues that most absorb RF energy emitted by mobile phones: tumours of the brain (glioma and meningioma), acoustic nerve (schwannoma) and parotid gland. The objective was to determine whether mobile phone use increases the risk of these tumours and, specifically, whether RF energy emitted by mobile phones is carcinogenic. The methods, results and conclusions are provided here and thus this report to the UICC marks the completion of the Interphone Study. A major strength of the Interphone study was the conduct of several validation studies to assist in assessing the study's strengths and limitations and inform the researchers about possible shortcomings when interpreting the main results. In this context Interphone is quite unique among epidemiological studies on health effects of mobile phone use and the insight obtained from the validation studies is also informative when it comes to evaluating other studies in this field. The comprehensive validation studies are a unique feature of Interphone, enabling the researchers to quantify problems persistent in this type of observational studies and to assist in the

  1. IV access in dental practice.

    LENUS (Irish Health Repository)

    Fitzpatrick, J J

    2009-04-01

    Intravenous (IV) access is a valuable skill for dental practitioners in emergency situations and in IV sedation. However, many people feel some apprehension about performing this procedure. This article explains the basic principles behind IV access, and the relevant anatomy and physiology, as well as giving a step-by-step guide to placing an IV cannula.

  2. Assessment of Serosal Invasion and Criteria for the Classification of Pathological (p) T4 Staging in Colorectal Carcinoma: Confusions, Controversies and Criticisms

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Colin J. R., E-mail: colin.stewart@health.wa.gov.au; Hillery, Simon [Department of Histopathology, SJOG Hospital, Perth, Western Australia (Australia); Platell, Cameron [Colorectal Surgery Unit, SJOG Hospital, Perth, Western Australia and University of Western (Australia); Puppa, Giacomo [Division of Pathology, ‘G. Fracastoro’ City Hospital, Verona (Italy)

    2011-01-04

    Transmural spread by colorectal carcinoma can result in tumor invasion of the serosal surface and, hence, more likely dissemination within the peritoneal cavity and potentially to additional metastatic sites. The adverse prognostic significance of serosal invasion is widely accepted and its presence may be considered an indication for chemotherapy in patients with node negative disease. However, controversy persists regarding the most appropriate criteria for diagnosis and there are also practical difficulties associated with histological assessment in some cases. Therefore, serosal invasion may be under-diagnosed in a significant proportion of tumors, potentially leading to sub-optimal treatment of high-risk patients. The examination of multiple microscopic sections combined with ancillary studies such as cytology preparations, elastin stains, and immunohistochemistry may prove beneficial in selected problematic cases, but these are not used routinely. The relative prognostic significance of serosal invasion and of direct tumor spread to other organs, both of which are incorporated within the pT4 category of the AJCC/UICC TNM staging system, remains unclear. Further studies are required to demonstrate whether recent adjustments to the TNM staging of pT4 tumors are appropriate.

  3. A phase 2, multicenter, open-label study of sepantronium bromide (YM155) plus docetaxel in patients with stage III (unresectable) or stage IV melanoma

    International Nuclear Information System (INIS)

    Kudchadkar, Ragini; Ernst, Scott; Chmielowski, Bartosz; Redman, Bruce G; Steinberg, Joyce; Keating, Anne; Jie, Fei; Chen, Caroline; Gonzalez, Rene; Weber, Jeffrey

    2015-01-01

    Survivin is a microtubule-associated protein believed to be involved in preserving cell viability and regulating tumor cell mitosis, and it is overexpressed in many primary tumor types, including melanoma. YM155 is a first-in-class survivin suppressant. The purpose of this Phase 2 study was to evaluate the 6-month progression-free survival (PFS) rate in patients with unresectable Stage III or IV melanoma receiving a combination of YM155 plus docetaxel. The study had two parts: Part 1 established the dose of docetaxel that was tolerable in combination with YM155, and Part 2 evaluated the tolerable docetaxel dose (75 mg/m 2 ) in combination with YM155 (5 mg/m 2 per day continuous infusion over 168 h every 3 weeks). The primary endpoint was 6-month PFS rate. Secondary endpoints were objective response rate (ORR), 1-year overall survival (OS) rate, time from first response to progression, clinical benefit rate (CBR), and safety. Sixty-four patients with metastatic melanoma were treated with docetaxel and YM155. Eight patients received an initial docetaxel dose of 100 mg/m 2 and 56 patients received 75 mg/m 2 of docetaxel. Six-month PFS rate per Independent Review Committee (IRC) was 34.8% (n = 64; 95% CI, 21.3–48.6%), and per Investigator was 31.3% (n = 64; 95% CI, 19.5–43.9%). The best ORR (complete response [CR] + partial response [PR]) per IRC was 12.5% (8/64). The stable disease (SD) rate was 51.6% (33/64), leading to a CBR (CR + PR + SD) of 64.1% (41/64). Estimated probability of 1-year survival was 56.3%. YM155 is a novel agent showing modest activity when combined with docetaxel for treating patients with melanoma. YM155 was generally well tolerated, but the predetermined primary efficacy endpoint (i.e., 6-month PFS rate ≥20%) was not achieved

  4. Type IV collagen is a novel DEJ biomarker that is reduced by radiotherapy.

    Science.gov (United States)

    McGuire, J D; Gorski, J P; Dusevich, V; Wang, Y; Walker, M P

    2014-10-01

    The dental basement membrane (BM) is composed of collagen types IV, VI, VII, and XVII, fibronectin, and laminin and plays an inductive role in epithelial-mesenchymal interactions during tooth development. The BM is degraded and removed during later-stage tooth morphogenesis; however, its original position defines the location of the dentin-enamel junction (DEJ) in mature teeth. We recently demonstrated that type VII collagen is a novel component of the inner enamel organic matrix layer contiguous with the DEJ. Since it is frequently co-expressed with and forms functional complexes with type VII collagen, we hypothesized that type IV collagen should also be localized to the DEJ in mature human teeth. To identify collagen IV, we first evaluated defect-free erupted teeth from various donors. To investigate a possible stabilizing role, we also evaluated extracted teeth exposed to high-dose radiotherapy--teeth that manifest post-radiotherapy DEJ instability. We now show that type IV collagen is a component within the morphological DEJ of posterior and anterior teeth from individuals aged 18 to 80 yr. Confocal microscopy revealed that immunostained type IV collagen was restricted to the 5- to 10-µm-wide optical DEJ, while collagenase treatment or previous in vivo tooth-level exposure to > 60 Gray irradiation severely reduced immunoreactivity. This assignment was confirmed by Western blotting with whole-tooth crown and enamel extracts. Without reduction, type IV collagen contained macromolecular α-chains of 225 and 250 kDa. Compositionally, our results identify type IV collagen as the first macromolecular biomarker of the morphological DEJ of mature teeth. Given its network structure and propensity to stabilize the dermal-epidermal junction, we propose that a collagen-IV-enriched DEJ may, in part, explain its well-known fracture toughness, crack propagation resistance, and stability. In contrast, loss of type IV collagen may represent a biochemical rationale for the DEJ

  5. Gender and gonadal maturity stage identification of captive Chinese sturgeon, Acipenser sinensis, using ultrasound imagery and sex steroids.

    Science.gov (United States)

    Du, Hao; Zhang, Xiaoyan; Leng, Xiaoqian; Zhang, Shuhuan; Luo, Jiang; Liu, Zhigang; Qiao, Xingmei; Kynard, Boyd; Wei, Qiwei

    2017-05-01

    Long lifespan and late maturation make it difficult to establish gamete maturity and breeding age of captive endangered Chinese sturgeon, Acipenser sinensis. This greatly handicaps timely breeding and future conservation stocking efforts. We used ultrasound imagery and sex steroids to determine the gender and gonadal maturity stage of captive Chinese sturgeon (age, 10-17years old). The echogenicity of the reproductive organs and the respective morphology of the gonads were described and two quantitative parameters p o (proportion of the ovary to the entire reproductive organs) and d (thickness of the reproductive organs) were measured to characterize sex and maturity stage of Chinese sturgeon. Females were accordingly placed fish into several categories: F II (F II - , F II , F II + ), F III (F III , F III + ) and F IV (F IV , F IV + ) and F VI and males as M II , M III , M IV , M V and M VI . The accuracy of gender and maturity stage determination provided by ultrasonographic methods was 72.7% for F II - ovary (n=11) and 76.2% for M II testis (n=42). Accuracy of sex and maturity determination using only serum sex steroid of testosterone (T) and estradiol-17β (E 2 ) was low (58-73%, depending on maturity stage). However, when the two methods were used together, accuracy increased sharply, especially for immature (II stage) females. In summary, of 151 Chinese sturgeon, whose sex and maturity stage were independently confirmed, 88.1% (n=133), 62.9% (n=95), and 96.7% (n=146) were successfully sexed and staged using ultrasound, sex steroids, or both methods, respectively. The results provide reliable non-invasive techniques for determining sex and gonadal maturation of captive Chinese sturgeon. These methods can track individual gonad characteristics over multi-year reproductive cycles, which will assist captive broodstock management, artificial reproduction, and future conservation stocking. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Treatment results of radiotherapy for carcinoma of the cervical esophagus

    International Nuclear Information System (INIS)

    Yamada, Kazunari; Okuno, Yoshishige; Nakajima, Toshifumi; Kusumi, Fusako; Takakuwa, Hiroshi; Matsusue, Satoru; Murakami, Masao; Okamoto, Yoshiaki

    2006-01-01

    The methods and results of treatment for cancer of the cervical esophagus differ from those for cancer of the thoracic esophagus. Our objective was to retrospectively review the outcome for cervical esophageal cancer patients treated with radiotherapy. Twenty-seven patients with carcinoma of the cervical esophagus treated with definitive radiotherapy from 1988 to 2002 were enrolled in the study. Clinical stage (UICC 1997) was stage I in five, II in six, III in 12 and IV in four. Concurrent head and neck malignancy was found in six patients (22%). The mean radiation dose was 66 Gy. Concurrent chemotherapy (cisplatin and 5-fluorouracil) was performed in 23 patients. The actuarial overall survival rates at 1, 3 and 5 years were 55.6%, 37.9% and 37.9%, respectively, with a median survival of 13.9 months. In the patients with stage I, the 3-year and 5-year survival rates were 75% and 75%, respectively. With univariate analysis, only two of the possible prognostic factors were found to actually influence survival: performance status (p<0.01) and tumor length (p<0.01). The survival of patients with cervical esophageal cancer remains poor. It is thought that organ preservation is possible by definitive chemoradiation for early cancer

  7. A randomized phase II trial of first-line treatment with gemcitabine, erlotinib, or gemcitabine and erlotinib in elderly patients (age ≥70 years) with stage IIIB/IV non-small cell lung cancer.

    Science.gov (United States)

    Stinchcombe, Thomas E; Peterman, Amy H; Lee, Carrie B; Moore, Dominic T; Beaumont, Jennifer L; Bradford, Daniel S; Bakri, Kamal; Taylor, Mark; Crane, Jeffrey M; Schwartz, Garry; Hensing, Thomas A; McElroy, Edwin; Niell, Harvey B; Harper, Harry D; Pal, Sridhar; Socinski, Mark A

    2011-09-01

    Single-agent gemcitabine is a standard of care for elderly patients with advanced non-small cell lung cancer, but novel therapies are needed for this patient population. We performed a noncomparative randomized phase II trial of gemcitabine, erlotinib, or the combination in elderly patients (age ≥70 years) with stage IIIB or IV non-small cell lung cancer. Patients were randomized to arms: A (gemcitabine 1200 mg/m on days 1 and 8 every 21 days), B (erlotinib 150 mg daily), or C (gemcitabine 1000 mg/m on days 1 and 8 every 21 days and erlotinib 100 mg daily). Arms B and C were considered investigational; the primary objective was 6-month progression-free survival. Between March 2006 and May 2010, 146 eligible patients received protocol therapy. The majority of the patients (82%) had stage IV disease, 64% reported adenocarcinoma histology, 90% reported current or previous tobacco use, and 28% had a performance status of 2. The 6-month progression-free survival rate observed in arms A, B, and C was 22% (95% confidence interval [CI] 11-35), 24% (95% CI 13-36), and 25% (95% CI 15-38), respectively; the median overall survival observed was 6.8 months (95% CI 4.8-8.5), 5.8 months (95% CI 3.0-8.3), and 5.6 months (95% CI 3.5-8.4), respectively. The rate of grade ≥3 hematological and nonhematological toxicity observed was similar in all three arms. The best overall health-related quality of life response did not differ between treatment arms. Erlotinib or erlotinib and gemcitabine do not warrant further investigation in an unselected elderly patient population.

  8. IMPACT STUDY: MK-0646 (DALOTUZUMAB, INSULIN GROWTH FACTOR 1 RECEPTOR (IGF-1R ANTIBODY COMBINED WITH PEMETREXED AND CISPLATIN IN STAGE IV METASTATIC NON-SQUAMOUS LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Chao H Huang

    2016-01-01

    Full Text Available Background: Insulin-like growth factor 1 receptor (IGF-1R regulates cell growth, proliferation and apoptosis. Adenocarcinoma and never-smokers have a higher expression of IGF-1R, which is associated with worse overall survival. Dalotuzumab-MK0646 (D is a humanized monoclonal antibody that targets IGF-1R. Pemetrexed (P has higher activity in non-squamous lung cancer (NSQL. We initiated a randomized phase II trial to test the combination of P and Cisplatin (C +/- D in NSQL.Methods: Eligibility criteria: untreated NSQL stage IIIB or IV, ECOG 0 or 1, measurable disease, adequate renal, hepatic and hematologic function, and no other intercurrent illness. P at 500mg/m2 and C at 75mg/m2 IV were given every 3 weeks. D was given at 10mg/kg IV weekly on days 1, 8 and 15 of every 3-week cycle in the experimental group. The patients had a radiographic assessment after every 2 cycles and were treated for a maximum of 6 cycles if there was a response or stable disease. The primary objective of the study was to compare the clinical response rates of PC vs PC+D. Results: From 1/2009 to 2/2011, the study accrued 26 subjects: 16 male and 10 female, with a median age of 59; 14 were treated with PC and 12 were treated with PC+D. We observed 2 partial responses (PR, 7 stable disease (SD, 3 progressive disease (PD, and 2 were not evaluable (NE in the PC arm. In comparison, for the PC+D arm there were: 3 PR, 4 SD, 4 PD and 1 NE. The hematologic toxicity was similar in both groups. There higher incidence of hyperglycemia the experimental group; 4 cases with grade 3 and 1 case with grade 4. Conclusion: PC+D had a similar response rate compared to PC, with a higher rate of hyperglycemia. Identification of responders using predictive markers would be key to continuing the study of D in NSQL.

  9. Multimodality treatment including postoperative radiation and concurrent chemotherapy with weekly docetaxel is feasible and effective in patients with oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Kovacs, A.F.; Bitter, K.; Mose, S.; Boettcher, H.D.

    2005-01-01

    Background: to examine the feasibility and efficacy of weekly docetaxel with concurrent radiation as postoperative treatment in a multimodality approach to oral and oropharyngeal cancer. Patients and methods: 94 patients (Table 1) with primary resectable squamous cell carcinoma of the oral cavity and oropharynx (UICC stage I 14%, II 15%, III 18%, IV 53%; Table 2) were treated with a multimodality therapy program consisting of neoadjuvant intra-arterial high-dose chemotherapy (cisplatin 150 mg/m 2 with parallel systemic sodium thiosulfate 9 g/m 2 for neutralization), followed by surgery of the primary and neck, and postoperative concurrent radiation and chemotherapy with weekly docetaxel (20-30 mg/m 2 ; Table 3). Chronic toxicities were followed over a period of 5 years. Results: at a median follow-up of 4 years, the 5-year survival rate for all 94 patients was 80%, and disease-free survival was 73% (Figures 1 and 2). Among patients with advanced disease (stage III and IV), survival was 83 and 59%, respectively (Figure 4). Grade 3 and 4 mucositis was the main acute toxicity necessitating supportive care. Long-term toxicity appears to be moderate (Table 4). The maximum tolerated dose of weekly docetaxel was 25 mg/m 2 . Conclusions: concurrent radiation and chemotherapy with weekly docetaxel is a feasible postoperative treatment in a multimodality approach to oral and oropharyngeal cancer, resulting in high overall and disease-free survival. This approach warrants further evaluation in prospective randomized trials. (orig.)

  10. Complexation of the An(IV) by NTA; Complexation des An(IV) par le NTA

    Energy Technology Data Exchange (ETDEWEB)

    Bonin, L. [Paris-11 Univ., 91 - Orsay (France)]|[CEA Valrho, Lab. de Chimie des Actinides (LCA), 30 - Marcoule (France)

    2006-07-01

    In the framework of the Nuclear and Environmental Toxicology program, developed in France, it has been decided to take again the studies concerning the actinides decorporation. A similar study of the neptunium complexation by the citrate ions has been carried out on the complexation of Np(IV) with the nitrilotriacetic acid (NTA). The NTA can be considered as a model molecule of the de-corporating molecules (amino-carboxy- ligand). The results of the spectrophotometric measurements being encouraging, the behaviour of several actinides at the same oxidation state (+IV) (Th(IV), U(IV), Np(IV), and Pu(IV)) has been determined. The experimental results are presented. In order to determine the structure of the complexes of stoichiometry 1:2 An(IV)-(NTA){sub 2} in solution, quantic chemistry calculations and EXAFS measurements have been carried out in parallel. These studies confirm the presence of An(IV)-nitrogen bonds whose length decreases from thorium to plutonium and indicate the presence of a water molecule bound to the thorium and the uranium (coordination number 8 for Np/Pu, 9 for Th/U). The evolution of the complexation constants determined in this study in terms of 1/r (r ionic radius of the cation taking into account its coordination number 8 or 9) confirms the change of the coordination number between Th/U and Np/Pu. (O.M.)

  11. Rectal cancer in Luxembourg : a national population-based data report, 1988–1998

    International Nuclear Information System (INIS)

    Scheiden, René; Sand, Julien; Weber, Joseph; Turk, Philippe; Wagener, Yolande; Capesius, Catherine

    2003-01-01

    Morphologic criteria which might help to support the need for a preventive strategy for early detection of rectal cancer were analysed. Population-based data on rectal adenomas with high-grade dysplastic changes (n = 199) and invasive adenocarcinomas (n = 912) registered by the national Morphologic Tumour Registry (MTR) and diagnosed in a central department of pathology in Luxembourg between 1988 and 1998 were considered. The analysis concerned time trends in frequency, crude incidence, tumour-stage, the rectal 'high-grade' adenoma/invasive adenocarcinoma-ratio and the survival rates. Histopathological tumour-stage parameters (UICC/AJCC, 1997) in a consecutive series of 641 resected rectal cancers and their relationship with the observed patient survival are investigated. The majority of invasive adenocarcinomas are diagnosed at a late stage (i.e. Stage II and III) into contrast with the highly significant increase (355 %) in frequency of rectal high-grade adenomas (Stage 0). During the two-time periods 1988–1992 and 1994–1998 Stage I and Stage IV-cases decreased by 11 % and 47 % respectively. Tumour-stage correlates with prognosis. The rectal high-grade adenoma / invasive adenocarcinoma-ratio improved significantly over the last five years. Over the study period, there has been a highly significant rise in the incidence of resected rectal adenomas with high-grade intraepithelial neoplasia. The ratio of early tumours to invasive cancers has risen while the numbers of colonoscopies and rectoscopies remained unchanged respectively decreased. As the number of advanced tumour-stages remained stable, mass-screening procedures focusing on the fifty to sixty age group should be reinforced

  12. Endemic chronic kidney disease of unknown etiology in Sri Lanka: Correlation of pathology with clinical stages.

    Science.gov (United States)

    Wijetunge, S; Ratnatunga, N V I; Abeysekera, T D J; Wazil, A W M; Selvarajah, M

    2015-01-01

    Chronic kidney disease of unknown etiology (CKDU) is endemic among the rural farming communities in several localities in and around the North Central region of Sri Lanka. This is an interstitial type renal disease and typically has an insidious onset and slow progression. This study was conducted to identify the pathological features in the different clinical stages of CKDU. This is a retrospective study of 251 renal biopsies identified to have a primary interstitial disease from regions endemic for CKDU. Pathological features were assessed and graded in relation to the clinical stage. The mean age of those affected by endemic CKDU was 37.3 ± 12.5 years and the male to female ratio was 3.3:1. The predominant feature of stage I disease was mild and moderate interstitial fibrosis; most did not have interstitial inflammation. The typical stage II disease had moderate interstitial fibrosis with or without mild interstitial inflammation. Stage III disease had moderate and severe interstitial fibrosis, moderate interstitial inflammation, tubular atrophy and some glomerulosclerosis. Stage IV disease typically had severe interstitial fibrosis and inflammation, tubular atrophy and glomerulosclerosis. The mean age of patients with stage I disease (27 ± 10.8 years) was significantly lower than those of the other stages. About 79.2%, 55%, 49.1% and 50% in stage I, II, III and IV disease respectively were asymptomatic at the time of biopsy.

  13. Pre-irradiation and surgical intervention in patients with squamous cell carcinomas of the oral cavity and the oropharynx: Results of a study conducted from 1973 to 1984

    International Nuclear Information System (INIS)

    Knoebber, D.; Sack, H.; Stuetzer, H.; Rose, K.G.

    1987-01-01

    In collaboration with the Radiotherapeutic Hospital, 87 patients with squamous cell carcinomas of the oral cavity and the oropharynx were treated by combined pre-irradiation and surgical intervention at the University ORL Hospital of Cologne. The study was supposed to improve the five-year survival of patients suffering from advanced carcinomas of the head and neck area. The male and female patient's ratio was 4,5 to 1. Half of the patients had squamous cell carcinomas of the oropharynx, 21 patients had tumors of the floor of the mouth, and another 21 had tumors of the anterior two thirds of the tongue. The tumor and lymph node status was classified according to the UICC regulations (1979). In the pre-irradiation, 40 to 50 Gy were applied to the primary tumor and the regional lymph nodes. Surgery was executed generally four weeks after pre-irradiation. The tumor remission following to pre-irradiation was very good. 27% of the patients showed little or moderate post-operative disturbances in wound healing. An osteoradionecrosis was found in 4,6%. Almost 25% of the patients developed local recurrences. The cumulated five-year survival of all patients is 32%. In dependence on TNM stages, the three-year survival rates are as follows: stage I and II 80%, stage III 44%, and stage IV 40%. (orig.) [de

  14. Second-line Treatment of Stage III/IV Non-Small-Cell Lung Cancer (NSCLC with pemetrexed in routine clinical practice: Evaluation of performance status and health-related quality of life

    Directory of Open Access Journals (Sweden)

    Schuette Wolfgang

    2012-01-01

    Full Text Available Abstract Background Second-line treatment of advanced non-small-cell lung cancer (NSCLC improves overall survival. There is a lack of data regarding the impact on patients' overall health condition. This prospective, non-interventional study evaluated performance status (PS and health-related quality of life (HR-QoL during second-line pemetrexed treatment in routine clinical practice. Methods Stage III/IV NSCLC patients who initiated second-line pemetrexed (standard vitamin and dexamethasone supplementation were observed for a maximum of 9 treatment cycles. The primary objective was to evaluate the proportion of patients achieving improvement of Karnofsky Index (KI of ≥ 10% (absolute or maintaining KI ≥ 80% after the second treatment cycle ("KI benefit response". HR-QoL was self-rated using the EuroQoL-5D questionnaire (EQ-5D. Factors potentially associated with KI benefit response were evaluated using logistic regression models. Results Of 521 eligible patients (73.5% Stage IV, median age 66.3 yrs, 36.1% ≥ 70 yrs, 62.0% with KI ≥ 80%, 471 (90.4% completed at least 2 treatment cycles. 58.0% (95%CI 53.6%;62.2% achieved KI benefit response after the second cycle. Patients with baseline KI ≥ 80%, no Grade 3/4 toxicities during the first 2 cycles, or combination regimen as prior first-line therapy were more likely to achieve a KI benefit response. EQ-5D scores improved over time. Grade 3/4 toxicities were reported in 23.8% of patients (mainly fatigue/asthenia 15.9%, neutropenia 8.7%. Conclusions In this large prospective, non-interventional study of second-line pemetrexed treatment in patients with advanced NSCLC, including 36% elderly patients ( ≥ 70 years, physician-rated PS and self-rated HR-QoL were maintained or improved in the majority of patients. Trial registration Registered on ClinicalTrials.gov (NCT00540241 on October 4, 2007

  15. Metabolic tumor burden quantified on [{sup 18}F]FDG PET/CT improves TNM staging of lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Lapa, Paula; Isidoro, Jorge; Costa, Gracinda [Centro Hospitalar e Universitario de Coimbra, Nuclear Medicine Department, Coimbra (Portugal); Oliveiros, Barbara [University of Coimbra, Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, Coimbra (Portugal); University of Coimbra, Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, Coimbra (Portugal); Marques, Margarida [University of Coimbra, Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, Coimbra (Portugal); Centro Hospitalar e Universitario de Coimbra, Technology and Information Systems Department, Coimbra (Portugal); Caseiro Alves, Filipe [Centro Hospitalar e Universitario de Coimbra, Radiology Department, Coimbra (Portugal); Nascimento Costa, J.M. [University of Coimbra, University Oncology Clinic, Faculty of Medicine, Coimbra (Portugal); Lima, Joao Pedroso de [Centro Hospitalar e Universitario de Coimbra, Nuclear Medicine Department, Coimbra (Portugal); University of Coimbra, Institute of Nuclear Sciences Applied to Health-ICNAS, Coimbra (Portugal)

    2017-12-15

    The purpose of our study was to test a new staging algorithm, combining clinical TNM staging (cTNM) with whole-body metabolic active tumor volume (MATV-WB), with the goal of improving prognostic ability and stratification power. Initial staging [{sup 18}F]FDG PET/CT of 278 non-small cell lung cancer (NSCLC) patients, performed between January/2011 and April/2016, 74(26.6%) women, 204(73.4%) men; aged 34-88 years (mean ± SD:66 ± 10), was retrospectively evaluated, and MATV-WB was quantified. Each patient's follow-up time was recorded: 0.7-83.6 months (mean ± SD:25.1 ± 20.3). MATV-WB was an independent and statistically-significant predictor of overall survival (p < 0.001). The overall survival predictive ability of MATV-WB (C index: mean ± SD = 0.7071 ± 0.0009) was not worse than cTNM (C index: mean ± SD = 0.7031 ± 0.007) (Z = -0.143, p = 0.773). Estimated mean survival times of 56.3 ± 3.0 (95%CI:50.40-62.23) and 21.7 ± 2.2 months (95%CI:17.34-25.98) (Log-Rank = 77.48, p < 0.001), one-year survival rate of 86.8% and of 52.8%, and five-year survival rate of 53.6% and no survivors, were determined, respectively, for patients with MATV-WB < 49.5 and MATV-WB ≥ 49.5. Patients with MATV-WB ≥ 49.5 had a mortality risk 2.9-5.8 times higher than those with MATV-WB < 49.5 (HR = 4.12, p < 0.001). MATV-WB cutoff points were also determined for each cTNM stage: 23.7(I), 49.5(II), 52(III), 48.8(IV) (p = 0.029, p = 0.227, p = 0.025 and p = 0.001, respectively). At stages I, III and IV there was a statistically-significant difference in the estimated mean overall survival time between groups of patients defined by the cutoff points (p = 0.007, p = 0.004 and p < 0.001, respectively). At stage II (p = 0.365), there was a clinically-significant difference of about 12 months between the groups. In all cTNM stages, patients with MATV-WB ≥ cutoff points had lower survival rates. Combined clinical TNM-PET staging (cTNM-P) was then tested: Stage I < 23.7; Stage I

  16. Preparation of graphene oxide-manganese dioxide for highly efficient adsorption and separation of Th(IV)/U(VI).

    Science.gov (United States)

    Pan, Ning; Li, Long; Ding, Jie; Li, Shengke; Wang, Ruibing; Jin, Yongdong; Wang, Xiangke; Xia, Chuanqin

    2016-05-15

    Manganese dioxide decorated graphene oxide (GOM) was prepared via fixation of crystallographic MnO2 (α, γ) on the surface of graphene oxide (GO) and was explored as an adsorbent material for simultaneous removal of thorium/uranium ions from aqueous solutions. In single component systems (Th(IV) or U(VI)), the α-GOM2 (the weight ratio of GO/α-MnO2 of 2) exhibited higher maximum adsorption capacities toward both Th(IV) (497.5mg/g) and U(VI) (185.2 mg/g) than those of GO. In the binary component system (Th(IV)/U(VI)), the saturated adsorption capacity of Th(IV) (408.8 mg/g)/U(VI) (66.8 mg/g) on α-GOM2 was also higher than those on GO. Based on the analysis of various data, it was proposed that the adsorption process may involve four types of molecular interactions including coordination, electrostatic interaction, cation-pi interaction, and Lewis acid-base interaction between Th(IV)/U(VI) and α-GOM2. Finally, the Th(IV)/U(VI) ions on α-GOM2 can be separated by a two-stage desorption process with Na2CO3/EDTA. Those results displayed that the α-GOM2 may be utilized as an potential adsorbent for removing and separating Th(IV)/U(VI) ions from aqueous solutions. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Reduction stripping of plutonium (IV) with hydroxylamine nitrate in the centrifugal contactor

    International Nuclear Information System (INIS)

    Zhang Zefu; Ding Dachun; Fei Hongcheng

    1989-01-01

    Reduction stripping of Pu(IV) with hydroxylamine nitrate under conditions of Purex 3B contactor is carried out with 16-stage mixer-centrifugal settler in laboratory scale. Results show that the apparent recovery of Pu is more than 99.9%. But there is a great difference in the concentration of plutonium of every stage in extraction equipment at different temperature. For example, plutonium concentrations in organic phase of several stages near the organic effluent at 45-50 deg C are lower than that at 20-24 deg C. Thus, recovery efficiency of plutonium can be assured only for the former. However, plutonium will probably be lost, if operating conditions are fluctuated. In addition, plutonium accumulated in the extraction equipment increased appreciably for the case of 20-24 deg C. Therefore, in order to ensure recovery efficiency of Pu, reduction stripping of Pu should be made at higher temperature

  18. [Evaluation of the quality of life in patients with breast cancer at different TNM stages after standardized treatment].

    Science.gov (United States)

    Huang, Rong; Huang, Yuan; Tao, Ping; Li, Hui; Wang, Qiong; Li, Hui; Li, Jia-yuan

    2013-01-01

    To evaluate the quality of life (QOL) in patients with breast cancer at different TNM stages and to estimate the value of EuroQol Five Dimension Indicator (EQ-5D) in measuring QOL among Chinese breast cancer patients. A survey with Quality of Life Instruments for Cancer Patients-Breast Cancer (QLICP-BR) and EQ-5D was undertaken in breast cancer patients who had completed their standardized treatment (except for the endocrine treatment) six months ago. Chi-square test, one-way ANOVA, and covariance analysis were used to evaluate the possible factors influencing the QOL of breast cancer patients. Simultaneously, with the results of Quality of Life Instruments for Cancer Patients-General Module (QLICP-GM, which is included in QLICP-BR.) and the total scores of QLICP-BR as standard, we conducted Pearson correlation analysis to evaluate the value of EQ-5D. A total of 178 female breast cancer survivors were collected from March 2010 to September 2010. There were 47 cases (26.4%) at stage 0 and I, 81 cases (45.5%) at stage II, and 50 cases (28.1%) at stage III and IV. The total standardized score of QLICP-BR was 72.55 ± 3.10 in patients at stage 0 and I, 64.09 ± 2.69 in patients at stage II and 58.21 ± 3.00 in patients at stage III and IV. The total standardized score of QLICP-BR and social domain of patients at stage 0 and I were higher than patients at stage II (all P stage 0 and I were higher than patients at stage III and IV (all P stages when age, degree of education, birth place (metropolis or rural), occupation, domestic income, and medical insurance were controlled (P = 0.002). Correlation analysis indicated that EQ-5D has a positive correlation with QLICP-GM and QLICP-BR (all P stage breast cancer is better than those at late stage. Early diagnosis and treatment can improve QOL of breast cancer patients. Chinese version of EQ-5D can well detect the differences of QOL among patients with different TNM stages, which can be used for evaluating QOL in Chinese

  19. Avascular necrosis of the femoral head; Staging by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    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).

  20. X-Band Electron Paramagnetic Resonance Comparison of Mononuclear Mn(IV)-oxo and Mn(IV)-hydroxo Complexes and Quantum Chemical Investigation of Mn(IV) Zero-Field Splitting.

    Science.gov (United States)

    Leto, Domenick F; Massie, Allyssa A; Colmer, Hannah E; Jackson, Timothy A

    2016-04-04

    X-band electron paramagnetic resonance (EPR) spectroscopy was used to probe the ground-state electronic structures of mononuclear Mn(IV) complexes [Mn(IV)(OH)2(Me2EBC)](2+) and [Mn(IV)(O)(OH)(Me2EBC)](+). These compounds are known to effect C-H bond oxidation reactions by a hydrogen-atom transfer mechanism. They provide an ideal system for comparing Mn(IV)-hydroxo versus Mn(IV)-oxo motifs, as they differ by only a proton. Simulations of 5 K EPR data, along with analysis of variable-temperature EPR signal intensities, allowed for the estimation of ground-state zero-field splitting (ZFS) and (55)Mn hyperfine parameters for both complexes. From this analysis, it was concluded that the Mn(IV)-oxo complex [Mn(IV)(O)(OH)(Me2EBC)](+) has an axial ZFS parameter D (D = +1.2(0.4) cm(-1)) and rhombicity (E/D = 0.22(1)) perturbed relative to the Mn(IV)-hydroxo analogue [Mn(IV)(OH)2(Me2EBC)](2+) (|D| = 0.75(0.25) cm(-1); E/D = 0.15(2)), although the complexes have similar (55)Mn values (a = 7.7 and 7.5 mT, respectively). The ZFS parameters for [Mn(IV)(OH)2(Me2EBC)](2+) were compared with values obtained previously through variable-temperature, variable-field magnetic circular dichroism (VTVH MCD) experiments. While the VTVH MCD analysis can provide a reasonable estimate of the magnitude of D, the E/D values were poorly defined. Using the ZFS parameters reported for these complexes and five other mononuclear Mn(IV) complexes, we employed coupled-perturbed density functional theory (CP-DFT) and complete active space self-consistent field (CASSCF) calculations with second-order n-electron valence-state perturbation theory (NEVPT2) correction, to compare the ability of these two quantum chemical methods for reproducing experimental ZFS parameters for Mn(IV) centers. The CP-DFT approach was found to provide reasonably acceptable values for D, whereas the CASSCF/NEVPT2 method fared worse, considerably overestimating the magnitude of D in several cases. Both methods were poor in

  1. IV treatment at home

    Science.gov (United States)

    ... Other IV treatments you may receive after you leave the hospital include: Treatment for hormone deficiencies Medicines for severe nausea that cancer chemotherapy or pregnancy may cause Patient-controlled analgesia (PCA) for pain (this is IV ...

  2. Endemic chronic kidney disease of unknown etiology in Sri Lanka: Correlation of pathology with clinical stages

    Directory of Open Access Journals (Sweden)

    S Wijetunge

    2015-01-01

    Full Text Available Chronic kidney disease of unknown etiology (CKDU is endemic among the rural farming communities in several localities in and around the North Central region of Sri Lanka. This is an interstitial type renal disease and typically has an insidious onset and slow progression. This study was conducted to identify the pathological features in the different clinical stages of CKDU. This is a retrospective study of 251 renal biopsies identified to have a primary interstitial disease from regions endemic for CKDU. Pathological features were assessed and graded in relation to the clinical stage. The mean age of those affected by endemic CKDU was 37.3 ± 12.5 years and the male to female ratio was 3.3:1. The predominant feature of stage I disease was mild and moderate interstitial fibrosis; most did not have interstitial inflammation. The typical stage II disease had moderate interstitial fibrosis with or without mild interstitial inflammation. Stage III disease had moderate and severe interstitial fibrosis, moderate interstitial inflammation, tubular atrophy and some glomerulosclerosis. Stage IV disease typically had severe interstitial fibrosis and inflammation, tubular atrophy and glomerulosclerosis. The mean age of patients with stage I disease (27 ± 10.8 years was significantly lower than those of the other stages. About 79.2%, 55%, 49.1% and 50% in stage I, II, III and IV disease respectively were asymptomatic at the time of biopsy.

  3. Various Stages of Pink Fungus (Upasia salmonicolor in Java

    Directory of Open Access Journals (Sweden)

    Ambarwati Harsojo Tjokrosoedarmo

    1995-12-01

    Full Text Available Pink fungus in Java is classified as Upasia salmonicolor (Basidiomycetes: Corticiaceae and its anamorph is Necator decretus. This fungus is a serious pathogen which attacks many woody plants. The pink fungus in Java exhibits five developmental stages on the surface of the host bark: I. An initial cobweb stage as thin, white, cobweb-like hyphal layer, which creeps over the surface of the bark, during which penetration of the host occurs; II. Pseudonodular stage, as conical white pustules occurring only on lenticels or cracks, and only on shady side of branches; III. Teleomorph, occurs as pink incrustation and pink pustules on shady side of branches; IV. Nodular stages, as globose white pustules occurring chiefly on intact bark, but also on the lenticels or cracks, on exposed side of branches; V. Anamorph, as small orange-red sporodochium, on exposed side of branches. Key words: pink fungus, Corticiaceae, Basidiomycetes, Necator

  4. Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero

    2011-01-01

    Cervical cancer is the second most common cancer among women in Sudan, with more than two-thirds of all women with invasive cervical cancer being diagnosed at an advanced stage (stages III and IV). The lack of a screening program for cervical cancer in Sudan may contribute to the late presentation...... of this cancer, but other factors potentially associated with advanced stages of cervical cancer at diagnosis are unknown. The purpose of this research was to investigate the relationship between age, marital status, ethnicity, health insurance coverage, residence in an urban vs a rural setting, and stage (at...... diagnosis) of cervical cancer in Sudan....

  5. Cisplatin, Intensity-Modulated Radiation Therapy, and Pembrolizumab in Treating Patients With Stage III-IV Head and Neck Squamous Cell Carcinoma

    Science.gov (United States)

    2018-05-18

    CDKN2A-p16 Negative; Stage III Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage III Laryngeal Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7

  6. Cost effectiveness of adding clostridial collagenase ointment to selective debridement in individuals with stage IV pressure ulcers.

    Science.gov (United States)

    Carter, Marissa J; Gilligan, Adrienne M; Waycaster, Curtis R; Schaum, Kathleen; Fife, Caroline E

    2017-03-01

    The purpose of this study was to determine the cost effectiveness (from a payer's perspective) of adding clostridial collagenase ointment (CCO) to selective debridement compared with selective debridement alone (non-CCO) in the treatment of stage IV pressure ulcers among patients identified from the US Wound Registry. A 3-state Markov model was developed to determine costs and outcomes between the CCO and non-CCO groups over a 2-year time horizon. Outcome data were derived from a retrospective clinical study and included the proportion of pressure ulcers that were closed (epithelialized) over 2 years and the time to wound closure. Transition probabilities for the Markov states were estimated from the clinical study. In the Markov model, the clinical outcome is presented as ulcer-free weeks, which represents the time the wound is in the epithelialized state. Costs for each 4-week cycle were based on frequencies of clinic visits, debridement, and CCO application rates from the clinical study. The final model outputs were cumulative costs (in US dollars), clinical outcome (ulcer-free weeks), and incremental cost-effectiveness ratio (ICER) at 2 years. Compared with the non-CCO group, the CCO group incurred lower costs ($11,151 vs $17,596) and greater benefits (33.9 vs 16.8 ulcer-free weeks), resulting in an economically dominant ICER of -$375 per ulcer. Thus, for each additional ulcer-free week that can be gained, there is a concurrent cost savings of $375 if CCO treatment is selected. Over a 2-year period, an additional 17.2 ulcer-free weeks can be gained with concurrent cost savings of $6,445 for each patient. In this Markov model based on real-world data from the US Wound Registry, the addition of CCO to selective debridement in the treatment of pressure ulcers was economically dominant over selective debridement alone, resulting in greater benefit to the patient at lower cost.

  7. Challenging a dogma; AJCC 8th staging system is not sufficient to predict outcomes of patients with malignant pleural mesothelioma.

    Science.gov (United States)

    Abdel-Rahman, Omar

    2017-11-01

    The 8th edition of malignant pleural mesothelioma (MPM) American Joint Committee on Cancer (AJCC) staging system has been published. The current analysis aims to evaluate its performance in a population-based setting among patients recorded within the surveillance, epidemiology and end results (SEER) database. SEER database (2004-2013) has been accessed through SEER*Stat program and AJCC 8th edition stage groups were reconstructed. Survival analyses (overall and cancer-specific) were conducted according to 6th and 8th editions through Kaplan-Meier analysis. Cox-regression multivariate model was also utilized for pair wise comparisons between different prognostic groups for overall and cancer-specific survival. A total of 5382 patients with MPM were identified in the period from 2004 to 2013. According to the 6th edition, significant pair wise P values for overall survival included: IA vs. III (P=0.027); IA vs. IV: P<0.0001; IB vs. IV: P<0.0001; II vs. III: P<0.0001; II vs. IV: P<0.0001; III vs. IV: P<0.0001). According to the 8th edition, significant pair wise P values for overall survival included: all stages vs. IV: P<0.0001; IA vs. II: P=0.046; IA vs. IIIA: P=0.022; IA vs. IIIB: P <0.0001; IB vs. II: P<0.0001; IB vs. IIIB: P<0.0001; II vs. IIIA: P<0.0001; IIIA vs. IIIB: P<0.0001). C-index for 6th edition was 0.539 (SE: 0.008; 95% CI: 0.524-0.555); while C-index for 8th edition was 0.540 (SE: 0.008; 95% CI: 0.525-0.556). Based on the above findings, a simplified staging system was proposed and overall and cancer-specific survivals were evaluated according to the simplified system. For overall and cancer-specific survival assessment, P values for all pair wise comparisons among different stages were significant (<0.01). The prognostic performance of both the 6th and 8th AJCC editions is unsatisfactory; there is a need for a more practical and prognostically relevant staging system for MPM. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. A cerium(IV)-carbon multiple bond

    Energy Technology Data Exchange (ETDEWEB)

    Gregson, Matthew; Lu, Erli; McMaster, Jonathan; Lewis, William; Blake, Alexander J.; Liddle, Stephen T. [Nottingham Univ. (United Kingdom). School of Chemistry

    2013-12-02

    Straightforward access to a cerium(IV)-carbene complex was provided by one-electron oxidation of an anionic ''ate'' cerium(III)-carbene precursor, thereby avoiding decomposition reactions that plague oxidations of neutral cerium(III) compounds. The cerium(IV)-carbene complex is the first lanthanide(IV)-element multiple bond and involves a twofold bonding interaction of two electron pairs between cerium and carbon. [German] Auf direktem Wege zu einem Cer(IV)-Carbenkomplex gelangt man durch die Einelektronenoxidation einer anionischen Carben-Cerat(III)-Vorstufe. So werden Zersetzungsprozesse vermieden, die die Oxidation neutraler Cer(III)-Verbindungen erschweren. Der Cer(IV)-Carbenkomplex enthaelt die erste Lanthanoid(IV)-Element-Mehrfachbindung; dabei binden Cer und Kohlenstoff ueber zwei Elektronenpaare.

  9. Combined-modality treatment in advanced oral squamous cell carcinoma. Primary surgery followed by adjuvant concomitant radiochemotherapy

    International Nuclear Information System (INIS)

    Kreppel, Matthias; Dreiseidler, Timo; Zoeller, Joachim E.; Scheer, Martin; Drebber, Uta; Eich, Hans-Theodor; Mueller, Rolf-Peter

    2011-01-01

    The efficacy of adjuvant radiochemotherapy (RCT) in patients with advanced stage head and neck carcinoma has been proven in prospective randomized trials. However, these trials focused on different head and neck sites. Specific analyses for treatment effects in squamous cell carcinoma of the oral cavity (OSCC) are missing. We evaluated our experiences with adjuvant concomitant RCT in advanced OSCC to compare the results with other treatment schemes using adjuvant RCT. A total of 183 patients with OSCC of UICC stages II-IVb were reviewed retrospectively. All patients were treated with radical surgery followed by adjuvant, conventional fractionated concomitant RCT using carboplatin. Overall survival was plotted by Kaplan-Meier analysis. Prognostic factors were identified through univariate and multivariate analysis. Univariate analysis showed a significant impact of T, N, and UICC stage, histopathologic grading, surgical margins, extracapsular spread (ECS), and lymphangiosis carcinomatosa on overall survival (Table 3). Patients with stage IVa had a higher 5-year overall survival rate (42.8%) than patients with stage IVb (25.0%) (Figure 1). The differences were significant in multivariate analysis (p = 0.033) (Table 4). Adjuvant concomitant RCT is an effective treatment in patients with advanced stage OSCC. However, it remains unclear, which patients should be treated with adjuvant RCT. For patients with stage IVb, adjuvant RCT yields poor results. Prospective randomized trials are needed to confirm which patients should be treated with adjuvant RCT. (orig.)

  10. Identification of novel dipeptidyl peptidase IV (DPP-IV) inhibitory peptides in camel milk protein hydrolysates.

    Science.gov (United States)

    Nongonierma, Alice B; Paolella, Sara; Mudgil, Priti; Maqsood, Sajid; FitzGerald, Richard J

    2018-04-01

    Nine novel dipeptidyl peptidase IV (DPP-IV) inhibitory peptides (FLQY, FQLGASPY, ILDKEGIDY, ILELA, LLQLEAIR, LPVP, LQALHQGQIV, MPVQA and SPVVPF) were identified in camel milk proteins hydrolysed with trypsin. This was achieved using a sequential approach combining liquid chromatography tandem mass spectrometry (LC-MS/MS), qualitative/quantitative structure activity relationship (QSAR) and confirmatory studies with synthetic peptides. The most potent camel milk protein-derived DPP-IV inhibitory peptides, LPVP and MPVQA, had DPP-IV half maximal inhibitory concentrations (IC 50 ) of 87.0 ± 3.2 and 93.3 ± 8.0 µM, respectively. DPP-IV inhibitory peptide sequences identified within camel and bovine milk protein hydrolysates generated under the same hydrolysis conditions differ. This was linked to differences in enzyme selectivity for peptide bond cleavage of camel and bovine milk proteins as well as dissimilarities in their amino acid sequences. Camel milk proteins contain novel DPP-IV inhibitory peptides which may play a role in the regulation of glycaemia in humans. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Genetic and cytokine changes associated with symptomatic stages of CLL.

    Science.gov (United States)

    Agarwal, Amit; Cooke, Lawrence; Riley, Christopher; Qi, Wenqing; Mount, David; Mahadevan, Daruka

    2014-09-01

    The pathogenesis and drug resistance of symptomatic CLL patients involves genetic changes associated with the CLL clone as well as changes within the microenvironment. To further understand these processes, we compared early stage CLL to symptomatic late stage using gene expression and serum cytokine profiling to gain insight of the genetic and microenvironment changes associated with the most severe form of the disease. Patients were classified into low stage (Rai stage 0/I/II) and high stage (Rai stage III/IV). Gene expression profiles were obtained on pretreatment samples using the HG-U133A 2.0 Affymetrix platform. A comparison of low versus high stage CLL revealed a set of 21 genes differentially expressed genes. 15 genes were up regulated in the high stage compared to low stage while 6 genes were down regulated. Analysis of GO molecular function revealed 9 of 21 genes were involved in transcription factor activity. Serum cytokine profiles showed six cytokines to be significantly different in high stage patients. Two chemokines, SDF-1/CXCL12 and uPAR known to be involved in stem cell mobilization and homing were increased in serum of high stage patients. This study has identified therapeutic targets for symptomatic CLL patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Who should be admitted to the intensive care unit? The outcome of intensive care unit admission in stage IIIB-IV lung cancer patients.

    Science.gov (United States)

    Kim, Yu Jung; Kim, Mi-Jung; Cho, Young-Jae; Park, Jong Sun; Kim, Jin Won; Chang, Hyun; Lee, Jeong-Ok; Lee, Keun-Wook; Kim, Jee Hyun; Yoon, Ho Il; Bang, Soo-Mee; Lee, Jae Ho; Lee, Choon-Taek; Lee, Jong Seok

    2014-03-01

    Critical care for advanced lung cancer patients is still controversial, and the appropriate method for the selection of patients who may benefit from intensive care unit (ICU) care is not clearly defined. We retrospectively reviewed the medical records of stage IIIB-IV lung cancer patients admitted to the medical ICU of a university hospital in Korea between 2003 and 2011. Of 95 patients, 64 (67%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS)≥2, and 79 (84%) had non-small-cell lung cancer. In total, 28 patients (30%) were newly diagnosed or were receiving first-line treatment, and 22 (23%) were refractory or bedridden. Mechanical ventilation was required in 85 patients (90%), and ICU mortality and hospital mortality were 57 and 78%, respectively. According to a multivariate analysis, a PaO2/FiO2 ratiobedridden patients (n=22) showed significantly poorer overall survival (11.0 vs. 29.0 days, p=0.005). Among 21 patients who were discharged from the hospital, 11 (52%) received further chemotherapy. Certain advanced lung cancer patients may benefit from ICU management. However, refractory patients and patients with a poor PS do not seem to benefit from ICU care. Oncologists should try to discuss palliative care and end-of-life issues in advance to avoid futile care.

  13. Complexes of uranium (IV) and thorium (IV) with α-picolinic acid, nicotinic acid, anthranilic acid and N-phenylanthranilic acid

    International Nuclear Information System (INIS)

    Singh, M.; Singh, R.

    1979-01-01

    Stable U(IV) and Th(IV) complexes with the title ligands have been synthesised from U(OAc) 4 , and Th(OAc) 4 . Magnetic susceptibilities, IR and reflectance spectra of U(IV) and IR spectra of Th(IV) complexes have been studied which indicate eight coordination for U(IV) in these chelates. (auth.)

  14. Clinical stage of oral cancer patients at the time of initial diagnosis

    International Nuclear Information System (INIS)

    Shah, I.; Sefvan, O.; Luqman, Z.; Ibrahim, W.; Mehmood, S.

    2010-01-01

    Background: Squamous cell carcinoma is the most common oral cancer. Early diagnosis ensures better prognosis. Late diagnosis is however common around the world and contributes to the high morbidity and mortality related to oral cancer. The objective of this study was to determine the clinical stage of oral cancer patients at the time of diagnosis. Methods: This retrospective study was carried out on 334 oral cancer patients who presented to the outdoor departments of Armed Forces Institute of Dentistry, and Armed Forces Institute of Pathology, Rawalpindi from July 2008 to December 2009. The records that were reviewed included history and clinical examination findings, OPG and CT scans of the head and neck region, chest X-rays, abdominal ultrasounds and liver function tests. Size of the primary tumour, the size, number and laterality of the involved cervical lymph nodes and the presence/absence of distant metastases were documented and statistically analysed using SPSS-17. Results: Out of the 334 patients, 203 (60.8%) were males and 131 (39.2%) females. The age range was from 21 to 88 years. Buccal mucosa was the most commonly involved site (32 %). The primary tumour was 4 Cm or more in size, (T3/T4) 71.25% of the cases. Cervical lymph nodes were involved in 211 patients (63.2%) and distant metastases were present in 39 patients (11.7%). Overall, clinical stage IV was the most common (57.18%) followed by stage III(24.55%), stage II (13.77%) and stage I (4.49%). Conclusion: Oral cancers are diagnosed late (Stage III and IV) in Pakistan and need immediate public and professional attention. (author)

  15. Clinical stage of oral cancer patients at the time of initial diagnosis.

    Science.gov (United States)

    Shah, Irfan; Sefvan, Omer; Luqman, Uzair; Ibrahim, Waseem; Mehmood, Sana; Alamgir, Wajiha

    2010-01-01

    Squamous cell carcinoma is the most common oral cancer. Early diagnosis ensures better prognosis. Late diagnosis is however common around the world and contributes to the high morbidity and mortality related to oral cancer. The objective of this study was to determine the clinical stage of oral cancer patients at the time of diagnosis. This retrospective study was carried out on 334 oral cancer patients who presented to the outdoor departments of Armed Forces Institute of Dentistry, and Armed Forces Institute of Pathology, Rawalpindi from July 2008 to December 2009. The records that were reviewed included history and clinical examination findings. OPG and CT scans of the head and neck region, chest X-rays, abdominal ultrasounds and liver function tests. Size of the primary tumour, the size, number and laterality of the involved cervical lymph nodes and the presence/absence of distant metastases were documented and statistically analysed using SPSS-17. Out of the 334 patients, 203 (60.8%) were males and 131 (39.2%) females. The age range was from 21 to 88 years. Buccal mucosa was the most commonly involved site (32%). The primary tumour was 4 Cm or more in size, (T3/T4) 71.25% of the cases. Cervical lymph nodes were involved in 211 patients (63.2%) and distant metastases were present in 39 patients (11.7%). Overall, clinical stage IV was the most common (57.18%) followed by stage III (24.55%), stage II (13.77%) and stage I (4.49%). Oral cancers are diagnosed late (Stage III and IV) in Pakistan and need immediate public and professional attention.

  16. Thorium(IV) and zirconium(IV) complexes of oxygen donor ligands. Pt. 12

    International Nuclear Information System (INIS)

    Agarwal, R.K.; Jain, P.C.; Kapur, V.; Sharma, S.; Srivastava, A.K.

    1980-01-01

    Crystalline thorium (IV) chelates with mono N-oxides of 2,2'-bipyridine (bipyNO) and 1,10-phenanthroline (phenNO), ThX 4 x 2L(X = Cl,Br,NO 3 or NCS) and ThX 4 x 3L(X = I or ClO 4 and L = bipyNO or phenNO) have been synthesised and characterized on the basis of i.r. spectra, molar conductance, molecular weights, t.g.a. and d.t.a. data. All the complexes are weakly diamagnetic and contain bipyNO and phenNO bonded to thorium(IV) through nitrogen and oxygen. The coordination number of thorium(IV) varies from six to twelve depending on the nature of the anions. (orig.) [de

  17. Solubility of Tc(IV) oxides

    International Nuclear Information System (INIS)

    Liu, D.J.; Fan, X.H.

    2005-01-01

    Full text of publication follows: The deep geological disposal of the high level radioactive wastes is expected to be a safer disposal method in most countries. The long-lived fission product 99 Tc is present in large quantities in nuclear wastes and its chemical behavior in aqueous solution is of considerable interest. Under the reducing conditions, expected to exist in a deep geological repository, it is generally predicted that technetium will be present as TcO 2 .nH 2 O. The solubility of Tc(IV) is used as a source term in performance assessment of radioactive waste repository. Technetium oxide was prepared by reduction of a technetate solution with Sn 2+ . The solubility of Tc(IV) oxide has been determined in simulated groundwater and re-distilled water under aerobic and anaerobic conditions. The effects of pH and CO 3 2- concentration of solution on solubility of Tc(IV) oxide were studied. The concentration of total technetium and Tc(IV) species in the solutions were periodically determined by separating the oxidized and reduced technetium species using a solvent extraction procedure and counting the beta activity of the 99 Tc with a liquid scintillation counter. The experimental results show that the rate of oxidation of Tc(IV) in simulated groundwater and re-distilled water is about (1.49∼1.86) x 10 -9 mol/(L.d) under aerobic conditions, but Tc(IV) in simulated groundwater and re-distilled water is not oxidized under anaerobic conditions. Under aerobic or anaerobic conditions the solubility of Tc(IV) oxide in simulated groundwater and re-distilled water is equal on the whole after centrifugation or ultrafiltration. The solubility of Tc(IV) oxide decreases with the increase of pH at pH 10 and is pH independent in the range 2 -8 to 10 -9 mol/L at 2 3 2- concentration. These data could be used to estimate the Tc(IV) solubility for cases where solubility limits transport of technetium in reducing environments of high-level waste repositories. (authors)

  18. Common molecular determinants of tarantula huwentoxin-IV inhibition of Na+ channel voltage sensors in domains II and IV.

    Science.gov (United States)

    Xiao, Yucheng; Jackson, James O; Liang, Songping; Cummins, Theodore R

    2011-08-05

    The voltage sensors of domains II and IV of sodium channels are important determinants of activation and inactivation, respectively. Animal toxins that alter electrophysiological excitability of muscles and neurons often modify sodium channel activation by selectively interacting with domain II and inactivation by selectively interacting with domain IV. This suggests that there may be substantial differences between the toxin-binding sites in these two important domains. Here we explore the ability of the tarantula huwentoxin-IV (HWTX-IV) to inhibit the activity of the domain II and IV voltage sensors. HWTX-IV is specific for domain II, and we identify five residues in the S1-S2 (Glu-753) and S3-S4 (Glu-811, Leu-814, Asp-816, and Glu-818) regions of domain II that are crucial for inhibition of activation by HWTX-IV. These data indicate that a single residue in the S3-S4 linker (Glu-818 in hNav1.7) is crucial for allowing HWTX-IV to interact with the other key residues and trap the voltage sensor in the closed configuration. Mutagenesis analysis indicates that the five corresponding residues in domain IV are all critical for endowing HWTX-IV with the ability to inhibit fast inactivation. Our data suggest that the toxin-binding motif in domain II is conserved in domain IV. Increasing our understanding of the molecular determinants of toxin interactions with voltage-gated sodium channels may permit development of enhanced isoform-specific voltage-gating modifiers.

  19. Influenceofanelevatednutritionriskscoreinpatientssufferingfromesophagealcancerfollowingtumorresection

    Directory of Open Access Journals (Sweden)

    BachmannJ

    2017-08-01

    Full Text Available Background: Patients who suffer from malignant tumors of the esophagus and esophagogastric junction have 5-year survival rates of up to 83%, something that is documented in the early stages of cancer. Too often, weight loss is an underestimated sign for patients suffering from cancer on the upper gastrointestinal tract. Weight loss is associated with different adverse outcomes. Even after tumor resection, malnutrition remains a severe problem that still affects long-term disease free survivors. Material and methods: This study included the clinical courses of 205 patients suffering from cancer of the esophagus or the esophagogastric junction who were operated on between July 2007 and December 2009. On admission, the nutrition risk score was evaluated. Follow-up data were collected routinely. The aim of the underlying study was to show the prevalence of an elevated nutrition risk score (NRS and to demonstrate its influence on perioperative mortality and morbidity. Furthermore, the relevance of an elevated nutrition risk score on the postoperative survival was analyzed. Results: More than a third (35.8% of the patients included in this study had a nutrition risk score of at least three. A preoperative elevated nutrition risk score did not have a significant influence on perioperative morbidity or on 30-days mortality rate. In patients with early tumor stage UICC stage I a/b, an elevated risk score of 3 or more had a significant influence on postoperative survival. In contrast, in advanced tumor stages an increased NRS did not have a significant negative influence on survival within both UICC II a/b and UICC IIII a/b. Conclusions: Further studies are required to demonstrate whether a nutritional intervention can improve the survival rates of patients suffering from malignant tumors within the esophagus and in whom an operation has to be performed.

  20. Concurrent chemoradiotherapy with S-1 in patients with stage III-IV oral squamous cell carcinoma: A retrospective analysis of nodal classification based on the neck node level.

    Science.gov (United States)

    Murakami, Ryuji; Semba, Akiko; Kawahara, Kenta; Matsuyama, Keiya; Hiraki, Akimitsu; Nagata, Masashi; Toya, Ryo; Yamashita, Yasuyuki; Oya, Natsuo; Nakayama, Hideki

    2017-07-01

    The aim of the present study was to retrospectively evaluate the treatment outcomes of concurrent chemoradiotherapy (CCRT) with S-1, an oral fluoropyrimidine anticancer agent, for advanced oral squamous cell carcinoma (SCC). The study population consisted of 47 patients with clinical stage III or IV oral SCC, who underwent CCRT with S-1. Pretreatment variables, including patient age, clinical stage, T classification, midline involvement of the primary tumor and nodal status, were analyzed as predictors of survival. In addition to the N classification (node-positive, multiple and contralateral), the prognostic impact of the level of nodal involvement was assessed. Nodal involvement was mainly observed at levels Ib and II; involvement at levels Ia and III-V was considered to be anterior and inferior extension, respectively, and was recorded as extensive nodal involvement (ENI). The 3-year overall survival (OS) and progression-free survival (PFS) rates were 37 and 27%, respectively. A finding of ENI was a significant factor for OS [hazard ratio (HR)=2.16; 95% confidence interval (CI): 1.03-4.55; P=0.038] and PFS (HR=2.65; 95% CI: 1.32-5.33; P=0.005); the 3-year OS and PFS rates in patients with vs. those without ENI were 23 vs. 50% and 9 vs. 43%, respectively. The other variables were not significant. Therefore, CCRT with S-1 may be an alternative treatment for advanced oral SCC; favorable outcomes are expected in patients without ENI.

  1. Treatment results of non-operated lung cancer by radiotherapy and radiochemotherapy

    International Nuclear Information System (INIS)

    Seino, Yasuo; Watarai, Jiro; Kobayashi, Mitsuru; Sashi, Ryuji; Shindo, Masaaki; Kato, Toshio

    1993-01-01

    The treatment results of 152 non-operated lung cancer patients were analyzed. Median survival times (MST; months) for all patients based on the stage (UICC'87) were 28 M (n=12) for stage I, 18 M (n=16) for stage II, 8 M (n=58) for stage III A, 6 M (n=46) for stage III B, and 4 M (n=20) for stage IV. The effect of combined radiochemotherapy was quite evident in small cell lung cancer (SCLC) patients. Here, the MST of the radiotherapy alone group (n=11) was 5 M, whereas that of radiochemotherapy group (n=14) was 12 M (p<0.05). In non-small cell lung cancer (NSCLC), the effect of radiochemotherapy was recognized only in stage III A and III B patients. In this case, the MST of the radiotherapy alone group (n=50) was 6 M, whereas that of the radiochemotherapy group (n=38) was 9 M (p<0.05). The duration of time from the initial therapy to the occurrence of distant metastasis in stage III A and III B patients was longer in the radiochemotherapy group than in the radiotherapy alone group (p<0.05). As for the metastatic sites, a delay in the occurrence of brain, lung and pleural metastasis was also recognized in the radiochemotherapy group (p<0.05). In this retrospective study, the value of combined radiochemotherapy was evident in SCLC and stage III-NSCLC patients. However, there was considerable case to case variation in the dosage, combination of agents and timing of chemotherapy. Recently, more aggressive chemotherapy is now being applied. (author)

  2. On the stabilization of niobium(V) solutions by zirconium(IV) and hafnium(IV)

    DEFF Research Database (Denmark)

    Sørensen, E.; Bjerre, A.B.

    1992-01-01

    Niobium cannot be separated from zirconium or hafnium when these elements occur together in solution with common anions such as chloride and sulphate. This is ascribed to the co-polymerization of niobium(V) and the hydrolysed ionic species of zirconium(IV) and hafnium(IV) to form colloidal...

  3. Prognostic factors of nasopharynx tumors investigated by MR imaging and the value of MR imaging in the newly published TNM staging

    International Nuclear Information System (INIS)

    Sakata, Koh-ichi; Hareyama, Masato; Tamakawa, Mituharu; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Akiba, Hidenari; Koito, Kazumitsu; Himi, Tetsuo; Asakura, Kohji

    1999-01-01

    Purpose: To examine the usefulness of MR imaging for predicting local control of nasopharyngeal carcinoma (NPC) and the value of MR imaging in the newly published fifth edition of the TNM classification. Methods and Materials: We studied 29 patients with NPC with MR imaging and CT before and after treatment. Staging was done according to the fourth and newly published fifth editions of the International Union Against Cancer (UICC) staging system. The radiotherapy protocol was designed to deliver 66 to 68 Gy to the primary tumor and clinically involved nodes. Results: MR proved better than CT at identifying obliteration of the pharyngobasilar fascia, invasion of the sinus of Morgagni, through which the cartilaginous portion of the eustachian tube and the levator veli palatini muscle pass, invasion of the skull base, and metastases to lymph nodes in the carotid and retropharyngeal spaces. All seven patients without invasion of the pharyngobasilar fascia had local control. The local control rates of patients with invasion of the skull base were not good (60 to 73%). There was no apparent relationship between tumor volume determined by T1-weighted MR images and local control when the tumor volume was more than 20 cc. The newly published N staging system appears to successfully identify the high-risk group for distant metastasis as N3. In our series, four of five patients with N3 disease developed distant metastases. Conclusion: Deep infiltration of the tumor is a more important prognostic factor in NPC than tumor volume. Since the newly published T staging system requires a search for tumor invasion into soft tissue such as parapharyngeal space and bony structures, MR imaging may be indispensable for the newly published NPC staging system

  4. Neptunium (IV) oxalate solubility

    International Nuclear Information System (INIS)

    Luerkens, D.W.

    1983-07-01

    The equilibrium solubility of neptunium (IV) oxalate in nitric/oxalic acid solutions was determined at 22 0 C, 45 0 C, and 60 0 C. The concentrations of nitric/oxalic acid solutions represented a wide range of free oxalate ion concentration. A mathematical solubility model was developed which is based on the formation of the known complexes of neptunium (IV) oxalate. the solubility model uses a simplified concentration parameter which is proportional to the free oxalate ion concentration. The solubility model can be used to estimate the equilibrium solubility of neptunium (IV) oxalate over a wide range of oxalic and nitric acid concentrations at each temperature

  5. The Chemical Chaperone, PBA, Reduces ER Stress and Autophagy and Increases Collagen IV α5 Expression in Cultured Fibroblasts From Men With X-Linked Alport Syndrome and Missense Mutations

    Directory of Open Access Journals (Sweden)

    Dongmao Wang

    2017-07-01

    Discussion: Sodium 4-phenylbutyrate increases collagen IV α5 mRNA levels, reduces ER stress and autophagy, and possibly facilitates collagen IV α5 extracellular transport. Whether these actions delay end-stage renal failure in men with X-linked Alport syndrome and missense mutations will only be determined with clinical trials.

  6. P38 mitogen-activated protein kinase (p38 MAPK) overexpression in clinical staging of nasopharyngeal carcinoma

    Science.gov (United States)

    Farhat; Asnir, R. A.; Yudhistira, A.; Daulay, E. R.; Muzakkir, M. M.; Yulius, S.

    2018-03-01

    Molecular biological research on nasopharyngeal carcinoma has been widely practiced, such as VEGF, EGFR, COX-2 expression and so on. MAPK plays a role in cell growth such as proliferation, differentiation, and apoptosis, primarily contributing to gene expression, where p38 MAPK pathway mostly associate with anti-apoptosis and cause cell transformation. The aim of this study is to determine the expression of p38 MAPK in clinical stage of nasopharyngeal carcinoma so that the result can be helpful in prognosis and adjunctive therapy in nasopharyngeal carcinoma. The research design is descriptive. It was done in THT- KL Department of FK USU/RSUP Haji Adam Malik, Medan and Pathology Anatomical Department of FK USU. The study was conducted from December 2011 to May 2012. The Samples are all patients who diagnosed with nasopharyngeal carcinoma in oncology division of Otorhinolaryngology Department. p38 MAPK overexpression was found in 21 samples (70%) from 30 nasopharyngeal carcinoma samples. The elevated of p38 MAPK expression most found on T4 by eight samples (38.1%), N3 lymph node group by nine samples (42.9%), stage IV of clinical staging is as many as 15 samples (71.4%). p38 MAPK most expressed in stage IV clinical staging of patients with nasopharyngeal carcinoma.

  7. SURGICAL TREATMENT OF PATIENTS WITH COLON CANCER IN DEPARTMENT FOR ABDOMINAL AND GENERAL SURGERY AT MARIBOR GENERAL HOSPITAL IN YEARS 1998–2001

    Directory of Open Access Journals (Sweden)

    Borut Gajzer

    2004-07-01

    Full Text Available Background. The aim of this paper is to present and assess a surgical treatment of patients with colon cancer.Methods. All patients with colon cancer, who were operated in years 1998–2001, were included in the analysis. We have collected data including patients age, localization and stage of cancer, types of preformed procedures, postoperative mortality, disease recurrence and survival of the patients.Results. We have operated on 308 patients with histological evidence of colon cancer in abovementioned period. The average patients age was 66.5 years (SD = 11.1; 95% CI: 44.3– 88.7. Primary tumor was most commonly (36% located in sigmoid colon. UICC stages were as follows: stage I 34 patients, 11%; stage II 141, 46%; stage III 64, 21%; stage IV 69, 22%. We have performed 287 resections of colon (93% resectabillity, of these 214 (75% were potentially curative R0 resections. Share of urgent procedures was 21%. In the postoperative period 22 patients (7% have died. Postoperative mortality was significantly higher by urgent (19% compared to scheduled procedures (4% ( χ 2 = 16; df = 1; p = 0,005. In the observed time 22% of patients developed recurrent cancer. Mean survival rate of our patients was 1274 days or 3.5 years (SD = 191; 95% CI: 900–1648. Calculated overall five years survival rate was 45%.Conclusions. Planned and registered surgical treatment of patients with colon cancer, surgical specialization in colon surgery and adjuvant oncological treatment have shown the same incentive results, reflected in increased survival rate.

  8. Enhanced Design Alternative IV

    International Nuclear Information System (INIS)

    Kramer, N.E.

    1999-01-01

    This report evaluates Enhanced Design Alternative (EDA) IV as part of the second phase of the License Application Design Selection (LADS) effort. The EDA IV concept was compared to the VA reference design using criteria from the Design Input Request for LADS Phase II EDA Evaluations (CRWMS M and O 1999b) and (CRWMS M and O 1999f). Briefly, the EDA IV concept arranges the waste packages close together in an emplacement configuration known as line load. Continuous pre-closure ventilation keeps the waste packages from exceeding their 350 C cladding and 200 C (4.3.6) drift wall temperature limits. This EDA concept keeps relatively high, uniform emplacement drift temperatures (post-closure) to drive water away from the repository and thus dry out the pillars between emplacement drifts. The waste package is shielded to permit human access to emplacement drifts and includes an integral filler inside the package to reduce the amount of water that can contact the waste form. Closure of the repository is desired 50 years after first waste is emplaced. Both backfill and drip shields will be emplaced at closure to improve post-closure performance. The EDA IV concept includes more defense-in-depth layers than the VA reference design because of its backfill, drip shield, waste package shielding, and integral filler features. These features contribute to the low dose-rate to the public achieved during the first 10,000 years of repository life as shown in Figure 3. Investigation of the EDA IV concept has led to the following general conclusions: (1) The total life cycle cost for EDA IV is about $21.7 billion which equates to a $11.3 billion net present value (both figures rounded up). (2) The incidence of design basis events for EDA IV is similar to the VA reference design. (3) The emplacement of the waste packages in drifts will be similar to the VA reference design. However, heavier equipment may be required because the shielded waste package will be heavier. (4) The heavier

  9. Multiple-Stage Structure Transformation of Organic-Inorganic Hybrid Perovskite CH3NH3PbI3

    Science.gov (United States)

    Chen, Qiong; Liu, Henan; Kim, Hui-Seon; Liu, Yucheng; Yang, Mengjin; Yue, Naili; Ren, Gang; Zhu, Kai; Liu, Shengzhong; Park, Nam-Gyu; Zhang, Yong

    2016-07-01

    By performing spatially resolved Raman and photoluminescence spectroscopy with varying excitation wavelength, density, and data acquisition parameters, we achieve a unified understanding towards the spectroscopy signatures of the organic-inorganic hybrid perovskite, transforming from the pristine state (CH3NH3PbI3 ) to the fully degraded state (i.e., PbI2 ) for samples with varying crystalline domain size from mesoscopic scale (approximately 100 nm) to macroscopic size (centimeters), synthesized by three different techniques. We show that the hybrid perovskite exhibits multiple stages of structure transformation occurring either spontaneously or under light illumination, with exceptionally high sensitivity to the illumination conditions (e.g., power, illumination time, and interruption pattern). We highlight four transformation stages (stages I-IV, with stage I being the pristine state) along either the spontaneous or photoinduced degradation path exhibiting distinctly different Raman spectroscopy features at each stage, and point out that previously reported Raman spectra in the literature reflect highly degraded structures of either stage III or stage IV. Additional characteristic optical features of partially degraded materials under the joint action of spontaneous and photodegradation are also given. This study offers reliable benchmark results for understanding the intrinsic material properties and structure transformation of this unique category of hybrid materials, and the findings are pertinently important to a wide range of potential applications where the hybrid material is expected to function in greatly different environment and light-matter interaction conditions.

  10. Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia.

    Science.gov (United States)

    Devi, B C R; Tang, T S; Corbex, M

    2007-07-01

    The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak. The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff. Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998). The overall cost of this program was stage (III and IV) where screening programs meet important difficulties. Our data analyses revealed important shortcomings in the PAP smear screening program where inadequate groups of women were screened. It resulted in a pick up rate of only 5% of the cases. This finding confirmed the need for the simple and complementary downstaging approach.

  11. Synthesis and characterization of thorium(IV) and uranium(IV) complexes with Schiff bases

    Energy Technology Data Exchange (ETDEWEB)

    Radoske, Thomas; Maerz, Juliane; Kaden, Peter; Patzschke, Michael; Ikeda-Ohno, Atsushi [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Chemistry of the F-Elements

    2017-06-01

    We report herein the synthesis and characterization of several imine complexes of tetravalent thorium (Th(IV)) and uranium (U(IV)). The ligands investigated in this study are a Schiff base type, including the well-known salen ligand (H{sub 2}Le, Fig. 1). The complexation in solution was investigated by NMR measurements indicating paramagnetic effects of unpaired f-electrons of U(IV) on the ligand molecule. We also determined the solid-state molecular structures of the synthesized complexes by single crystal X-ray diffraction. The synthesized complexes show an eight-fold coordination geometry around the actinide center surrounded by two tetradentate ligands with 2N- and 2O-donor atoms.

  12. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study

    DEFF Research Database (Denmark)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten Lindberg; Høgdall, Estrid Vilma Solyom

    2016-01-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood...... samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor...... removal. One hundred fifty patients with advanced epithelial ovarian cancer were treated with primary debulking surgery (PDS). Complete PDS was achieved in 41 cases (27 %). The receiver operating characteristic curves demonstrated an area under the curve of 0.785 for HE4, 0.678 for CA125, and 0...

  13. [Helicobacter pylori gastritis: assessment of OLGA and OLGIM staging systems].

    Science.gov (United States)

    Ben Slama, Sana; Ben Ghachem, Dorra; Dhaoui, Amen; Jomni, Mohamed Taieb; Dougui, Mohamed Hédi; Bellil, Khadija

    2016-01-01

    Helicobacter pylori (H pylori) gastritis presents a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.

  14. Hyperfractionated radiotherapy and simultaneous cisplatin for stage-III and -IV carcinomas of the head and neck. Long-term results including functional outcome

    International Nuclear Information System (INIS)

    Huguenin, P.; Glanzmann, C.; Taussky, D.; Luetolf, U.M.; Schmid, S.; Moe, K.

    1998-01-01

    Purpose: To assess the survival rate, the probability of local control, the patterns of relapse and late sequelae including self-reported quality of life in patients treated with hyperfractionated radiotherapy (RT) and simultaneous CDDP chemotherapy for stage-III to stage-IV carcinomas of the head and neck. Methods: From 1988 to 1994, 64 patients (median age 55.5 years) with carcinomas of different subsites, excluding the nasopharynx, were treated in a pilot study with 1.2 Gy bid (6 h interval; total dose 74.4 Gy) and simultaneous CDDP (20 mg/m 2 daily, 5 days in week 1 and 5) and followed at regular intervals. Overall survival and local control, as well as the rates of late toxicity, were estimated using the actuarial method. Median follow-up was 3.3 years for all and 5.2 years for surviving patients. To assess the quality of life, the EORTC QLQ-C 30 questionnaire and the H and N35 module questionnaire were sent to the patients surviving with no evidence of disease or second primary tumors; they were answered by 15/23 (67%). Results: Overall survival was 37% at 5 years, whereas disease-specific survival was 59%. Twenty-three patients died from uncontrolled head and neck cancer. Second primary tumors were observed in 13 patients, most frequently in the lung. Local control without salvage surgery was 74% at 5 years for all subsites and stages, and loco-regional disease-free survival was 72%. Eleven patients developed distant metastases, which was the only site of failure in 6 cases. Salvage surgery was successful in 2 cases. The actuarial estimates of ≥grade-3 late toxicity was 4% for the mandibular bone and 23% for dysphagia, and 50% of the patients experienced a permanent xerostomy. Self-reported global quality of life in surviving patients was good (mean 68 points on a scale 0 to 100); consequences of impaired salivary function had most impact on nutritional and social aspects. Conclusions: Hyperfractionated RT with concomitant CDDP is well tolerated and highly

  15. The kinetics of the cerium(IV)-uranium(IV) reaction at low sulfate concentrations

    International Nuclear Information System (INIS)

    Michaille, P.; Kikindai, T.

    1977-01-01

    The rate of oxidation of uranium(IV) by cerium(IV) was measured with a stopped-flow spectrophotometer at sulfuric acid concentrations of 2 x 10 -6 to 0.5 M. At a constant hydrogen ion concentration of 0.5 M, the maximum rate constant was observed for 2 x 10 -3 M sulfuric acid; at that concentration, two sulfate ions were involved in the activated complex. The dependence of the rate constant on the hydrogen ion concentration showed that the reaction paths involving one or two sulfate ions also involved one hydroxyl ion, whereas one hydrogen ion was involved in the five sulfate dependent path. Spectrophotometric measurements supported the existence of a hydrolyzed monosulfatocomplex of cerium(IV). (author)

  16. Diorganotin(IV) Complexes with Methionine Methyl Ester. Equilibria ...

    African Journals Online (AJOL)

    IV) (DBT) and diphenyltin(IV) (DPT) was investigated at 25 °C and 0.1 mol dm–3 ionic strength in water for dimethyltin(IV) and in 50 % dioxane–water mixture for dibutyltin(IV) and diphenyltin(IV). Methionine methyl ester forms1:1 and 1:2 ...

  17. Adsorption of Th(IV) and Pu(IV) on the surface of Pseudomonas fluorescens and Bacillus subtilis in the presence of desferrioxamine siderophore

    International Nuclear Information System (INIS)

    Yoshida, Takahiro; Ozaki, Takuo; Ohnuki, Toshihiko; Francis, Arokiasamy J.

    2005-01-01

    Adsorption of Th(IV) and Pu(IV) on a Gram-negative bacterium Pseudomonas fluorescens and a Gram-positive bacterium Bacillus subtilis in the presence of siderophore desferrioxamine B (DFO) was studied. Thorium(IV) and Pu(IV) were dissociated from DFO during adsorption on the cells. Thorium(IV) adsorption on bacterial cells in the presence of DFO was larger than that of Pu(IV) because of the smaller stability of the Th(IV)-DFO complex than that of the Pu(IV)-DFO complex. On the other hand, adsorption of Pu(IV) was larger than that of Fe(III), wherein the stability of the Pu(IV)- and Fe(III)-DFO complex is comparable. P. fluorescens showed a higher affinity for Th(IV) and Pu(IV) than B. subtilis, though potentiometric titration of bacterial cells indicated that surfaces of P. fluorescens and B. subtilis cells showed similar proton binding properties. (author)

  18. A combined XAFS, ESI TOF-MS and LIBD study on the formation of polynuclear Zr(IV), Th(IV) and Pu(IV) species

    Science.gov (United States)

    Rothe, J.; Walther, C.; Brendebach, B.; Büchner, S.; Fuss, M.; Denecke, M. A.; Geckeis, H.

    2009-11-01

    The long term radiotoxicity of spent nuclear fuel disposed of in deep underground repositories after discharge from nuclear power reactors is determined by actinide elements, mainly plutonium. Water intrusion into the repository might cause container corrosion and leaching of the waste matrices, leading to the release of Pu and other actinides into the geological environment. Performance assessment for a future nuclear waste repository requires detailed knowledge on actinide aqueous chemistry in the aquifer surrounding the disposal site. Tetravalent actinides exhibit a strong tendency towards hydrolysis and subsequent polymerization and/or colloid formation. These species provide a potential pathway for migration of actinides away from the repository. Therefore, it is of fundamental interest to study their generation and properties in-situ. To this end, X-ray Absorption Fine Structure Spectroscopy (XAFS) at the INE-Beamline for actinide research at ANKA, Electrospray Mass-Spectrometry (ESI TOF-MS) and Laser Induced Breakdown Detection (LIBD) are combined at FZK-INE in a comprehensive attempt to characterize Zr(IV) (An(IV) analogue), Th(IV) and Pu(IV) polymerization and colloid formation.

  19. Correlation functions for the distribution coefficients of U(IV) and Pu(III) ions between aqueous nitric acid and 30% TBP in an aliphatic diluent

    International Nuclear Information System (INIS)

    Geldard, J.F.; Beyerlein, A.L.; Phillips, L.

    1985-01-01

    Distribution coefficient correlations for U(IV) and Pu(III) are obtained in terms of a modified form of the total nitrate ion salting strength that was successfully used to obtain distribution coefficient correlations for U(VI) and Pu(IV) in the earlier work of G.L. Richardson. The modification of salting strength was needed to account for the fact that the U(IV) distribution coefficients measured under conditions where U(VI) is present consistently fall below those obtained when it is absent. The correlations were incorporated into the mixer-settler computer model PUBG, and in the simulation of a 20-stage 1B partitioning contactor, calculated product stream concentrations were in excellent agreement with experiment. Earlier mixer-settler computer models, which failed to account for U(IV) distribution coefficients, predicted that U(IV) remained in the aqueous product stream, which is contrary to the experimental measurements

  20. Correlation functions for the distribution coefficients of U(IV) and Pu(III) ions between aqueous nitric acid and 30% TBP in an aliphatic diluent

    Energy Technology Data Exchange (ETDEWEB)

    Geldard, J.F.; Beyerlein, A.L.; Phillips, L.

    1985-09-01

    Distribution coefficient correlations for U(IV) and Pu(III) are obtained in terms of a modified form of the total nitrate ion salting strength that was successfully used to obtain distribution coefficient correlations for U(VI) and Pu(IV) in the earlier work of G.L. Richardson. The modification of salting strength was needed to account for the fact that the U(IV) distribution coefficients measured under conditions where U(VI) is present consistently fall below those obtained when it is absent. The correlations were incorporated into the mixer-settler computer model PUBG, and in the simulation of a 20-stage 1B partitioning contactor, calculated product stream concentrations were in excellent agreement with experiment. Earlier mixer-settler computer models, which failed to account for U(IV) distribution coefficients, predicted that U(IV) remained in the aqueous product stream, which is contrary to the experimental measurements.

  1. The Impact of Local and Regional Disease Extent on Overall Survival in Patients With Advanced Stage IIIB/IV Non-Small Cell Lung Carcinoma

    International Nuclear Information System (INIS)

    Higginson, Daniel S.; Chen, Ronald C.; Tracton, Gregg; Morris, David E.; Halle, Jan; Rosenman, Julian G.; Stefanescu, Mihaela; Pham, Erica; Socinski, Mark A.; Marks, Lawrence B.

    2012-01-01

    Purpose: Patients with advanced stage IIIB or stage IV non-small cell lung carcinoma are typically treated with initial platinum-based chemotherapy. A variety of factors (eg, performance status, gender, age, histology, weight loss, and smoking history) are generally accepted as predictors of overall survival. Because uncontrolled pulmonary disease constitutes a major cause of death in these patients, we hypothesized that clinical and radiographic factors related to intrathoracic disease at diagnosis may be prognostically significant in addition to conventional factors. The results have implications regarding the selection of patients for whom palliative thoracic radiation therapy may be of most benefit. Methods and Materials: We conducted a pooled analysis of 189 patients enrolled at a single institution into 9 prospective phase II and III clinical trials involving first-line, platinum-based chemotherapy. Baseline clinical and radiographic characteristics before trial enrollment were analyzed as possible predictors for subsequent overall survival. To assess the relationship between anatomic location and volume of disease within the thorax and its effect on survival, the pre-enrollment computed tomography images were also analyzed by contouring central and peripheral intrapulmonary disease. Results: On univariate survival analysis, multiple pulmonary-related factors were significantly associated with worse overall survival, including pulmonary symptoms at presentation (P=.0046), total volume of intrathoracic disease (P=.0006), and evidence of obstruction of major bronchi or vessels on prechemotherapy computed tomography (P<.0001). When partitioned into central and peripheral volumes, central (P<.0001) but not peripheral (P=.74) disease was associated with worse survival. On multivariate analysis with known factors, pulmonary symptoms (hazard ratio, 1.46; P=.042), central disease volume (hazard ratio, 1.47; P=.042), and bronchial/vascular compression (hazard ratio, 1

  2. Comparison of Survival Rates, Tumor Stages, and Localization in between Obese and Nonobese Patients with Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Hakan Kocoglu

    2016-01-01

    Full Text Available Purpose. In this study we tried to determine the association between body-mass index (BMI, survival rate, and the stage of tumor at the time of diagnosis in patients with gastric cancer. Methods. A total of 270 gastric cancer patients’ hospital records were retrospectively evaluated. Patients were grouped according to their BMI at the time of tumor diagnosis. Tumor stages at admission were compared according to their BMI values. Results. There were no differences in OS among BMI subgroups (p=0.230. The percent of patients with stage III tumor was significantly higher in nonobese while the percent of stage IV tumor was surprisingly higher in obese patients (p was 0.011 and 0.004, resp.. Percent of patients who did not have any surgical intervention was significantly lower in overweight and obese patients than normal and/or underweight patients. Conclusions. At the time of diagnosis, obese patients had significantly higher percent of stage IV tumor than nonobese patients. Despite of that, there were no differences in survival rates among BMI subgroups. Our study results are consistent with “obesity paradox” in gastric cancer patients. We also did not find any relationship between BMI and localization of gastric tumor.

  3. New trend in colorectal cancer in Germany: are young patients at increased risk for advanced colorectal cancer?

    Science.gov (United States)

    Ambe, Peter C; Jansen, Stefan; Zirngibl, Hubert

    2017-08-23

    The role of colonoscopy in the screening of colorectal cancer (CRC) has been unequivocally established. In Germany, screening colonoscopy with full insurance reimbursement is available for individuals aged 55 and above, and/or for persons with well-known risk factors for CRC. However, advanced CRC is not uncommon in individuals below 55 years. This study was designed to investigate the incidence of advanced CRC in patients < 55 years. A retrospective analysis of data from a prospectively maintained CRC database of a university hospital in Germany was performed. Using the recommended age for screening colonoscopy as cutoff, the study population was divided into two groups: < 55 years (study group) and ≥ 55 years (control group). Both groups were compared with regard to the extent of CRC using the UICC stages. Only surgically managed patients were included for analysis. Advanced CRC was defined as UICC stage III or IV. Complete follow-up data was available for 609 patients treated between 2009 and 2013. The study group included 83 patients, 42 females and 41 males with a median age of 48.0 ± 10 years, while the control group was made up of 526 patients, 230 females and 296 males with a median age of 75.5 ± 8.3 years. Both groups were comparable with regard to gender distribution, p = 0.24. Significantly more patients from the study group were diagnosed with advanced CRC in comparison to the control group, 56.6 vs. 43.9%, p = 0.03. There was no statistically significant difference amongst both groups with respect to cancer-related mortality, 10.8 vs. 12.5%, p = 0.66. Patients below the recommended age for screening colonoscopy might be at increased risk for advanced CRC. There is need to decrease the recommended age for screening colonoscopy to prevent CRC or enable an early diagnosis in patients below 55 years.

  4. Generation IV national program

    International Nuclear Information System (INIS)

    Preville, M.; Sadhankar, R.; Brady, D.

    2007-01-01

    This paper outlines the Generation IV National Program. This program involves evolutionary and innovative design with significantly higher efficiencies (∼50% compared to present ∼30%) - sustainable, economical, safe, reliable and proliferation resistant - for future energy security. The Generation IV Forum (GIF) effectively leverages the resources of the participants to meet these goals. Ten countries signed the GIF Charter in 2001

  5. Staging performance of whole-body DWI, PET/CT and PET/MRI in invasive ductal carcinoma of the breast.

    Science.gov (United States)

    Catalano, Onofrio Antonio; Daye, Dania; Signore, Alberto; Iannace, Carlo; Vangel, Mark; Luongo, Angelo; Catalano, Marco; Filomena, Mazzeo; Mansi, Luigi; Soricelli, Andrea; Salvatore, Marco; Fuin, Niccolo; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce Robert

    2017-07-01

    The aim of the present study was to evaluate the performance of whole-body diffusion-weighted imaging (WB-DWI), whole-body positron emission tomography with computed tomography (WB-PET/CT), and whole-body positron emission tomography with magnetic resonance imaging (WB-PET/MRI) in staging patients with untreated invasive ductal carcinoma of the breast. Fifty-one women with newly diagnosed invasive ductal carcinoma of the breast underwent WB-DWI, WB-PET/CT and WB-PET/MRI before treatment. A radiologist and a nuclear medicine physician reviewed in consensus the images from the three modalities and searched for occurrence, number and location of metastases. Final staging, according to each technique, was compared. Pathology and imaging follow-up were used as the reference. WB-DWI, WB-PET/CT and WB-PET/MRI correctly and concordantly staged 33/51 patients: stage IIA in 7 patients, stage IIB in 8 patients, stage IIIC in 4 patients and stage IV in 14 patients. WB-DWI, WB-PET/CT and WB-PET/MRI incorrectly and concordantly staged 1/51 patient as stage IV instead of IIIA. Discordant staging was reported in 17/51 patients. WB-PET/MRI resulted in improved staging when compared to WB-PET/CT (50 correctly staged on WB-PET/MRI vs. 38 correctly staged on WB-PET/CT; McNemar's test; p<0.01). Comparing the performance of WB-PET/MRI and WB-DWI (43 correct) did not reveal a statistically significant difference (McNemar test, p=0.14). WB-PET/MRI is more accurate in the initial staging of breast cancer than WB-DWI and WB-PET/CT, however, the discrepancies between WB-PET/MRI and WB-DWI were not statistically significant. When available, WB-PET/MRI should be considered for staging patient with invasive ductal breast carcinoma.

  6. Tumor angiogenesis in advanced stage ovarian carcinoma.

    Science.gov (United States)

    Hollingsworth, H C; Kohn, E C; Steinberg, S M; Rothenberg, M L; Merino, M J

    1995-07-01

    Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 43 cases of advanced stage (International Federation of Gynecologists and Obstetricians stages III and IV) ovarian cancer by using the highly specific endothelial cell marker CD34. Microvessel counts and stage were associated with disease-free survival and with overall survival by Kaplan-Meier analysis. The plots show that higher stage, higher average vessel count at 200x (200x avg) and 400x (400x avg) magnification and highest vessel count at 400x (400x high) magnification confer a worse prognosis for disease-free survival. Average vessel count of less than 16 (400x avg, P2 = 0.01) and less than 45 (200x avg, P2 = 0.026) suggested a better survival. Similarly, a high vessel count of less than 20 (400x high, P2 = 0.019) conferred a better survival as well. The plots suggest that higher stage, higher average vessel count at 200x and 400x, and highest vessel count at 200x and 400x show a trend to worse overall survival as well. With the Cox proportional hazards model, stage was the best predictor of overall survival, however, the average microvessel count at 400x was found to be the best predictor of disease-free survival. These results suggest that analysis of neovascularization in advanced stage ovarian cancer may be a useful prognostic factor.

  7. Solubility studies of Np(IV)

    International Nuclear Information System (INIS)

    Zhang Yingjie; Yao Jun; Jiao Haiyang; Ren Lihong; Zhou Duo; Fan Xianhua

    2001-01-01

    The solubility of Np(IV) in simulated underground water and redistilled water has been measured with the variations of pH(6-12) and storage time (0-100 d) in the presence of reductant (Na 2 S 2 O 4 , metallic Fe). All experiments are performed in a low oxygen concentration glove box containing high purity Ar(99.99%), with an oxygen content of less than 5 x 10 -6 mol/mol. Experimental results show that the variation of pH in solution has little effect on the solubility of Np(IV) in the two kinds of water; the measured solubility of Np(IV) is affected by the composition of solution; with Na 2 S 2 O 4 as a reductant, the solubility of Np(IV) in simulated underground water is (9.23 +- 0.48) x 10 -10 mol/L, and that in redistilled water is (8.31 +- 0.35) x 10 -10 mol/L; with metallic Fe as a reductant, the solubility of Np(IV) in simulated underground water is (1.85 +- 0.56) x 10 -9 mol/L, and that in redistilled water is (1.48 +- 0.66) x 10 -9 mol/L

  8. Materials for generation-IV nuclear reactors

    International Nuclear Information System (INIS)

    Alvarez, M. G.

    2009-01-01

    Materials science and materials development are key issues for the implementation of innovative reactor systems such as those defined in the framework of the Generation IV. Six systems have been selected for Generation IV consideration: gas-cooled fast reactor, lead-cooled fast reactor, molten salt-cooled reactor, sodium-cooled fast reactor, supercritical water-cooled reactor, and very high temperature reactor. The structural materials need to resist much higher temperatures, higher neutron doses and extremely corrosive environment, which are beyond the experience of the current nuclear power plants. For this reason, the first consideration in the development of Generation-IV concepts is selection and deployment of materials that operate successfully in the aggressive operating environments expected in the Gen-IV concepts. This paper summarizes the Gen-IV operating environments and describes the various candidate materials under consideration for use in different structural applications. (author)

  9. Adduct formation in Ce(IV) thenolytrifluoroacetonate

    International Nuclear Information System (INIS)

    Anufrieva, S.I.; Polyakova, G.V.; Snezhko, N.I.; Pechurova, N.I.; Martynenko, L.I.; Spitsyn, V.I.

    1982-01-01

    The literature contains no information on adduct formation in Ce(IV) β-diketonates with additional ligands. Since tetrakis-β-diketonates of Ce(IV) have four six-membered chelate rings, we can suppose that the introduction of an additional monodentate or bidentate ligand into the coordination sphere of Ce(IV) β-diketonates would lead to an increase in the coordination number (CN) of the Ce(IV) to nine or ten. The possibility of realization of such a high CN for Ce(IV) has not been proved; a study of adduct formation by Ce(IV) tetrakis-β-diketonates is thus of theoretical interest. Such an investigation might also be of practical interest, because the introduction of an additional ligand into the coordination sphere of a rare-earth β-diketonate usually increases the solubility of the β-diketonate in nonpolar solvents and increases the volatility of the compound; such a modification of the properties is important for various practical purposes. The aim of our work was to study the possibility of separating solid adducts of Ce(IV) tetrakis-thenoyltrifluoroacetonate with certain oxygen-containing and nitrogen-containing donor monodentate and bidentate ligands, and also to investigate their properties. As the β-diketone we used thenoyltrifluoroacetone (HTTFA), since in a parallel investigation it was found that Ce(TTFA) 4 has a high oxidation-reduction stability

  10. Colorectal cancer and the 7th revision of the TNM staging system: review of changes and suggestions for uniform pathologic reporting.

    Science.gov (United States)

    Obrocea, F L; Sajin, Maria; Marinescu, Elena Cristina; Stoica, D

    2011-01-01

    Colorectal cancer (CRC) is a neoplastic disease with a continuously growing incidence in Romania and throughout the world. Although the surgery remains the first line treatment for most of the cases, newly discovered targeted molecular therapies - effective for some patients, but with various side effects and significant financial burden for the national health systems - requires not only stratification of patients in prognostic groups but also evaluation of some non-anatomic factors with major impact on the prognosis and therapeutic strategy. The AJCC/UICC TNM staging system, in his 7th revision, effective for cases diagnosed on or after January 1, 2010, responds to these needs. On the other hand, the role of the pathologist is increasing in terms of workload and amount of information to be included in the pathology report in order to deliver a personalized diagnosis. There are concerns worldwide regarding relevance, validity and completeness of pathologic reporting of CRC in the absence of a uniform reporting format. Therefore, suggestions for a standardized pathology report of CRC are made, based on TNM 7 and recent, up-to-date conclusive published data.

  11. Genetics Home Reference: glycogen storage disease type IV

    Science.gov (United States)

    ... Home Health Conditions Glycogen storage disease type IV Glycogen storage disease type IV Printable PDF Open All ... Javascript to view the expand/collapse boxes. Description Glycogen storage disease type IV (GSD IV) is an ...

  12. Appendectomy in the surgical staging of ovarian carcinoma.

    Science.gov (United States)

    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.

  13. Functioning in early and late stages of schizophrenia

    Directory of Open Access Journals (Sweden)

    Leonardo Gazzi Costa

    2014-12-01

    Full Text Available INTRODUCTION: Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.OBJECTIVE:To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late and healthy sex- and age-matched controls.METHODS: This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST.RESULTS: Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.CONCLUSION: Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.

  14. Separation of uranium(V I) from binary solution mixtures with thorium(IV), zirconium(IV) and cerium(III) by foaming

    International Nuclear Information System (INIS)

    Shakir, K.; Aziz, M.; Benyamin, K.

    1992-01-01

    Foam separation has been investigated for the removal of uranium(V I), thorium(IV), zirconium(IV) and cerium(III) from dilute aqueous solutions at pH values ranging from about I to about II. Sodium laurel sulphate (Na L S) and acetyl trimethyl ammonium bromide (CTAB), being a strong anionic and a strong cationic surfactants, were used as collectors. The results indicate that Na L S can efficiently remove thorium(IV), zirconium(IV) and cerium(III) but not uranium(V I). CTAB, on the other hand, can successfully float only uranium(V I) and zirconium(IV). These differences in flotation properties of the different cations could be used to establish methods for the separation of uranium(V I) from binary mixtures with thorium(IV), zirconium(IV) or cerium(III). The results are discussed in terms of the hydrolytic behaviour of the tested cations and properties of used collectors.2 fig., 1 tab

  15. IUE observations of interstellar Si IV and C IV lines observed in the spectra of Wolf-Rayet stars

    International Nuclear Information System (INIS)

    Smith, L.J.; Willis, A.J.; Wilson, R.

    1980-01-01

    Recent IUE observations of Wolf-Rayet stars show narrow absorption lines in the highly ionized species of Si IV and C IV. The strengths of these 'interstellar' Si IV and C IV lines observed in the spectra of 10 WR stars and two other early-type stars are compared. Of the WR sample, six stars exhibit very strong Si IV and C IV lines (Wsub(lambda) approximately 0.3 to 0.5 A) whilst the other four stars show much weaker lines (Wsub(lambda) approximately 0.1 A). There is no correlation between the strengths of these lines with either stellar distance or colour excess. The weaker absorptions may arise in the individual stellar H II regions, the observed strengths being consistent with those expected for stars with Tsub(eff) = 30 000 K. Five of the other stars which exhibit very strong absorptions lie in the line of sight to active interstellar regions (Cygnus and Carina nebulae) and it is considered probable that, in addition to their H II region components, the bulk of the strong Si IV and C IV absorptions originate in hot gas associated with these active regions. In the case of the WN5 star HD 50896 violet-displaced components are observed in the interstellar lines of low ionization species. These are thought to be produced in the ring nebula S308 surrounding HD 50896. (author)

  16. Factors influencing late stage of breast cancer at presentation in a district Hospital - Segamat Hospital, Johor.

    Science.gov (United States)

    Cheng, M L; Ling, D Y; Nanu P, K P; Nording, H; Lim, C H

    2015-06-01

    In Malaysia, late stage presentation of breast cancer (stage III or IV) has been a healthcare problem that varies geographically throughout the country. This study aims to understand the factors influencing late stage of breast cancer at presentation among Malaysian women in Segamat Hospital, Johor, which is a district hospital. A retrospective descriptive study was conducted on secondary data of all newly diagnosed breast cancer women from 1st August 2011 to 28th February 2014. Secondary data includes age, ethnicity, marital status, family history, education level, occupation, presenting symptom, duration of symptom, tumour size, tumour pathology, tumour grading, oestrogen, progesterone and HER-2 receptor status were collected and analysed using SPSS version 20.0.0. In total, data from 52 women was analysed and two women were excluded for incompleteness as these women defaulted. Late stage at presentation was 59.6% of all new cases (17.3% stage III and 42.3% stage IV). The commonest age group of all women diagnosed with breast cancer was in the 5th decade. Majority of them were Malay, married and housewives with no family history of breast cancer. The statistically significant factors associated with late stage at presentation include Malay ethnicity (p=0.019), presenting symptoms other than breast lump (p=0.047), and duration of breast lump more than 3 months (p=0.009). The study demonstrated presentation at late stage of breast cancer is a major health concern among Malaysian women in district hospital. This may be attributed to different sociocultural beliefs, strong belief in complementary and alternative medicine, lack of awareness, and difficult accessibility to healthcare services.

  17. Kinetics and mechanism of photoaccelerated isotope exchange between U(VI) and U(IV) in oxalate solutions

    International Nuclear Information System (INIS)

    Shaban, I.S.; Owreit, M.F.; Nikitenko, S.I.

    1992-01-01

    A kinetic study of thermal and photoaccelerated U(IV)-U(VI) isotope exchange has been carried out in oxalate solutions at 11-40 deg C. The rate and quantum yield were determined as a function of U(IV), U(VI) and oxalate concentration, wavelength of incident light, temperature and absorbed dose of γ-radiation. The kinetic equations for thermal and photoaccelerated exchange have been obtained. It was assumed that the mechanism of exchange involves formation of U(V) as an intermediate, followed by slow exchange between U(V) and U(IV). The isokinetic dependence confirms the identity of limiting stages for thermal and photostimulated exchange. The upper component of photoexcited T 1 level of uranyl is supposed to be the most reactive in the process of U(V) generation. It was observed that the small doses of γ-radiation evoke the acceleration of isotope exchange, however, at D>100 krad the rate of exchange is reduced to the level of thermal exchange. (author) 8 refs.; 4 figs.; 2 tabs

  18. High serotonin levels during brain development alter the structural input-output connectivity of neural networks in the rat somatosensory layer IV

    Directory of Open Access Journals (Sweden)

    Stéphanie eMiceli

    2013-06-01

    Full Text Available Homeostatic regulation of serotonin (5-HT concentration is critical for normal topographical organization and development of thalamocortical (TC afferent circuits. Down-regulation of the serotonin transporter (SERT and the consequent impaired reuptake of 5-HT at the synapse, results in a reduced terminal branching of developing TC afferents within the primary somatosensory cortex (S1. Despite the presence of multiple genetic models, the effect of high extracellular 5-HT levels on the structure and function of developing intracortical neural networks is far from being understood. Here, using juvenile SERT knockout (SERT-/- rats we investigated, in vitro, the effect of increased 5-HT levels on the structural organization of (i the thalamocortical projections of the ventroposteromedial thalamic nucleus towards S1, (ii the general barrel-field pattern and (iii the electrophysiological and morphological properties of the excitatory cell population in layer IV of S1 (spiny stellate and pyramidal cells. Our results confirmed previous findings that high levels of 5-HT during development lead to a reduction of the topographical precision of TCA projections towards the barrel cortex. Also, the barrel pattern was altered but not abolished in SERT-/- rats. In layer IV, both excitatory spiny stellate and pyramidal cells showed a significantly reduced intracolumnar organization of their axonal projections. In addition, the layer IV spiny stellate cells gave rise to a prominent projection towards the infragranular layer Vb. Our findings point to a structural and functional reorganization, of TCAs, as well as early stage intracortical microcircuitry, following the disruption of 5-HT reuptake during critical developmental periods. The increased projection pattern of the layer IV neurons suggests that the intracortical network changes are not limited to the main entry layer IV but may also affect the subsequent stages of the canonical circuits of the barrel

  19. Health system delay and its effect on clinical stage of breast cancer: Multicenter study.

    Science.gov (United States)

    Unger-Saldaña, Karla; Miranda, Alfonso; Zarco-Espinosa, Gelasio; Mainero-Ratchelous, Fernando; Bargalló-Rocha, Enrique; Miguel Lázaro-León, Jesús

    2015-07-01

    The objective of this study was to determine the correlation between health system delay and clinical disease stage in patients with breast cancer. This was a cross-sectional study of 886 patients who were referred to 4 of the largest public cancer hospitals in Mexico City for the evaluation of a probable breast cancer. Data on time intervals, sociodemographic factors, and clinical stage at diagnosis were retrieved. A logistic regression model was used to estimate the average marginal effects of delay on the probability of being diagnosed with advanced breast cancer (stages III and IV). The median time between problem identification and the beginning of treatment was 7 months. The subinterval with the largest delay was that between the first medical consultation and diagnosis (median, 4 months). Only 15% of the patients who had cancer were diagnosed with stage 0 and I disease, and 48% were diagnosed with stage III and IV disease. Multivariate analyses confirmed independent correlations for the means of problem identification, patient delay, health system delay, and age with a higher probability that patients would begin cancer treatment in an advanced stage. In the sample studied, the majority of patients with breast cancer began treatment after a delay. Both patient delays and provider delays were associated with advanced disease. Research aimed at identifying specific access barriers to medical services is much needed to guide the design of tailored health policies that go beyond the promotion of breast care awareness and screening participation to include improvements in health services that facilitate access to timely diagnosis and treatment. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  20. Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse

    OpenAIRE

    Sun, Yi-Hung; Kan, Wei-Chih; Wu, Ming-Ping

    2016-01-01

    Objective: We would like to provide an option of minimal invasive surgical intervention for a patient with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis, who was at the advanced-stage pelvic organ prolapse (POP) and who also failed to be treated conservatively. Materials and method: We present a case of uterine prolapse stage IV in a woman who underwent continuous ambulatory peritoneal dialysis due to end-stage renal disease. Her severity of POP had only limi...

  1. In Vivo1H Magnetic Resonance Spectroscopy of Lactate in Patients With Stage IV Head and Neck Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    Le, Quynh-Thu; Koong, Albert; Lieskovsky, Yee Yie; Narasimhan, Balasubramanian; Graves, Edward; Pinto, Harlan; Brown, J. Martin; Spielman, Daniel

    2008-01-01

    Purpose: To investigate in vivo 1 H magnetic resonance spectroscopy imaging of lactate for assessing tumor hypoxia in head and neck cancers and to determine its utility in predicting the response and outcomes. Methods and Materials: Volume-localized lactate-edited 1 H magnetic resonance spectroscopy at 1.5 T was performed in vivo on involved neck nodes and control subcutaneous tissues in 36 patients with Stage IV head and neck cancer. The signal intensities (SIs) of lactate, choline, and creatine and the choline/creatine ratio were measured. The tumor partial pressure of oxygen (pO 2 ) was obtained in the same lymph node before MRS. Patients were treated with either two cycles of induction chemotherapy (tirapazamine, cisplatin, 5-fluorouracil) followed by simultaneous chemoradiotherapy or the same regimen without tirapazamine. The lactate SI and the choline/creatine ratio correlated with the tumor pO 2 , nodal response, and locoregional control. Results: The lactate SI was greater for the involved nodes (median, 0.25) than for the subcutaneous tissue (median, 0.04; p = 0.07). No significant correlation was found between the lactate SI and tumor pO 2 (mean, 0.46 ± 0.10 for hypoxic nodes [pO 2 ≤10 mm Hg, n = 15] vs. 0.36 ± 0.07 for nonhypoxic nodes [pO 2 >10 mm Hg, n = 21], p = 0.44). A significant correlation was found between the choline/creatine ratios and tumor pO 2 (mean, 2.74 ± 0.34 for hypoxic nodes vs. 1.78 ± 0.31 for nonhypoxic nodes, p = 0.02). No correlation was found between the lactate SI and the complete nodal response (p = 0.52) or locoregional control rates. Conclusions: The lactate SI did not correlate with tumor pO 2 , treatment response, or locoregional control. Additional research is needed to refine this technique

  2. Collagen type IV at the fetal-maternal interface.

    Science.gov (United States)

    Oefner, C M; Sharkey, A; Gardner, L; Critchley, H; Oyen, M; Moffett, A

    2015-01-01

    Extracellular matrix proteins play a crucial role in influencing the invasion of trophoblast cells. However the role of collagens and collagen type IV (col-IV) in particular at the implantation site is not clear. Immunohistochemistry was used to determine the distribution of collagen types I, III, IV and VI in endometrium and decidua during the menstrual cycle and the first trimester of pregnancy. Expression of col-IV alpha chains during the reproductive cycle was determined by qPCR and protein localisation by immunohistochemistry. The structure of col-IV in placenta was examined using transmission electron microscopy. Finally, the expression of col-IV alpha chain NC1 domains and collagen receptors was localised by immunohistochemistry. Col-IV alpha chains were selectively up-regulated during the menstrual cycle and decidualisation. Primary extravillous trophoblast cells express collagen receptors and secrete col-IV in vitro and in vivo, resulting in the increased levels found in decidua basalis compared to decidua parietalis. A novel expression pattern of col-IV in the mesenchyme of placental villi, as a three-dimensional network, was found. NC1 domains of col-IV alpha chains are known to regulate tumour cell migration and the selective expression of these domains in decidua basalis compared to decidua parietalis was determined. Col-IV is expressed as novel forms in the placenta. These findings suggest that col-IV not only represents a structural protein providing tissue integrity but also influences the invasive behaviour of trophoblast cells at the implantation site. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A Si IV/O IV Electron Density Diagnostic for the Analysis of IRIS Solar Spectra

    Science.gov (United States)

    Young, P. R.; Keenan, F. P.; Milligan, R. O.; Peter, H.

    2018-04-01

    Solar spectra of ultraviolet bursts and flare ribbons from the Interface Region Imaging Spectrograph (IRIS) have suggested high electron densities of > {10}12 cm‑3 at transition region temperatures of 0.1 MK, based on large intensity ratios of Si IV λ1402.77 to O IV λ1401.16. In this work, a rare observation of the weak O IV λ1343.51 line is reported from an X-class flare that peaked at 21:41 UT on 2014 October 24. This line is used to develop a theoretical prediction of the Si IV λ1402.77 to O IV λ1401.16 ratio as a function of density that is recommended to be used in the high-density regime. The method makes use of new pressure-dependent ionization fractions that take account of the suppression of dielectronic recombination at high densities. It is applied to two sequences of flare kernel observations from the October 24 flare. The first shows densities that vary between 3× {10}12 and 3× {10}13 cm‑3 over a seven-minute period, while the second location shows stable density values of around 2× {10}12 cm‑3 over a three-minute period.

  4. [An unexpected stage of alkalosis in the dynamics of the early posthemorrhagic period].

    Science.gov (United States)

    Beliaev, A V

    2000-01-01

    A study was made on acid-base metabolism in early posthemorrhagic period as exemplified by examination of patients presenting with gastrointestinal hemorrhage. It has been ascertained that hemorrhage is accompanied by a mixed variant of the acid-base state (ABS) deviation, namely metabolic lactate-acidosis and respiratory alkalosis. In the time-related course of posthemorrhagic period such deviations persist in patients with lethal outcome; with the disease running a favourable course the above deviations are found to return to normal quite soon. The development of complications leads to staging in ABC, its stages being as follows: stage I--the initial stage, stage II--persisting metabolic acidosis and respiratory alkalosis, stage III--alkalosis, stage IV--normalization, with stage III of ABS being encouraged by hypocapnia caused by function disorders of the lungs in early posthemorrhagic period, normalization of cell metabolism, increase in the rate of urination as a reflection of the third earlier identified stage of water metabolism, with the H+ excretion in the urine at the previous level. The identified ABS stage III threatens coming trouble, being accompanied by metabolic deviations together with a risk of function disorder of the myocardium.

  5. Batch and column adsorption behaviors of Se(IV) and Te(IV) on organic and inorganic ion exchangers from HCl solutions

    Energy Technology Data Exchange (ETDEWEB)

    El-Sweify, Fatma H.; Abdel-Fattah, Alaa El-Din A.; Aly, Shorouk M.; Ghamry, Mohamed A. [Atomic Energy Authority, Cairo (Egypt). Hot Laboratories Center; El-Sheikh, Ragaa [Zagazig Univ. (Egypt). Chemistry Dept.

    2017-07-01

    Adsorption behaviors of Se(IV) and Te(IV) on the inorganic ion exchanger ceric tungstate (CeW) was studied under static and dynamic conditions and compared with the adsorption on the organic cation and anion exchangers Dowex-50X8 and AG-2X8, respectively. The radioactive isotopes {sup 75}Se and {sup 123m}Te were used to trace the respective elements. Some parameters affecting the adsorption were investigated under static conditions. In the case of batch technique the adsorption was studied from slightly acidic HCl as well as slightly alkaline media, i.e. at two pH-ranges. Se(IV) and Te(IV) were adsorbed on both the inorganic ion exchanger (CeW) and on AG-2X8, from slightly alkaline solutions. From the similarity of adsorption on both ion exchangers it was clear that (CeW) acts as an anion exchanger. Moreover, the obtained K{sub d}-values for the adsorption on (CeW) were much higher than those for the adsorption on the organic anion exchanger AG-2X8. Se(IV) was not adsorbed on Dowex-50X8 all over the studied pH-range whereas Te(IV) was slightly adsorbed. Loading and elution behaviors of Se(IV) and Te(IV) on columns of AG-2X8 and (CeW) were studied using solutions of HCl of different concentrations. Some good separation alternatives of Se(IV) and Te(IV) under certain conditions were achieved.

  6. Description of nighttime cough epochs in patients with stable COPD GOLD II-IV.

    Science.gov (United States)

    Fischer, Patrick; Gross, Volker; Kroenig, Johannes; Weissflog, Andreas; Hildebrandt, Olaf; Sohrabi, Keywan; Koehler, Ulrich

    Chronic cough is one of the main symptoms of COPD. Ambulatory objective monitoring provides novel insights into the determinants and characteristics of nighttime cough in COPD. Nighttime cough was monitored objectively by LEOSound lung sound monitor in patients with stable COPD II-IV. In 30 patients, with 10 patients in each stage group, nighttime cough was analyzed for epoch frequency, epoch severity (epoch length and coughs per epoch), and pattern (productive or nonproductive). Cough was found in all patients ranging from 1 to 294 events over the recording period. In 29 patients, cough epochs were monitored, ranging from 1 to 75 epochs. The highest amount of cough epochs was found in patients with COPD stage III. Active smokers had significantly more productive cough epochs (61%) than nonsmokers (24%). We found a high rate of nighttime cough epochs in patients with COPD, especially in those in stage III. Productive cough was predominantly found in patients with persistent smoking. LEOSound lung sound monitor offers a practical and valuable opportunity to evaluate cough objectively.

  7. Predicting DPP-IV inhibitors with machine learning approaches

    Science.gov (United States)

    Cai, Jie; Li, Chanjuan; Liu, Zhihong; Du, Jiewen; Ye, Jiming; Gu, Qiong; Xu, Jun

    2017-04-01

    Dipeptidyl peptidase IV (DPP-IV) is a promising Type 2 diabetes mellitus (T2DM) drug target. DPP-IV inhibitors prolong the action of glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), improve glucose homeostasis without weight gain, edema, and hypoglycemia. However, the marketed DPP-IV inhibitors have adverse effects such as nasopharyngitis, headache, nausea, hypersensitivity, skin reactions and pancreatitis. Therefore, it is still expected for novel DPP-IV inhibitors with minimal adverse effects. The scaffolds of existing DPP-IV inhibitors are structurally diversified. This makes it difficult to build virtual screening models based upon the known DPP-IV inhibitor libraries using conventional QSAR approaches. In this paper, we report a new strategy to predict DPP-IV inhibitors with machine learning approaches involving naïve Bayesian (NB) and recursive partitioning (RP) methods. We built 247 machine learning models based on 1307 known DPP-IV inhibitors with optimized molecular properties and topological fingerprints as descriptors. The overall predictive accuracies of the optimized models were greater than 80%. An external test set, composed of 65 recently reported compounds, was employed to validate the optimized models. The results demonstrated that both NB and RP models have a good predictive ability based on different combinations of descriptors. Twenty "good" and twenty "bad" structural fragments for DPP-IV inhibitors can also be derived from these models for inspiring the new DPP-IV inhibitor scaffold design.

  8. Spectroscopy study of ceramic pigments based on Ce(IV)-Pr(IV) oxide

    International Nuclear Information System (INIS)

    Furtado, L.; Toma, H.E.

    1991-01-01

    The synthesis and spectroscopic properties of a series of cerium(IV)-praseodimium(IV) oxide pigments are reported. The pigments exhibit brick-red colours and are suitable for ceramic applications because of their high temperature stability. Electronic absorption spectra of the pigments suspended in a gel matrix of polyvinyl alcohol-sodium tetradecaborate mixture, consists of broad band with gaussian components at 372 and 472nm. These bands are described to charge -transfer transitions from the occupied oxygen p-orbitals to the empty f levels of the lanthanides. (author)

  9. Soluble CD44 concentration in the serum and peritoneal fluid samples of patients with different stages of endometriosis.

    Science.gov (United States)

    Mashayekhi, Farhad; Aryaee, Hadis; Mirzajani, Ebrahim; Yasin, Ashraf Ale; Fathi, Abdolsatar

    2015-09-01

    Endometriosis is a gynecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity, most commonly implanted over visceral and peritoneal surface within the female pelvis. CD44 is a membrane protein expressed by human endometrial cells, and it has been shown to promote the adhesion of endometrial cells. The aim of this study was to determine the levels of soluble CD44 (sCD44) in the serum and peritoneal fluid (PF) samples of patients with different stages of endometriosis. 39 PF and serum samples from normal healthy and 130 samples from different stages of patients with endometriosis (33 cases of stage I, 38 stage II, 30 stage III and 29 stage IV) were included in this study. Total protein concentration (TPC) and the level of s-cMet in the serum were determined by Bio-Rad protein assay based on the Bradford dye procedure and enzyme-linked immunosorbent assay, respectively. No significant change in the TPC was seen in the serum of patients with endometriosis when compared to normal controls. Results obtained demonstrated that all serum and peritoneal fluid samples, presented sCD44 expression, whereas, starting from stages I to IV endometriosis, a significant increase of sCD44 expression was observed as compared to control group. The results of this study show that a high expression of sCD44 is correlated with advanced stages of endometriosis. It is also concluded that the detection of serum and/or peritoneal fluid sCD44 may be useful in classifying endometriosis.

  10. 1L Mark-IV Target Design Review

    Energy Technology Data Exchange (ETDEWEB)

    Koehler, Paul E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-16

    This presentation includes General Design Considerations; Current (Mark-III) Lower Tier; Mark-III Upper Tier; Performance Metrics; General Improvements for Material Science; General Improvements for Nuclear Science; Improving FOM for Nuclear Science; General Design Considerations Summary; Design Optimization Studies; Expected Mark-IV Performance: Material Science; Expected Mark-IV Performance: Nuclear Science (Disk); Mark IV Enables Much Wider Range of Nuclear-Science FOM Gains than Mark III; Mark-IV Performance Summary; Rod or Disk? Center or Real FOV?; and Project Cost and Schedule.

  11. Investigating the reasons of variability in Si IV and C IV broad absorption line troughs of quasars

    Science.gov (United States)

    Stathopoulos, Dimitrios; Lyratzi, Evangelia; Danezis, Emmanuel; Antoniou, Antonios; Tzimeas, Dimitrios

    2017-09-01

    In this paper we analyze the C IV and Si IV broad absorption troughs of two BALQSOs (J101056.69+355833.3, J114548.38+393746.6) to the individual components they consist of. By analyzing a BAL trough to its components we have the advantage to study the variations of the individual absorbing systems in the line of sight and not just the variations of the whole absorption trough or the variations of selected portions of BAL troughs exhibiting changes. We find that the velocity shifts and FWHMs (Full Width at Half Maximum) of the individual components do not vary between an interval of six years. All variable components show changes in the optical depths at line centers which are manifested as variations in the EW (Equivalent Width) of the components. In both BALQSOs, over corresponding velocities, Si IV has higher incidence of variability than C IV. From our analysis, evidence is in favour of different covering fractions between C IV and Si IV. Finally, although most of our results favour the crossing cloud scenario as the cause of variability, there is also strong piece of evidence indicating changing ionization as the source of variability. Thus, a mixed situation where both physical mechanisms contribute to BAL variability is the most possible scenario.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Topological characterisation and identification of critical domains within glucosyltransferase IV (GtrIV of Shigella flexneri

    Directory of Open Access Journals (Sweden)

    Nair Anesh

    2011-12-01

    Full Text Available Abstract Background The three bacteriophage genes gtrA, gtrB and gtr(type are responsible for O-antigen glucosylation in Shigella flexneri. Both gtrA and gtrB have been demonstrated to be highly conserved and interchangeable among serotypes while gtr(type was found to be specific to each serotype, leading to the hypothesis that the Gtr(type proteins are responsible for attaching glucosyl groups to the O-antigen in a site- and serotype- specific manner. Based on the confirmed topologies of GtrI, GtrII and GtrV, such interaction and attachment of the glucosyl groups to the O-antigen has been postulated to occur in the periplasm. Results In this study, the topology of GtrIV was experimentally determined by creating different fusions between GtrIV and a dual-reporter protein, PhoA/LacZ. This study shows that GtrIV consists of 8 transmembrane helices, 2 large periplasmic loops, 2 small cytoplasmic N- and C- terminal ends and a re-entrant loop that occurs between transmembrane helices III and IV. Though this topology differs from that of GtrI, GtrII, GtrV and GtrX, it is very similar to that of GtrIc. Furthermore, both the N-terminal periplasmic and the C-terminal periplasmic loops are important for GtrIV function as shown via a series of loop deletion experiments and the creation of chimeric proteins between GtrIV and its closest structural homologue, GtrIc. Conclusion The current study provides the basis for elucidating the structure and mechanism of action of this important O-antigen modifying glucosyltransferase.

  14. Correlation between serum and peritoneal fluid glutathione S-transferases T1 concentration with different stages of endometriosis

    Directory of Open Access Journals (Sweden)

    Sohail Mashayekhi

    2018-03-01

    Full Text Available Endometriosis is a gynecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity. Ectopic endometrial cell proliferation and chronic inflammation in endometriosis were shown to be associated with oxidative stress (OS induction. OS is a condition in which reactive oxygen species (ROS overproduction and antioxidant deficiency cause a shift in oxidant/antioxidant balance. Glutathione S-transferases (GSTs comprise a family of eukaryotic and prokaryotic phase II metabolic isozymes best known for their ability to catalyze the conjugation of the reduced form of glutathione (GSH to xenobiotic substrates for the purpose of detoxification. The aim of this project was to study the concentrations of GSTT1 in the serum and peritoneal fluid (PF of patients with different stages of endometriosis. Frothy two PF and serum from normal and 152 from different stages of patients with endometriosis (stage I: n = 30, stage II: n = 39, stage III: n = 43 and stage IV: n = 40 were included in this study. The level of GSTT1 in the serum was determined by enzyme linked immunosorbent assay (ELISA. The results showed the presence of GSTT1 in all serum and peritoneal fluid samples, while, starting from stages I to IV endometriosis, a significant decrease in GSTT1 concentration was seen as compared to controls. It is concluded that levels of GSTT1 is negatively correlated with advanced stages of endometriosis. It is also suggested that the detection of serum and/or peritoneal fluid GSTT1 concentration may be valuable in the classifying of endometriosis.

  15. Single-layer group IV-V and group V-IV-III-VI semiconductors: Structural stability, electronic structures, optical properties, and photocatalysis

    Science.gov (United States)

    Lin, Jia-He; Zhang, Hong; Cheng, Xin-Lu; Miyamoto, Yoshiyuki

    2017-07-01

    Recently, single-layer group III monochalcogenides have attracted both theoretical and experimental interest at their potential applications in photonic devices, electronic devices, and solar energy conversion. Excited by this, we theoretically design two kinds of highly stable single-layer group IV-V (IV =Si ,Ge , and Sn; V =N and P) and group V-IV-III-VI (IV =Si ,Ge , and Sn; V =N and P; III =Al ,Ga , and In; VI =O and S) compounds with the same structures with single-layer group III monochalcogenides via first-principles simulations. By using accurate hybrid functional and quasiparticle methods, we show the single-layer group IV-V and group V-IV-III-VI are indirect bandgap semiconductors with their bandgaps and band edge positions conforming to the criteria of photocatalysts for water splitting. By applying a biaxial strain on single-layer group IV-V, single-layer group IV nitrides show a potential on mechanical sensors due to their bandgaps showing an almost linear response for strain. Furthermore, our calculations show that both single-layer group IV-V and group V-IV-III-VI have absorption from the visible light region to far-ultraviolet region, especially for single-layer SiN-AlO and SnN-InO, which have strong absorption in the visible light region, resulting in excellent potential for solar energy conversion and visible light photocatalytic water splitting. Our research provides valuable insight for finding more potential functional two-dimensional semiconductors applied in optoelectronics, solar energy conversion, and photocatalytic water splitting.

  16. Performance evaluation study of IHX-IV seal assembly

    Energy Technology Data Exchange (ETDEWEB)

    Padmakumar, G.; Venkatramanan, J.; Balasubramanian, V.; Prakash, V.; Vaidyanathan, G. [Indira Gandhi Centre for Atomic Research, Kalpakkam - 603102 (India); Konnur, M.S.; Ram Mohan, S.; Suresh, M.; Manikandan, S.; Rajesh, V. [Fluid Control Research Institute, Palakkad - 678 623 (India)

    2005-07-01

    Full text of publication follows: The construction of the 500 MWe Prototype Fast Breeder Reactor (PFBR) has commenced at IGCAR, Kalpakkam. PFBR has four intermediate Heat Exchangers (IHX) and two primary Sodium Pumps. The secondary circuits consist of two loops with each loop having one secondary pump, two intermediate heat exchangers, one surge tank and four steam generators. Primary circuit has both hot and cold sodium and is separated into hot and cold pools by Inner Vessel(IV). IHX forms the interface between the primary circuit and secondary circuit of PFBR. The IHX and pumps are supported from at the top in the roof slab and penetrate through the conical portion of inner vessel. Proper sealing arrangements are necessary to prevent leakage of hot sodium into the cold pool through the penetration. The Mechanical Seal is employed to minimize the leakage through the penetration. This seal arrangement can facilitate Differential radial and thermal expansion between IHX and IV stand pipe at the region of penetration Relative tilting between the axis of IHX and IV stand pipe Smooth installation during commissioning and easy removal during maintenance Minimizes the forces transmitted to IV The hydraulic simulation study, of the IHX - IV mechanical seal assembly was undertaken at the Fluid Control Research Institute, Palghat. The seal has two leakage paths viz. Axial and radial. The leakage depends on the contact pressure on the sealing surface and the head causing the leakage. High leakage flow may lead to damage of inner vessel and may affect the thermal efficiency of the IHX. CFD analysis of the geometry was done in detail. This was done for prototype and the model condition. The optimized design obtained using CFD was employed for experimental evaluation. In the experimental set up, the leakage characteristics was studied for varying axial and radial clearance that prevails during the various stages of operation of the seal assembly in the reactor. A 1/2 scaled

  17. Catalytic conversion of light alkanes-proof-of-concept stage - Phase IV. Topical report, February 1, 1994--January 31, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    This report details the research performed on Phase IV of the extended Cooperative Agreement. This Phase, entitled C{sub 1}-C{sub 4} Research, provides the research support which accompanies the C{sub 4} Proof-of-Concept Phase (Phase V) as the two major activities of the Cooperative Agreement during calendar 1993. It is the objective of this phase to understand the nature of the catalysts and catalytic activity of perhaloporphyrin complexes uncovered during Phases I-III in order that superior catalytic materials can be made and tested which meet commercial criteria for the oxidation of the C{sub 1}-C{sub 4} light alkane gases found in natural gas and other available hydrocarbon streams. During Phase IV, we have examined the physical and electronic structures of the very active perhaloporphyrin catalysts which we have developed, and have gained an understanding of the properties which make them active. This has led us to design and synthesize materials which are cheaper, more active, more robust and, in general superior for carrying out practical catalysis. Our early generation perhaloporphyrin catalysts, while exhibiting unprecedented catalytic activity, were far too expensive for use in converting natural gas or its C{sub 1}-C{sub 4} components.

  18. Effectiveness and safety of proton beam therapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Park, Joong-Won; Kim, Tae Hyun; Kim, Yeon-Joo; Woo, Sang Myung; Koh, Young-Hwan; Lee, Woo Jin; Park, Sang-Jae; Kim, Dae Yong; Kim, Chang-Min [National Cancer Center, Center for Liver Cancer, Research Institute and Hospital, Goyang-si, Gyeonggi-do (Korea, Republic of)

    2014-09-15

    To evaluate the clinical effectiveness and safety of proton beam therapy (PBT) in advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Twenty-seven HCC patients with PVTT underwent PBT, including 22 patients with modified International Union Against Cancer (mUICC) stage IVA,five patients with stage IVB primary tumors, and 16 with main PVTT. A median dose of 55 GyE (range, 50-66 GyE) in 20-22 fractions was delivered to a target volume encompassing both the PVTT and primary tumor. Overall, treatment was well tolerated, with no toxicity of grade ≥ 3. Median overall survival (OS) times in all patients and in stage IVA patients were 13.2 months and 16 months, respectively. Assessments of PVTT response showed complete response in 0 of 27 (0 %) patients, partial response in 15 (55.6 %), stable disease in 10 (37 %), and progressive disease in 2 (7.4 %) patients, with an objective response rate of 55.6 %. PVTT responders showed significantly higher actuarial 1-year local progression-free survival (LPFS; 85.6 % vs. 51.3 %), relapse-free survival (RFS; 20 % vs. 0 %) and OS (80 % vs. 25 %) rates than nonresponders (p < 0.05 each). Multivariate analysis showed that PVTT response and mUICC stage were independent prognostic factors for OS. Our data suggest that PBT could improve LPFS, RFS, and OS in advanced HCC patients with PVTT and it is feasible and safe for these patients. (orig.) [German] In der vorliegenden Arbeit wurde versucht, die klinische Wirksamkeit und Sicherheit der Protonenstrahltherapie (PBT) fuer Patienten mit fortgeschrittenem Leberzellkarzinom (HCC) in Verbindung mit Portadertumorthrombosen (PVTT) zu bewerten. Ausgefuehrt wurde die PBT fuer 27 HCC-Patienten mit PVTT, einschliesslich 22 Patienten im mUICC-Stadium (''International Union Against Cancer'') IVA sowie 5 Patienten mit Primaertumor im Stadium IVB und 16 Patienten mit PVTT im primaeren Stadium nach der geaenderten UICC-Klassifikation. Eine

  19. The impact of stage, grade, and mucinous histology on the efficacy of systemic chemotherapy in adenocarcinomas of the appendix: Analysis of the National Cancer Data Base.

    Science.gov (United States)

    Asare, Elliot A; Compton, Carolyn C; Hanna, Nader N; Kosinski, Lauren A; Washington, Mary Kay; Kakar, Sanjay; Weiser, Martin R; Overman, Michael J

    2016-01-15

    Adenocarcinomas of the appendix represent a heterogeneous disease depending on the presence of mucinous histology, histologic grade, and stage. In the current study, the authors sought to explore the interplay of these factors with systemic chemotherapy in a large population data set. Patients in the National Cancer Data Base (NCDB) who were diagnosed with mucinous, nonmucinous, and signet ring cell-type appendiceal neoplasms from 1985 through 2006 were selected. Multivariable Cox proportional hazards regression models were developed. A total of 11,871 patients met the inclusion criteria for the current study: 50.3% had mucinous neoplasms, 40.5% had nonmucinous neoplasms, and 9.2% had signet ring cell-type neoplasms. The 5-year overall survival (OS) stratified by grade was similar among patients with American Joint Committee on Cancer stage I to stage III disease but not for those with stage IV disease. The median OS for patients with stage IV mucinous and nonmucinous tumors was 6.4 years and 2.3 years, respectively, for those with well differentiated histology (Pchemotherapy improved OS for both mucinous and nonmucinous histologies, with hazard ratios (HRs) of 0.78 (95% confidence interval [95% CI], 0.68-0.89 [P = .0002]) and 0.83 (95% CI, 0.74-0.94 [P = .002]), respectively. For patients with stage IV disease, systemic chemotherapy significantly improved OS for those with nonmucinous (HR, 0.72; 95% CI, 0.64-0.82 [Pchemotherapy versus no chemotherapy was 6.4 years versus 6.5 years (P value not significant) for patients with mucinous, well-differentiated tumors and 1.6 years versus 1.0 years (P = .0007) for patients with mucinous, poorly differentiated tumors. Adjuvant chemotherapy demonstrated a significant OS benefit regardless of histology. However, for patients with stage IV disease, the benefit of systemic chemotherapy varied by tumor histology and grade, with patients with well-differentiated, mucinous, appendiceal adenocarcinomas deriving no

  20. Larvicidal potentiality, longevity and fecundity inhibitory activities of Bacillus sphaericus (Bs G3-IV on vector mosquitoes, Aedes aegypti and Culex quinquefasciatus

    Directory of Open Access Journals (Sweden)

    Arjunan Nareshkumar

    2012-12-01

    Full Text Available Intervention measures to control the transmission of vector-borne diseases include control of the vector population. In mosquito control, synthetic insecticides used against both the larvae (larvicides and adults (adulticides create numerous problems, such as environmental pollution, insecticide resistance and toxic hazards to humans. In the present study, a bacterial pesticide, Bacillus sphaericus (Bs G3-IV, was used to control the dengue and filarial vectors, Aedes aegypti and Culex quinquefasciatus. Bacillus sphaericus (Bs G3-IV was very effective against Aedes aegypti and Culex quinquefasciatus, showing significant larval mortality. Evaluated lethal concentrations (LC50 and LC90 were age-dependent, with early instars requiring a lower concentration compared with later stages of mosquitoes. Culex quinquefasciatus was more susceptible to Bacillus sphaericus (Bs G3-IV than was Aedes aegypti. Fecundity rate was highly reduced after treatment with different concentrations of Bacillus sphaericus (Bs G3-IV. Larval and pupal longevity both decreased after treatment with Bacillus sphaericus (Bs G3-IV, total number of days was lower in the B. sphaericus treatments compared with the control. Our results show the bacterial pesticide Bacillus sphaericus (Bs G3-IV to be an effective mosquito control agent that can be used for more integrated pest management programs.

  1. Relationship between age at menarche and skeletal maturation stages in Taiwanese female orthodontic patients.

    Science.gov (United States)

    Lai, Eddie Hsiang-Hua; Chang, Jenny Zwei-Chieng; Jane Yao, Chung-Chen; Tsai, Shih-Jaw; Liu, Jen-Pei; Chen, Yi-Jane; Lin, Chun-Pin

    2008-07-01

    The age at menarche reflects a pubertal girl's physiologic maturity. The aims of this study were to evaluate the relationship between the age at menarche and skeletal maturation in female orthodontic patients. Hand-wrist radiographs and lateral cephalometric radiographs from 304 adolescent female subjects (age, 8-18.9 years) were selected from the files of the Department of Orthodontics, National Taiwan University Hospital (NTUH). Hand-wrist bone maturation stages were assessed using the NTUH Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages (CVMS) were determined using the latest CVMS Index. Menarcheal ages were self-reported by the patients and verified by the patients' mothers. The relationships between the NTUH-SMI or CVM stages and menarcheal status were investigated. More than 90% of the 148 subjects who had already attained menstruation had skeletal maturation beyond the NTUH-SMI stage four or CVMS III. However, the subjects who had never experienced menarche mostly had skeletal maturation before NTUH-SMI stage five or CVMS IV. During the period of orthodontic treatment, 19 females experienced their menarche. The mean age at menarche for the 167 female patients in total was 11.97 years. In average, menarche occurred between NTUH-SMI stages four and five or between CVM stages III and IV. The percentage of girls with menses increased from 1.2% at age 9 to 6.6% at age 10, 39.5% at age 11, 81.4% at age 12, 97% at age 13, and 100% at age 14. Compared with the results obtained 20 years previously, we found a downward shift of 0.47 years per decade for the mean age at menarche in female orthodontic patients. The majority of female orthodontic patients have passed the pubertal growth spurt when they experience their menarche. Menarche usually follows the pubertal growth spurt by about 1 year and occurs after NTUH-SMI stage four or CVMS III.

  2. MRI imaging and staging of atlantodental lesions in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kuroda, Mana

    1992-01-01

    Sixty-five patients with a 3 year or more history of rheumatoid arthritis (RA) underwent magentic resonance (MR) imaging to determine the atlantodental interval (ADI), space available for the spinal cord (SAC), intensity of dens, dense erosion, periodontoid masses, and atlantodental subluxation. These MR findings were classified into stages 0 to IV. Stenbroker stage, disease duration, clinical symptoms, and ADI were compared with MR stages. Gd-DTPA enhanced MR images of the craniovertebral junction were also obtained in 16 patients with obvious periodontal pannus to examine a relationship between uptake of Gd-DTPA and quantitative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the joint score as the marker of the activity. Steinbroker stage, disease duration, and clinical symptoms were not correlaed with MR stage of craniovertebral junction. MR imaging was capable of detecting periodontoid lesion even in the early stage. It was also superior to conventional plain film and tomography in depicting the retrodental pannus without ADI dilatation. Pannus having noticeable contrast enhancement was associated with an extremely increased CRP and ESR. When it had no increase in signal intensity, laboratory findings were various. MR enhancement pattern seemed to correlate with RA activity. The present MR classification of atlantodental lesions would contribute to the therapeutic decision and evaluation of treatment outcome. (N.K.)

  3. MRI imaging and staging of atlantodental lesions in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Mana (Tokyo Medical Coll. (Japan))

    1992-03-01

    Sixty-five patients with a 3 year or more history of rheumatoid arthritis (RA) underwent magentic resonance (MR) imaging to determine the atlantodental interval (ADI), space available for the spinal cord (SAC), intensity of dens, dense erosion, periodontoid masses, and atlantodental subluxation. These MR findings were classified into stages 0 to IV. Stenbroker stage, disease duration, clinical symptoms, and ADI were compared with MR stages. Gd-DTPA enhanced MR images of the craniovertebral junction were also obtained in 16 patients with obvious periodontal pannus to examine a relationship between uptake of Gd-DTPA and quantitative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the joint score as the marker of the activity. Steinbroker stage, disease duration, and clinical symptoms were not correlaed with MR stage of craniovertebral junction. MR imaging was capable of detecting periodontoid lesion even in the early stage. It was also superior to conventional plain film and tomography in depicting the retrodental pannus without ADI dilatation. Pannus having noticeable contrast enhancement was associated with an extremely increased CRP and ESR. When it had no increase in signal intensity, laboratory findings were various. MR enhancement pattern seemed to correlate with RA activity. The present MR classification of atlantodental lesions would contribute to the therapeutic decision and evaluation of treatment outcome. (N.K.).

  4. Glycogen Storage Disease Type IV

    DEFF Research Database (Denmark)

    Bendroth-Asmussen, Lisa; Aksglaede, Lise; Gernow, Anne B

    2016-01-01

    molecular genetic analyses confirmed glycogen storage disease Type IV with the finding of compound heterozygosity for 2 mutations (c.691+2T>C and c.1570C>T, p.R524X) in the GBE1 gene. We conclude that glycogen storage disease Type IV can cause early miscarriage and that diagnosis can initially be made...

  5. IV&V Project Assessment Process Validation

    Science.gov (United States)

    Driskell, Stephen

    2012-01-01

    The Space Launch System (SLS) will launch NASA's Multi-Purpose Crew Vehicle (MPCV). This launch vehicle will provide American launch capability for human exploration and travelling beyond Earth orbit. SLS is designed to be flexible for crew or cargo missions. The first test flight is scheduled for December 2017. The SLS SRR/SDR provided insight into the project development life cycle. NASA IV&V ran the standard Risk Based Assessment and Portfolio Based Risk Assessment to identify analysis tasking for the SLS program. This presentation examines the SLS System Requirements Review/System Definition Review (SRR/SDR), IV&V findings for IV&V process validation correlation to/from the selected IV&V tasking and capabilities. It also provides a reusable IEEE 1012 scorecard for programmatic completeness across the software development life cycle.

  6. Dissimilatory Fe(III) and Mn(IV) reduction.

    Science.gov (United States)

    Lovley, D R

    1991-06-01

    The oxidation of organic matter coupled to the reduction of Fe(III) or Mn(IV) is one of the most important biogeochemical reactions in aquatic sediments, soils, and groundwater. This process, which may have been the first globally significant mechanism for the oxidation of organic matter to carbon dioxide, plays an important role in the oxidation of natural and contaminant organic compounds in a variety of environments and contributes to other phenomena of widespread significance such as the release of metals and nutrients into water supplies, the magnetization of sediments, and the corrosion of metal. Until recently, much of the Fe(III) and Mn(IV) reduction in sedimentary environments was considered to be the result of nonenzymatic processes. However, microorganisms which can effectively couple the oxidation of organic compounds to the reduction of Fe(III) or Mn(IV) have recently been discovered. With Fe(III) or Mn(IV) as the sole electron acceptor, these organisms can completely oxidize fatty acids, hydrogen, or a variety of monoaromatic compounds. This metabolism provides energy to support growth. Sugars and amino acids can be completely oxidized by the cooperative activity of fermentative microorganisms and hydrogen- and fatty-acid-oxidizing Fe(III) and Mn(IV) reducers. This provides a microbial mechanism for the oxidation of the complex assemblage of sedimentary organic matter in Fe(III)- or Mn(IV)-reducing environments. The available evidence indicates that this enzymatic reduction of Fe(III) or Mn(IV) accounts for most of the oxidation of organic matter coupled to reduction of Fe(III) and Mn(IV) in sedimentary environments. Little is known about the diversity and ecology of the microorganisms responsible for Fe(III) and Mn(IV) reduction, and only preliminary studies have been conducted on the physiology and biochemistry of this process.

  7. Assembling filamentous phage occlude pIV channels.

    Science.gov (United States)

    Marciano, D K; Russel, M; Simon, S M

    2001-07-31

    Filamentous phage f1 is exported from its Escherichia coli host without killing the bacterial cell. Phage-encoded protein pIV, which is required for phage assembly and secretion, forms large highly conductive channels in the outer membrane of E. coli. It has been proposed that the phage are extruded across the bacterial outer membrane through pIV channels. To test this prediction, we developed an in vivo assay by using a mutant pIV that functions in phage export but whose channel opens in the absence of phage extrusion. In E. coli lacking its native maltooligosacharride transporter LamB, this pIV variant allowed oligosaccharide transport across the outer membrane. This entry of oligosaccharide was decreased by phage production and still further decreased by production of phage that cannot be released from the cell surface. Thus, exiting phage block the pIV-dependent entry of oligosaccharide, suggesting that phage occupy the lumen of pIV channels. This study provides the first evidence, to our knowledge, for viral exit through a large aqueous channel.

  8. Non-equilibrium ionization by a periodic electron beam. II. Synthetic Si IV and O IV transition region spectra

    Science.gov (United States)

    Dzifčáková, Elena; Dudík, Jaroslav

    2018-03-01

    Context. Transition region (TR) spectra typically show the Si IV 1402.8 Å line to be enhanced by a factor of 5 or more compared to the neighboring O IV 1401.2 Å, contrary to predictions of ionization equilibrium models and the Maxwellian distribution of particle energies. Non-equilibrium effects in TR spectra are therefore expected. Aims: To investigate the combination of non-equilibrium ionization and high-energy particles, we apply the model of the periodic electron beam, represented by a κ-distribution that recurs at periods of several seconds, to plasma at chromospheric temperatures of 104 K. This simple model can approximate a burst of energy release involving accelerated particles. Methods: Instantaneous time-dependent charge states of silicon and oxygen were calculated and used to synthesize the instantaneous and period-averaged spectra of Si IV and O IV. Results: The electron beam drives the plasma out of equilibrium. At electron densities of Ne = 1010 cm-3, the plasma is out of ionization equilibrium at all times in all cases we considered, while for a higher density of Ne = 1011 cm-3, ionization equilibrium can be reached toward the end of each period, depending on the conditions. In turn, the character of the period-averaged synthetic spectra also depends on the properties of the beam. While the case of κ = 2 results in spectra with strong or even dominant O IV, higher values of κ can approximate a range of observed TR spectra. Spectra similar to typically observed spectra, with the Si IV 1402.8 Å line about a factor 5 higher than O IV 1401.2 Å, are obtained for κ = 3. An even higher value of κ = 5 results in spectra that are exclusively dominated by Si IV, with negligible O IV emission. This is a possible interpretation of the TR spectra of UV (Ellerman) bursts, although an interpretation that requires a density that is 1-3 orders of magnitude lower than for equilibrium estimates. Movies associated to Fig. A.1 are available at http://https://www.aanda.org

  9. Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Ling Na PhD

    2017-03-01

    Full Text Available Objectives: Activity of daily living (ADL stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002 were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D], only the complete limitation stage (Stage IV showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

  10. Relation between clinical findings and progression of cerebral cortical pathology in MM1-type sporadic Creutzfeldt-Jakob disease: proposed staging of cerebral cortical pathology.

    Science.gov (United States)

    Iwasaki, Yasushi; Tatsumi, Shinsui; Mimuro, Maya; Kitamoto, Tetsuyuki; Hashizume, Yoshio; Yoshida, Mari

    2014-06-15

    In our pathologic observation of the cerebral cortex including the neocortex, hippocampus, and limbic cortex in 43 Japanese patients with MM1-type sporadic Creutzfeldt-Jakob disease, the earliest pathologic finding was spongiform change and next was gliosis. Subsequently, neuropil rarefaction appeared, followed by neuron loss. On the basis of these observations, we propose the following cortical pathologic staging: Stage I, spongiform change; Stage II, hypertrophic astrocytosis; Stage III, neuropil rarefaction; Stage IV, neuron loss; Stage V, status spongiosus; and Stage VI, large cavity formation. We also suggest a more simple staging classification: Stages I and II, mild; Stages III and IV, moderate; and Stages V and VI, severe involvement. Based on statistical analysis of the cases, strong correlation coefficients were obtained between the neocortical and limbic pathologic stage and both total disease duration and brain weight. We estimated that the first observation times of cortical hyperintensity on diffusion-weighted images of magnetic resonance imaging, myoclonus, and periodic sharp wave complexes on the electroencephalogram approximately correspond to the early phase of Stage II of the neocortex. The time to reach the akinetic mutism state approximately corresponds to the middle phase of Stage II of the neocortex. Therefore, we think that approximate clinical manifestations at death, total disease duration, and brain weight can be estimated according to the pathologic stage of the neocortex or limbic cortex. Panencephalopathic-type pathology appeared approximately 12 months after disease onset, and this time approximately corresponds to the middle phase of Stage III of the neocortex. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Three-Dimensional Radiation Therapy to the Primary Tumor With Concurrent Chemotherapy in Patients With Stage IV Non-Small Cell Lung Cancer: Results of a Multicenter Phase 2 Study From PPRA-RTOG, China

    Energy Technology Data Exchange (ETDEWEB)

    Su, ShengFa [Department of Thoracic Oncology, Affiliated Hospital of Guizhou Medical University, and Guizhou Cancer Hospital, Guiyang (China); Teaching and Research Section of Oncology, Guizhou Medical University, Guiyang (China); Li, Tao [Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu (China); Lu, Bing, E-mail: lbgymaaaa@163.com [Department of Thoracic Oncology, Affiliated Hospital of Guizhou Medical University, and Guizhou Cancer Hospital, Guiyang (China); Teaching and Research Section of Oncology, Guizhou Medical University, Guiyang (China); Wang, XiaoHu, E-mail: xhwanggansu@163.com [Department of Radiation Oncology, Gansu Cancer Hospital, Lanzhou (China); Li, JianCheng [Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou (China); Chen, Ming [Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou (China); Lu, You [Department of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Bai, YuJu [Department of Oncology, Affiliated Hospital of Zunyi Medical College, Zunyi (China); Hu, YinXiang; Ouyang, WeiWei; Ma, Zhu; Li, QingSong; Li, HuiQin; Wang, Yu [Department of Thoracic Oncology, Affiliated Hospital of Guizhou Medical University, and Guizhou Cancer Hospital, Guiyang (China); Teaching and Research Section of Oncology, Guizhou Medical University, Guiyang (China)

    2015-11-15

    Purpose: The aim of this prospective multi-institutional phase 2 study was to investigate disease control, survival outcomes, and toxicity after thoracic three-dimensional radiation therapy (3D-RT) with concurrent chemotherapy for newly diagnosed stage IV non-small cell lung cancer (NSCLC). Methods and Materials: Eligible patients were 18 to 80 years of age, had a Karnofsky performance status (KPS) score ≥70%, and newly diagnosed stage IV NSCLC with limited metastatic disease (defined as involving ≤3 organs). Patients received platinum-doublet chemotherapy with concurrent irradiation to the primary tumor. Primary endpoints were overall survival (OS) and acute toxicity. Results: From May 2008 to May 2012, 198 eligible patients were enrolled from 7 cancer centers. Most patients died with distant metastasis; only 10% died with isolated primary recurrence. Median OS time was 13.0 months (95% confidence interval [CI]: 11.7-14.3); OS rates were 53.5% at 1 year, 15.8% at 2 years, and 9.2% at 3 years. Median progression-free survival (PFS) time was 9.0 months (95% CI: 7.7-10.3); corresponding PFS rates were 30.8%, 8.2%, and 6.1%. The 1-year, 2-year, and 3-year local (primary tumor) control rates were 78.8%, 57.7%, and 55.4%. Multivariate analysis showed that delivery of ≥63 Gy to the primary tumor (P=.014), having a primary tumor volume <134 cm{sup 3} (P=.008), and having a stable or higher KPS score after treatment (P=.01) were independent predictors of better OS. The most common severe (grades 3-4) acute toxicities were hematologic: leukopenia (37.9%), thrombocytopenia (10.1%), and anemia (6.9%). No patients experienced grade 4 or 5 radiation-related toxicity; 2.5% had acute grade 3 pneumonitis, and 6.6% had acute grade 3 radiation esophagitis. Conclusions: Thoracic 3D-RT to the primary tumor with concurrent chemotherapy led to satisfactory survival outcomes with acceptable toxicity. Radiation dose, primary tumor volume, and PFS after treatment all

  12. Solubility study of Tc(IV) oxides

    International Nuclear Information System (INIS)

    Liu, D.J.; Fan, X.H.

    2005-01-01

    The deep geological disposal of the high level radioactive wastes is expected to be a safer disposal method in most countries. The long-lived fission product 99 Tc is present in large quantities in nuclear wastes and its chemical behavior in aqueous solution is of considerable interest. Under oxidizing conditions technetium exists as the anionic species TcO 4 - whereas under the reducing conditions, expected to exist in a deep geological repository, it is generally predicted that technetium will be present as TcO 2 ·nH 2 O. Hence, the mobility of Tc(IV) in reducing groundwater may be limited by the solubility of TcO 2 ·nH 2 O under these conditions. Due to this fact it is important to investigate the solubility of TcO 2 ·nH 2 O. The solubility determines the release of radionuclides from waste form and is used as a source term in radionuclide migration analysis in performance assessment of radioactive waste repository. Technetium oxide was prepared by reduction of a technetate solution with Sn 2 + . The solubility of Tc(IV) oxide has been determined in simulated groundwater and redistilled water under aerobic and anaerobic conditions. The effects of pH and CO 3 2- concentration of solution on solubility of Tc(IV) oxide were studied. The concentration of total technetium and Tc(IV) species in the solutions were periodically determined by separating the oxidized and reduced technetium species using a solvent extraction procedure and counting the beta activity of the 99 Tc with a liquid scintillation counter. The experimental results show that the rate of oxidation of Tc(IV) in simulated groundwater and redistilled water is about (1.49-1.86) x 10 -9 mol/(L·d) under aerobic conditions, but Tc(IV) in simulated groundwater and redistilled water is not oxidized under anaerobic conditions. Under aerobic or anaerobic conditions the solubility of Tc(IV) oxide in simulated groundwater and redistilled water is equal on the whole after centrifugation or ultrafiltration. The

  13. [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)

  14. The Contribution of IVS to IGGOS

    Science.gov (United States)

    Nothnagel, A.

    2002-05-01

    Since its inauguration in 1999, the International VLBI Service for Geodesy and Astrometry has made significant progress in the coordination and utilisation of worldwide VLBI resources. Improving the visibility of the IVS components to a wider public in turn led to a higher motivation of the individuals to contribute to the global effort. Not only the number of IVS components but also their investments in terms of funds and manpower demonstrate the increased awareness of the importance of this joint international endeavour. The different demands of the users but also of the contributors often require the definition of priorities which are only being acceptable due to the existence of a strong umbrella organisation like the IVS. Significant progress has also been made in the area of routine data analysis and combination of results. By now, six IVS Analysis Centers provide the redundancy necessary for a robust combination of the results. The use of ITRF2000 station coordinates as the basis for the IVS combined EOP series is the most recent step towards the generation of a consistent chain from the quasi-inertial frame of radio sources to system Earth.

  15. Purification, identification and molecular mechanism of two dipeptidyl peptidase IV (DPP-IV) inhibitory peptides from Antarctic krill (Euphausia superba) protein hydrolysate.

    Science.gov (United States)

    Ji, Wei; Zhang, Chaohua; Ji, Hongwu

    2017-10-01

    Dipeptidyl peptidase IV (DPP-IV) played an important role in blood glucose regulation. Inhibition of DPP-IV may improve glycemic control in diabetics by preventing the rapid breakdown of incretin hormones and prolonging their physiological action. In this study, Antarctic krill (Euphausia superba) protein was hydrolyzed using animal proteolytic enzymes. The hydrolysate was purified sequentially by ultrafiltration, gel filtration chromatography and reversed phase high-performance liquid chromatography (RP-HPLC). DPP-IV inhibitory activity of the fractions achieved from Antarctic krill protein was determined by DPP-IV screening reagent kit. Two purified peptides were identified by Xevo G2-XS QTof mass spectrometer (QTOF-MS). One peptide purified was Ala-Pro (AP) with IC 50 values of 0.0530mg/mL, the other Ile-Pro-Ala (IPA) with IC 50 values of 0.0370mg/mL. They both exhibited strong DPP-IV inhibitory activity. The molecular docking analysis revealed that DPP-IV inhibition by AP and IPA was mainly due to formation of a strong interaction surface force with the 91-96 and 101-105 amino acids of the DPP-IV. Our results suggested that the protein hydrolysate from Antarctic krill can be considered as a promising natural source of DPP-IV inhibitory peptides in the management of diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. On the Importance of the Nonequilibrium Ionization of Si IV and O IV and the Line of Sight in Solar Surges

    Science.gov (United States)

    Nóbrega-Siverio, D.; Moreno-Insertis, F.; Martínez-Sykora, J.

    2018-05-01

    Surges are ubiquitous cool ejections in the solar atmosphere that often appear associated with transient phenomena like UV bursts or coronal jets. Recent observations from the Interface Region Imaging Spectrograph show that surges, although traditionally related to chromospheric lines, can exhibit enhanced emission in Si IV with brighter spectral profiles than for the average transition region (TR). In this paper, we explain why surges are natural sites to show enhanced emissivity in TR lines. We performed 2.5D radiative-MHD numerical experiments using the Bifrost code including the nonequilibrium (NEQ) ionization of silicon and oxygen. A surge is obtained as a by-product of magnetic flux emergence; the TR enveloping the emerged domain is strongly affected by NEQ effects: assuming statistical equilibrium would produce an absence of Si IV and O IV ions in most of the region. Studying the properties of the surge plasma emitting in the Si IV λ1402.77 and O IV λ1401.16 lines, we find that (a) the timescales for the optically thin losses and heat conduction are very short, leading to departures from statistical equilibrium, and (b) the surge emits in Si IV more and has an emissivity ratio of Si IV to O IV larger than a standard TR. Using synthetic spectra, we conclude the importance of line-of-sight effects: given the involved geometry of the surge, the line of sight can cut the emitting layer at small angles and/or cross it multiple times, causing prominent, spatially intermittent brightenings in both Si IV and O IV.

  17. May one-stage exchange for Candida albicans peri-prosthetic infection be successful?

    Science.gov (United States)

    Jenny, J-Y; Goukodadja, O; Boeri, C; Gaudias, J

    2016-02-01

    Fungal infection of a total joint arthroplasty has a low incidence but is generally considered as more difficult to cure than bacterial infection. As for bacterial infection, two-stage exchange is considered as the gold standard of treatment. We report two cases of one-stage total joint exchange for fungal peri-prosthetic infection with Candida albicans, where the responsible pathogens was only identified on intraoperative samples. This situation can be considered as a one-stage exchange for fungal peri-prosthetic infection without preoperative identification of the responsible organism, which is considered as having a poor prognosis. Both cases were free of infection after two years. One-stage revision has several potential advantages over two-stage revision, including shorter hospital stay and rehabilitation, no interim period with significant functional impairment, shorter antibiotic treatment, better functional outcome and probably lower costs. We suggest that one-stage revision for C. albicans peri-prosthetic infection may be successful even without preoperative fungal identification. Level IV-Historical cases. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Synthesis and spectroscopic studies of mono- and dicyclopentadienyl titanium (IV)/zirconium (IV) derivatives with S-alkyl-β-N-(acetylferrocenyl) methylene dithiocarbazates

    International Nuclear Information System (INIS)

    Srivastava, B.K.; Srivastava, S.K.; Pandey, O.P.; Sengupta, S.K.

    1996-01-01

    The reactions of dicyclopentadienyl titanium (IV)/zirconium (IV) dichloride and monocyclopentadienyl titanium (IV) trichloride with thio-Schiff bases (LH), derived by the condensation of S-methyl/ethyl/propyl dithiocarbazic acid and acetylferrocene have been carried out under inert atmosphere and anhydrous conditions in different stoichiometric ratios. Complexes of the types Cp 2 M(L)Cl, CpM(L) 2 Cl (M= Ti(IV) or Zr(IV)), CpTi(L)Cl 2 , CpTi(L) 2 Cl are synthesised and characterized by elemental analysis, electrical conductance, magnetic moment and spectral (electronic, infrared, 1 H NMR) data. (author). 12 refs., 1 tab

  19. The outcome and prognosis factors of adolescent nasopharyngeal carcinoma treated in a single institute-analysis of 148 patients

    International Nuclear Information System (INIS)

    Pei Su; Gao Li; Yi Junlin

    2011-01-01

    Objective: To evaluate the clinical characteristics, outcome and prognostic factors of adolescent nasopharyngeal carcinoma. Methods: Between Jan 1990 and Dec 2009, totally 148 pathological confirmed nasopharyngeal carcinoma (NPC) patients with age ≤20 years were treated in our hospital, including stage II 8, stage III 58, stage IV 81, and unknown 1 when restaged by TNM system (UICC 2002), ninety-four (63.5%) patients were treated with radiotherapy alone, 54 (36.5%)patients were treated with radiotherapy combined with cisplatin-based chemotherapy. Results: The median follow-up time for all patients was 44.5 months. The 5-year overall survival (OS), local-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 82.9%, 85.1% and 78.6%. There were 42 patients (28.4%) failed with 16 regional recurrence and 29 distant metastasis, and 3 with both; bone metastasis was the most common site of distant metastasis(22/29). In univariate analysis,the adverse prognostic factors for OS were stage T 4 (χ 2 =5.61, P=0.018), radiation dose 2 =5.30, P=0.021), for LRC was radiation dose 2 =4.24, P=0.039). In multivariate analysis, radiation dose 4 were the independent prognostic factors for OS (χ 2 =5.73, 5.56, P=0.017, 0.018), for LRC was radiation dose 2 =5.81, P=0.016). Conclusions: The outcome of the present series was excellent, total nasopharyngeal radiation dose less than 70 Gy is inappropriate. Reduce the distant metastasis and late toxicities were the future direction for the treatment of adolescent nasopharyngeal carcinoma. (authors)

  20. SAGE IV Pathfinder

    Data.gov (United States)

    National Aeronautics and Space Administration — Utilizing a unique, new occultation technique involving imaging, the SAGE IV concept will meet or exceed the quality of previous SAGE measurements at a small...

  1. Facile and reversible formation of iron(III)-oxo-cerium(IV) adducts from nonheme oxoiron(IV) complexes and cerium(III)

    Energy Technology Data Exchange (ETDEWEB)

    Draksharapu, Apparao; Rasheed, Waqas; Klein, Johannes E.M.N.; Que, Lawrence Jr. [Department of Chemistry and Center for Metals in Biocatalysis, University of Minnesota, Minneapolis, MN (United States)

    2017-07-24

    Ceric ammonium nitrate (CAN) or Ce{sup IV}(NH{sub 4}){sub 2}(NO{sub 3}){sub 6} is often used in artificial water oxidation and generally considered to be an outer-sphere oxidant. Herein we report the spectroscopic and crystallographic characterization of [(N4Py)Fe{sup III}-O-Ce{sup IV}(OH{sub 2})(NO{sub 3}){sub 4}]{sup +} (3), a complex obtained from the reaction of [(N4Py)Fe{sup II}(NCMe)]{sup 2+} with 2 equiv CAN or [(N4Py)Fe{sup IV}=O]{sup 2+} (2) with Ce{sup III}(NO{sub 3}){sub 3} in MeCN. Surprisingly, the formation of 3 is reversible, the position of the equilibrium being dependent on the MeCN/water ratio of the solvent. These results suggest that the Fe{sup IV} and Ce{sup IV} centers have comparable reduction potentials. Moreover, the equilibrium entails a change in iron spin state, from S=1 Fe{sup IV} in 2 to S=5/2 in 3, which is found to be facile despite the formal spin-forbidden nature of this process. This observation suggests that Fe{sup IV}=O complexes may avail of reaction pathways involving multiple spin states having little or no barrier. (copyright 2017 Wiley-VCH Verlag GmbH and Co. KGaA, Weinheim)

  2. Plasma metabolism of apolipoprotein A-IV in humans

    International Nuclear Information System (INIS)

    Ghiselli, G.; Krishnan, S.; Beigel, Y.; Gotto, A.M. Jr.

    1986-01-01

    As assessed by molecular sieve chromatography and quantitation by a specific radioimmunoassay, apoA-IV is associated in plasma with the triglyceride-rich lipoproteins, to a high density lipoprotein (HDL) subfraction of smaller size than HDL3, and to the plasma lipoprotein-free fraction (LFF). In this study, the turnover of apoA-IV associated to the triglyceride-rich lipoproteins, HDL and LFF was investigated in vivo in normal volunteers. Human apoA-IV isolated from the thoracic duct lymph chylomicrons was radioiodinated and incubated with plasma withdrawn from normal volunteers after a fatty meal. Radioiodinated apoA-IV-labeled triglyceride-rich lipoproteins, HDL, and LFF were then isolated by chromatography on an AcA 34 column. Shortly after the injection of the radioiodinated apoA-IV-labeled triglyceride-rich lipoproteins, most of the radioactivity could be recovered in the HDL and LFF column fractions. On the other hand, when radioiodinated apoA-IV-labeled HDL or LFF were injected, the radioactivity remained with the originally injected fractions at all times. The residence time in plasma of 125 I-labeled apoA-IV, when injected in association with HDL or LFF, was 1.61 and 0.55 days, respectively. When 125 I-labeled apoA-IV was injected as a free protein, the radioactivity distributed rapidly among the three plasma pools in proportion to their mass. The overall fractional catabolic rate of apoA-IV in plasma was measured in the three normal subjects and averaged 1.56 pools per day. The mean degradation rate of apoA-IV was 8.69 mg/kg X day

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Diagnosis and staging of carcinoma localized in the antral part of the stomach with spiral CT

    International Nuclear Information System (INIS)

    Pomakov, P.; Grudeva, V.; Mlachkova, D.

    2009-01-01

    The aim of the study was to characterize CT images and stages of carcinomas localized in the antral part of the stomach obtained with spiral CT. Seven men aged from 54 years old to 81 years old inclusive, with subjective complaints and clinical suspicion of a neoplasm in the upper gastrointestinal tract were examine Examinations were performed following stomach wall re relaxation with Buscolysin.The stomach is distended by drinking 600 ml of water. Upper abdomen scans were performed with spiral CT/e General Electric with the following parameters: slice thickness 3-5 mm, spacing 3 mm, pitch 1,5, reconstruction index 3 mm. After the pre-contrast scans, 100 ml of non-ionic contrast media is administered intravenously with an injection rate of 30 ml/sec. Scan delay time - 30 seconds after start of injection. Exposition data-120 kV, 180 mAs. Carcinoma localized in the antral part of the stomach was demonstrated in 7 patients. The staging showed: I stage - one patient, II stage - 2, III stage - 1 and IV stage - three patients. According to the macro morphological characteristic: exophytic type - 4, endophytic tumor - 1, ulcerous tumor - 1 and early carcinoma - 1 patient. In our material only male patients were present. Early carcinoma was demonstrated in a male patient at an age of 80 years old. An enhancing nodular local thickness was visualized. Differential diagnosis between malignant and benign ulcer is necessary in certain cases. It is performed on the contrast scans, the malignant process enhances twice its density, When performing a purposive CT examination it is possible to diagnose neoplasms in the antral part of the stomach, from stage i to IV with different macro morphologic characteristic

  5. Collagen type IV at the fetal-maternal interface

    OpenAIRE

    Oefner, C M; Sharkey, A; Gardner, L; Critchley, H; Oyen, M; Moffett, A

    2015-01-01

    Introduction Extracellular matrix proteins play a crucial role in influencing the invasion of trophoblast cells. However the role of collagens and collagen type IV (col-IV) in particular at the implantation site is not clear. Methods Immunohistochemistry was used to determine the distribution of collagen types I, III, IV and VI in endometrium and decidua during the menstrual cycle and the first trimester of pregnancy. Expression of col-IV alpha chains during the reproductive cycle ...

  6. On the stabilization of NbV-solutions by ZrIV and HfIV

    International Nuclear Information System (INIS)

    Soerensen, E.; Bjerre, A.B.

    1987-11-01

    Niobium cannot be separated from zirconium or hafnium when these elements occur together in solution with common anions such as Cl- and SO 4 --. This is ascribed to the copolymerisation of Nb v and the hydrolyzed ionic species of Zr IV v and Hf IV by which the colloidal particles are masked as Zr- and Hf-compounds. In HCl the particles are positively charged as opposed to when they are in sulphate solution where the Zr- and Hf- sulphate complexes confer a negative charge. The two cases are considered separately. (author)

  7. Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy

    International Nuclear Information System (INIS)

    Chan, Alexander K.P.; Wong, Alfred; Jenken, Daryl; Heine, John; Buie, Donald; Johnson, Douglas

    2005-01-01

    Purpose: To evaluate the prognostic value of the posttreatment TNM stage as a predictor of outcome in locally advanced rectal cancers treated with preoperative chemotherapy and radiotherapy. Methods and materials: Between 1993 and 2000, 128 patients with tethered (103) or fixed (25) rectal cancers were treated with 50 Gy preoperative pelvic radiotherapy and two cycles of concurrent 5-fluorouracil infusion (20 mg/kg/d) and leucovorin (200 mg/m 2 /d) chemotherapy on Days 1-4 and 22-25 and a single bolus mitomycin C injection (8 mg/m 2 ) on Day 1. Of the 128 patients, 111 had Stage T3 and 17 Stage T4 according to the rectal ultrasound or CT findings and clinical evaluation. All 128 patients underwent surgery 8 weeks after chemoradiotherapy. Postoperatively, the disease stage was determined according to the surgical and pathologic findings using the American Joint Committee on Cancer TNM staging system. Results: Of the 128 patients, 32 had postchemoradiotherapy (pCR) Stage 0 (T0N0M0), 37 pCR Stage I, 26 pCR Stage II, 28 pCR Stage III, and 5 pCR Stage IV disease. Of the 128 patients, 79 had pCR Stage T0-T2, 35 pCR Stage T3, and 14 pCR Stage T4. The rate of T stage downstaging was 66% (84 of 128). Of the 128 patients, 25% achieved a pathologic complete response, and 31 (24%) had positive nodal disease. Lymphovascular or perineural invasion was found in 13 patients (10%). The 5-year disease-specific survival rate was 97% for pCR Stage 0, 88% for pCR Stage I, 74% for pCR Stage II, 44% for pCR Stage III, and 0% for pCR Stage IV (p = 0.0000059). The 5-year relapse-free survival rate was 97% for pCR Stage 0, 80% for pCR Stage I, 72% for pCR Stage II, 42% for pCR Stage III, and 0% for pCR Stage IV (p < 0.000001). In univariate analysis, the pretreatment tumor status (fixed vs. tethered tumors), the pCR TNM stage, T stage downstaging, pathologic T4 tumors, node-positive disease after chemoradiotherapy, and lymphovascular or perineural invasion were statistically significant

  8. Synthesis and evaluation of artificial antigens for astragaloside IV

    Directory of Open Access Journals (Sweden)

    Sheng-lan Yu

    Full Text Available The objective of this study was to produce artificial antigens for astragaloside IV that could be used to prepare antibodies against astragaloside IV screened in Radix astragali (Astragalus membranaceus (Fisch Bunge, Fabaceae and its preparations, using an indirect ELISA. Astragaloside IV was coupled to carrier proteins, bovine serum albumin and ovalbumin using the sodium periodate method and was then evaluated using SDS-PAGE, MALDI-TOF MS and animal immunizations. The coupling ratio of astragaloside IV to bovine serum albumin ratio was determined to be thirteen, and the indirect ELISA demonstrated that three groups of mice immunized with astragaloside IV-bovine serum albumin produced anti-astragaloside IV- bovine serum albumin-specific antibody, with a minimum serum titer of 1:9600. A method for synthesizing highly immunogenic astragaloside IV artificial antigens was successfully developed thus indicating its feasibility in the establishment of a fast immunoassay for astragaloside IV content determination in Radix astragali and its products.

  9. Market opportunities: U.S. - PADD IV

    International Nuclear Information System (INIS)

    Garner, R.P.

    1997-01-01

    The current supply and demand balance, the short and long term expectations and marketing opportunities for Canadian crude oil in PADD IV, the Rocky Mountain region in the US, were reviewed. It was suggested that market opportunities in PADD IV are derived from the following four factors: (1) crude oil declines within that area, (2) federal regulations, (3) competitive presence with markets, and (4) population growth. The overall conclusion was that Canadian producers and PADD IV refiners will be looking at an ever-growing relationship based on freight equalized world crude prices. 8 tabs., 5 figs

  10. Report for 2011 from the Bordeaux IVS Analysis Center

    Science.gov (United States)

    Charlot, Patrick; Bellanger, Antoine; Bourda, Geraldine; Collioud, Arnaud; Baudry, Alain

    2012-01-01

    This report summarizes the activities of the Bordeaux IVS Analysis Center during the year 2011. The work focused on (i) regular analysis of the IVS-R1 and IVS-R4 sessions with the GINS software package; (ii) systematic VLBI imaging of the RDV sessions and calculation of the corresponding source structure index and compactness values; (iii) imaging of the sources observed during the 2009 International Year of Astronomy IVS observing session; and (iv) continuation of our VLBI observational program to identify optically-bright radio sources suitable for the link with the future Gaia frame. Also of importance is the enhancement of the IVS LiveWeb site which now comprises all IVS sessions back to 2003, allowing one to search past observations for session-specific information (e.g. sources or stations).

  11. Direct Bandgap Group IV Materials

    Science.gov (United States)

    2016-01-21

    AFRL-AFOSR-JP-TR-2017-0049 Direct Bandgap group IV Materials Hung Hsiang Cheng NATIONAL TAIWAN UNIVERSITY Final Report 01/21/2016 DISTRIBUTION A...NAME(S) AND ADDRESS(ES) NATIONAL TAIWAN UNIVERSITY 1 ROOSEVELT RD. SEC. 4 TAIPEI CITY, 10617 TW 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING...14. ABSTRACT Direct bandgap group IV materials have been long sought for in both academia and industry for the implementation of photonic devices

  12. Urinary type IV collagen is related to left ventricular diastolic function and brain natriuretic peptide in hypertensive patients with prediabetes.

    Science.gov (United States)

    Iida, Masato; Yamamoto, Mitsuru; Ishiguro, Yuko S; Yamazaki, Masatoshi; Ueda, Norihiro; Honjo, Haruo; Kamiya, Kaichirou

    2014-01-01

    Urinary type IV collagen is an early biomarker of diabetic nephropathy. Concomitant prediabetes (the early stage of diabetes) was associated with left ventricular (LV) diastolic dysfunction and increased brain natriuretic peptide (BNP) in hypertensive patients. We hypothesized that urinary type IV collagen may be related to these cardiac dysfunctions. We studied hypertensive patients with early prediabetes (HbA1c 110, n=18), those with prediabetes (HbA1c 5.7-6.4, n=98), and those with diabetes (HbA1c>6.5 or on diabetes medications, n=92). The participants underwent echocardiography to assess left atrial volume/body surface area (BSA) and the ratio of early mitral flow velocity to mitral annular velocity (E/e'). Left ventricular diastolic dysfunction (LVDD) was defined if patients had E/e'≥15, or E/e'=9-14 accompanied by left atrial volume/BSA≥32ml/mm(2). Urinary samples were collected for type IV collagen and albumin, and blood samples were taken for BNP and HbA1c. Urinary type IV collagen and albumin increased in parallel with the deterioration of glycemic status. In hypertensive patients with prediabetes, subjects with LVDD had higher levels of BNP and urinary type IV collagen than those without LVDD. In contrast, in hypertensive patients with diabetes, subjects with LVDD had higher urinary albumin and BNP than those without LVDD. Urinary type IV collagen correlated positively with BNP in hypertensive patients with prediabetes, whereas it correlated with HbA1c in those with diabetes. In hypertensive patients with prediabetes, urinary type IV collagen was associated with LV diastolic dysfunction and BNP. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Free-format RPG IV

    CERN Document Server

    Martin, Jim

    2013-01-01

    This how-to guide offers a concise and thorough introduction to the increased productivity, better readability, and easier program maintenance that comes with the free-format style of programming in RPG IV. Although free-format information is available in IBM manuals, it is not separated from everything else, thereby requiring hours of tedious research to track down the information needed. This book provides everything one needs to know to write RPG IV in the free-format style, and author Jim Martin not only teaches rules and syntax but also explains how this new style of coding has the pot

  14. Preparation of some complexes of Th(IV) and U(IV) with tetradentate Schiff bases. The crystal structure of bis(N,N'-ethylenebis(3-methoxysalicylaldiminato)) thorium(IV) monopyridine

    Energy Technology Data Exchange (ETDEWEB)

    Hill, R J; Rickard, C E.F.; White, H E [Auckland Univ. (New Zealand). Dept. of Chemistry

    1981-01-01

    Complexes of Th(IV) and U(IV) with tetradentate Schiff bases derived from substituted salicylaldehydes have been prepared and characterised. The structure of bis(N,N'-ethylenebis(3-methoxysalicylaldiminato)) Th(IV) monopyridine has been determined by X-ray crystallographic methods. The crystals are triclinic, a = 13.468, b = 9.932, c = 16.552 A, ..cap alpha.. = 91.74, ..beta.. = 94.69, ..gamma.. = 93.03/sup 0/, space group P/sub 1//sup -/. The molecules are eight coordinate with a slightly distorted dodecahedral geometry with the imine nitrogen atoms in the dodecahedral A sites. The pyridine molecule is uncoordinated and functions in a space-filling role.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: Advanced-stage mycosis fungoides (MF; stage IIB to IV) and Sézary syndrome (SS) are aggressive lymphomas with a median survival of 1 to 5 years. Clinical management is stage based; however, there is wide range of outcome within stages. Published prognostic studies in MF/SS have been single......, proliferation index, large-cell transformation, WBC/lymphocyte count, serum lactate dehydrogenase, and identical T-cell clone in blood and skin. Data were collected at specialist centers on patients diagnosed with advanced-stage MF/SS from 2007. Each parameter recorded at diagnosis was tested against overall...... survival (OS). RESULTS: Staging data on 1,275 patients with advanced MF/SS from 29 international sites were included for survival analysis. The median OS was 63 months, with 2- and 5-year survival rates of 77% and 52%, respectively. The median OS for patients with stage IIB disease was 68 months...

  16. Association of drug transporter expression with mortality and progression-free survival in stage IV head and neck squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Rolf Warta

    Full Text Available Drug transporters such as P-glycoprotein (ABCB1 have been associated with chemotherapy resistance and are considered unfavorable prognostic factors for survival of cancer patients. Analyzing mRNA expression levels of a subset of drug transporters by quantitative reverse transcription polymerase chain reaction (qRT-PCR or protein expression by tissue microarray (TMA in tumor samples of therapy naïve stage IV head and neck squamous cell carcinoma (HNSCC (qRT-PCR, n = 40; TMA, n = 61, this in situ study re-examined the significance of transporter expression for progression-free survival (PFS and overall survival (OS. Data from The Cancer Genome Atlas database was used to externally validate the respective findings (n = 317. In general, HNSCC tended to lower expression of drug transporters compared to normal epithelium. High ABCB1 mRNA tumor expression was associated with both favorable progression-free survival (PFS, p = 0.0357 and overall survival (OS, p = 0.0535. Similar results were obtained for the mRNA of ABCC1 (MRP1, multidrug resistance-associated protein 1; PFS, p = 0.0183; OS, p = 0.038. In contrast, protein expression of ATP7b (copper transporter ATP7b, mRNA expression of ABCG2 (BCRP, breast cancer resistance protein, ABCC2 (MRP2, and SLC31A1 (hCTR1, human copper transporter 1 did not correlate with survival. Cluster analysis however revealed that simultaneous high expression of SLC31A1, ABCC2, and ABCG2 indicates poor survival of HNSCC patients. In conclusion, this study militates against the intuitive dogma where high expression of drug efflux transporters indicates poor survival, but demonstrates that expression of single drug transporters might indicate even improved survival. Prospectively, combined analysis of the 'transportome' should rather be performed as it likely unravels meaningful data on the impact of drug transporters on survival of patients with HNSCC.

  17. 78 FR 21491 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption...

    Science.gov (United States)

    2013-04-10

    ... SMALL BUSINESS ADMINISTRATION [License No. 02/02-0662, 02/02-0661] DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that DeltaPoint Capital IV, L.P. and DeltaPoint...

  18. Clinical study on N0-stage tongue cancer

    International Nuclear Information System (INIS)

    Maruoka, Yasubumi; Ando, Tomohiro; Hoshino, Makoto; Sangu, Yoshikuni; Ogiuchi, Hideki

    2003-01-01

    We retrospectively analyzed the cases of N0-stage tongue cancer patients treated at the Department of Oral Maxillofacial Surgery, Tokyo Women's Medical University Hospital, between January 1980 and December 2000. Primary tongue cancers were treated by surgery (52%) and radiotherapy (48%). In principle, we did not perform elective neck dissection for N0-stage necks. Instead, a policy of careful observation was adopted for the management of N0-stage necks in patients with tongue cancer, and a radical neck dissection or modified radical neck dissection was performed in the event of a secondary neck metastasis. A local recurrence was confirmed in 25 patients. Twenty of the 25 local recurrences were successfully controlled by a therapy. The incidence of secondary neck metastasis was 4/46 (8%) for T1 patients, 21/48 (45%) for T2 patients, and 9/15 (60%) for T3/T4 patients. Overall, secondary neck metastases occurred in 34 out of 109 (32%) patients, and eventually 12 patients died from uncontrolled tumors. As for the distribution of involved lymph nodes, level I to level III nodes were involved in 30 (88%) patients, and level IV nodes were involved in 4 patients. (author)

  19. Heterogeneity of (18)F-FDG PET combined with expression of EGFR may improve the prognostic stratification of advanced oropharyngeal carcinoma.

    Science.gov (United States)

    Wang, Hung-Ming; Cheng, Nai-Ming; Lee, Li-Yu; Fang, Yu-Hua Dean; Chang, Joseph Tung-Chieh; Tsan, Din-Li; Ng, Shu-Hang; Liao, Chun-Ta; Yang, Lan-Yan; Yen, Tzu-Chen

    2016-02-01

    The Ang's risk profile (based on p16, smoking and cancer stage) is a well-known prognostic factor in oropharyngeal squamous cell carcinoma (OPSCC). Whether heterogeneity in (18)F-fluorodeoxyglucose (FDG) positron emission tomographic (PET) images and epidermal growth factor receptor (EGFR) expression could provide additional information on clinical outcomes in advanced-stage OPSCC was investigated. Patients with stage III-IV OPSCC who completed primary therapy were eligible. Zone-size nonuniformity (ZSNU) extracted from pretreatment FDG PET scans was used as an index of image heterogeneity. EGFR and p16 expression were examined by immunohistochemistry. Disease-specific survival (DSS) and overall survival (OS) served as outcome measures. Kaplan-Meier estimates and Cox proportional hazards regression models were used for survival analysis. A bootstrap resampling technique was applied to investigate the stability of outcomes. Finally, a recursive partitioning analysis (RPA)-based model was constructed. A total of 113 patients were included, of which 28 were p16-positive. Multivariate analysis identified the Ang's profile, EGFR and ZSNU as independent predictors of both DSS and OS. Using RPA, the three risk factors were used to devise a prognostic scoring system that successfully predicted DSS in both p16-positive and -negative cases. The c-statistic of the prognostic index for DSS was 0.81, a value which was significantly superior to both AJCC stage (0.60) and the Ang's risk profile (0.68). In patients showing an Ang's high-risk profile (N = 77), the use of our scoring system clearly identified three distinct prognostic subgroups. It was concluded that a novel index may improve the prognostic stratification of patients with advanced-stage OPSCC. © 2015 UICC.

  20. Hyperfractionated radiotherapy and simultaneous cisplatin for stage-III and -IV carcinomas of the head and neck. Long-term results including functional outcome

    Energy Technology Data Exchange (ETDEWEB)

    Huguenin, P.; Glanzmann, C.; Taussky, D.; Luetolf, U.M. [Univ. Hospital Zurich (Switzerland). Radiation Oncology Dept.; Schmid, S.; Moe, K. [Univ. Hospital Zurich (Switzerland). Dept. of Head and Neck Surgery

    1998-08-01

    Purpose: To assess the survival rate, the probability of local control, the patterns of relapse and late sequelae including self-reported quality of life in patients treated with hyperfractionated radiotherapy (RT) and simultaneous CDDP chemotherapy for stage-III to stage-IV carcinomas of the head and neck. Methods: From 1988 to 1994, 64 patients (median age 55.5 years) with carcinomas of different subsites, excluding the nasopharynx, were treated in a pilot study with 1.2 Gy bid (6 h interval; total dose 74.4 Gy) and simultaneous CDDP (20 mg/m{sup 2} daily, 5 days in week 1 and 5) and followed at regular intervals. Overall survival and local control, as well as the rates of late toxicity, were estimated using the actuarial method. Median follow-up was 3.3 years for all and 5.2 years for surviving patients. To assess the quality of life, the EORTC QLQ-C 30 questionnaire and the H and N35 module questionnaire were sent to the patients surviving with no evidence of disease or second primary tumors; they were answered by 15/23 (67%). Results: Overall survival was 37% at 5 years, whereas disease-specific survival was 59%. Twenty-three patients died from uncontrolled head and neck cancer. Second primary tumors were observed in 13 patients, most frequently in the lung. Local control without salvage surgery was 74% at 5 years for all subsites and stages, and loco-regional disease-free survival was 72%. Eleven patients developed distant metastases, which was the only site of failure in 6 cases. Salvage surgery was successful in 2 cases. The actuarial estimates of {>=}grade-3 late toxicity was 4% for the mandibular bone and 23% for dysphagia, and 50% of the patients experienced a permanent xerostomy. Self-reported global quality of life in surviving patients was good (mean 68 points on a scale 0 to 100); consequences of impaired salivary function had most impact on nutritional and social aspects. Conclusions: Hyperfractionated RT with concomitant CDDP is well tolerated and

  1. Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: a randomised-controlled clinical trial.

    Science.gov (United States)

    Demarré, L; Beeckman, D; Vanderwee, K; Defloor, T; Grypdonck, M; Verhaeghe, S

    2012-04-01

    The duration and the amount of pressure and shear must be reduced in order to minimize the risk of pressure ulcer development. Alternating low pressure air mattresses with multi-stage inflation and deflation cycle of the air cells have been developed to relieve pressure by sequentially inflating and deflating the air cells. Evidence about the effectiveness of this type of mattress in clinical practice is lacking. This study aimed to compare the effectiveness of an alternating low pressure air mattress that has a standard single-stage inflation and deflation cycle of the air cells with an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. A randomised controlled trial was performed in a convenience sample of 25 wards in five hospitals in Belgium. In total, 610 patients were included and randomly assigned to the experimental group (n=298) or the control group (n=312). In the experimental group, patients were allocated to an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. In the control group, patients were allocated to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. The outcome was defined as cumulative pressure ulcer incidence (Grade II-IV). An intention-to-treat analysis was performed. There was no significant difference in cumulative pressure ulcer incidence (Grade II-IV) between both groups (Exp.=5.7%, Contr.=5.8%, p=0.97). When patients developed a pressure ulcer, the median time was 5.0 days in the experimental group (IQR=3.0-8.5) and 8.0 days in the control group (IQR=3.0-8.5) (Mann-Whitney U-test=113, p=0.182). The probability to remain pressure ulcer free during the observation period in this trial did not differ significantly between the experimental group and the control group (log-rank χ(2)=0.013, df=1, p=0.911). An alternating low pressure air mattress with multi-stage inflation

  2. ASTRID, Generation IV advanced sodium technological reactor for industrial demonstration

    International Nuclear Information System (INIS)

    Gauche, F.

    2013-01-01

    ASTRID (Advanced Sodium Technological Reactor for Industrial Demonstration) is an integrated technology demonstrator designed to demonstrate the operability of the innovative choices enabling fast neutron reactor technology to meet the Generation IV criteria. ASTRID is a sodium-cooled fast reactor with an electricity generating power of 600 MWe. In order to meet the generation IV goals, ASTRID will incorporate the following decisive innovations: -) an improved core with a very low, even negative void coefficient; -) the possible installation of additional safety devices in the core. For example, passive anti-reactivity insertion devices are explored; -) more core instrumentation; -) an energy conversion system with modular steam generators, to limit the effects of a possible sodium-water reaction, or sodium-nitrogen exchangers; -) considerable thermal inertia combined with natural convection to deal with decay heat; -)elimination of major sodium fires by bunkerization and/or inert atmosphere in the premises; -) to take into account off-site hazards (earthquake, airplane crash,...) right from the design stage; -) a complete rethink of the reactor architecture in order to limit the risk of proliferation. ASTRID will also include systems for reducing the length of refueling outages and increasing the burn-up and the duration of the cycle. In-service inspection, maintenance and repair are also taken into account right from the start of the project. The ASTRID prototype should be operational by about 2023. (A.C.)

  3. Risk-adapted robotic stereotactic body radiation therapy for inoperable early-stage non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Temming, Susanne; Kocher, Martin; Baus, Wolfgang W.; Semrau, Robert; Baues, Christian; Marnitz, S. [University of Cologne, Department of Radiation Oncology, Center for Integrated Oncology, Cologne (Germany); Stoelben, Erich [Hospital of Cologne, Lung Clinic Merheim, Cologne (Germany); Hagmeyer, Lars [University of Cologne, Bethanien Hospital, Institute of Pneumology, Solingen (Germany); Chang, De-Hua [University of Cologne, Department of Diagnostic and Interventional Radiology, Center for Integrated Oncology, Cologne (Germany); Frank, Konrad [Heart Centre of the University of Cologne, Department III of Internal Medicine, Cologne (Germany); Hekmat, Khosro [University of Cologne, Department of Cardiothoracic Surgery, Center for Integrated Oncology, Cologne (Germany); Wolf, Juergen [University Hospital of Cologne, First Department of Internal Medicine, Center for Integrated Oncology, Cologne (Germany)

    2018-02-15

    To evaluate efficacy and toxicity of stereotactic body radiation therapy (SBRT) with CyberKnife {sup registered} (Accuray, Sunnyvale, CA, USA) in a selected cohort of primary, medically inoperable early-stage non-small cell lung cancer (NSCLC) patients. From 2012 to 2016, 106 patients (median age 74 years, range 50-94 years) with primary NSCLC were treated with SBRT using CyberKnife {sup registered}. Histologic confirmation was available in 87 patients (82%). For mediastinal staging, 92 patients (87%) underwent {sup 18}F-fluorodeoxyglucose positron-emission tomography (18-FDG-PET) and/or endobronchial ultrasound (EBUS)-guided lymph node biopsy or mediastinoscopy. Tumor stage (UICC8, 2017) was IA/B (T1a-c, 1-3 cm) in 86 patients (81%) and IIA (T2a/b, 3-5 cm) in 20 patients (19%). Depending on tumor localization, three different fractionation schedules were used: 3 fractions of 17Gy, 5 fractions of 11Gy, or 8 fractions of 7.5 Gy. Tracking was based on fiducial implants in 13 patients (12%) and on image guidance without markers in 88%. Median follow-up was 15 months (range 0.5-46 months). Acute side effects were mild (fatigue grade 1-2 in 20% and dyspnea grade 1-2 in 17%). Late effects were observed in 4 patients (4%): 3 patients developed pneumonitis requiring therapy (grade 2) and 1 patient suffered a rib fracture (grade 3). In total, 9/106 patients (8%) experienced a local recurrence, actuarial local control rates were 88% (95% confidence interval, CI, 80-96%) at 2 years and 77% (95%CI 56-98%) at 3 years. The median disease-free survival time was 27 months (95%CI 23-31 months). Overall survival was 77% (95%CI 65-85%) at 2 years and 56% (95%CI 39-73%) at 3 years. CyberKnife {sup registered} lung SBRT which allows for real-time tumor tracking and risk-adapted fractionation achieves satisfactory local control and low toxicity rates in inoperable early-stage primary lung cancer patients. (orig.) [German] Untersuchung von Wirkung und Toxizitaet einer stereotaktischen

  4. Dipeptidyl peptidase IV inhibitory activity of protein hydrolyzates ...

    African Journals Online (AJOL)

    Background: Type 2 diabetes is a chronic metabolic disorder. Recently, dipeptidyl peptidase IV (DPP-IV) inhibitors that protect incretin hormones from being cleaved by DPP-IV have been used as drugs to control glycemia. This study examined the potential hypoglycemic effect of amaranth grain storage protein hydrolyzates ...

  5. Hodgkin's disease: problems of staging. [/sup 67/Ga

    Energy Technology Data Exchange (ETDEWEB)

    Sweet, D.L. Jr.; Kinnealey, A.; Ultmann, J.E.

    1978-08-01

    The preferred histopathological classification of Hodgkin's disease (HD) is suggested by Lukes and Butler as modified at the Rye Symposium; the histologic subtypes are highly reproducible and correlate well with the anatomic sites of involvement, clinical stage, and survival. The accuracy of the bipedal lymphangiogram, /sup 67/gallium scan, and ultrasonography in predicting abdominal involvement by HD is 90 percent, 50 percent, and 88 percent, respectively. Staging laparotomy remains the most accurate method of detecting intra-abdominal disease and has added immensely to new concepts in the management of HD. These concepts suggest that patients with nodal disease limited to the celiac axis or upper para-aortic areas (substage III/sub 1/) or pathologic stage (PS) III/sub S+N-/A, when treated with extended field radiotherapy alone have survival rates comparable to PS IIA patients. In contrast, patients in PS IIIA with lower abdominal nodal disease (substage III/sub 2/), regardless of splenic involvement, have a prognosis comparable to PS IV disease. Thus, there may only be two stages of HD, those curable with extended mantle or smaller radiotherapy fields alone, and those requiring chemotherapy with or without supplemental radiotherapy.

  6. The prognostic value of quantified MRI at an early stage of Bell's palsy

    International Nuclear Information System (INIS)

    Kress, B.P.J.; Efinger, K.; Gottschalk, A.; Nissen, S.; Solbach, T.; Baehren, W.; Griesbeck, F.; Goriup, A.; Kornhuber, A.W.

    2002-01-01

    Objective: The aim of the study was to assess whether MRI has a prognostic value at an early stage of Bell's palsy. Material and Methods: Prospective, blinded study on 30 patients suffering from Bell's palsy, who came to hospital until the sixth day of illness, to receive high dosis steroid therapy. MRI was done on the first day of inpatient treatment as a gradient-echo-sequence with a slice thickness of 0.7 mm before and after i.v. administration of 0.1 mmol GdDTPA/kg weight. The signal intensity increase was evaluated quantitatively by region on interest (ROI). The results were compared to the clinical outcome and the results of electrophysiology. Results: The examinations of all patients could be evaluated. The 3 patients who developed a chronic facial paralysis were detected by MRI on the first day of inpatient treatment. The patients, who showed MR signs for an unfavorable course, had a highly significant pathologic compound muscle action potential (CMAP) as a result of the electrophysiologic measurement. Rather than using complex measurement procedures it is possible to obtain reliable prognostic information from just one measurement within the Internal auditory canal before and after i.v. administration of contrast. Conclusion: MRI has a prognostic value at an early stage of the illness. In the clinical setting this measurement is easy to perform, so that it is possible to obtain prognostic information at a stage when causal treatment is still possible. (orig.) [de

  7. Astragaloside IV liposomes ameliorates adriamycin-induced ...

    African Journals Online (AJOL)

    Methods: The rats were given a single tail intravenous injection of adriamycin (6 mg/kg) within 1 week, and then divided into four groups including normal, model, benazepril and astragaloside IV liposomes group. They were all orally administered dosage of benazepril and astragaloside IV liposomes once daily for 8 weeks.

  8. Appendectomy in primary and secondary staging operations for ovarian malignancy.

    Science.gov (United States)

    Rose, P G; Reale, F R; Fisher, A; Hunter, R E

    1991-01-01

    Appendectomy was performed at primary or secondary staging operations in 100 patients with ovarian malignancies. Of 80 patients who underwent appendectomy at the time of their primary surgery, 25 (31.2%) had appendiceal metastases. Among 47 patients who were believed to have disease limited to the pelvis at the time of surgery--stage I (N = 34), II (N = 7), IIIA (N = 5), and those designated stage IIIC solely on the basis of microscopic para-aortic nodal metastasis (N = 1)--the appendix was involved with disease in only two patients (4.3%). However, among 33 patients with advanced disease--stage IIIB (N = 6), IIIC except those designated IIIC solely on the basis of microscopic paraaortic nodal metastasis (N = 19), and IV (N = 8)--the appendix was involved with disease in 23 patients (69.7%) (P less than .001). Poorly differentiated tumors and serous histologic cell types more frequently metastasized to the appendix (64, 15, 6, and 8% for grades 3, 2, and 1 and borderline histology, respectively; P less than .001; and 48, 13, and 8% for serous, endometrioid, and mucinous; P less than .001). Of 20 patients who underwent appendectomy at their secondary staging procedure, two had metastases. Metastatic disease in the appendix was microscopic in nine of 27 patients. Because the frequency of appendiceal metastasis is similar to that of other metastatic sites in stages I and II ovarian cancer, it should be removed at primary staging procedures. Appendectomy should also be performed in patients with advanced ovarian malignancies if it contributes to cytoreduction or at the time of secondary staging procedures.

  9. How the 2SLS/IV estimator can handle equality constraints in structural equation models: a system-of-equations approach.

    Science.gov (United States)

    Nestler, Steffen

    2014-05-01

    Parameters in structural equation models are typically estimated using the maximum likelihood (ML) approach. Bollen (1996) proposed an alternative non-iterative, equation-by-equation estimator that uses instrumental variables. Although this two-stage least squares/instrumental variables (2SLS/IV) estimator has good statistical properties, one problem with its application is that parameter equality constraints cannot be imposed. This paper presents a mathematical solution to this problem that is based on an extension of the 2SLS/IV approach to a system of equations. We present an example in which our approach was used to examine strong longitudinal measurement invariance. We also investigated the new approach in a simulation study that compared it with ML in the examination of the equality of two latent regression coefficients and strong measurement invariance. Overall, the results show that the suggested approach is a useful extension of the original 2SLS/IV estimator and allows for the effective handling of equality constraints in structural equation models. © 2013 The British Psychological Society.

  10. External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

    DEFF Research Database (Denmark)

    Ladeby Erichsen, Julie; Jensen, Carsten; Damborg, Frank Lindhøj

    Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients...

  11. Oxovanadium(IV), cerium(III), thorium(IV) and dioxouranium(VI) complexes of 1-ethyl-4-hydroxy-3-(nitroacetyl)quinolin-2(1H)-one: Synthesis, spectral, thermal, fluorescence, DFT calculations, antimicrobial and antitumor studies

    Science.gov (United States)

    El-Shafiy, H. F.; Shebl, Magdy

    2018-03-01

    A new series of mononuclear oxovanadium(IV), cerium(III), thorium(IV) and dioxouranium(VI) complexes of a quinolinone ligand; 1-ethyl-4-hydroxy-3-(nitroacetyl)quinolin-2(1H)-one (H2L) have been synthesized. The metal complexes were characterized by different techniques such as elemental and thermal analyses, IR, 1H NMR, electronic, ESR, mass spectra and powder XRD, TEM in addition to magnetic susceptibility and conductivity measurements. The quinolinone ligand acts as a dibasic bidentate ligand forming mononuclear complexes, which can be formulated as: [(L)VO(H2O)2]·0.5H2O, [(L)M(NO3)x(H2O)y]·nH2O; M = Ce or Th, x = 1 or 2, y = 3 or 4 and n = 2 or 7 and [(L)UO2(H2O)x(MeOH)y]·nH2O; x = 2 or 3, y = 0 or 1 and n = 0.5 or 2.5. The photoluminescent properties of the prepared complexes were studied. The ligand and its thorium(IV) complex are characterized by an intense green emission. Kinetic parameters (Ea, A, ΔH, ΔS and ΔG) of the thermal decomposition stages have been evaluated using Coats-Redfern equations. The geometry of the ligand and its oxovanadium(IV) complex has been optimized using density functional theory (DFT). Total energy, energy of HOMO and LUMO, dipole moment and structure activity relationship were performed and confirmed practical antimicrobial and antitumor results. The antimicrobial activity of the ligand and its metal complexes was conducted against the microorganisms S. aureus, K. pnemonia, E. coli, P. vulgaris and C. albicans and the MIC values were determined. The antitumor activity of the ligand and its metal complexes was investigated against human Hepatocelluar carcinoma and human breast cancer cell lines.

  12. Painlevé IV coherent states

    Energy Technology Data Exchange (ETDEWEB)

    Bermudez, David, E-mail: david.bermudez@weizmann.ac.il [Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 76100 (Israel); Departamento de Física, Cinvestav, A.P. 14-740, 07000 México D.F. (Mexico); Contreras-Astorga, Alonso, E-mail: aloncont@iun.edu [Department of Mathematics and Actuarial Science, Indiana University Northwest, 3400 Broadway, Gary IN 46408 (United States); Departamento de Física, Cinvestav, A.P. 14-740, 07000 México D.F. (Mexico); Fernández C, David J., E-mail: david@fis.cinvestav.mx [Departamento de Física, Cinvestav, A.P. 14-740, 07000 México D.F. (Mexico)

    2014-11-15

    A simple way to find solutions of the Painlevé IV equation is by identifying Hamiltonian systems with third-order differential ladder operators. Some of these systems can be obtained by applying supersymmetric quantum mechanics (SUSY QM) to the harmonic oscillator. In this work, we will construct families of coherent states for such subset of SUSY partner Hamiltonians which are connected with the Painlevé IV equation. First, these coherent states are built up as eigenstates of the annihilation operator, then as displaced versions of the extremal states, both involving the related third-order ladder operators, and finally as extremal states which are also displaced but now using the so called linearized ladder operators. To each SUSY partner Hamiltonian corresponds two families of coherent states: one inside the infinite subspace associated with the isospectral part of the spectrum and another one in the finite subspace generated by the states created through the SUSY technique. - Highlights: • We use SUSY QM to obtain Hamiltonians with third-order differential ladder operators. • We show that these systems are related with the Painlevé IV equation. • We apply different definitions of coherent states to these Hamiltonians using the third-order ladder operators and some linearized ones. • We construct families of coherent states for such systems, which we called Painlevé IV coherent states.

  13. Painlevé IV coherent states

    International Nuclear Information System (INIS)

    Bermudez, David; Contreras-Astorga, Alonso; Fernández C, David J.

    2014-01-01

    A simple way to find solutions of the Painlevé IV equation is by identifying Hamiltonian systems with third-order differential ladder operators. Some of these systems can be obtained by applying supersymmetric quantum mechanics (SUSY QM) to the harmonic oscillator. In this work, we will construct families of coherent states for such subset of SUSY partner Hamiltonians which are connected with the Painlevé IV equation. First, these coherent states are built up as eigenstates of the annihilation operator, then as displaced versions of the extremal states, both involving the related third-order ladder operators, and finally as extremal states which are also displaced but now using the so called linearized ladder operators. To each SUSY partner Hamiltonian corresponds two families of coherent states: one inside the infinite subspace associated with the isospectral part of the spectrum and another one in the finite subspace generated by the states created through the SUSY technique. - Highlights: • We use SUSY QM to obtain Hamiltonians with third-order differential ladder operators. • We show that these systems are related with the Painlevé IV equation. • We apply different definitions of coherent states to these Hamiltonians using the third-order ladder operators and some linearized ones. • We construct families of coherent states for such systems, which we called Painlevé IV coherent states

  14. Synthesis, characterization and thermal behaviour of cadmium (II) complexes of photosubstituted octacyano-molybdate(IV) and -tungstate(IV) with ethylenediamine

    International Nuclear Information System (INIS)

    Ali, S.I.; Majid, Kowsar

    1998-01-01

    Photosubstituted ethylenediamine complexes of M(CN) 8 4- [where M =Mo(IV) or W(IV)] with cadmium (II) chloride have been synthesized and characterized by infrared (IR), thermogravimetric (TG) and differential scanning calorimetry (DSC). Both Mo(IV) and W(IV) show similar stoichiometric as well as thermal decomposition behaviour. The assigned general formula is Cd[M(CN) 3 (OH)(C 2 H 8 N 2 ) 2 ](C 2 H 8 N 2 ) Cl 2 XH 2 O [where M = Mo(IV) for which X = 1(I) and M = W(IV) for which X = 2 (II)]. The presence of CN - , OH - and C 2 H 8 N 2 has been shown by observed characteristic IR peaks. The extra absorption bands appearing in complex (II) are due to librational modes of water which show the formation of hydrogen bonding, which is also supported by TG analysis. The loss of these absorption bands rules out this type of bonding in (I). Both the complexes decompose in three steps up to 650 degC after which there is no change. DSC of the complexes also shows three transitions, two exothermic and one endothermic. On the basis of TG and DSC thermograms, mechanism for the decomposition of each step has been shown. Kinetic parameters like activation energy (E a ), frequency factor (A) and entropy of activation (ΔS) have been calculated using different integral methods. (author)

  15. Nordic Nuclear Materials Forum for Generation IV Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Anghel, C. (Studsvik Nuclear AB, Nykoeping (Sweden)); Penttilae, S. (Technical Research Centre of Finland, VTT (Finland))

    2010-03-15

    A network for material issues for Generation IV nuclear power has been initiated within the Nordic countries. The objectives of the Generation IV Nordic Nuclear Materials Forum (NOMAGE4) are to put the basis of a sustainable forum for Gen IV issues, especially focussing on fuels, cladding, structural materials and coolant interaction. Other issues include reactor physics, dynamics and diagnostics, core and fuel design. The present report summarizes the work performed during the year 2009. The efforts made include identification of organisations involved in Gen IV issues in the Nordic countries, update of the forum website, http://www.studsvik.se/GenerationIV, and investigation of capabilities for research within the area of Gen IV. Within the NOMAGE4 project a seminar on Generation IV Nuclear Energy Systems has been organized during 15-16th of October 2009. The aim of the seminar was to provide a forum for exchange of information, discussion on future research needs and networking of experts on Generation IV reactor concepts. As an outcome of the NOMAGE4, a few collaboration project proposals have been prepared/planned in 2009. The network was welcomed by the European Commission and was mentioned as an exemplary network with representatives from industries, universities, power companies and research institutes. NOMAGE4 has been invited to participate to the 'European Energy Research Alliance, EERA, workshop for nuclear structural materials' http://www.eera-set.eu/index.php?index=41 as external observers. Future plans include a new Nordic application for continuation of NOMAGE4 network. (author)

  16. Nordic Nuclear Materials Forum for Generation IV Reactors

    International Nuclear Information System (INIS)

    Anghel, C.; Penttilae, S.

    2010-03-01

    A network for material issues for Generation IV nuclear power has been initiated within the Nordic countries. The objectives of the Generation IV Nordic Nuclear Materials Forum (NOMAGE4) are to put the basis of a sustainable forum for Gen IV issues, especially focussing on fuels, cladding, structural materials and coolant interaction. Other issues include reactor physics, dynamics and diagnostics, core and fuel design. The present report summarizes the work performed during the year 2009. The efforts made include identification of organisations involved in Gen IV issues in the Nordic countries, update of the forum website, http://www.studsvik.se/GenerationIV, and investigation of capabilities for research within the area of Gen IV. Within the NOMAGE4 project a seminar on Generation IV Nuclear Energy Systems has been organized during 15-16th of October 2009. The aim of the seminar was to provide a forum for exchange of information, discussion on future research needs and networking of experts on Generation IV reactor concepts. As an outcome of the NOMAGE4, a few collaboration project proposals have been prepared/planned in 2009. The network was welcomed by the European Commission and was mentioned as an exemplary network with representatives from industries, universities, power companies and research institutes. NOMAGE4 has been invited to participate to the 'European Energy Research Alliance, EERA, workshop for nuclear structural materials' http://www.eera-set.eu/index.php?index=41 as external observers. Future plans include a new Nordic application for continuation of NOMAGE4 network. (author)

  17. Radiochemotherapy including cisplatin alone versus cisplatin + 5-fluorouracil for locally advanced unresectable stage IV squamous cell carcinoma of the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Tribius, Silke; Kilic, Yasemin [Dept. of Radiation Oncology, Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany); Kronemann, Stefanie [Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Schroeder, Ursula [Dept. of Head and Neck Surgery, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Hakim, Samer [Dept. of Oro-Maxillo-Facial Surgery, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany); Schild, Steven E. [Dept. of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Rades, Dirk [Dept. of Radiation Oncology, Univ. Medical Center Hamburg-Eppendorf, Hamburg (Germany); Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Campus Luebeck (Germany)

    2009-10-15

    Background and purpose: the optimal radiochemotherapy regimen for advanced head-and-neck cancer is still debated. This nonrandomized study compares two cisplatin-based radiochemotherapy regimens in 128 patients with locally advanced unresectable stage IV squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: concurrent chemotherapy consisted of either two courses cisplatin (20 mg/m{sup 2}/d1-5 + 29-33; n = 54) or two courses cisplatin (20 mg/m{sup 2}/d1-5 + 29-33) + 5-fluorouracil (5-FU; 600 mg/m{sup 2}/d1-5 + 29-33; n = 74). Results: at least one grade 3 toxicity occurred in 25 of 54 patients (46%) receiving cisplatin alone and in 52 of 74 patients (70%) receiving cisplatin + 5-FU. The latter regimen was particularly associated with increased rates of mucositis (p = 0.027) and acute skin toxicity (p = 0.001). Seven of 54 (13%) and 20 of 74 patients (27%) received only one chemotherapy course due to treatment-related acute toxicity. Late toxicity in terms of xerostomia, neck fibrosis, skin toxicity, and lymphedema was not significantly different. The 2-year locoregional control rates were 67% after cisplatin alone and 52% after cisplatin + 5-FU (p = 0.35). The metastases-free survival rates were 79% and 69%, respectively (p = 0.65), and the overall survival rates 70% and 51%, respectively (p = 0.10). On multivariate analysis, outcome was significantly associated with performance status, T-category, N-category, hemoglobin level prior to radiotherapy, and radiotherapy break > 1 week. Conclusion: two courses of fractionated cisplatin (20 mg/m{sup 2}/day) alone appear preferable, as this regimen resulted in similar outcome and late toxicity as two courses of cisplatin + 5-FU, but in significantly less acute toxicity. (orig.)

  18. A COMPARATIVE CLINICAL STUDY BETWEEN IV ESMOLOL AND IV FENTANYL ON ATTENUATION OF HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION

    Directory of Open Access Journals (Sweden)

    Abu Lais Mustaque

    2016-04-01

    Full Text Available INTRODUCTION Laryngoscopy and intubation is an integral part for providing general anaesthesia to patients undergoing various types of surgery. It also plays an important role in critical care units viz. for providing mechanical ventilation. It is a very essential tool in the hands of anaesthesiologist in maintaining airway. The present study is undertaken to determine and compare the efficacy of single bolus dose of IV esmolol 1 mg/kg and IV fentanyl 2 mcg/kg in attenuating the haemodynamic responses to laryngoscopy and tracheal intubation and to ascertain the effectiveness of esmolol hydrochloride and fentanyl citrate in suppressing sympathetic responses. MATERIAL & METHODS The study was conducted under the Department of Anaesthesiology and Critical Care, Assam Medical College and Hospital, Dibrugarh, during the period July 2013 to June 2014. For this purpose, 150 patients of either sex between 20-50 years of ASA I & II physical status were selected after obtaining informed and written consent and were divided into two groups namely, Group E receiving IV esmolol (1 mg/kg and Group F receiving IV fentanyl (2 mcg/kg. RESULTS Inj. fentanyl 2 mcg/kg IV administered 5 minutes before laryngoscopy and intubation was able to prevent adverse haemodynamic changes better than Inj. esmolol 1 mg/kg IV administered 3 minutes prior to laryngoscopy and intubation during elective surgeries under general anaesthesia. CONCLUSION Hence, from the findings of this study we can conclude that IV bolus dose of fentanyl 2 mcg/kg administered 5 minutes before laryngoscopy and intubation can attenuate the sympathetic response to laryngoscopy and intubation without any side effects of the drug in healthy patients undergoing elective surgeries under general anaesthesia.

  19. Computations of nuclear response functions with MACK-IV

    International Nuclear Information System (INIS)

    Abdou, M.A.; Gohar, Y.

    1978-01-01

    The MACK computer program calculates energy pointwise and multigroup nuclear response functions from basic nuclear data in ENDF/B format. The new version of the program, MACK-IV, incorporates major developments and improvements aimed at maximizing the utilization of available nuclear data and ensuring energy conservation in nuclear heating calculations. A new library, MACKLIB-IV, of nuclear response functions was generated in the CTR energy group structure of 171 neutron groups and 36 gamma groups. The library was prepared using MACK-IV and ENDF/B-IV and is suitable for fusion, fusion-fission hybrids, and fission applications

  20. Computations of nuclear response functions with MACK-IV

    Energy Technology Data Exchange (ETDEWEB)

    Abdou, M A; Gohar, Y

    1978-01-01

    The MACK computer program calculates energy pointwise and multigroup nuclear response functions from basic nuclear data in ENDF/B format. The new version of the program, MACK-IV, incorporates major developments and improvements aimed at maximizing the utilization of available nuclear data and ensuring energy conservation in nuclear heating calculations. A new library, MACKLIB-IV, of nuclear response functions was generated in the CTR energy group structure of 171 neutron groups and 36 gamma groups. The library was prepared using MACK-IV and ENDF/B-IV and is suitable for fusion, fusion-fission hybrids, and fission applications.

  1. Redox behavior of Ce(IV)/Ce(III) in the presence of nitrilotriacetic acid: a surrogate study for An(IV)/An(III) redox behavior

    International Nuclear Information System (INIS)

    Suzuki, Y.; Nankawa, T.; Ohnuki, T.; Francis, A.J.

    2010-01-01

    Using cyclic voltammetry, we investigated the redox behavior of Ce(IV)/Ce(III), which is a surrogate for An(IV)/An(III) (An = actinides), in a solution of nitrilotriacetic acid (NTA) at 25 C. The cyclic voltammogram of Ce in a 0.1 M NTA solution at pH 6 showed a reversible one-electron redox reaction for Ce(IV)/Ce(III) at 0.51 V vs. Ag/AgCl. This redox potential was much lower than that obtained in 1 M nitric acid, indicating that Ce(IV) was preferentially stabilized by complexation with NTA. The redox potential in the NTA solution was independent of the Ce concentration from 2 to 20 mM, NTA concentration from 5 to 200 mM and pH between 3 and 7. These results indicated that no polymerization and no additional coordination of NTA and OH to the Ce(III)-NTA complex took place during the redox reaction. As the speciation calculation of Ce(III) in the NTA solution showed that the predominant species was Ce III (nta) 2 3 (H 3 nta = NTA), the redox reaction of the Ce-NTA complex was expressed by the following: Ce IV (nta) 2 2- + e - ↔ Ce III (nta) 2 3 . The logarithm of the stability constant of Ce IV (nta) 2 2- was calculated to be 38.6 ± 0.8 for I = 0 from the redox potential shift of Ce(IV)/Ce(III) in the NTA solution. The value was in good accordance with the stability constant of the Np IV (nta) 2 2- complex, demonstrating that the aqueous coordination chemistry of Ce(IV) with NTA is quite similar to that of An(IV). These results strongly suggest that a negative shift of the Pu(IV)/Pu(III) redox potential in the NTA solution should make Pu(IV) more stable than Pu(III) even in a reducing environment. (orig.)

  2. U(IV) fluorescence spectroscopy. A new speciation tool

    Energy Technology Data Exchange (ETDEWEB)

    Lehmann, Susanne; Brendler, Vinzenz [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Surface Processes; Steudtner, Robin [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). Inst. of Resource Ecology

    2017-06-01

    We combined absorption and fluorescence spectroscopy to study the speciation of U(IV) in solution in concentrations down to 10{sup -6} M uranium. With our time-resolved laser-induced fluorescence setup we could determine the fluorescence decay time of U(IV) in perchloric as well as in chloric acid with 2.6 ± 0.3 ns at room temperature and 148.4 ± 6.5 ns at liquid nitrogen temperature. For the U(IV) sulfate system, we observed a bathochromic shift and a peak shape modification in the fluorescence spectra with increasing sulfate concentration in solution. Thus, the potential of U(IV) fluorescence for speciation analysis could be proven.

  3. A sputnik IV saga

    Science.gov (United States)

    Lundquist, Charles A.

    2009-12-01

    The Sputnik IV launch occurred on May 15, 1960. On May 19, an attempt to deorbit a 'space cabin' failed and the cabin went into a higher orbit. The orbit of the cabin was monitored and Moonwatch volunteer satellite tracking teams were alerted to watch for the vehicle demise. On September 5, 1962, several team members from Milwaukee, Wisconsin made observations starting at 4:49 a.m. of a fireball following the predicted orbit of Sputnik IV. Requests went out to report any objects found under the fireball path. An early morning police patrol in Manitowoc had noticed a metal object on a street and had moved it to the curb. Later the officers recovered the object and had it dropped off at the Milwaukee Journal. The Moonwarch team got the object and reported the situation to Moonwatch Headquarters at the Smithsonian Astrophysical Observatory. A team member flew to Cambridge with the object. It was a solid, 9.49 kg piece of steel with a slag-like layer attached to it. Subsequent analyses showed that it contained radioactive nuclei produced by cosmic ray exposure in space. The scientists at the Observatory quickly recognized that measurements of its induced radioactivity could serve as a calibration for similar measurements of recently fallen nickel-iron meteorites. Concurrently, the Observatory directorate informed government agencies that a fragment from Sputnik IV had been recovered. Coincidently, a debate in the UN Committee on Peaceful Uses of Outer Space involved the issue of liability for damage caused by falling satellite fragments. On September 12, the Observatory delivered the bulk of the fragment to the US Delegation to the UN. Two days later, the fragment was used by US Ambassador Francis Plimpton as an exhibit that the time had come to agree on liability for damage from satellite debris. He offered the Sputnik IV fragment to USSR Ambassador P.D. Morozov, who refused the offer. On October 23, Drs. Alla Massevitch and E.K. Federov of the USSR visited the

  4. Feasibility Study of Moderately Accelerated Intensity-Modulated Radiotherapy Plus Concurrent Weekly Cisplatin After Induction Chemotherapy in Locally Advanced Head-and Neck Cancer

    International Nuclear Information System (INIS)

    Morganti, Alessio G.; Mignogna, Samantha; Deodato, Francesco; Massaccesi, Mariangela; Cilla, Savino; Calista, Franco; Serafini, Giovanni; Digesu, Cinzia; Macchia, Gabriella; Picardi, Vincenzo; Caravatta, Luciana; Di Lullo, Liberato; Giglio, Gianfranco; Sallustio, Giuseppina; Piermattei, Angelo

    2011-01-01

    Purpose: To evaluate the feasibility and efficacy of moderately accelerated intensity-modulated radiation therapy (IMRT) along with weekly cisplatin, after induction chemotherapy, in patients with locally advanced unresectable head and neck cancer (HNC). Methods and Materials: Patients with Stage III or IV locally advanced HNC, without progressive disease after three courses of induction chemotherapy, received concurrent chemo-IMRT (weekly cisplatin 30 mg/m 2 plus simultaneous integrated boost IMRT). A total of 67.5 Gy in 30 fractions were delivered to primary tumor and involved nodes, 60 Gy in 30 fractions to high-risk nodal areas, and 55.5 Gy in 30 fractions to low-risk nodal areas. Results: In all, 36 patients (median age, 56 years) with International Union Against Cancer (UICC) Stage III (n = 5) and IV (n = 31) were included. Of the 36 patients, 17 had received CF (cisplatin and 5-fluorouracil (CF) and 19 had received docetaxel cisplatin and 5-fluorouracil (DCF). During concurrent chemoradiation, 11 of 36 patients (30.5%) experienced Grade III mucositis (CF, 47%; DCF, 15%; p < 0.04). Grade III pharyngeal-esophageal toxicity was observed in 5 of 19 patients (26.3%; CF, 0.0%; DCF, 26.3%; p = 0.02). Two patients died of complications (5.5%). After chemoradiation, the complete response rate was 63.8%. Two-year local control was 88.7%. Two-year progression free survival and overall survival were 74.5% and 60.9%, respectively. Conclusions: In our experience, a moderately accelerated chemo-IMRT was feasible after induction chemotherapy. However, a noteworthy early death rate of 5.5% was observed. Intensive supportive care strategies should be defined to better manage radiation-induced toxic effects. Longer follow-up is required to determine the incidence of late radiation toxicities and tumor control rates.

  5. Single Ion transient-IBIC analyses of semiconductor devices using a cryogenic temperature stage

    International Nuclear Information System (INIS)

    Laird, J.S.; Bardos, R.; Legge, G.J.F.; Jagadish, C.

    1998-01-01

    A new Transient - IBIC data acquisition and analysis system at MARC is described. A discussion on the need for single ion control and temperature control is also given. The recorded signal is used as the trigger for beam pulsing. The new cryostatic temperature control stage is introduced. Data is presented on line profiles across the edge of a Au-Si junction collected over the temperature range of 25-300K using a developed C-V and I-V variable temperature stage incorporating a liquid helium cryostat. It demonstrates the potential improvements in spatial resolution in materials of long lifetime by mapping on timing windows around the prompt charge component in the charge transient

  6. A Qualitative Assessment of Diversion Scenarios for a GEN IV Example Sodium Fast Reactor Using the GEN IV PR and PP Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Zentner, M.D.; Coles, G.A. [PNNL, P.O. Box 999, 902 Battelle Boulvard, Richland, WA 99336 (United States); Therios, I.U. [Argonne National Lab. - ANL (United States)

    2009-06-15

    An experts working group was created in 2002 by The Generation IV International Forum for the purpose of developing an internationally accepted methodology for assessing the proliferation resistance of a nuclear energy system (NES) and its individual elements. A two year case study was performed by the working group using this methodology to assess the proliferation resistance of a hypothetical NES called the Example Sodium Fast Reactor (ESFR). This work demonstrates how the PR and PP methodology can be used to provide important information to designers at various levels of details, including pre-conceptual design stage. The study analyzes the response of the ESFR entire nuclear energy system to different proliferation and theft strategies. The challenges considered comprise concealed diversion, concealed misuse and abrogation strategies. This paper describes the work done in performing a qualitative assessment of potential concealed diversion scenarios from the ESFR, and includes an evaluation of the potential effect of changes in the conversion ratio on diversion strategies. (authors)

  7. Determination of uranium (IV) by flow voltammetry

    International Nuclear Information System (INIS)

    Ding Anqing

    1987-01-01

    According to the quantitative reaction of U(IV) and Fe(III) in H 2 SO 4 as well as the relation between current and concentration of substance detected, U(IV) has been determined indirectly by measurement of the electrolysis current of residual Fe(III). The columniform electrode used is made of glass carbon particles. At the range of U(IV) from a few micrograms to 40 μg, the linear relation is excellent. The relative standard deviation is within ±4%. The interference of Fe(II), Ti(IV) and U(VI) is negligible but of Ti(III) is serious. This method has been successfully applied in the determination of actual samples (both out line and on line). Main advantages of this procedure are rapid, simple, small amount of sample (only at microgram level) and easy to realize automation, able to use for on line or process analysis

  8. Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

    Science.gov (United States)

    Fink, Bernd; Schlumberger, Michael; Oremek, Damian

    2017-08-01

    patients were assessed before surgery, between stages, every 3 months during the first year after surgery, every 6 months during the second year postoperative, and at latest followup, and were retrospectively drawn from a longitudinally maintained institutional database. Thirty-four of 35 patients (97.2%; 95% CI, 85.4%-99.5%) appeared free of infection by criteria of Masri et al. and Zimmerli et al. at latest followup. The Harris hip score was 61 ± 13 points after the first operation and 82 ± 16 points 2 years after the second operation. This technique is a promising treatment option for periprosthetic infections of the hip in which substantial acetabular defects exclude implantation of a normal spacer and a two-stage revision of the femoral component is favored. Level IV, therapeutic study.

  9. Testing and economical evaluation of U(IV) in Purex

    International Nuclear Information System (INIS)

    Hoisington, J.E.; Hsu, T.C.

    1983-01-01

    The use of uranous nitrate, U(IV), as a plutonium reductant in the Purex solvent extraction process could significantly reduce the waste generation at the Savannah River Plant. The current reductant is a ferrous sulfamate (FS)/hydroxylamine nitrate (HAN) mixture. The iron and sulfate in the FS are major contributors to waste generation. The U(IV) reductant oxidizes to U(VI) producing no waste. The Savannah River Laboratory has developed an efficient electrochemical cell for U(IV) production and has demonstrated the effectiveness of U(IV) as a plutonium reductant. Plant tests and economic analyses are currently being conducted to determine the cost effectiveness of U(IV) implementation. The results of recent studies are presented

  10. COBRA-IV wire wrap data comparisons

    International Nuclear Information System (INIS)

    Donovan, T.E.; George, T.L.; Wheeler, C.L.

    1979-02-01

    Thermal hydraulic analyses of hexagonally packed wire-wrapped fuel assemblies are complicated by the induced crossflow between adjacent subchannels. The COBRA-IV computer code simultaneously solves the hydrodynamics and thermodynamics of fuel assemblies. The modifications and the results are presented which are predicted by the COBRA-IV calculation. Comparisons are made with data measured in five experimental models of a wire-wrapped fuel assembly

  11. Colorectal signet-ring cell carcinoma: benefit from adjuvant chemotherapy but a poor prognostic factor.

    Science.gov (United States)

    Hugen, Niek; Verhoeven, Rob H; Lemmens, Valery E; van Aart, Carola J; Elferink, Marloes A; Radema, Sandra A; Nagtegaal, Iris D; de Wilt, Johannes H

    2015-01-15

    Colorectal signet-ring cell carcinoma (SRCC) has been associated with poor survival compared with mucinous adenocarcinoma (MC) and the more common adenocarcinoma (AC). Efficacy of adjuvant chemotherapy in SRCC has never been assessed. This study analyzes the prognostic impact of SRCC and determines whether colonic SRCC patients benefit from adjuvant chemotherapy equally compared with MC and AC patients. Data on 196,757 colorectal cancer (CRC) patients in the period 1989-2010 was included in this Dutch nationwide population-based study. Five-year relative survival estimates were calculated and multivariate relative survival analyses using a multiple regression model of relative excess risk (RER) were performed. SRCC was found in 1,972 (1.0%) patients. SRCC patients presented more frequently with stage III or IV disease than AC patients (75.2% vs. 43.6%, p chemotherapy (RER 1.10, 95% CI 0.81-1.51), suggesting a comparable benefit from adjuvant chemotherapy in AC and SRCC. In conclusion, the prognostic impact of SRCC is dismal in both colon and rectal cancer patients, but adjuvant chemotherapy is associated with improved survival in AC, MC, and SRCC patients. © 2014 UICC.

  12. Development and validation of prognostic models in metastatic breast cancer: a GOCS study.

    Science.gov (United States)

    Rabinovich, M; Vallejo, C; Bianco, A; Perez, J; Machiavelli, M; Leone, B; Romero, A; Rodriguez, R; Cuevas, M; Dansky, C

    1992-01-01

    The significance of several prognostic factors and the magnitude of their influence on response rate and survival were assessed by means of uni- and multivariate analyses in 362 patients with stage IV (UICC) breast carcinoma receiving combination chemotherapy as first systemic treatment over an 8-year period. Univariate analyses identified performance status and prior adjuvant radiotherapy as predictors of objective regression (OR), whereas the performance status, prior chemotherapy and radiotherapy (adjuvants), white blood cells count, SGOT and SGPT levels, and metastatic pattern were significantly correlated to survival. In multivariate analyses favorable characteristics associated to OR were prior adjuvant radiotherapy, no prior chemotherapy and postmenopausal status. Regarding survival, the performance status and visceral involvement were selected by the Cox model. The predictive accuracy of the logistic and the proportional hazards models was retrospectively tested in the training sample, and prospectively in a new population of 126 patients also receiving combined chemotherapy as first treatment for metastatic breast cancer. A certain overfitting to data in the training sample was observed with the regression model for response. However, the discriminative ability of the Cox model for survival was clearly confirmed.

  13. Determination of the solubility of Np(IV), Pu(III) - (VI),Am(III) - (VI), and Te(IV), (V) hydroxo compounds in 0.5 - 14 M NaOH solutions

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, C.H.

    1996-09-24

    The solubilities of Am(III), Np(IV), Pu(IV), Tc(IV), Np(V), Pu(V), Am(V), and Tc(V) hydroxo compounds were studied in 0.5 to 14 M NaOH solutions at 25{+-}2 {degrees}C. The effects of fluoride, phosphate, carbonate, oxalate, and some other organic complexing agents on the solubilities of Np(IV), Pu(IV), and TC(IV) hydroxides were investigated at 1.0 and 4.0 M NAOH. Some predictions were made on the dissolved (I.V) and (V) species present in alkali solutions.

  14. Ehlers-Danlos syndrome type IV

    Directory of Open Access Journals (Sweden)

    Germain Dominique P

    2007-07-01

    Full Text Available Abstract Ehlers-Danlos syndrome type IV, the vascular type of Ehlers-Danlos syndromes (EDS, is an inherited connective tissue disorder defined by characteristic facial features (acrogeria in most patients, translucent skin with highly visible subcutaneous vessels on the trunk and lower back, easy bruising, and severe arterial, digestive and uterine complications, which are rarely, if at all, observed in the other forms of EDS. The estimated prevalence for all EDS varies between 1/10,000 and 1/25,000, EDS type IV representing approximately 5 to 10% of cases. The vascular complications may affect all anatomical areas, with a tendency toward arteries of large and medium diameter. Dissections of the vertebral arteries and the carotids in their extra- and intra-cranial segments (carotid-cavernous fistulae are typical. There is a high risk of recurrent colonic perforations. Pregnancy increases the likelihood of a uterine or vascular rupture. EDS type IV is inherited as an autosomal dominant trait that is caused by mutations in the COL3A1 gene coding for type III procollagen. Diagnosis is based on clinical signs, non-invasive imaging, and the identification of a mutation of the COL3A1 gene. In childhood, coagulation disorders and Silverman's syndrome are the main differential diagnoses; in adulthood, the differential diagnosis includes other Ehlers-Danlos syndromes, Marfan syndrome and Loeys-Dietz syndrome. Prenatal diagnosis can be considered in families where the mutation is known. Choriocentesis or amniocentesis, however, may entail risk for the pregnant woman. In the absence of specific treatment for EDS type IV, medical intervention should be focused on symptomatic treatment and prophylactic measures. Arterial, digestive or uterine complications require immediate hospitalisation, observation in an intensive care unit. Invasive imaging techniques are contraindicated. Conservative approach is usually recommended when caring for a vascular

  15. Ehlers-Danlos syndrome type IV

    Science.gov (United States)

    Germain, Dominique P

    2007-01-01

    Ehlers-Danlos syndrome type IV, the vascular type of Ehlers-Danlos syndromes (EDS), is an inherited connective tissue disorder defined by characteristic facial features (acrogeria) in most patients, translucent skin with highly visible subcutaneous vessels on the trunk and lower back, easy bruising, and severe arterial, digestive and uterine complications, which are rarely, if at all, observed in the other forms of EDS. The estimated prevalence for all EDS varies between 1/10,000 and 1/25,000, EDS type IV representing approximately 5 to 10% of cases. The vascular complications may affect all anatomical areas, with a tendency toward arteries of large and medium diameter. Dissections of the vertebral arteries and the carotids in their extra- and intra-cranial segments (carotid-cavernous fistulae) are typical. There is a high risk of recurrent colonic perforations. Pregnancy increases the likelihood of a uterine or vascular rupture. EDS type IV is inherited as an autosomal dominant trait that is caused by mutations in the COL3A1 gene coding for type III procollagen. Diagnosis is based on clinical signs, non-invasive imaging, and the identification of a mutation of the COL3A1 gene. In childhood, coagulation disorders and Silverman's syndrome are the main differential diagnoses; in adulthood, the differential diagnosis includes other Ehlers-Danlos syndromes, Marfan syndrome and Loeys-Dietz syndrome. Prenatal diagnosis can be considered in families where the mutation is known. Choriocentesis or amniocentesis, however, may entail risk for the pregnant woman. In the absence of specific treatment for EDS type IV, medical intervention should be focused on symptomatic treatment and prophylactic measures. Arterial, digestive or uterine complications require immediate hospitalisation, observation in an intensive care unit. Invasive imaging techniques are contraindicated. Conservative approach is usually recommended when caring for a vascular complication in a patient suffering

  16. Gen IV Materials Handbook Implementation Plan

    International Nuclear Information System (INIS)

    Rittenhouse, P.; Ren, W.

    2005-01-01

    A Gen IV Materials Handbook is being developed to provide an authoritative single source of highly qualified structural materials information and materials properties data for use in design and analyses of all Generation IV Reactor Systems. The Handbook will be responsive to the needs expressed by all of the principal government, national laboratory, and private company stakeholders of Gen IV Reactor Systems. The Gen IV Materials Handbook Implementation Plan provided here addresses the purpose, rationale, attributes, and benefits of the Handbook and will detail its content, format, quality assurance, applicability, and access. Structural materials, both metallic and ceramic, for all Gen IV reactor types currently supported by the Department of Energy (DOE) will be included in the Gen IV Materials Handbook. However, initial emphasis will be on materials for the Very High Temperature Reactor (VHTR). Descriptive information (e.g., chemical composition and applicable technical specifications and codes) will be provided for each material along with an extensive presentation of mechanical and physical property data including consideration of temperature, irradiation, environment, etc. effects on properties. Access to the Gen IV Materials Handbook will be internet-based with appropriate levels of control. Information and data in the Handbook will be configured to allow search by material classes, specific materials, specific information or property class, specific property, data parameters, and individual data points identified with materials parameters, test conditions, and data source. Details on all of these as well as proposed applicability and consideration of data quality classes are provided in the Implementation Plan. Website development for the Handbook is divided into six phases including (1) detailed product analysis and specification, (2) simulation and design, (3) implementation and testing, (4) product release, (5) project/product evaluation, and (6) product

  17. Independent Examination of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV): What Does the WAIS-IV Measure?

    Science.gov (United States)

    Benson, Nicholas; Hulac, David M.; Kranzler, John H.

    2010-01-01

    Published empirical evidence for the Wechsler Adult Intelligence Scale--Fourth Edition (WAIS-IV) does not address some essential questions pertaining to the applied practice of intellectual assessment. In this study, the structure and cross-age invariance of the latest WAIS-IV revision were examined to (a) elucidate the nature of the constructs…

  18. Determinants of stage at diagnosis of breast cancer in Nigerian women: sociodemographic, breast cancer awareness, health care access and clinical factors.

    Science.gov (United States)

    Jedy-Agba, Elima; McCormack, Valerie; Olaomi, Oluwole; Badejo, Wunmi; Yilkudi, Monday; Yawe, Terna; Ezeome, Emmanuel; Salu, Iliya; Miner, Elijah; Anosike, Ikechukwu; Adebamowo, Sally N; Achusi, Benjamin; Dos-Santos-Silva, Isabel; Adebamowo, Clement

    2017-07-01

    Advanced stage at diagnosis is a common feature of breast cancer in Sub-Saharan Africa (SSA), contributing to poor survival rates. Understanding its determinants is key to preventing deaths from this cancer in SSA. Within the Nigerian Integrative Epidemiology of Breast Cancer Study, a multicentred case-control study on breast cancer, we studied factors affecting stage at diagnosis of cases, i.e. women diagnosed with histologically confirmed invasive breast cancer between January 2014 and July 2016 at six secondary and tertiary hospitals in Nigeria. Stage was assessed using clinical and imaging methods. Ordinal logistic regression was used to examine associations of sociodemographic, breast cancer awareness, health care access and clinical factors with odds of later stage (I, II, III or IV) at diagnosis. A total of 316 women were included, with a mean age (SD) of 45.4 (11.4) years. Of these, 94.9% had stage information: 5 (1.7%), 92 (30.7%), 157 (52.4%) and 46 (15.3%) were diagnosed at stages I, II, III and IV, respectively. In multivariate analyses, lower educational level (odds ratio (OR) 2.35, 95% confidence interval: 1.04, 5.29), not believing in a cure for breast cancer (1.81: 1.09, 3.01), and living in a rural area (2.18: 1.05, 4.51) were strongly associated with later stage, whilst age at diagnosis, tumour grade and oestrogen receptor status were not. Being Muslim (vs. Christian) was associated with lower odds of later stage disease (0.46: 0.22, 0.94). Our findings suggest that factors that are amenable to intervention concerning breast cancer awareness and health care access, rather than intrinsic tumour characteristics, are the strongest determinants of stage at diagnosis in Nigerian women.

  19. Value of preoperative enhanced multi-slice spiral CT scan for judging TNM staging of gastric cancer as well as its relationship with tumor marker and proliferation molecule expression

    Directory of Open Access Journals (Sweden)

    Ai-Jun Wu

    2016-12-01

    Full Text Available Objective: To study the value of preoperative enhanced multi-slice spiral CT scan for judging TNM staging of gastric cancer as well as its relationship with tumor marker and proliferation molecule expression. Methods: A total of 135 patients with gastric cancer who received surgical resection in our hospital between May 2012 and October 2015 were selected as the research subjects, preoperative enhanced multi-slice spiral CT scan was conducted to judge TNM staging, and serum was collected to determine the content of tumor markers; tumor tissue was collected after operation to determine the content of cytokines and pro-proliferation molecules. Results: CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM II, III and IV stage gastric cancer were significantly higher than those of patients with TNM I stage; CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM III and IV stage gastric cancer were significantly higher than those of patients with TNM II stage; CEA, CA199, CA153, CA125 and CA724 content in serum as well as TGFβ1, TGFβ2, VEGF, FGF2, PTP1B, PIK3CD, Survivin, Ezrin and YAP content in gastric cancer tissue of patients with TNM IV stage gastric cancer were significantly higher than those of patients with TNM III stage. Conclusions: TNM staging of gastric cancer decided by preoperative enhanced multi-slice spiral CT scan has good consistency with the content of tumor markers in serum and proliferation molecules in tumor lesion.

  20. Comparison of Bispectral Index™ values during the flotation restricted environmental stimulation technique and results for stage I sleep: a prospective pilot investigation.

    Science.gov (United States)

    Dunham, C Michael; McClain, Jesse V; Burger, Amanda

    2017-11-29

    To determine whether Bispectral Index™ values obtained during flotation-restricted environment stimulation technique have a similar profile in a single observation compared to literature-derived results found during sleep and other relaxation-induction interventions. Bispectral Index™ values were as follows: awake-state, 96.6; float session-1, 84.3; float session-2, 82.3; relaxation-induction, 82.8; stage I sleep, 86.0; stage II sleep, 66.2; and stages III-IV sleep, 45.1. Awake-state values differed from float session-1 (%difference 12.7%; Cohen's d = 3.6) and float session-2 (%difference 14.8%; Cohen's d = 4.6). Relaxation-induction values were similar to float session-1 (%difference 1.8%; Cohen's d = 0.3) and float session-2 (%difference 0.5%; Cohen's d = 0.1). Stage I sleep values were similar to float session-1 (%difference 1.9%; Cohen's d = 0.4) and float session-2 (%difference 4.3%; Cohen's d = 1.0). Stage II sleep values differed from float session-1 (%difference 21.5%; Cohen's d = 4.3) and float session-2 (%difference 19.6%; Cohen's d = 4.0). Stages III-IV sleep values differed from float session-1 (%difference 46.5%; Cohen's d = 5.6) and float session-2 (%difference 45.2%; Cohen's d = 5.4). Bispectral Index™ values during flotation were comparable to those found in stage I sleep and nadir values described with other relaxation-induction techniques.

  1. Generation IV nuclear reactors: Current status and future prospects

    International Nuclear Information System (INIS)

    Locatelli, Giorgio; Mancini, Mauro; Todeschini, Nicola

    2013-01-01

    Generation IV nuclear power plants (GEN IV NPPs) are supposed to become, in many countries, an important source of base load power in the middle–long term (2030–2050). Nowadays there are many designs of these NPPs but for political, strategic and economic reasons only few of them will be deployed. International literature proposes many papers and reports dealing with GEN IV NPPs, but there is an evident difference in the types and structures of the information and a general unbiased overview is missing. This paper fills the gap, presenting the state-of-the-art for GEN IV NPPs technologies (VHTR, SFR, SCWR, GFR, LFR and MSR) providing a comprehensive literature review of the different designs, discussing the major R and D challenges and comparing them with other advanced technologies available for the middle- and long-term energy market. The result of this research shows that the possible applications for GEN IV technologies are wider than current NPPs. The economics of some GEN IV NPPs is similar to actual NPPs but the “carbon cost” for fossil-fired power plants would increase the relative valuation. However, GEN IV NPPs still require substantial R and D effort, preventing short-term commercial adoption. - Highlights: • Generation IV reactors are the middle–long term technology for nuclear energy. • This paper provides an overview and a taxonomy for the designs under consideration. • R and D efforts are in the material, heat exchangers, power conversion unit and fuel. • The life cycle costs are competitive with other innovative technologies. • The hydrogen economy will foster the development of Generation IV reactors

  2. IVS Organization

    Science.gov (United States)

    2004-01-01

    International VLBI Service (IVS) is an international collaboration of organizations which operate or support Very Long Baseline Interferometry (VLBI) components. The goals are: To provide a service to support geodetic, geophysical and astrometric research and operational activities. To promote research and development activities in all aspects of the geodetic and astrometric VLBI technique. To interact with the community of users of VLBI products and to integrate VLBI into a global Earth observing system.

  3. Independent examination of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV): what does the WAIS-IV measure?

    Science.gov (United States)

    Benson, Nicholas; Hulac, David M; Kranzler, John H

    2010-03-01

    Published empirical evidence for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) does not address some essential questions pertaining to the applied practice of intellectual assessment. In this study, the structure and cross-age invariance of the latest WAIS-IV revision were examined to (a) elucidate the nature of the constructs measured and (b) determine whether the same constructs are measured across ages. Results suggest that a Cattell-Horn-Carroll (CHC)-inspired structure provides a better description of test performance than the published scoring structure does. Broad CHC abilities measured by the WAIS-IV include crystallized ability (Gc), fluid reasoning (Gf), visual processing (Gv), short-term memory (Gsm), and processing speed (Gs), although some of these abilities are measured more comprehensively than are others. Additionally, the WAIS-IV provides a measure of quantitative reasoning (QR). Results also suggest a lack of cross-age invariance resulting from age-related differences in factor loadings. Formulas for calculating CHC indexes and suggestions for interpretation are provided. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  4. Reaction of uranium (IV) with xenon difluoride by chemiluminescence, spectrophotometric, and spectrofluorimetric methods

    Energy Technology Data Exchange (ETDEWEB)

    Mamykin, A.V.; Kazakov, V.P.

    1988-07-01

    A study is made of the kinetics of the chemiluminescent reaction of oxidation of uranium (IV) by xenon difluoride in 1M HClO/sub 4/ U/sup 4 +/ + XeF/sub 2/ ..-->.. UO/sub 2//sup 2 +/ = h/eta/. The optical density D and the intensity of the photoluminescence of the solution I/sub PL/ were measured in parallel with recording of the luminescence intensity I/sub CL/. I/sub CL/ attains a maximum value some time after the beginning of the reaction, after which it decays exponentially. On the kinetic curves of the time dependence of D and I/sub PL/ an induction period is observed, the extent of which depends on concentrations of reagents and temperature of the solution. The maximum of I/sub CL/ coincides with the end of the induction period if the measurements are carried out under identical conditions. The rate of the reaction after the induction period is described by a first order equation in U/sup (IV)/. The rate constants of the reaction, obtained by chemiluminescence, spectrophotometric, and spectrofluorimetric methods, have close values 2.0 +- 0.4, 1.8 +- 0.3, and 2.1 +- 0.3 sec/sup /minus/1/ x 10/sup 2/, respectively. On the basis of the results obtained, we conclude that the stages of formation of UO/sub 2//sup 2 +/ and of chemiluminescence coincide, i.e., formation of the excited state (UD/sub 2//sup 2 +/) and of chemiluminescence coincide, i.e., formation of the excited state (UD/sub 2//sup 2 +/)* takes place during the reaction. It is proposed and experimentally verified that the reaction passes through an intermediate stage of formation of uranyl ion UO/sub 2//sup +/.

  5. Low Tumor Infiltrating Mast Cell Density Confers Prognostic Benefit and Reflects Immunoactivation in Colorectal Cancer.

    Science.gov (United States)

    Mao, Yihao; Feng, Qingyang; Zheng, Peng; Yang, Liangliang; Zhu, Dexiang; Chang, Wenju; Ji, Meiling; He, Guodong; Xu, Jianmin

    2018-06-06

    The role of mast cells (MCs) in colorectal cancer (CRC) progression was controversial. Thus, this study was designed to evaluate the prognostic value of MCs as well as their correlation with immune microenvironment. A retrospective cohort of CRC patients of stage I-IV was enrolled in this study. 854 consecutive patients were divided into training set (427 patients) and validation set (427 patients) randomly. The findings were further validated in a GEO cohort, GSE39582 (556 patients). The mast cell density (MCD) was measured by immunohistochemical staining of tryptase or by CIBERSORT algorithm. Low MCD predicted prolonged overall survival (OS) in training and validation set. Moreover, MCD was identified as an independent prognostic indicator in both sets. Better stratification for CRC prognosis can be achieved by building a MCD based nomogram. The prognostic role of MCD was further validated in GSE39582. In addition, MCD predicted improved survival in stage II and III CRC patients receiving adjuvant chemotherapy (ACT). Multiple immune pathways were enriched in low MCD group while cytokines/chemokines promoting anti-tumor immunity were highly expressed in such group. Furthermore, MCD was negatively correlated with CD8+ T cells infiltration. In conclusion, MCD was identified as an independent prognostic factor, as well as a potential biomarker for ACT benefit in stage II and III CRC. Better stratification of CRC prognosis could be achieved by building a MCD based nomogram. Moreover, immunoactivation in low MCD tumors may contributed to improved prognosis. This article is protected by copyright. All rights reserved. © 2018 UICC.

  6. Industrial Waste Landfill IV upgrade package

    International Nuclear Information System (INIS)

    1994-01-01

    The Y-12 Plant, K-25 Site, and ORNL are managed by DOE's Operating Contractor (OC), Martin Marietta Energy Systems, Inc. (Energy Systems) for DOE. Operation associated with the facilities by the Operating Contractor and subcontractors, DOE contractors and the DOE Federal Building result in the generation of industrial solid wastes as well as construction/demolition wastes. Due to the waste streams mentioned, the Y-12 Industrial Waste Landfill IV (IWLF-IV) was developed for the disposal of solid industrial waste in accordance to Rule 1200-1-7, Regulations Governing Solid Waste Processing and Disposal in Tennessee. This revised operating document is a part of a request for modification to the existing Y-12 IWLF-IV to comply with revised regulation (Rule Chapters 1200-1-7-.01 through 1200-1-7-.08) in order to provide future disposal space for the ORR, Subcontractors, and the DOE Federal Building. This revised operating manual also reflects approved modifications that have been made over the years since the original landfill permit approval. The drawings referred to in this manual are included in Drawings section of the package. IWLF-IV is a Tennessee Department of Environmental and Conservation/Division of Solid Waste Management (TDEC/DSWM) Class 11 disposal unit

  7. IVS: Current Status and Future Plans

    Science.gov (United States)

    Behrend, D.; Nothnagel, A.; Petrachenko, W. T.; Tuccari, G.

    2016-12-01

    The International VLBI Service for Geodesy and Astrometry (IVS) is a globally operating service that coordinates and performs Very Long Baseline Interferometry (VLBI) activities through its constituent components. The VLBI activities are associated with the creation, provision, dissemination, and archiving of relevant VLBI data and products. The products mostly pertain to the determination of the celestial and terrestrial reference frames, the Earth orientation parameters (EOP), atmospheric parameters as well as other ancillary parameters. The IVS observational network currently consists of about 40 radio telescopes worldwide. Subsets of these telescopes (8-12 stations) participate in 24-hour observing sessions that are run several times per week and in 1-hour intensive sessions for UT1 determination every day. The current VLBI network was developed mainly in the 1970s and 1980s. A number of factors, including aging infrastructure and demanding new scientific requirements, started to challenge its future sustainability and relevance. In response, the IVS and other groups developed and started implementing the next generation VLBI system, called VGOS (VLBI Global Observing System), at existing and new sites. The VGOS network is expected to reach maturity in the early 2020s. We describe the current status, progress, and anticipated prospects of geodetic/astrometric VLBI and the IVS.

  8. Stages III and IV squamous cell carcinoma of the mouth: Three-year experience with superselective intraarterial chemotherapy using cisplatin prior to definitive treatment

    International Nuclear Information System (INIS)

    Hirai, Toshinori; Korogi, Yukunori; Hamatake, Satoshi; Nishimura, Ryuichi; Baba, Yuji; Takahashi, Mutsumasa; Uji, Yasuyoshi; Taen, Akira

    1999-01-01

    Purpose: This study was designed to assess the 3-year experience with superselective intraarterial chemotherapy prior to definitive treatment for stages III and IV squamous cell carcinomas of the mouth.Methods: Twenty-two patients prospectively received superselective intraarterial chemotherapy using relatively low-dose cisplatin via a transfemoral approach. The locations of the tumors were the tongue (n=12), gingiva (n=5), buccal mucosa (n=2), hard palate (n=1), floor of the mouth (n=1), and lip (n=1). After intraarterial chemotherapy, 21 patients underwent surgery (n=14), radiation therapy (n=6), or both (n=1). The survival rate of 25 patients who underwent surgery with/without radiationtherapy until 1992 at Kumamoto University Hospital was also evaluated as a historical control. The survival curve was calculated with the Kaplan-Meier method, and the statistical difference between survival curves was determined with the generalized Wilcoxon test.Results: The overall response rate was 95% [complete response (tumor completely resolved), 24%; partial response (tumor reduction ≥50%), 71%]. Fifty-two intraarterial infusions were performed without any catheter-related complications. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. One patient died of renal failure from cisplatin. After a median follow-up of 20 months (range 2-41 months), the estimated 3-year survival rate for patients who underwent intraarterial chemotherapy plus surgery was 91%. The survival of the patients who underwent intraarterial chemotherapy plus surgery tended to be longer than that of the historical control.Conclusions: Early tumor reduction without delay of subsequent treatments can be obtained by intraarterial chemotherapy while minimizing complications and possibly improving survival. Further investigations of long-term survival with larger series need to be performed.

  9. Zirconium (IV) complexes with some polymethylenediimines | Na ...

    African Journals Online (AJOL)

    The syntheses of zirconium (IV) complexes have been carried out by the reaction of oxozirconium (IV) chloride with the appropriate diimines (Schiff bases). The complexes were isolated as yellow solids which are stable to heat. The complexes were found to be insoluble in most solvents. The infrared spectra, elemental ...

  10. Development of Electromagnetic Analysis Model for IV-CEAPI

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jinseok; Jang, Yongtae; Lee, Myounggoo; Cho, Yeonho; Kim, Hyunmin [KEPCO Engineering and Construction, Inc., Daejeon (Korea, Republic of); Hong, Hoonbin; Baek, Minho [Woojin Inc., Osan (Korea, Republic of)

    2016-05-15

    There are many different types of position indicators such as reed switch type, ultrasonic type, solenoid type, etc. Through an analysis of strengths and weakness of those types, solenoid type was selected for an IV-CEAPI. Although solenoid type CEAPIs have been used world-wide, the IV-CEAPI is to be very different from the conventional designs due to its harsh operating environment. The concept of the IV-CEAPI is simple as shown in Figure 1. The coil is made of mineral insulated wire to be able to operate inside reactor vessel. The CEA is connected to the shaft which is made of ferromagnetic material. As the CEA position varies, the inductance variation is detected by the inductance meter located outside the vessel. Unlike the conventional ones, the IV-CEAPI used only one coil to eliminate coil connection point and electric components inside vessel. A finite element model was developed to calculate inductance of the solenoid type IV-CEAPI. The model considers eddy current effect to calculate frequency dependent inductance value. Analyses were performed to produce an inductance curve to the shaft position.

  11. Development of Electromagnetic Analysis Model for IV-CEAPI

    International Nuclear Information System (INIS)

    Park, Jinseok; Jang, Yongtae; Lee, Myounggoo; Cho, Yeonho; Kim, Hyunmin; Hong, Hoonbin; Baek, Minho

    2016-01-01

    There are many different types of position indicators such as reed switch type, ultrasonic type, solenoid type, etc. Through an analysis of strengths and weakness of those types, solenoid type was selected for an IV-CEAPI. Although solenoid type CEAPIs have been used world-wide, the IV-CEAPI is to be very different from the conventional designs due to its harsh operating environment. The concept of the IV-CEAPI is simple as shown in Figure 1. The coil is made of mineral insulated wire to be able to operate inside reactor vessel. The CEA is connected to the shaft which is made of ferromagnetic material. As the CEA position varies, the inductance variation is detected by the inductance meter located outside the vessel. Unlike the conventional ones, the IV-CEAPI used only one coil to eliminate coil connection point and electric components inside vessel. A finite element model was developed to calculate inductance of the solenoid type IV-CEAPI. The model considers eddy current effect to calculate frequency dependent inductance value. Analyses were performed to produce an inductance curve to the shaft position

  12. The affinity plutonium(IV) for nitrogen donor ligands

    International Nuclear Information System (INIS)

    Jarvis, N.V.; Hancock, R.D.

    1994-01-01

    Established ligand design principles are used to predict the solution chemistry of Pu(IV) with nitrogen donor ligands which do not contain carboxylate donors. pK a 's of the nitrogen donors are lowered by addition of hydroxyalkyl groups causing Pu(IV) to have a greater affinity for these ligands than for hydroxide. Potentiometric studies using the ligands N,N,N'N',N''-pentakis(2-hydroxypropyl)-1,4,7-triazaheptane; N,N,N',N',N''-pentakis(2-hydroxyethyl)-1,4,7-triazaheptane; N,N,N',N',N'-tetrakis(2-hydroxyethyl)-1,2-diaminoethane; N,N,N',N'-tetrakis(2-hydroxyethyl)-trans-1,2-diaminocyclohexane; 1,4,8,11-tetrakis(2-hydroxyethyl)-1,4,8,11-tetraazacyclotetradecane and N,N-bis(2-hydroxyethyl)glycine with Pu(IV) showed that Pu(IV) has a considerable aqueous solution chemistry with these ligands. Data were processed by the ESTA library of programs and stability constants for all the systems are reported. Implications for selective ligand design for Pu(IV) are discussed. (orig.)

  13. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2016.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  14. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2014.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  15. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2015.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  16. DSM-IV: a nosology sold before its time?

    Science.gov (United States)

    Zimmerman, M; Jampala, V C; Sierles, F S; Taylor, M A

    1991-04-01

    The purpose of this study was to determine whether American psychiatrists believe that DSM-IV is being published too soon after DSM-III-R. The authors conducted a mail survey of the attitudes of practicing psychiatrists (N = 454), residency program directors (N = 128), residents (N = 1,331), and researchers (N = 196) toward the scheduled publication of DSM-IV in the early 1990s. They found that the majority of all four groups believed that DSM-IV is being published prematurely. In contrast to respondents who believed that the timing of DSM-IV is appropriate, those who indicated that it is being published too soon had more recently completed their residency training and also believed that DSM-III-R was published prematurely. There was no association between the psychiatrists' responses and their theoretical orientation, Board certification status, ownership of the DSM manuals, the length of time they had used DSM-III, and the diagnostic manual (DSM-III or DSM-III-R) they were currently using. The belief that DSM-IV is being published too soon could contribute to underuse of DSM-IV by substantial numbers of psychiatrists. Thus, to foster compliance with it, APA must preserve in its efforts to demonstrate that the advantages of publishing it in 1993 outweigh the disadvantages of adopting yet another manual.

  17. Dipeptidyl-peptidase IV (DPP-IV) inhibitor delays tolerance to anxiolytic effect of ethanol and withdrawal-induced anxiety in rats.

    Science.gov (United States)

    Sharma, Ajaykumar N; Pise, Ashish; Sharma, Jay N; Shukla, Praveen

    2015-06-01

    Dipeptidyl-peptidase IV (DPP-IV) is an enzyme responsible for the metabolism of endogenous gut-derived hormone, glucagon-like peptide-1 (GLP-1). DPP-IV is known for its role in energy homeostasis and pharmacological blockade of this enzyme is a recently approved clinical strategy for the management of type II diabetes. Accumulating evidences suggest that enzyme DPP-IV can affect spectrum of central nervous system (CNS) functions. However, little is known about the role of this enzyme in ethanol-mediated neurobehavioral complications. The objective of the present study was to examine the impact of DPP-IV inhibitor, sitagliptin on the development of tolerance to anxiolytic effect of ethanol and anxiety associated with ethanol withdrawal in rats. A dose-response study revealed that sitaglitpin (20 mg/kg, p.o.) per se exhibit anxiolytic effect in the elevated plus maze (EPM) test in rats. Tolerance to anxiolytic effect of ethanol (2 g/kg, i.p.; 8 % w/v) was observed from 7(th) day of ethanol-diet (6 % v/v) consumption. In contrast, tolerance to anxiolytic effect of ethanol was delayed in rats that were treated daily with sitagliptin (20 mg/kg, p.o.) as tolerance was observed from 13(th)day since commencement of ethanol-diet consumption. Discontinuation of rats from ethanol-diet after 15-days of ethanol consumption resulted in withdrawal anxiety between 8 h and 12 h post-abstinence. However, rats on 15-day ethanol-diet with concomitant sitagliptin (20 mg/kg, p.o.) treatment exhibited delay in appearance (24 h post-withdrawal) of withdrawal anxiety. In summary, DPP-IV inhibitors may prove as an attractive research strategy against ethanol tolerance and dependence.

  18. Oxovanadium(IV)-catalysed oxidation of dibenzothiophene and 4,6-dimethyldibenzothiophene.

    Science.gov (United States)

    Ogunlaja, Adeniyi S; Chidawanyika, Wadzanai; Antunes, Edith; Fernandes, Manuel A; Nyokong, Tebello; Torto, Nelson; Tshentu, Zenixole R

    2012-12-07

    The reaction between [V(IV)OSO(4)] and the tetradentate N(2)O(2)-donor Schiff base ligand, N,N-bis(o-hydroxybenzaldehyde)phenylenediamine (sal-HBPD), obtained by the condensation of salicylaldehyde and o-phenylenediamine in a molar ratio of 2 : 1 respectively, resulted in the formation of [V(IV)O(sal-HBPD)]. The molecular structure of [V(IV)O(sal-HBPD)] was determined by single crystal X-ray diffraction, and confirmed the distorted square pyramidal geometry of the complex with the N(2)O(2) binding mode of the tetradentate ligand. The formation of the polymer-supported p[V(IV)O(sal-AHBPD)] proceeded via the nitrosation of sal-HBPD, followed by the reduction with hydrogen to form an amine group that was then linked to Merrifield beads followed by the reaction with [V(IV)OSO(4)]. XPS and EPR were used to confirm the presence of oxovanadium(IV) within the beads. The BET surface area and porosity of the heterogeneous catalyst p[V(IV)O(sal-AHBPD)] were found to be 6.9 m(2) g(-1) and 180.8 Å respectively. Microanalysis, TG, UV-Vis and FT-IR were used for further characterization of both [V(IV)O(sal-HBPD)] and p[V(IV)O(sal-AHBPD)]. Oxidation of dibenzothiophene (DBT) and 4,6-dimethyldibenzothiophene (4,6-DMDBT) was investigated using [V(IV)O(sal-HBPD)] and p[V(IV)O(sal-AHBPD)] as catalysts. Progress for oxidation of these model compounds was monitored with a gas chromatograph fitted with a flame ionization detector. The oxidation products were characterized using gas chromatography-mass spectrometry, microanalysis and NMR. Dibenzothiophene sulfone (DBTO(2)) and 4,6-dimethyldibenzothiophene sulfone (4,6-DMDBTO(2)) were found to be the main products of oxidation. Oxovanadium(IV) Schiff base microspherical beads, p[V(IV)O(sal-AHBPD)], were able to catalyse the oxidation of sulfur in dibenzothiophene (DBT) and 4,6-dimethyldibenzothiophene (4,6-DMDBT) to a tune of 88.0% and 71.8% respectively after 3 h at 40 °C. These oxidation results show promise for potential application

  19. CT staging of renal cell carcinoma

    International Nuclear Information System (INIS)

    Spina, Juan C.; Garcia, Adriana T.; Rogondino, Jose; Spina, Juan C. h; Vidales, Valeria; Troiani, Guillermo; Iotti, Alejandro; Venditti, Julio

    2002-01-01

    detection and assessment of capsular perirenal fat invasion are subjective; therefore, those features should be evaluated cautiously (stages I and II). Regarding lymph node metastases and vascular invasion, since the number of cases in our series was small, we are unable to draw useful conclusions about CT usefulness (stages III and IV). (author)

  20. Diagnostic importance of computed tomography for the gastric carcinoma; in terms of the staging system

    International Nuclear Information System (INIS)

    Suh, Hyoung Sim; Lee, Jae Sub; Lee, Jong Jin; Chung, Soo Young; Bae, Sang Hoon

    1985-01-01

    The authors analysed the CT findings in 75 cases diagnosed as gastric carcinoma by U.G.I.S. or endoscopy in a 3 1/2 year period. The comparative analysis between CT findings and surgical pathologic findings was done in 55 cases who underwent surgery. 20 cases could not be operated upon because of distant metastasis. The gastric carcinoma was divided into 4 stages according to the staging system of the American Joint Committee on Cancer. The CT findings were than compared and the following results noted: 1. The relationship with gastric wall thickening and penetration degree of tumor; no thickening (lesser than 1.0 cm) of 3 cases showed all of T 1 , 11 of localized thickening (1.0-1.5 cm) showed 7 of T 2 , 38 of localized thickening (more than 1.5 cm) showed 37 of T 3 and 3 of diffuse thickening showed all of T 4 a. 2. The accuracy of lymph node detection by CT scan. 1) Regional lymph node showed 86% in operative finding and 73% in pathologic. 2) Extragastric lymph node showed 87% in operative finding and 89% in pathologic. 3) Retro-peritoneal lymph node showed 96% in operative finding and 95% in pathologic. ic. 3. In operated cases, there was one case of false positive distant metastasis and three false negative cases. 20 cases of non-operated cases showed distant metastasis such as liver, lung or kidney. 4. 55 cases were classified as stage I in 4 cases, II in 18, III in 23 and IV in 10 by pathologic findings, and I in 3, II in 24, III in 19 and IV in 9 by CT. The overall accuracy by CT staging is 75%. 5. Among a total of 75 cases, there were 46 operable cases by CT finding and 43 operation cases by pathologic staging. There were 29 inoperable cases by CT finding and 27 cases by pathologic staging. Therefore, there was a 93% overall accuracy by CT staging in terms of determination of operability. 6. The accuracy of adhesion into adjacent structure by CT findings was 69%, compared with operable finding

  1. Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study

    Science.gov (United States)

    Zietsman, Annelle; Galukande, Moses; Anele, Angelica; Adisa, Charles; Parham, Groesbeck; Pinder, Leeya; Cubasch, Herbert; Joffe, Maureen; Kidaaga, Frederick; Lukande, Robert; Offiah, Awa U.; Egejuru, Ralph O.; Shibemba, Aaron; Schuz, Joachim; Anderson, Benjamin O.; dos Santos Silva, Isabel; McCormack, Valerie

    2017-01-01

    Breast cancer (BC) survival rates in sub‐Saharan Africa (SSA) are low in part due to advanced stage at diagnosis. As one component of a study of the entire journey of SSA women with BC, we aimed to identify shared and setting‐specific drivers of advanced stage BC. Women newly diagnosed in the multicountry African Breast Cancer–Disparities in Outcomes (ABC‐DO) study completed a baseline interview and their stage information was extracted from medical records. Ordinal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for advanced stage (I, II, III, IV) in relation to individual woman‐level, referral and biological factors. A total of 1795 women were included from Nigeria, Uganda, Zambia, and the multiracial populations of Namibia and South Africa, 1091 of whom (61%) were stage III/IV. Stage was lower in women with greater BC knowledge (OR 0.77 (95% CI: 0.70, 0.85) per point on a 6 point scale). More advanced stage was associated with being black (4.00 (2.79, 5.74)), having attended stage BC in SSA is largely attributed to modifiable factors and strategies to improve BC education and awareness in women and the health system should be intensified. PMID:29197068

  2. MicroRNA‑133b inhibits connective tissue growth factor in colorectal cancer and correlates with the clinical stage of the disease.

    Science.gov (United States)

    Guo, Yihang; Li, Xiaorong; Lin, Changwei; Zhang, Yi; Hu, Gui; Zhou, Jianyu; Du, Juan; Gao, Kai; Gan, Yi; Deng, Hao

    2015-04-01

    Accumulating evidence indicates that dysregulation of microRNA‑133b (miR‑133b) is an important step in the development of certain types of human cancer and contributes to tumorigenesis. Altered expression of miR‑133b has been reported in colon carcinoma, but its association with clinical stage in colorectal cancer (CRC) has remained elusive. Connective tissue growth factor (CTGF), a potentially promising candidate gene for interaction with miR‑133b, was screened using microarray analysis. The expression of miR‑133b and CTGF was evaluated using reverse transcription‑quantitative polymerase chain reaction and western blot analysis. The regulatory effects of miR‑133b on CTGF were evaluated using a dual‑luciferase reporter assay. CTGF was identified as a functional target of miR‑133b. The results demonstrated low expression of miR‑133b in CRC specimens with poor cell differentiation (P=0.011), lymph node metastasis (P=0.037) and advanced clinical stages (stage III or IV vs. I or II; P=0.036). Furthermore, there was a significant association between a high level of expression of CTGF mRNA and an advanced clinical stage (stage III or IV vs. I or II; P=0.015) and lymph node metastasis (P=0.034). CTGF expression was negatively regulated by miR‑133b in the human colorectum, suggesting that miR‑133b and CTGF may be candidate therapeutic targets in colorectal cancer.

  3. Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study.

    Science.gov (United States)

    Rugge, M; de Boni, M; Pennelli, G; de Bona, M; Giacomelli, L; Fassan, M; Basso, D; Plebani, M; Graham, D Y

    2010-05-01

    Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk. To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression. Ninety-three Italian patients were followed up for more than 12 years (range: 144-204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2). All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori-status, gastritis patients could be confidently stratified and managed according to their different cancer risks.

  4. Neurofibrillary tangle pathology and Braak staging in chronic epilepsy in relation to traumatic brain injury and hippocampal sclerosis: a post-mortem study.

    Science.gov (United States)

    Thom, Maria; Liu, Joan Y W; Thompson, Pam; Phadke, Rahul; Narkiewicz, Marta; Martinian, Lillian; Marsdon, Derek; Koepp, Matthias; Caboclo, Luis; Catarino, Claudia B; Sisodiya, Sanjay M

    2011-10-01

    The long-term pathological effects of chronic epilepsy on normal brain ageing are unknown. Previous clinical and epidemiological studies show progressive cognitive decline in subsets of patients and an increased prevalence of Alzheimer's disease in epilepsy. In a post-mortem series of 138 patients with long-term, mainly drug-resistant epilepsy, we carried out Braak staging for Alzheimer's disease neurofibrillary pathology using tau protein immunohistochemistry. The stages were compared with clinicopathological factors, including seizure history and presence of old traumatic brain injury. Overall, 31% of cases were Braak Stage 0, 36% Stage I/II, 31% Stage III/IV and 2% Stage V/VI. The mean age at death was 56.5 years and correlated with Braak stage (P < 0.001). Analysis of Braak stages within age groups showed a significant increase in mid-Braak stages (III/IV), in middle age (40-65 years) compared with data from an ageing non-epilepsy series (P < 0.01). There was no clear relationship between seizure type (generalized or complex partial), seizure frequency, age of onset and duration of epilepsy with Braak stage although higher Braak stages were noted with focal more than with generalized epilepsy syndromes (P < 0.01). In 30% of patients, there was pathological evidence of traumatic brain injury that was significantly associated with higher Braak stages (P < 0.001). Cerebrovascular disease present in 40.3% and cortical malformations in 11.3% were not significantly associated with Braak stage. Astrocytic-tau protein correlated with the presence of both traumatic brain injury (P < 0.01) and high Braak stage (P < 0.001). Hippocampal sclerosis, identified in 40% (bilateral in 48%), was not associated with higher Braak stages, but asymmetrical patterns of tau protein accumulation within the sclerotic hippocampus were noted. In over half of patients with cognitive decline, the Braak stage was low indicating causes other than Alzheimer's disease pathology. In summary

  5. Dsm-iv hypochondriasis in primary care

    OpenAIRE

    Escobar, JI; Gara, M; Waitzkin, H; Silver, RC; Holman, A; Compton, W

    1998-01-01

    The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impair...

  6. Effect of Harvesting Stage on Sweet Sorghum (Sorghum bicolor L. Genotypes in Western Kenya

    Directory of Open Access Journals (Sweden)

    Moses Owuor Oyier

    2017-01-01

    Full Text Available Harvesting stage of sweet sorghum (Sorghum bicolor L. Moench cane is an important aspect in the content of sugar for production of industrial alcohol. Four sweet sorghum genotypes were evaluated for harvesting stage in a randomized complete block design. In order to determine sorghum harvest growth stage for bioethanol production, sorghum canes were harvested at intervals of seven days after anthesis. The genotypes were evaluated at different stages of development for maximum production of bioethanol from flowering to physiological maturity. The canes were crushed and juice fermented to produce ethanol. Measurements of chlorophyll were taken at various stages as well as panicles from the harvested canes. Dried kernels at 14% moisture content were also weighed at various stages. Chlorophyll, grain weight, absolute ethanol volume, juice volume, cane yield, and brix showed significant (p=0.05 differences for genotypes as well as the stages of harvesting. Results from this study showed that harvesting sweet sorghum at stages IV and V (104 to 117 days after planting would be appropriate for production of kernels and ethanol. EUSS10 has the highest ethanol potential (1062.78 l ha−1 due to excellent juice volume (22976.9 l ha−1 and EUSS11 (985.26 l ha−1 due to its high brix (16.21.

  7. The dependence of C IV broad absorption line properties on accompanying Si IV and Al III absorption: relating quasar-wind ionization levels, kinematics, and column densities

    Energy Technology Data Exchange (ETDEWEB)

    Filiz Ak, N.; Brandt, W. N.; Schneider, D. P.; Trump, J. R. [Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16802 (United States); Hall, P. B. [Department of Physics and Astronomy, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3 (Canada); Anderson, S. F. [Astronomy Department, University of Washington, Seattle, WA 98195 (United States); Hamann, F. [Department of Astronomy, University of Florida, Gainesville, FL 32611-2055 (United States); Myers, Adam D. [Department of Physics and Astronomy, University of Wyoming, Laramie, WY 82071 (United States); Pâris, I. [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile); Petitjean, P. [Institut d' Astrophysique de Paris, Universite Paris 6, F-75014 Paris (France); Ross, Nicholas P. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Shen, Yue [Carnegie Observatories, 813 Santa Barbara Street, Pasadena, CA 91101 (United States); York, Don, E-mail: nfilizak@astro.psu.edu [Department of Astronomy and Astrophysics, The University of Chicago, Chicago, IL 60637 (United States)

    2014-08-20

    We consider how the profile and multi-year variability properties of a large sample of C IV Broad Absorption Line (BAL) troughs change when BALs from Si IV and/or Al III are present at corresponding velocities, indicating that the line of sight intercepts at least some lower ionization gas. We derive a number of observational results for C IV BALs separated according to the presence or absence of accompanying lower ionization transitions, including measurements of composite profile shapes, equivalent width (EW), characteristic velocities, composite variation profiles, and EW variability. We also measure the correlations between EW and fractional-EW variability for C IV, Si IV, and Al III. Our measurements reveal the basic correlated changes between ionization level, kinematics, and column density expected in accretion-disk wind models; e.g., lines of sight including lower ionization material generally show deeper and broader C IV troughs that have smaller minimum velocities and that are less variable. Many C IV BALs with no accompanying Si IV or Al III BALs may have only mild or no saturation.

  8. Immunohistochmical Study of Glomerular Mesengial Collagen IV Expression in Diabetic Balb/c Mice

    Directory of Open Access Journals (Sweden)

    M. Jalali

    2006-04-01

    Full Text Available Introduction & Objective: Extra-cellular matrix and basement membrane play important roles in many developmental phenamenon during development and after birth. Among the components of the basement membrane, collagen fibers specially type IV, are the most important part of this area. As kidney is one of the target organs in diabetes mellitus and diabetic nephropathy is a major cause of end stage-renal disease and result an increase in morbidity and mortality of effected individuals, therefore early diagnosis leads to better treatment. The aim of this investigation was to study the primary diagnostic parameters by special regards to collagen IV fibers.Materials & Methods: In this study, 24 male balb/c mice were divided into experimental and control groups. In experimental group, the beta cells of Langerhance were chemically destroyed by an injection of 160 mg/kg alloxan and subdivided in experimental groups 1 and 2. Controls were kept untreated. Experimental group 1and 2 were sacrified 8 and 16 weeks after treatment with alloxan respectively. The same procedure was performed for control group. Immunohistochmical studies were carried out using monocolonal antibody against collagen type IV in Glomeruli. In addition, using morphometrical and stereological methods the volume of the glumerles was compared in all groups.Results: Our finding showed that in experimental groups with special regards in 16 weeks diabetic mice, the rate of collagen type IV in basement membrane around the parietal layer of Bowman capsule, mesangial cells and endothelium of capillary in glomerules increased significantly compared to controls and experimental group 1 (p<0.05, while there was not a significant difference among experimental group 2 and controls. Our data also revealed that the number of mesangial cells as well as glomerular volume increased significantly in experimental 2 (4.635±0.289×106µm3 compared to experimental 1 (3.504±0.189×106µm3 and controls (3.422

  9. Electrochemical studies of plutonium(IV) complexes in aqueous nitrate solutions

    International Nuclear Information System (INIS)

    Kim, Seong-Yun; Asakura, Toshihide; Morita, Yasuji

    2005-01-01

    Electrochemistry has been used to investigate the behavior of plutonium (IV) in 1-7 M HNO 3 solutions. These Pu(IV) complexes were found to be reduced quasi-reversibly to Pu(III) species. The formal redox potentials (E 0 ) for Pu(IV)/Pu(III) couples were determined to be +0.721, +0.712, +0.706, +0.705, +0.704, 0.694, and +0.696 V (vs. Ag/AgCl(SSE)) for Pu(IV) complexes in 1, 2, 3, 4, 5, 6, 7 M HNO 3 solutions, respectively. These results indicate that the reduction product of Pu(IV) is Pu(III), which is considerably stable in HNO 3 solution. (author)

  10. Crystal structure of ammonium octacyanomolybdate(IV) and rubidium octacyanomolybdate(IV)

    Energy Technology Data Exchange (ETDEWEB)

    Semenishin, D.I.; Glovyak, T.; Mys' kiv, M.G.

    1985-11-01

    The crystal structure of ammonium octacyanomolybdate(IV) and rubidium octacyanomolybdate(IV) has been determined by the single-crystal method on a Syntex P2/sub 1/ automatic diffractometer: ((NH/sub 4/)/sub 4/ Mo(CN)/sub 4/) 0.5H/sub 2/O (I) (space group Pma2, a = 15.550(3), b = 14.118(3), c = 7.438(1) A, Z = 4, R = 0.062) and Rb/sub 4/(Mo(CN)/sub 8/). 3H/sub 2/O (II) (space group P4/sub 1/2/sub 1/2, a = 9.300(10, c = 21.807(3) A, Z = 4, R = 0.065). The Mo atoms in structure I occupy two special positions (2(b) and 2(c)) and are each surrounded by eight CN ligands. The mean value of the Mo-C distances for Mo(1) is equal to 2.216 A, and the corresponding value for Mo(2) is 2.235 A. The mean Mo-N lengths are practically identical in both molybdenum anions and are equal to 3.353 A. The mean values of the C identical with N bond lengths in the Mo(1) and Mo(2) anions are 1.118 and 1.137 A, respectively. The MoCn angles vary from 175.0 to 178.4/sup 0/. The coordination sphere of the Mo(1) atom corresponds to a dodecahedron with a single twofold symmetry axis, and the coordination polyhedron of the Mo(2) atom in an antiprism of m symmetry. In structure II the Mo-C distances are within the 2.130-2.160-A range, and the Mo-N distances range from 3.290 to 3.307 A. The MoCN angles vary from 176.0 to 179.3/sup 0/, and the coordination polyhedron of (MoC/sub 8/) is a dodecahedron of 2 symmetry. The existence of two types of coordination of Mo in structure I is presently the only example among the structurally studied octahyanomolybdates(IV).

  11. Kinetics of U(VI) reduction control kinetics of U(IV) reoxidation

    International Nuclear Information System (INIS)

    Senko, J.M.; Minyard, M.L.; Dempsey, B.A.; Roden, E.E.; Yeh, G.-T.; Burgos, W.D.

    2006-01-01

    For the in situ reductive immobilization of U to be an acceptable strategy for the removal of that element from groundwater, the long-term stability of U(IV) must be determined. Rates of biotransformation of Fe species influence the mineralogy of the resulting products (Fredrickson et al., 2003; Senko et al., 2005), and we hypothesize that the rate of U(VI) reduction influences the mineralogy of resultant U(IV) precipitates. We hypothesize that slower rates of U(VI) reduction will yield U(IV) phases that are more resistant to reoxidation, and will therefore be more stable upon cessation of electron donor addition. U(IV) phases formed by relatively slow reduction may be more crystalline or larger in comparison to their relatively rapidly-formed counterparts (Figure 1), thus limiting the reactivity of slowly-formed U(IV) phases toward various oxidants. The physical location of U(IV) precipitates relative to bacterial cells may also limit the reactivity of biogenic U(IV) phases. In this situation, we expect that precipitation of U(IV) within the bacterial cell may protect U(IV) from reoxidation by limiting physical contact between U(IV) and oxidants (Figure 1). We assessed the effect of U(VI) reduction rate on the subsequent reoxidation of biogenic U(IV) and are currently conducting column scale studies to determine whether U(VI) reduction rate can be manipulated by varying the electron donor concentration used to stimulate U(VI) reduction

  12. The carbonate complexation of plutonium(IV)

    International Nuclear Information System (INIS)

    Hobart, D.E.; Palmer, P.D.; Newton, T.W.

    1985-01-01

    Plutonium(IV) carbonate complexes are expected to be of particular importance in typical groundwaters at the Yucca Mountain site of the candidate nuclear waste repository being studied by the Nevada Nuclear Waste Storage Investigations Project. The chemistry of these complexes is also important in the areas of nuclear fuel reprocessing and purification, actinide separations, and environmental studies. This report describes initial experiments performed to determine the identity and equilibrium quotients of plutonium(IV) carbonate complexes. These experiments were performed at pH values between 7.2 and 9.6 using a spectrophotometric method. In addition, a brief review of the published literature on Pu(IV) carbonate complexes is presented. Since Pu(IV) exhibits low solubility in the near-neutral pH range, a complex-competition reaction where citrate ligands compete with carbonate ions for the plutonium will be employed. This will permit us to study the pure carbonate system; study the mixed carbonate/citrate system, and confirm and extend the literature work on the pure citrate system. The current experiments have demonstrated the existence of at least three distinct species in the pH region studied. This work will continue in the extended study of the pure citrate system, followed by the investigation of the citrate/carbonate complex/competition reaction. 9 refs., 4 figs., 2 tabs

  13. Resection of the primary tumour versus no resection prior to systemic therapy in patients with colon cancer and synchronous unresectable metastases (UICC stage IV): SYNCHRONOUS - a randomised controlled multicentre trial (ISRCTN30964555)

    International Nuclear Information System (INIS)

    Rahbari, Nuh N; Koch, Moritz; Büchler, Markus W; Kieser, Meinhard; Weitz, Jürgen; Lordick, Florian; Fink, Christine; Bork, Ulrich; Stange, Annika; Jäger, Dirk; Luntz, Steffen P; Englert, Stefan; Rossion, Inga

    2012-01-01

    Currently, it remains unclear, if patients with colon cancer and synchronous unresectable metastases who present without severe symptoms should undergo resection of the primary tumour prior to systemic chemotherapy. Resection of the primary tumour may be associated with significant morbidity and delays the beginning of chemotherapy. However, it may prevent local symptoms and may, moreover, prolong survival as has been demonstrated in patients with metastatic renal cell carcinoma. It is the aim of the present randomised controlled trial to evaluate the efficacy of primary tumour resection prior to systemic chemotherapy to prolong survival in patients with newly diagnosed colon cancer who are not amenable to curative therapy. The SYNCHRONOUS trial is a multicentre, randomised, controlled, superiority trial with a two-group parallel design. Colon cancer patients with synchronous unresectable metastases are eligible for inclusion. Exclusion criteria are primary tumour-related symptoms, inability to tolerate surgery and/or systemic chemotherapy and history of another primary cancer. Resection of the primary tumour as well as systemic chemotherapy is provided according to the standards of the participating institution. The primary endpoint is overall survival that is assessed with a minimum follow-up of 36 months. Furthermore, it is the objective of the trial to assess the safety of both treatment strategies as well as quality of life. The SYNCHRONOUS trial is a multicentre, randomised, controlled trial to assess the efficacy and safety of primary tumour resection before beginning of systemic chemotherapy in patients with metastatic colon cancer not amenable to curative therapy. http://www.controlled-trials.com/ISRCTN30964555

  14. Måleegenskaper ved den norske versjonen av ADHD Rating Scale IV, Skoleversjon (ADHD-RS-IV Skole)

    OpenAIRE

    Kornør, Hege; Bøe, Tormod

    2011-01-01

    - Beskrivelse. ADHD-RS-IV Skole er et spørreskjema som skal fylles ut av lærere eller førskolelærere for å fange opp ADHD-symptomer hos barn og ungdom. Spørreskjemaet har 18 ledd med fire svaralternativer. Det tar under 20 minutter å fylle ut. Hovedskalaen og de to delskalaene skåres ved å summere enkeltskårer. Kompetansekrav for bruk av ADHD-RS-IV inkluderer generell opplæring i testbruk, samt yrkesstatus som psykolog, lege, annet helsepersonell med utdanning på mastergradsnivå, spesialpe...

  15. Dipeptidyl peptidase IV in two human glioma cell lines

    Directory of Open Access Journals (Sweden)

    A Sedo

    2009-12-01

    Full Text Available There is growing evidence that dipeptidyl peptidase IV [DPP-IV, EC 3.4.14.5] takes part in the metabolism of biologically active peptides participating in the regulation of growth and transformation of glial cells. However, the knowledge on the DPP-IV expression in human glial and glioma cells is still very limited. In this study, using histochemical and biochemical techniques, the DPP-IV activity was demonstrated in two commercially available human glioma cell lines of different transformation degree, as represented by U373 astrocytoma (Grade III and U87 glioblastoma multiforme (Grade IV lines. Higher total activity of the enzyme, as well as its preferential localisation in the plasma membrane, was observed in U87 cells. Compared to U373 population, U87 cells were morphologically more pleiomorphic, they were cycling at lower rate and expressing less Glial Fibrillary Acidic Protein. The data revealed positive correlation between the degree of transformation of cells and activity of DPP-IV. Great difference in expression of this enzyme, together with the phenotypic differences of cells, makes these lines a suitable standard model for further 57 studies of function of this enzyme in human glioma cells.

  16. Psychological variables and Wechsler Adult Intelligence Scale-IV performance.

    Science.gov (United States)

    Gass, Carlton S; Gutierrez, Laura

    2017-01-01

    The MMPI-2 and WAIS-IV are commonly used together in neuropsychological evaluations yet little is known about their interrelationships. This study explored the potential influence of psychological factors on WAIS-IV performance in a sample of 180 predominantly male veteran referrals that underwent a comprehensive neuropsychological examination in a VA Medical Center. Exclusionary criteria included failed performance validity testing and self-report distortion on the MMPI-2. A Principal Components Analysis was performed on the 15 MMPI-2 content scales, yielding three broader higher-order psychological dimensions: Internalized Emotional Dysfunction (IED), Externalized Emotional Dysfunction (EED), and Fear. Level of IED was not related to performance on the WAIS-IV Full Scale IQ or its four indexes: (Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed). EED was not related to WAIS-IV performance. Level of Fear, which encompasses health preoccupations (HEA) and distorted perceptions (BIZ), was significantly related to WAIS-IV Full Scale IQ and Verbal Comprehension. These results challenge the common use of high scores on the MMPI-2 IED measures (chiefly depression and anxiety) to explain deficient WAIS-IV performance. In addition, they provide impetus for further investigation of the relation between verbal intelligence and Fear.

  17. Chemical nature of implant-derived titanium(IV) ions in synovial fluid

    International Nuclear Information System (INIS)

    Silwood, Christopher J.L.; Grootveld, Martin

    2005-01-01

    Previous investigations have indicated a deleterious leakage of Ti(III) and/or Ti(IV) species from Ti-Al-V alloy joint prostheses into adjacent tissue, synovium or synovial fluid (SF) in vivo. In view of the importance of the particular chemical nature of such complexes in determining their biological activity, we have employed high field proton ( 1 H) NMR spectroscopy to 'speciate' Ti(IV) in inflammatory SF. Treatment of osteoarthritic SF samples with increasing concentrations of Ti(IV) (0.10-1.03 mM [TiO(C 2 O 4 ) 2 ] 2- ) gave rise to a specific broadening of the citrate proton resonances, indicating that this bioavailable oxygen-donor ligand plays an important role in complexing implant-derived Ti(IV). 1 H NMR analysis of Ti(IV)-loaded SF samples subsequently treated with a large excess of ascorbate (0.05 M) showed that this added Ti(IV) chelator was only poorly effective in removing this metal ion from Ti(IV)-citrate/Ti(IV)-oxycitrate complexes. The results obtained here provide evidence for complexation of the low-molecular-mass (non-protein-bound) fraction of implant-derived Ti(IV) by citrate in vivo

  18. Modulators of cytoskeletal reorganization in CA1 hippocampal neurons show increased expression in patients at mid-stage Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Patricia F Kao

    2010-10-01

    Full Text Available During the progression of Alzheimer's disease (AD, hippocampal neurons undergo cytoskeletal reorganization, resulting in degenerative as well as regenerative changes. As neurofibrillary tangles form and dystrophic neurites appear, sprouting neuronal processes with growth cones emerge. Actin and tubulin are indispensable for normal neurite development and regenerative responses to injury and neurodegenerative stimuli. We have previously shown that actin capping protein beta2 subunit, Capzb2, binds tubulin and, in the presence of tau, affects microtubule polymerization necessary for neurite outgrowth and normal growth cone morphology. Accordingly, Capzb2 silencing in hippocampal neurons resulted in short, dystrophic neurites, seen in neurodegenerative diseases including AD. Here we demonstrate the statistically significant increase in the Capzb2 expression in the postmortem hippocampi in persons at mid-stage, Braak and Braak stage (BB III-IV, non-familial AD in comparison to controls. The dynamics of Capzb2 expression in progressive AD stages cannot be attributed to reactive astrocytosis. Moreover, the increased expression of Capzb2 mRNA in CA1 pyramidal neurons in AD BB III-IV is accompanied by an increased mRNA expression of brain derived neurotrophic factor (BDNF receptor tyrosine kinase B (TrkB, mediator of synaptic plasticity in hippocampal neurons. Thus, the up-regulation of Capzb2 and TrkB may reflect cytoskeletal reorganization and/or regenerative response occurring in hippocampal CA1 neurons at a specific stage of AD progression.

  19. Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

    Science.gov (United States)

    Hansen, Eric; Panwala, Kathryn; Holland, John

    2002-11-01

    Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

  20. BALTICA IV. Plant maintenance for managing life and performance

    Energy Technology Data Exchange (ETDEWEB)

    Hietanen, S; Auerkari, P [eds.; VTT Manufacturing Technology, Espoo (Finland). Operational Reliability

    1999-12-31

    BALTICA IV International Conference on Plant Maintenance Managing Life and performance held on September 7-9, 1998 on board M/S Silja Symphony on its cruise between Helsinki-Stockholm and at Aavaranta in Kirkkonummi. The BALTICA IV conference provides a forum for the transfer of technology from applied research to practice. This is one of the two volumes of the proceedings of the BALTICA IV International Conference on Plant Maintenance Managing Life and Performance. The BALTICA IV conference focuses on new technology, recent experience and applications of condition and life management, and on improvements in maintenance strategies for safe and economical operation of power plants. (orig.)